+CLICK: Harnessing web-based training to reduce secondary transmission among HIV-positive youth

Christine Margaret Markham, Ross Shegog, Amy Dolph Leonard, Thanh C. Bui, Mary E. Paul

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

Adolescents and young adults account for over 10 million HIV infections worldwide. Prevention of secondary transmission is a major concern as many HIV-positive youth continue to engage in risky sexual behavior. This study pilot-tested + CLICK, an innovative, web-based, sexual risk reduction intervention for HIV-positive youth as an adjunct to traditional clinic-based, self-management education. The theory-based application, developed for perinatally and behaviorally infected youth 13-24 years of age, provides tailored activities addressing attitudes, knowledge, skills, and self-efficacy related to sexual risk reduction. HIV-positive youth (N=32) pilot-tested + CLICK to assess usability (ease of use, credibility, understandability, acceptability, motivation) and short-term psychosocial outcomes (importance and self-efficacy related to abstinence and condom use) using a single group, pre-/post-test study design in a hospital-based pediatric clinic and community locations. A subsample of participants (n=20) assessed feasibility for clinic use. Participants were 62.5% female, 68.8% Black, and 28.1% Hispanic. Mean age was 17.8 years (SD = 2.55), 43.8% were infected behaviorally, 56.2% perinatally, and 68.8% were sexually experienced. Usability ratings were high: 84.4% rated the application very easy to use; 93.8% perceived content as trustworthy; 87.5% agreed most words were understandable; 87.5% would use the application again. Short-term psychosocial outcomes indicate a significant increase in condom use self-efficacy (p=0.008) and positive trends toward importance (p=0.067) and self-efficacy (p=0.071) for waiting before having sex. Regarding feasibility, participants accessed + CLICK during waiting periods (average time, 15 minutes) in their routine clinic visit. Clinic staff rated + CLICK highly in providing consistent, confidential, and motivational sexual health education without significant disruption to clinic flow. Results suggest that the application is a feasible tool for use in the clinic and has the potential to affect psychological antecedents to sexual behavior change. Further research on long-term and behavioral effects is indicated prior to broader dissemination into clinical practice.

Original languageEnglish (US)
Pages (from-to)622-631
Number of pages10
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume21
Issue number5
DOIs
StatePublished - May 2009

Keywords

  • Behavioral interventions
  • Computer-based interventions
  • HIV-positive
  • Self-management training
  • Youth

ASJC Scopus subject areas

  • Social Psychology
  • Health(social science)
  • Public Health, Environmental and Occupational Health

Fingerprint

Dive into the research topics of '+CLICK: Harnessing web-based training to reduce secondary transmission among HIV-positive youth'. Together they form a unique fingerprint.

Cite this