Keep It Up! Reduces STIs and Risky Sexual Behaviors Among Young Men Who Have Sex With Men

ISGMH has published  a new study in the American Journal of Preventive Medicine evaluating the effectiveness of Keep It Up!, an interactive online HIV prevention intervention tailored to racially and ethnically diverse young men who have sex with men (YMSM). The study shows that Keep It Up! is significantly more effective than non-tailored online HIV prevention programs in reducing the incidence of sexually transmitted infections (STIs), and also results in a decrease in the practice of condomless anal sex.  It is the first online program proven to reduce sexually transmitted infections.

In 2015, the U.S. National HIV/AIDS strategy called for a 15% reduction in STI incidence among YMSM. The Centers for Disease Control has estimated that, among young men who have sex with men (YMSM), the rate of new HIV diagnoses is 44 times higher than that of other men. Despite the alarming statistics, only two of 59 current HIV-related evidence based interventions target YMSM. HIV prevention programs for YMSM should not be simple modifications of those developed for heterosexual youth, as YMSM are impacted by a unique set of challenges related to their sexual orientation, such as feeling isolated or not having supportive networks. Epidemiologists agree that, without innovative HIV prevention and treatment programs, the national HIV strategy’s goal is unattainable.

Keep It Up! takes an innovative approach that includes seven modules that use videos, interactive animation, and games to increase HIV knowledge, teach safer behaviors, and improve confidence in HIV prevention strategies. The modules were carefully designed to be as salient as possible to the audience, presenting situations particularly relevant to that group. As part of the ISGMH study, Keep It Up! was compared with a control eHealth intervention that had the same number of modules but was not tailored to a specific population, and reflected static HIV information that is generally readily available online. The control group was not interactive and focused specifically on facts.

According to the study’s results, STI incidence was found to be 40% lower in the Keep It Up! group compared with the control group at the 12-month timepoint. Participant in both study group significantly reduces their condomless anal sex across the 12-month study, but those in the Keep It Up! group showing a significant larger reduction in self-reported condomless anal sex. These findings suggest that Keep It Up! is ideally suited for scaling up as a particularly effective and cost-effective means to deliver prevention programs to at-risk groups.

Keep It Up! had 901 participants primarily from the Atlanta, Chicago, and New York City study sites. Study participants were males between the ages of 18-29 who had received a HIV-negative test during screening. The participants had not been in a monogamous relationship for at least six months prior to recruitment, and reported at least one or more acts of condomless anal sex during that period. Participants completed online questionnaires and performed testing for urethral and rectal gonorrhea and chlamydia upon enrollment as well as 12 months post intervention. The study was supported by a grant from the National Institute on Drug Abuse and National Institute of Mental Health (R01DA035145).

Learn more about the Keep It Up! story here.