JMIR Publications

ABSTRACT

Background:

Gay, bisexual, and other men who have sex with men living with HIV (GBMSM-LWH) in the United States bear a heavy burden of bacterial sexually transmitted infections (STIs). Timely diagnosis and treatment are key to prevention. Home specimen self-collection has increasingly been used to test for bacterial STIs in studies conducted with diverse populations. Telehealth has also demonstrated promise in managing mental health and increasing antiretroviral therapy adherence in people living with HIV. Only a few studies have combined home specimen self-collection with live audio and video (AV) conferencing, all of which excluded people living with HIV. None have focused on GBMSM-LWH or incorporated motivational interviewing (MI), a client-centered, strengths-based counseling approach that seeks to support individuals towards positive behavioral change.

Objective:

Our study seeks to investigate the feasibility and acceptability of an MI-based telehealth intervention that integrates home specimen self-collection from different anatomical sites of possible exposure and MI delivered via live AV conferencing to engage sexually active GBMSM-LWH in bacterial STI screening.

Methods:

Participants are being recruited from across the United States via advertising on mobile dating apps and social networking sites and via peer referral. Phase 1 involves piloting the delivery of an innovative telehealth intervention for bacterial STI screening to 75 GBMSM-LWH. Our intervention includes three components: (1) a pre-test live AV conferencing session involving an MI-guided discussion to elicit awareness of bacterial STIs and fill any knowledge gaps, bolster the perceived importance of regularly testing for gonorrhea, chlamydia, and syphilis, and build self-efficacy for specimen self-collection, (2) self-collecting at home and returning by mail a urine sample (for gonorrhea and chlamydia testing), a throat swab (for gonorrhea and chlamydia testing), a rectal swab (for gonorrhea and chlamydia testing), and a finger-stick blood sample (for syphilis testing), and (3) a post-test live AV conferencing session involving an MI-guided discussion to prepare participants for receiving test results and formulate personalized action plans for seeking treatment (if warranted) and repeat testing. Phase 2 involves elucidating attitudes, facilitators, and barriers related to engaging in each intervention component via semi-structured in-depth interviews with a purposive subsample of 20 participants who complete progressively smaller subsets of the pre-test session, specimen return for bacterial STI testing, and the post-test session.

Results:

Study procedures were approved by the Institutional Review Board at the University of Michigan in September 2023. Participant recruitment began in April 2024 and is ongoing. Study results are pending.

Conclusions:

Our study will advance multiple goals of the 2021-2025 STI National Strategic Plan for the United States, specifically those pertaining to preventing new STIs, accelerating progress in STI research, technology, and innovation, and reducing STI-related health disparities. Clinical Trial: ClinicalTrials.gov NCT06100250; https://www.clinicaltrials.gov/study/NCT06100250