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| ID | Type | Description | Link |
|---|---|---|---|
| 5R01MH080662 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| Mbarara University of Science and Technology | OTHER |
| Harvard University | OTHER |
| University of Colorado, Denver | OTHER |
| Internet Solutions for Kids Uganda, Limited |
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The investigators propose to design and test an Internet-based HIV prevention program for adolescents in Uganda.
HIV/AIDS is a major contributor to morbidity and mortality in Uganda. Despite aggressive advances in HIV prevention efforts, recent data suggest that HIV prevalence is increasing generally, and HIV knowledge, a direct contributor to behavior, is on the decline among young people specifically as compared to a decade ago.
The Internet is a promising mode of intervention delivery in resource poor-settings because the costs associated with scaling up are minimal; dissemination online is the same if one person or 100,000 people use the program. Just as important, it provides access to important health information in a stigma-free, anonymous atmosphere. Our recent data indicate that 45% of adolescents in Mbarara, Uganda have used the Internet, 78% of whom went online at least once in the previous week. Eighty-one percent of respondents in the same survey indicated they would go to an HIV prevention web site if it existed. Based upon these data, we propose to develop a culturally appropriate, Internet-based HIV prevention program designed specifically for Ugandan adolescents between the ages of 12 and 18 years. Our specific aims are as follows:
Specific Aim 1: Design a 6-hour, Internet-based HIV prevention program for adolescents. Content will be culturally tailored to the HIV preventive information, motivation, and behavioral skills needs of Ugandan adolescents.
Specific Aim 2: Test the intervention in a randomized controlled trial (n=500) among adolescents attending grades Secondary 1-4 (similar to US high school grades 8th - 11th) at day schools in Mbarara.
This project has the potential to develop low-cost and salable interventions to HIV transmission risk behaviors among adolescents in Uganda.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CyberSenga | Experimental | 6-module HIV prevention program tailored for adolescents in Uganda |
|
| Control | No Intervention | "treatment as usual" - the sexual health education adolescents currently receive in secondary school |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CyberSenga | Behavioral | Internet-based HIV prevention program |
|
| Measure | Description | Time Frame |
|---|---|---|
| Sex Without a Condom as Assessed by Self-report | Unprotected sex (i.e., vaginal or anal sex without a condom) in the past three months | 6-months post-intervention |
| Sexual Abstinence | Not having had vaginal or anal sex in the past three months | 6-months post-intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Abstinence at Three-month Follow-up | Sexual abstinence (i.e., not having vaginal or anal sex) in the past 90 days | 3 months post-intervention |
| Unprotected Sex at Three-month Follow-up | Ever had vaginal or anal sex without a condom in the past 90 days |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Michele Ybarra, MPH PhD | Center for Innovative Public Health | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Internet Solutions for Kids Uganda, Limited | Mbarara | Uganda |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21536715 | Background | Mitchell KJ, Bull S, Kiwanuka J, Ybarra ML. Cell phone usage among adolescents in Uganda: acceptability for relaying health information. Health Educ Res. 2011 Oct;26(5):770-81. doi: 10.1093/her/cyr022. Epub 2011 May 2. | |
| 21413574 | Background | Bull S, Nabembezi D, Birungi R, Kiwanuka J, Ybarra M. Cyber-Senga: Ugandan youth preferences for content in an internet-delivered comprehensive sexuality education programme. East Afr J Public Health. 2010 Mar;7(1):58-63. |
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| ID | Type | URL | Comment |
|---|---|---|---|
| Intervention website | View IPD |
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We aimed to screen all 382 female students enrolled in the two mixed-sex schools and 772 of the 2,264 male students enrolled across the four schools to identify 400 eligible youth. Many youth were out of school trying to secure school fees or had changed schools. As a result, 740 of the youth were screened, 416 of whom were eligible (56%).
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| ID | Title | Description |
|---|---|---|
| FG000 | HIV Prevention | 6-module HIV prevention program tailored for adolescents in Uganda CybereSenga: Internet-based HIV prevention program |
| FG001 | Control | "treatment as usual" - the sexual health education adolescents currently receive in secondary school CybereSenga: Internet-based HIV prevention program |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | HIV Prevention | 6-module HIV prevention program tailored for adolescents in Uganda CybereSenga: Internet-based HIV prevention program |
| BG001 | Control | "treatment as usual" - the sexual health education adolescents currently receive in secondary school CybereSenga: Internet-based HIV prevention program |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Sex Without a Condom as Assessed by Self-report | Unprotected sex (i.e., vaginal or anal sex without a condom) in the past three months | ITT - Intention to Treat | Posted | Number | participants | 6-months post-intervention |
|
Adverse event data were collected through the study period (i.e., from baseline to 6 month follow-up).
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | HIV Prevention | 6-module HIV prevention program tailored for adolescents in Uganda CybereSenga: Internet-based HIV prevention program |
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Sexual activity in adolescence is a stigmatized behavior in Uganda, especially for females. Youth may have under-reported their sexual experiences, which in the intervention group would have led to them being triaged to the incorrect content.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Michele Ybarra | Center for Innovative Public Health Reserch | 877-302-6858 | 1-801# | michele@innovativepublichealth.org |
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| ID | Term |
|---|---|
| D012746 | Sexual Abstinence |
| ID | Term |
|---|---|
| D012725 | Sexual Behavior |
| D001519 | Behavior |
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| UNKNOWN |
| National Institute of Mental Health (NIMH) | NIH |
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| 3 months post-intervention |
| 22918136 | Background | Ybarra ML, Biringi R, Prescott T, Bull SS. Usability and navigability of an HIV/AIDS internet intervention for adolescents in a resource-limited setting. Comput Inform Nurs. 2012 Nov;30(11):587-95; quiz 596-7. doi: 10.1097/NXN.0b013e318266cb0e. |
| 24625122 | Background | Hampanda K, Ybarra M, Bull S. Perceptions of health care services and HIV-related health-seeking behavior among Uganda adolescents. AIDS Care. 2014;26(10):1209-17. doi: 10.1080/09540121.2014.894612. Epub 2014 Mar 13. |
| 22350827 | Background | Ybarra ML, Korchmaros J, Kiwanuka J, Bangsberg DR, Bull S. Examining the applicability of the IMB model in predicting condom use among sexually active secondary school students in Mbarara, Uganda. AIDS Behav. 2013 Mar;17(3):1116-28. doi: 10.1007/s10461-012-0137-x. |
| 22835224 | Background | Katz IT, Ybarra ML, Wyatt MA, Kiwanuka JP, Bangsberg DR, Ware NC. Socio-cultural and economic antecedents of adolescent sexual decision-making and HIV-risk in rural Uganda. AIDS Care. 2013;25(2):258-64. doi: 10.1080/09540121.2012.701718. Epub 2012 Jul 27. |
| 22299764 | Background | Ybarra ML, Bull SS, Kiwanuka J, Bangsberg DR, Korchmaros J. Prevalence rates of sexual coercion victimization and perpetration among Uganda adolescents. AIDS Care. 2012;24(11):1392-400. doi: 10.1080/09540121.2011.648604. Epub 2012 Feb 2. |
| 25865380 | Background | Birungi R, Nabembezi D, Kiwanuka J, Ybarra M, Bull S. Adolescents' perceptions of sexual coercion in Uganda. Afr J AIDS Res. 2011 Dec;10(4):487-94. doi: 10.2989/16085906.2011.646664. |
| 17639121 | Background | Ybarra ML, Emenyonu N, Nansera D, Kiwanuka J, Bangsberg DR. Health information seeking among Mbararan adolescents: results from the Uganda Media and You survey. Health Educ Res. 2008 Apr;23(2):249-58. doi: 10.1093/her/cym026. Epub 2007 Jul 16. |
| 25633626 | Result | Ybarra ML, Korchmaros JD, Prescott TL, Birungi R. A Randomized Controlled Trial to Increase HIV Preventive Information, Motivation, and Behavioral Skills in Ugandan Adolescents. Ann Behav Med. 2015 Jun;49(3):473-85. doi: 10.1007/s12160-014-9673-0. |
| 24093828 | Result | Ybarra ML, Bull SS, Prescott TL, Birungi R. Acceptability and feasibility of CyberSenga: an Internet-based HIV-prevention program for adolescents in Mbarara, Uganda. AIDS Care. 2014 Apr;26(4):441-7. doi: 10.1080/09540121.2013.841837. Epub 2013 Oct 4. |
| 23967069 | Result | Ybarra ML, Bull SS, Prescott TL, Korchmaros JD, Bangsberg DR, Kiwanuka JP. Adolescent abstinence and unprotected sex in CyberSenga, an Internet-based HIV prevention program: randomized clinical trial of efficacy. PLoS One. 2013 Aug 14;8(8):e70083. doi: 10.1371/journal.pone.0070083. eCollection 2013. |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Grade | Number | participants |
|
| Maternal Education | Number | participants |
|
| Paternal Education | Number | participants |
|
| Internet Use | Number | participants |
|
| Ever Had Oral Sex | Number | participants |
|
| Ever Had Vaginal Sex | Number | participants |
|
| Ever Had Anal Sex | Number | participants |
|
| Ever Been Tested for HIV | Number | participants |
|
| Ever known someone who died from AIDS | Number | participants |
|
| Tired of hearing about HIV prevention information | Number | participants |
|
| Above average change of getting HIV | Self-appraisal of one's likelihood of getting HIV | Number | participants |
|
| Beliefs supportive of HIV Stigma | This measure has a range from 0 to 4 with higher scores reflecting greater HIV stigma | Mean | Standard Deviation | units on a scale |
|
| Ever had a boyfriend/girlfriend | Number | participants |
|
| Ever been a victim of teen dating violence | Number | participants |
|
| Ever been a perpetrator of teen dating violence | Number | participants |
|
| Beliefs consistent with female empowerment in relationships | This measure has scores that can range from 2 to 10 with higher scores being higher in these beliefs | Mean | Standard Deviation | units on a scale |
|
| Fair or poor health | Number | participants |
|
| Bright future somewhat/very unlikely | subject chose between somewhat likely and very likely | Number | participants |
|
| Wish to have more self-respect | Number | participants |
|
| The Multidimensional Scale of Perceived Social Support : Social support from "special person" | This measure has scores possibly ranging form 1 to 20 with higher scores reflecting more support | Mean | Standard Deviation | units on a scale |
|
| The Multidimensional Scale of Perceived Social Support: Social support from family | This measure has scores possibly ranging form 1 to 20 with higher scores reflecting more support | Mean | Standard Deviation | units on a scale |
|
| Information | 80% or more answers about HIV correct | Number | participants |
|
| Motivation: Attitudes towards HIV preventive acts | This measure has scores possibly ranging form 1 to 5 with higher scores reflecting more motivation | Mean | Standard Deviation | units on a scale |
|
| Motivation: Subjective norms regarding HIV preventive acts | This measure has scores possibly ranging form 1 to 5 with higher scores reflecting more motivation | Mean | Standard Deviation | units on a scale |
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| Motivation: Behavioral intentions for HIV prevention | This measure has scores possibly ranging form 1 to 5 with higher scores reflecting more motivation | Mean | Standard Deviation | units on a scale |
|
| Behavioral Skills | This measure has scores possibly ranging form 1 to 5 with higher scores reflecting more skills | Mean | Standard Deviation | units on a scale |
|
| Units | Counts |
|---|---|
| Participants |
|
|
|
| Primary | Sexual Abstinence | Not having had vaginal or anal sex in the past three months | ITT - Intention to Treat | Posted | Number | participants | 6-months post-intervention |
|
|
|
|
| Secondary | Abstinence at Three-month Follow-up | Sexual abstinence (i.e., not having vaginal or anal sex) in the past 90 days | ITT--Intention to Treat | Posted | Number | participants | 3 months post-intervention |
|
|
|
|
| Secondary | Unprotected Sex at Three-month Follow-up | Ever had vaginal or anal sex without a condom in the past 90 days | ITT--Intention to Treat | Posted | Number | participants | 3 months post-intervention |
|
|
|
|
| 0 |
| 183 |
| 0 |
| 183 |
| EG001 | Control | "treatment as usual" - the sexual health education adolescents currently receive in secondary school CybereSenga: Internet-based HIV prevention program | 0 | 183 | 0 | 183 |
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