1. ehealth video-group interventions for MSM living with HIV: Potential for increasing intervention reach DeAnne Turner, M.P.H., Ayesha Johnson, M.S., Vinita Sharma, M.P.H., Rachel Logan, M.P.H, Stephanie Marhefka, Ph.D. Department of Community and Family Health

2. Disclosure
I have no conflicts of interest to disclose.

3. Why MSM?
Centers for Disease Control and Prevention
Gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV 1-4

4. Why ehealth?
Programs utilizing the Internet (ehealth programs) offer an opportunity for men to receive services, despite:
Lack of in-person programs in their area
Limited transportation
Discomfort with in-person groups9

5. Video-groups

6. Technology Readiness and Acceptance Model (TRAM) 10
Innovativeness
Technology Readiness
Perceived Usefulness
Perceived Ease of Use
Optimism
Discomfort
Insecurity
Behavioral Intention

7. Objective
Explore the potential for ehealth group based video-conferencing interventions, and how the TRAM could be utilized to determine the facilitators and barriers for MSM living with HIV to take part in such interventions

8. Methods Urban clinic in the southeast US Provider referral and flyers
Recruitment
Positive HIV serostatus
Identify as male
Report ever having sex with a man
At least 18 years of age
Eligibility

9. Methods Open-ended questions
Factors affecting willingness to participate in technology based group interventions
Interview
Qualitative data were grouped thematically 11, using the TRAM 10 as the guiding framework
N=106
Analysis

10. Vignettes
Talking with other men living with HIV in a group-based program accessed from:
Private space in community + video-phone
2) Private space in community + computer + webcam
3) Home + computer/tablet + webcam

11. Participants Characteristics
Participant Age: M = 44.5 years (20-71 years)

12. Willingness
74% of participants were willing to join a group computer-based intervention
75% of participants were willing to join
a group video-phone intervention
65% of participants were willing to join a group video-conferencing intervention accessed from home

13. Cons of participating in video-group programs: TRAM
Insecurity
Too many people getting information. Computers are not safe, [I] don't know who is listening.
Discomfort
I just know about a computer, it’s not as personal. You can see and hear people but I feel like it’s just not that personal. I'd rather meet the people, actually talk to them.

14. Cons of participating in video-group programs: OTHER
HIV-related privacy concerns
[It would have to be] confidential, make sure that all participate have HIV and are respectable and keep status private.
Group readiness
It's just too social. It won't stay focused.

15. [I] would love to try the technology.
Pros of participating in video-group programs: TRAM
Perceived usefulness
…for someone to have a person to turn to... Someone who is newly HIV positive may not know where to go or who to talk to. I might be able to tell my story and provide guidance as a resource.
Optimism
[video-groups would be] good places to meet other HIV positive since it’s not easy to find these people in bars etc.
Innovativeness
[I] would love to try the technology.

16. Delivery Modality
As noted, fewer men were willing to participate in video-groups at home (vs. community setting)
Cons of home:
Possible insecurity of home Internet connections
Concerns about who could view groups at other people’s homes
Pros of home:
Comfort
Removes transportation barriers

17. Adapted Technology Readiness and Acceptance Model

18. Key Points
The majority of MSM may be willing to adopt video-group based ehealth programs as they become available
TRAM may be useful for understanding willingness to adopt
TRAM may help point to key strategies for marketing such programs to MSM who are living with HIV

19. Questions?
Thoughts?

20. What theoretical frameworks have you applied to ehealth work?
How do these constructs relate to findings in your work?

21. Funding for this presentation was provided by the Student Honorary Award for Research and Practice (SHARP) at the University of South Florida.

22. References
1. Beyrer C, Baral SD, van Griensven F, et al. Global epidemiology of HIV infection in men who have sex with men. The Lancet 2012; 380(9839):
2. Beyrer C, Sullivan P, Sanchez J, et al. The increase in global HIV epidemics in MSM. Aids 2013; 27(17):
3. CDC. Estimated HIV incidence among adults and adolescents in the United States, 2007–2010. HIV Surveillance Supplemental Report 2012; 17(4).
4. Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, Sexual Transmitted Diseases and Tuberculosis Prevention, Centers for Disease Control and Prevention (accessed October ).
Herbst JH, Beeker C, Mathew A, et al. The effectiveness of individual-, group-, and community-level HIV behavioral risk-reduction interventions for adult men who have sex with men: a systematic review. American journal of preventive medicine 2007; 32(4):
6. Muessig KE, Nekkanti M, Bauermeister J, Bull S, Hightow-Weidman LB. A systematic review of recent smartphone, internet and web 2.0 interventions to address the HIV continuum of care. Current HIV/AIDS Reports 2015; 12(1):

23. References
7. Green SM, Lockhart E, Marhefka SL. Advantages and disadvantages for receiving Internet-based HIV/AIDS interventions at home or at community-based organizations. AIDS care 2015; (ahead-of-print): 1-5.
8. Marhefka SL, Buhi ER, Baldwin J, et al. Effectiveness of Healthy Relationships Video-Group—A Videoconferencing Group Intervention for Women Living with HIV: Preliminary Findings from a Randomized Controlled Trial. Telemedicine and e-Health 2014; 20(2):
9. Marhefka SL, Fuhrmann HJ, Gilliam P, Lopez B, Baldwin J. Interest in, concerns about, and preferences for potential video-group delivery of an Effective Behavioral Intervention among women living with HIV. AIDS Behav 2011.
10. Lin CH, Shih HY, Sher PJ. Integrating technology readiness into technology acceptance: The TRAM model. Psychology & Marketing 2007; 24(7):
11. Guest G, MacQueen KM, Namey EE. Applied thematic analysis. Los Angeles: Sage; 2011.