retension and hiv testing christine khosropour

Christine Khosropour, MPHRollins School of Public Health

Emory University

April 1, 2011Sex::Tech Conference

San Francisco, CA

Online HIV prevention intervention study design

Experience with at-home HIV testing as part of an online study

Difference in participant retention by follow-up method

Diagnoses of HIV Infection among Adults and Adolescents, 2005-2008

37 States and 5 US Dependent Areas

Centers for Disease Control and Prevention: http://www.cdc.gov/hiv/topics/surveillance/index.htm

CDC rating of HIV prevention studies rated on scientific evidence of efficacy: 41 classified as ‘best evidence’

9 proven to be efficacious with MSM

Internet-based interventions Difficult to follow same criteria as ‘real-

word’ interventions

CDC ‘best-evidence’ HIV prevention intervention criteria:

Prospective design Biological outcomes Adequate retention (> 70%) Adequate representation of racial/ethnic

minorities

CDC ‘best-evidence’ HIV prevention intervention criteria:

Prospective design Biological outcomes Adequate retention (> 70%) Adequate representation of racial/ethnic

minorities

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Screening Questions

Consent

Black

Online FU

SMS FU Bi-monthly FU

Month 12 Online Survey

Baseline Online Survey

Baseline HIV TestBaseline HIV Test

Month 12 HIV Test

Month 12 HIV Test

Bi-monthly FU

White

Online FU

SMS FU Bi-monthly FU

Month 12 Online Survey

Baseline Online Survey

Baseline HIV TestBaseline HIV Test

Month 12 HIV Test

Month 12 HIV Test

Bi-monthly FU

Hispanic

Online FU

SMS FU Bi-monthly FU

Month 12 Online Survey

Baseline Online Survey

Baseline HIV TestBaseline HIV Test

Month 12 HIV Test

Month 12 HIV Test

Bi-monthly FU

INTERVENTION

INTERVENTION

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Screening Questions

Consent

Black

Online FU

SMS FU Bi-monthly FU

Month 12 Online Survey

Baseline Online Survey

Baseline HIV TestBaseline HIV Test

Month 12 HIV Test

Month 12 HIV Test

Bi-monthly FU

White

Online FU

SMS FU Bi-monthly FU

Month 12 Online Survey

Baseline Online Survey

Baseline HIV TestBaseline HIV Test

Month 12 HIV Test

Month 12 HIV Test

Bi-monthly FU

Hispanic

Online FU

SMS FU Bi-monthly FU

Month 12 Online Survey

Baseline Online Survey

Baseline HIV TestBaseline HIV Test

Month 12 HIV Test

Month 12 HIV Test

Bi-monthly FU

Black

White

Hispanic

73% Return(115)

85% Return(482)

79% Return(139)

897 Kits

157

564

176

82% Return(736)

3% HIV-Positive(24)

7.8% Positive(9)

2.3% Positive(11)

2.9% Positive(4)

17.5%

62.9%

19.6%

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Screening Questions

Consent

Black

Online FU

SMS FU Bi-monthly FU

Month 12 Online Survey

Baseline Online Survey

Baseline HIV TestBaseline HIV Test

Month 12 HIV Test

Month 12 HIV Test

Bi-monthly FU

White

Online FU

SMS FU Bi-monthly FU

Month 12 Online Survey

Baseline Online Survey

Baseline HIV TestBaseline HIV Test

Month 12 HIV Test

Month 12 HIV Test

Bi-monthly FU

Hispanic

Online FU

SMS FU Bi-monthly FU

Month 12 Online Survey

Baseline Online Survey

Baseline HIV TestBaseline HIV Test

Month 12 HIV Test

Month 12 HIV Test

Bi-monthly FU

89%(327/367)

92%(317/345)

Overall Retention

90%(644/712)

SMS

Online

Black

White

Hispanic

84%(89/106)

93%(436/471)

88%(119/135)

75%(45/60)

96%(44/46) 93%

(225/242)

92%(211/229)

88%(57/65)

89%(62/70)

Online

SMS

Overall Retention:90%

Month 4

90%(250/277)

92%(198/215)

94%(192/205)

SMS

Online

Overall Retention

93%(390/420)

Month 6

Overall Retention

Successes: Over 80% of participants returned an at-home

HIV test Biological outcome = estimated HIV

incidence

90% of participants retained at first follow-up High retention (>70%) = can assess

outcomes Difference in retention by race/ethnicity =

different methods for data collection

Next step: Design an Intervention!

Research participants Patrick Sullivan, DVM, PhD Nicole Luisi, MPH Cyclogram Emory Center for AIDS Research

(CFAR) P30 AI050409

NIH, National Center on Minority Health and Health Disparities Grant # 1RC1MD004370-01