Miriam receives grant to develop online sex education resources to curb risky behaviors, HIV in men

PROVIDENCE – The National Institute of Mental Health has awarded The Miriam Hospital a five-year grant totaling $743,869 to study media influences on risk behaviors among young men who have sex with men and to develop an online health media literacy intervention to help reduce HIV and sexually transmitted diseases among this population.

“In today’s high-tech society in which individuals increasingly turn to the Internet for health information, health literacy is inextricably linked to media literacy,” Kimberly Nelson, research scientist at The Centers for Behavioral and Preventive Health at The Miriam Hospital, said in a statement. “This is particularly true for marginalized populations and stigmatized behaviors – cases in which individuals may not have access to or feel comfortable asking traditional sources for sexual health information. The intersection between health literacy and media literacy is especially pronounced for young men who have sex with men.”

According to Nelson, the prevalence of HIV among gay, bisexual and other men who have sex with men continues to increase. In the United States, this population accounts for 65 percent of new HIV infections, with younger men – between the ages of 13 and 24 years – having elevated incidence rates. Here in Rhode Island, during 2014, 97 Rhode Island residents were newly diagnosed with HIV and reported to the Department of Health’s HIV Surveillance Program, according to a December 2015 report from the DOH, 2014 Rhode Island HIV/AIDS Epidemiologic Profile with Surrogate Data. This number represents a minimum estimate of HIV infection, the report notes, as HIV-infected individuals who have not been tested and those who get anonymous testing are not included. Males accounted for 79 percent of those reported cases and the majority of males were between 20 and 39 years of age. Finally, 58 percent of the men reported that they acquired HIV through sex with men.

“Younger men in this population typically lack access to developmentally appropriate sexual education specific to their sexual orientation, said Nelson, as most sexual education currently taught in the United States is heavily geared to heterosexual relationships. Massachusetts, but not Rhode Island, has a sexual education program for LGBTQ students, which, said Nelson, has been shown to be a very effective public health intervention. Lacking access to appropriate information, these men often turn to online media to learn about sex and gay culture. Not only are such resources often incorrect, they can promote risky sexual behavior, she said. According to the Centers for Disease Control and Prevention, online media may be a significant contributor to this group’s high HIV infection rate. The good news, though, is that media literacy interventions can positively impact health behaviors, said Nelson.

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The five-year grant includes three study phases, Nelson told Providence Business News. The first phase will focus on developing online recruitment and retention methods for sexual minority males. For that effort, Nelson is partnering with Youth Pride Inc., Rhode Island’s largest LGBTQ youth population community-based organization, which, Nelson said, “does amazing work. I will be running my focus group out of their organization.” Recruiting initiatives began late last month.

In the second phase, she will establish a youth advisory board – and will recruit members for that board from her focus groups – and develop an online survey to create media literacy interventions designed to lower HIV-risk behaviors. Finally, in the last phase, an exploratory clinical trial will test and evaluate the completed online sexual health media literacy intervention.

Nelson, who began her career as a research coordinator and HIV counselor in San Francisco, has worked for 14 years in HIV and STD prevention, primarily with men engaging in sex with men. Calling this cohort the nation’s highest-risk group for HIV and STD infections, Nelson added that these men are generally “accommodating to being involved and very interested in research that is respectful and helpful to the community.”

The goal of this grant-funded project is to help these young men, early in their sexual development, learn how to have healthy sexual relationships and reduce their risk of acquiring and transmitting STDs and HIV, said Nelson, an assistant professor of psychiatry and human behavior (research) at The Warren Alpert Medical School of Brown University. “There’s … indication that online media is having a strong influence on this population; helping them become more critical consumers of this media [and to identify] what’s accurate and what’s not hopefully will help influence their sexual education and sexual behaviors,” she said.

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