Neighborhood-level characteristics as effect modifiers on the efficacy of the MyPEEPS mobile intervention in same-sex attracted adolescent men

Evette Cordoba; Robert Garofalo; Lisa M Kuhns; Cynthia Pearson; D Scott Batey; Patrick Janulis; Haomiao Jia; Josh Bruce; Marco A Hidalgo; Sabina Hirshfield; Asa Radix; Uri Belkind; Dustin T Duncan; Byoungjun Kim; Rebecca Schnall

doi:10.1016/j.pmedr.2024.102726

Neighborhood-level characteristics as effect modifiers on the efficacy of the MyPEEPS mobile intervention in same-sex attracted adolescent men

Prev Med Rep. 2024 Apr 12:42:102726. doi: 10.1016/j.pmedr.2024.102726. eCollection 2024 Jun.

Authors

Evette Cordoba¹, Robert Garofalo^{2

3}, Lisa M Kuhns^{2

3}, Cynthia Pearson⁴, D Scott Batey⁵, Patrick Janulis⁶, Haomiao Jia¹, Josh Bruce⁷, Marco A Hidalgo⁸, Sabina Hirshfield⁹, Asa Radix^{10

11}, Uri Belkind¹⁰, Dustin T Duncan¹¹, Byoungjun Kim¹², Rebecca Schnall^{1

13}

Affiliations

¹ School of Nursing, Columbia University, New York, NY 10032, USA.
² Division of Adolescent & Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Chicago, IL 60611, USA.
³ Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA.
⁴ Indigenous Wellness Research Institute, School of Social Work, University of Washington, 4101 15 Avenue Northeast, Seattle, WA, 98105, USA.
⁵ School of Social Work, Tulane University, 127 Elk Place, New Orleans, LA 70112, USA.
⁶ Department of Sociomedical Sciences, Northwestern University, Chicago, IL 60611, USA.
⁷ Birmingham AIDS Outreach, 205 32 Street, Birmingham, AL 35233, USA.
⁸ Division of Internal Medicine-Pediatrics and Preventive Medicine, Department of Medicine, David Geffen School of Medicine at UCLA, 911 Broxton Avenue, Los Angeles, CA 90024, USA.
⁹ STAR Program, Department of Medicine, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC 1240, Brooklyn, NY 11203, USA.
¹⁰ Callen-Lorde Community Health Center, 356 West 18 Street, New York, NY, 10011, USA.
¹¹ Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, NY 10032, USA.
¹² Department of Surgery, New York University, New York, NY, 10016, USA & Department of Population Health, New York University, New York, NY 10016, USA.
¹³ Columbia University, Mailman School of Public Health, Department of Population and Family Health, New York, NY, 10032, USA.

Abstract

To estimate the effect of neighborhood-level modification on the efficacy of the MyPEEPS Mobile intervention on the reduction of condomless anal sex acts among same-sex attracted adolescent men. A series of generalized linear mixed model was used to examine if the effect of the MyPEEPS Mobile intervention on condomless anal sex acts was moderated by neighborhood-level factors using data from the 2019 American Community Survey US Census Bureau. "The magnitudes of intervention were significantly smaller at both 6- and 9-month follow-up among adolescents living in neighborhood with high proportions of Hispanic or Latino residents (IRR6M = 1.02, 95 % CI: 1.01, 1.02; IRR9M = 1.03, 95 % CI: 1.01, 1.05) and high proportions of families with income below the poverty level (IRR6M = 1.07, 95 % CI: 1.01, 1.12; IRR9M = 1.05, 95 % CI: 1.01, 1.10), which indicated that living in communities with a higher concentration of residents living under poverty or of Hispanic/and Latino ethnicity significantly modified the effective of program intervention on condomless sex among adolescent MSM. Understanding how neighborhood characteristics modify the effect of HIV prevention interventions may be useful in better targeting delivery and tailoring content of interventions based on neighborhood level characteristics such as the ones identified in this study.

Keywords: Adolescent health; Community health; Gay/bisexual/transgender persons; Geospatial epidemiology; HIV prevention; HIV/AIDS; Men's health; Young sexual minority men.