Christine Khosropour, MPH Rollins School of Public Health Emory University Atlanta, GA July 18, 2011 IAS 2011 Rome, Italy.

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Presentation transcript:

Christine Khosropour, MPH Rollins School of Public Health Emory University Atlanta, GA July 18, 2011 IAS 2011 Rome, Italy

 Men who have sex with men (MSM) in the US are at increased risk for HIV infection  Internet has emerged as a venue for MSM to meet sex partners online  High-risk sexual behavior linked to meeting partners online

 Interest in online HIV prevention interventions has increased  Difficulty with online research: ▪ Retention in longitudinal studies ▪ High attrition of black and Hispanic study participants Alternatives?

Race/Ethnicity Own Mobile Phone (%) Send/Receive SMS (%) White8068 Black8779 Hispanic Pew Internet and American Life Project Survey: Smith A. Mobile Access Available from:

 Enrolled white, black, and Hispanic MSM in an online 12-month longitudinal study  > 18 years old  Had a male sex partner in past 12 months  Had an SMS-enabled mobile phone  Stratified randomization by race for bi-monthly follow-up  Online follow-up surveys  SMS follow-up surveys

 Automated reminder system  3 reminders sent via SMS or  Choice of reminder modality  Online Group: Text message or Phone Call  SMS Group: or Phone Call  Personal outreach  Phone call to participant

Click-through banner ad Screening Questions Consent Black Online FU SMS FU Bi-monthly FU Month 12 Online Survey Baseline Online Survey Bi-monthly FU White Online FU SMS FU Bi-monthly FU Month 12 Online Survey Baseline Online Survey Bi-monthly FU Hispanic Online FU SMS FU Bi-monthly FU Month 12 Online Survey Baseline Online Survey Bi-monthly FU

710 Enrolled in 12-month study 344 SMS 366 Online 229 White 46 Black 69 Hispanic 241 White 60 Black 65 Hispanic

Baseline Month 2Month 4Month 6 Follow-Up Time Point Survival Probability Online SMS P =.20 70% Retention of Study Participants by Follow-Up Group

Follow-Up Time Point White Hispanic Black BaselineMonth 2Month 4Month 6 Survival Probability P =.007 Retention of Study Participants by Race/Ethnicity

BaselineMonth 2Month 4Month 6 Survival Probability Follow-Up Time Point White Online Hispanic Online Black Online White SMS Hispanic SMS Black SMS Black Online White SMS White Online Hispanic Online Hispanic SMS 70% P =.03 P =.88 P =.87 Retention of Study Participants by Follow-Up Group, Stratified by Race/Ethnicity

 85% cumulative retention at Month 6  High retention  Difference in retention by race/ethnicity  Frequent follow-up and personal outreach increases retention of participants Can assess outcomes Utilize multiple data collection mechanisms

 Research participants  Patrick Sullivan, DVM, PhD  Sullivan Research Team  Cyclogram  Emory Center for AIDS Research (CFAR)  P30 AI  NIH, National Center on Minority Health and Health Disparities  Grant # RC1MD004370