Home-Based HIV Testing and Counseling for Male Couples (Project Nexus): A Protocol for a Randomized Controlled Trial.

• Type of Material: Article
• Authors: Robert Stephenson, Emory University; Ryan Freeland, University of Michigan; Stephen P. Sullivan, University of Michigan; Erin Riley, University of Michigan; Brent A. Johnson, University of Rochester Medical Center; Jason Mitchell, University of Hawai'i at Mānoa; Deborah McFarland, Emory University; Patrick Sullivan, Emory University
• Language: English
• Date: 2017-05-30
• Publisher: JMIR Publications
• Publication Version: Final Published Version
• Copyright Statement: ©Rob Stephenson, Ryan Freeland, Stephen P Sullivan, Erin Riley, Brent A Johnson, Jason Mitchell, Deborah McFarland, Patrick S Sullivan.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.2196/resprot.7341
• Title of Journal or Parent Work: JMIR Research Protocols
• Volume: 6
• Issue: 5
• Start Page: e101
• End Page: e101
• Keywords: male couples; telemedicine; HIV
• Research Categories: Health Sciences, Public Health

Abstract

BACKGROUND: HIV prevalence remains high among men who have sex with men (MSM) in the United States, yet the majority of research has focused on MSM as individuals, not as dyads, and has discussed HIV risks primarily in the context of casual sex. Nexus is an online prevention program that combines home-based HIV testing and couples HIV testing and counseling (CHTC). It allows partners in dyadic MSM relationships to receive HIV testing and care in the comfort of their designated residence, via video-based chat. By using video-based technologies (eg, VSee video chat), male couples receive counseling and support from a remote online counselor, while testing for HIV at home. OBJECTIVE: This randomized control trial (RCT) aims to examine the effects of video-based counseling combined with home-based HIV testing on couples' management of HIV risk, formation and adherence to explicit sexual agreements, and sexual risk-taking. METHODS: The research implements a prospective RCT of 400 online-recruited male couples: 200 self-reported concordant-negative couples and 200 self-reported discordant couples. Couples in the control arm will receive one or two home-based HIV self-testing kits and will be asked to report their results via the study's website. Couples in the experimental arm will receive one or two home-based HIV self-testing kits and will conduct these tests together under the facilitation of a remotely located counselor during a prescheduled VSee-based video CHTC session. Study assessments are taken at baseline, as well as at 3- and 6-month follow-up sessions. RESULTS: Project Nexus was launched in April 2016 and is ongoing. To date, 219 eligible couples have been enrolled and randomized. CONCLUSIONS: Combining home-based HIV testing with video-based counseling creates an opportunity to expand CHTC to male couples who (1) live outside metro areas, (2) live in rural areas without access to testing services or LGBTQ resources, or (3) feel that current clinic-based testing is not for them (eg, due to fears of discrimination associated with HIV and/or sexuality).