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Christine Khosropour, MPH Rollins School of Public Health Emory University Atlanta, GA July 18, 2011 IAS 2011 Rome, Italy
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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
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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?
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Race/Ethnicity Own Mobile Phone (%) Send/Receive SMS (%) White8068 Black8779 Hispanic8783 2010 Pew Internet and American Life Project Survey: Smith A. Mobile Access 2010. Available from: http://www.pewinternet.org/Reports/2010/Mobile-Access-2010.aspx.
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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
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Automated reminder system 3 reminders sent via SMS or email Choice of reminder modality Online Group: Text message or Phone Call SMS Group: Email or Phone Call Personal outreach Phone call to participant
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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
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710 Enrolled in 12-month study 344 SMS 366 Online 229 White 46 Black 69 Hispanic 241 White 60 Black 65 Hispanic
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Baseline Month 2Month 4Month 6 Follow-Up Time Point Survival Probability Online SMS P =.20 70% Retention of Study Participants by Follow-Up Group
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Follow-Up Time Point White Hispanic Black BaselineMonth 2Month 4Month 6 Survival Probability P =.007 Retention of Study Participants by Race/Ethnicity
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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
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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
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Research participants Patrick Sullivan, DVM, PhD Sullivan Research Team Cyclogram Emory Center for AIDS Research (CFAR) P30 AI050409 NIH, National Center on Minority Health and Health Disparities Grant # RC1MD004370
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