Soap Opera Video Episodes Streamed to Smartphones in a Randomized Controlled Trial to Reduce HIV Sex Risk in Young Urban African American/Black Women
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Abstract
Background We tested the efficacy of “Love, Sex, and Choicesâ€(LSC), a 12-week soap opera video series created to reduce HIV risk in the context of relationship dilemmas, in a randomized controlled trial among 238 high-risk African American/Black women, aged 18-29, in the urban Northeast.
Methods 117 were randomized to receive 12-weekly videos of LSC streamed to smartphones. The other 121 received 12-weekly HIV prevention messages on smartphones. Baseline and post-intervention interviews at 3 and 6 months were completed by audio computer assisted self-interview (ACASI). Post-intervention changes in unprotected vaginal (UVS) or unprotected anal sex (UAS) with high risk partners (HRP), measured by log transformed vaginal episode equivalent (VEE) score were compared between intervention arms. Pooled repeated measures mixed linear models of log (VEE) behavior at 3 and 6 months with baseline log (VEE) as a predictor were fit.
Results At baseline, 99% had UVS and 44% had UAS with HRPs. Risk reduction in VEE from pre to post-baseline was significant (p < 0.001) for both groups. The magnitude of reduction did not statistically significantly differ by group, p = 0.23. After adjusting for baseline log (VEE), women receiving the video intervention had 0.20 units greater reduction in log (VEE) at 3 and 6 months than equivalent women in the comparison group; roughly corresponding to a 20% greater reduction in risk behavior. However 93.1% of participants in the video group wanted the video series to continue.
Conclusion “Love, Sex, and Choices†was popular and reduced HIV risk behavior. The comparison intervention was also a viable HIV prevention intervention. This is the first study to report on streaming a soap opera video series to smartphones as a public health intervention. Increasing smartphone access and video streaming capability create a paradigm shift, opening new channels to address health disparities.
Methods 117 were randomized to receive 12-weekly videos of LSC streamed to smartphones. The other 121 received 12-weekly HIV prevention messages on smartphones. Baseline and post-intervention interviews at 3 and 6 months were completed by audio computer assisted self-interview (ACASI). Post-intervention changes in unprotected vaginal (UVS) or unprotected anal sex (UAS) with high risk partners (HRP), measured by log transformed vaginal episode equivalent (VEE) score were compared between intervention arms. Pooled repeated measures mixed linear models of log (VEE) behavior at 3 and 6 months with baseline log (VEE) as a predictor were fit.
Results At baseline, 99% had UVS and 44% had UAS with HRPs. Risk reduction in VEE from pre to post-baseline was significant (p < 0.001) for both groups. The magnitude of reduction did not statistically significantly differ by group, p = 0.23. After adjusting for baseline log (VEE), women receiving the video intervention had 0.20 units greater reduction in log (VEE) at 3 and 6 months than equivalent women in the comparison group; roughly corresponding to a 20% greater reduction in risk behavior. However 93.1% of participants in the video group wanted the video series to continue.
Conclusion “Love, Sex, and Choices†was popular and reduced HIV risk behavior. The comparison intervention was also a viable HIV prevention intervention. This is the first study to report on streaming a soap opera video series to smartphones as a public health intervention. Increasing smartphone access and video streaming capability create a paradigm shift, opening new channels to address health disparities.
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