JMIR Publications

ABSTRACT

Background:

Sexual and gender minority (SGM) adolescents who can benefit from HIV testing due to their sexual behavior (e.g., condomless anal or vaginal sex) report suboptimal HIV testing rates. However, interventions designed to increase HIV testing rates among SGM adolescents are lacking, and even when effective interventions exist, reaching SGM adolescents outside research settings can be a challenge. This hybrid type 1 study aims to evaluate the effectiveness of SHER, an MMS messaging intervention in increasing adolescent HIV testing rates and to address implementation challenges of reaching and engaging SGM adolescents into digital interventions in real-world settings. Method: SHER is guided by the Information-Motivation-Behavioral Skills theory and expands upon a previous intervention tested in a 2014 pilot trial. The previous version of the intervention significantly increased self-reported HIV testing among adolescent sexual minority males compared to an information only control. Updates to this intervention in the present study were driven by stakeholder and adolescent feedback and included modernizing technology, content, and gender inclusivity. An ongoing randomized controlled trial is comparing the impact of SHER vs. an information-only control condition on HIV testing rates among 360 U.S. SGM adolescents ages 13-19. The implementation aim is focused on understanding expert and adolescent perspectives on best practices for reaching and engaging SGM adolescents outside of research settings. Discussion: This study will evaluate whether an MMS messaging intervention based on health behavior change theory will increase SGM adolescent HIV testing relative to an information-only version of this intervention. This study will also produce expert- and adolescent-informed best practices for reaching SGM adolescents for sexual health interventions in real-world settings. Overall, this study aims to contribute to increased engagement in sexual healthcare and HIV testing in SGM adolescents engaging in HIV transmission risk behaviors. Highlights: This study will inform our understanding about whether a digital health approach can change HIV testing behaviors among SGM adolescents. This study will generate strategies for tailoring and adapting existing HIV intervention content for future interventions with SGM adolescents. This study will inform best practices for reaching SGM teens and implementing digital HIV interventions in real-world settings. This study has potential to yield an effective, scalable intervention that will increase SGM adolescent HIV testing rates.