RESUMO
Pre-exposure prophylaxis (PrEP) is an effective daily prevention medicine to reduce the risks of HIV infections. Even though the number of PrEP users has been rapidly growing in the United States since 2012, only approximately 5% of the men who have sex with men (MSM) population is currently taking PrEP. This study examined PrEP uptake among MSM using the integrative model of behavioral prediction (IMBP) as the theoretical framework. The authors conducted formative elicitation interviews and a cross-sectional survey with MSM. Among the survey respondents, half of them were PrEP takers and half were not. The path modeling results showed that attitudes and norms predicted behavioral intention, and intention predicted PrEP uptake among MSM. The results also identified the strongest attitudinal predictors and normative referents of PrEP uptake. The study offers practical implications in helping professionals and scholars to understand PrEP uptake among MSM in a theoretically grounded way.
Assuntos
Fármacos Anti-HIV/administração & dosagem , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade Masculina/psicologia , Intenção , Profilaxia Pré-Exposição/métodos , Adulto , Fármacos Anti-HIV/uso terapêutico , California , Estudos Transversais , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Masculino , Motivação , New York , Pesquisa Qualitativa , Sexo Seguro , Apoio Social , Inquéritos e QuestionáriosRESUMO
This meta-analysis investigated the efficacy of text messaging-based health promotion interventions. Nineteen randomized controlled trials conducted in 13 countries met inclusion criteria and were coded on a variety of participant, intervention, and methodological moderators. Meta-analytic procedures were used to compute and aggregate effect sizes. The overall weighted mean effect size representing the impact of these interventions on health outcomes was d = .329 (95% CI = .274, .385; p < .001). This effect size was statistically heterogeneous (Q18 = 55.60, p < .001, I(2) = 67.62), and several variables significantly moderated the effects of interventions. Smoking cessation and physical activity interventions were more successful than interventions targeting other health outcomes. Message tailoring and personalization were significantly associated with greater intervention efficacy. No significant differences were found between text-only interventions and interventions that included texting plus other components. Interventions that used an individualized or decreasing frequency of messages over the course of the intervention were more successful than interventions that used a fixed message frequency. We discuss implications of these results for health promotion interventions that use text messaging.