JMIR Publications

ABSTRACT

Background:

Sexual and gender minority (SGM) young people are disproportionately affected by human immunodeficiency virus (HIV) in the United States, and substance use is a major driver of new infections. People who use online venues to meet sex partners are more likely to report substance use, sexual risk behaviors, and sexually transmitted infections (STIs). To our knowledge, no machine learning (ML) interventions have been developed that utilize online and digital technologies to inform and personalize HIV and substance use prevention efforts with SGM young people.

Objective:

This study tests the acceptability, appropriateness, and feasibility of the uTECH intervention, a text message intervention using a ML algorithm to promote HIV prevention and substance use harm reduction among 18-29 year old SGM people who have sex with men. This intervention will be compared to YMHP (Young Men’s Health Program) alone, an existing Centers for Disease Control and Prevention (CDC) Best Evidence intervention for young SGM people, that consists of 4 motivational interviewing-based counseling sessions. The YMHP condition will receive YMHP sessions and will be compared to the uTECH+YMHP condition, which includes YMHP sessions as well as uTECH text messages.

Methods:

In a study funded by the National Institutes of Health, we will recruit and enroll SGM participants (aged 18 to 29 years) in the United States (N=330) to participate in a 12-month two-arm randomized comparison trial. All participants will receive 4 counseling sessions conducted over Zoom with a Masters-level social worker. Participants in the uTECH+YMHP condition will receive curated text messages informed by a ML algorithm that seeks to promote HIV and substance use risk reduction strategies as well as undergoing YMHP counseling. We hypothesize the uTECH+YMHP intervention will be considered acceptable, appropriate, and feasible to most participants. We also hypothesize that participants in the combined condition will experience enhanced and more durable reductions in substance use and sexual risk behaviors compared to participants receiving YMHP alone. Appropriate statistical methods, models, and procedures will be selected to evaluate primary hypotheses and behavioral health outcomes in both intervention conditions using an α<.05 significance level, including comparison tests, tests of fixed-effects, and growth curve modeling.

Results:

This study was funded in August 2019. As of June 2024, we have enrolled all participants. Data analysis has begun and expected results will be published in Fall 2025.

Conclusions:

This study aims develop and test the acceptability, appropriateness, and feasibility of uTECH, a novel approach to reduce HIV risk and substance use among sexual and gender minority young adults.