Substantial evidence indicates that up to two-thirds uae dating sites new HIV infections occur in the context of a main partnership. Couples HIV testing and counseling CHTC has been shown to be a promising and effective strategy for increasing HIV prevention uptake among male couples; however, YMSM who are ethnic dating site to relationships may not have yet developed the efficacy, negotiation, and communication skills to navigate HIV testing in their relationship and communicate around developing a prevention plan.
The intervention consists of two telehealth-delivered sessions: the first focuses on relationship skills and the second consists of CHTC and prevention planning. Both sessions are attended by both members of the dyad. This protocol describes daydreams gentlemens club development of the proposed intervention We Prevent and pilot test to examine its feasibility and preliminary efficacy.
The intervention will include two motivational interviewing—based sessions: session one is a relationship internet dating site reviews session, focused on techniques to explore and build communication skills in a relationship, to help YMSM develop and enhance necessary skills for their current and future relationships; the second session is a CHTC session with YMSM and their partners, puerto rico strip club help them develop an HIV prevention plan.
Through qualitative data collection and a one-arm pilot with YMSM, we will develop and refine a developmentally appropriate relationship skills session as an addition to the current CHTC intervention.
We will then conduct a pilot randomized controlled trial RCTcomparing the acceptability, feasibility, and preliminary efficacy of the adapted two-session telehealth intervention for YMSM versus a control group receiving one session only—a CHTC session delivered via telehealth.
The We Prevent intervention is deed to web site sex uptake of HIV prevention, shown through self-reported reductions in condomless sex and increases in knowledge and uptake of pre-exposure prophylaxis.
STI incidence is examined as a secondary outcome. A cost-input analysis will examine the costs associated with intervention delivery to inform future scale-up of the intervention.
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Drawing on theory and existing CHTC protocols delivered with video-based counseling, this proposed intervention affords the opportunity to empower YMSM with the best online dating sites reviews necessary to communicate with their partners and protect themselves from HIV in their current and future relationships.
A of individual and social factors eg, substance use, mental health, poverty, stigma, incarceration, and homelessness have been associated with increased HIV incidence among YMSM [ 3 ]. Numerous studies suggest that individuals are more likely to have condomless anal sex CAS with their primary partner as compared with casual partners [ 47 ], and relationship factors such as intimacy, closeness, and trust have been identified as powerful motivators for CAS in relationships [ 8 - 10 ].
For many individuals, there nederlandse date app be an underlying belief that condoms are antithetical to intimacy and that having condomless sex with their partners connotes an act of intimacy [ 1112 ].
Despite mounting evidence that dyadic approaches are generally efficacious in promoting safer sex behaviors 18 year old dating site free adult populations [ 20 - 22 ], few dyadic HIV prevention interventions exist for YMSM in relationships [ 2023 ]. CHTC has been shown to be effective for male couples in promoting the formation and adherence to prevention planning.
In contrast to individual HIV testing and counseling, CHTC includes both partners in 1 session where they receive counseling and testing together at the same time. Although CHTC holds promise in reducing HIV incidence among male couples in general, young male couples may lack the behavioral skills necessary to undergo HIV testing with their partner. With few exceptions [ 31 ], the majority HIV prevention strategies aimed at YMSM have focused in large part on reducing condomless sex with casual partners [ 32 ], effectively ignoring the role of relationships in shaping HIV risk.
Thus, YMSM may not perceive knoxville sex club to be at risk of HIV acquisition from their primary partner and may lack skills, such as assertive and effective communication, around negotiating relationship dynamics [ 33 ]. These factors may limit their uptake of CHTC.
HIV prevention interventions are beginning to recognize singleparent dating site role of relationship factors in shaping HIV risk, although they remain largely focused on adult men who dating sites with free membership sex with men MSM. One example is the 2GETHER intervention that was developed and pilot tested with same-sex male couples aged 18 to 29 years [ 31 ]. The 2GETHER intervention involved in-person group format and in-person couples sessions, providing relationship and HIV prevention education to adult male couples in an effort to increase knowledge, motivation, and behavioral skills among male dy.
Youth, aged 15 to 19 years, the target for the We Prevent intervention, are often just beginning to explore relationships; they thus have a very different set of informational, behavioral, and developmental needs. We Prevent aims to fill this intervention gap through an intervention tailored to the specific needs of to year-old male dy. By providing a web-based intervention, unlike the in-person format of 2GETHER, We Prevent also aims to allow young male couples to receive interventions in an environment in which they feel comfortable, surmounting structural barriers to accessing services.
Accumulating evidence also supports top 20 dating websites efficacy of motivationally focused behavioral interventions to reduce HIV transmission risk among YMSM who may not perceive themselves to be at risk for HIV [ 3435 ]. Therefore, motivational interviewing MI techniques may be particularly helpful alongside Ingalls and HIV prevention education to help Sex develop the skills necessary to navigate the complexities of Quality free dating sites prevention in their romantic relationships.
In addition, the reach of in-person interventions may be restricted by general barriers to dissemination and implementation eg, cost and highly skilled counselors speeddate dating site 36 ] as dating as the social context of YMSM eg, fears of being outed in their immediate geographical locale [ 3537 ].
Given the promise of brief technology-delivered interventions eg, Keep It Up! The proposed intervention, We Prevent, will be delivered to young male dy. That is, the intervention is intended to create behavioral change at the individual level; although participants receive the intervention as a dyad, it is expected that many relationships in this age group are relatively short in length. The We Prevent intervention thus aims to equip individuals with relationship skills to use in their current and future relationships.
As described above, YMSM often rely on online technologies to build their social and sexual networks, receive mexico city sex club support, and obtain relevant health information.
Thus, telehealth offers the opportunity to disseminate HIV prevention strategies to YMSM who might otherwise not have this opportunity.
Telehealth aims to circumvent traditional impediments to health care access. Over the past decade, telehealth formats have been adapted for use in MSM populations where stigma free emailing dating sites a lack of lesbian, gay, bisexual, transgender, queer LGBTQ —friendly health care providers contribute to reduced access to care [ 40 ].
Online interventions are seen as convenient for youth users and allow for home-based access to health messaging, thereby reducing fears of embarrassment or outing by connecting with local resources [ 3641 ]. Recently, CHTC was adapted and is currently being tested using telehealth, specifically videoconferencing software, with preliminary evidence showing high feasibility and acceptability [ 26 ].
We Prevent uses MI techniques and includes 2 sessions: session one—a motivational interview-guided pagan dating app that provides a facilitated discussion between YMSM and their partner, in which they explore and come to understand their own HIV risk and learn behavioral skills to improve communication—and session two—a CHTC session between the same YMSM and their partner, which facilitates the development of a prevention plan that meets the goals of both partners.
We also hypothesize that YMSM who engage in Ingalls Prevent will demonstrate greater communication skills to use in their relationship, which will provide them dating greater self-efficacy for developing an HIV prevention plan with their partner. The aim of this paper was to describe the protocol for the refinement, pilot testing, and pilot randomized controlled trial RCT to examine the acceptability and feasibility of the We Prevent intervention.
We Prevent will work closely with the innovative technology iTech real milf dating sites on the development, testing, and analysis elements of each of the 3 phases of research activities described below. Sex website tamil sex is not restricted to the iTech subject recruitment venues SRVsthe iTech technology core TC will provide guidance on the technology necessary for recruitment and retention strategies as well as technology-related ethical issues for conducting the project with YMSM and their partners.
The iTech analytic core AC will provide oversight for qualitative and quantitative analyses, including cost affordability analyses. The iTech management core will provide assistance with recruitment and regulatory compliance.
Reliance agreements were established for each SRV. The study will also be registered on ClinicalTrials. The study simi bonhill sex clubs 3 phases.
Phase I will collect qualitative data from YMSM and feedback from technical experts to develop and refine the 2 sessions the intervention comprises. STI incidence is examined as a secondary outcome, with biomarkers of STIs collected through self-samples that are mailed in by participants. Data on costs associated with the delivery of the intervention are collected to allow a cost analysis to inform the future scale-up of the intervention.
Male partners must meet the same criteria with the exception of the age restriction and HIV dating website scams lankwitz. We will exclude those who report a recent within the past 6 months history of any intimate partner violence, using methods specifically deed for dating sites mobile phone with male couples, which involves continuously monitoring the presence of intimate partner violence at each assessment point [ 44 ].
For all phases, participants will be recruited from across the United States via online advertisements placed on key social media websites eg, Facebook and social media sites aimed specifically at MSM eg, Grindr. YMSM who click on the advertisement will be taken to a Web that provides basic information on the study. Eligible YMSM will continue by registering. During the registration process, they will provide their contact information mobile free dating apps a nickname or name of choice.
YMSM who register will be provided with a link via to allow them to continue to set up an by selecting a username, password, and security questions. Once the index case the YMSM who initially clicks on the advertisement sex their partner have both completed the assent forms and the screening questionnaire, both partners have proven eligible for the study, and both have registered on the study website, s will be sent to the participants detailing the information for their next steps of project participation.
These chubby chaser dating website hoc verification procedures have been successfully used in other studies with male couples [ 45 ]. Study staff will follow up with a phone call to go over dating logistics and will confirm the contact information for each participant. We have been granted a waiver of parental consent for youth best hookup sites in vaughan 15 to 17 years.
During the call, the study staff member will review the consent process to ensure they understood their rights and the details of their participation. Participants are informed Ingalls they can choose any address other than a post office box.
Tests kits are delivered in unmarked boxes, and participants are informed of their delivery date. We will use similar procedures to ensure the safety of participants in phases II and Free datings sites of the activities.
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These data palm beach strip clubs be used to revise the content and study procedures in preparation strip clubs brampton implementation. For this task, 40 YMSM will be recruited to participate in IDIs using the recruitment methodology and eligibility criteria outlined above. The x gentlemens club shrewsbury of index participants will not be recruited or engage in phase I activities.
One way that participants can actively guide a qualitative interview process is through the use of activities in which participants are given guidelines or instructions by the researcher but then take control of the activity in a flexible and participant-centered approach. Qualitative data collection involving visualizations can be useful to convey depth and detail that expand dating verbal expression [ 47 ]. The IDI will companion dating site such a participatory methods approach.
During the IDI, participants will create a visual relationship timeline using virtual stickers to develop an overview of their dating and sexual history. The IDI follows a step-by-step process where participants place stickers on the timeline in response to questions about relationship dynamics, desires, and communication.
The timeline begins when the participant first sex the earliest partner and ends at the present time. Lines are added to show when and strip clubs in atlantic city long each relationship occurred. Participants are given flexibility on how to draw the lines to best represent the timeline of their relationship history eg, participants could choose to use different types of lines to represent different parts of the relationship, lines could stop and start again, and Ingalls for different people could overlap over the same time period.
Participants then answer a series of questions on each relationship through an action-oriented process that involves applying stickers with predetermined labels to the timelines. Follow-up questions examine why terms were chosen, definitions of terms, relationship development and transitions, and relationship rules eg, monogamous vs open relationship.
The timeline provides an anchor for discussion around relationship communication, negotiation, and desires. Using the timeline, participants will be asked to define what a relationship is, their definition of a successful relationship, and their desires for future relationships. Participants will be asked to describe positive and negative experiences they have had in communicating within relationships. The IDI will ask participants to outline the communication skills they believe they have and the communication skills they desire to have.
It will end by asking the participants to describe their desired content and sex chating sites for a relationship skills—focused facilitated session.