• Brian Mustanski, Jeffrey T Parsons, Patrick S Sullivan, Krystal Madkins, Eli Rosenberg, and Gregory Swann.
• Department of Medical Social Sciences, Feinberg School of Medicine and Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois. Electronic address: brian@northwestern.edu.
• Am J Prev Med. 2018 Aug 1; 55 (2): 151158151-158.

IntroductionHIV diagnoses among young men who have sex with men are increasing, but few effective HIV prevention interventions exist for this population. An RCT was conducted of the online Keep It Up! intervention to determine if it significantly reduced condomless anal sex and sexually transmitted infections compared with an HIV knowledge condition.Study DesignFrom May 2013 to March 2017, a total of 901 participants were enrolled in a double-blinded RCT of Keep It Up! with 1-year follow-up. After completing baseline surveys and sexually transmitted infection testing, participants were randomized by an eHealth platform to the intervention or control condition.Setting/ParticipantsHIV-negative men who have sex with men reporting condomless anal sex, aged 18-29 years, were recruited through advertising and from HIV testing sites and outreach in Atlanta, Georgia; Chicago, Illinois; and New York, New York.InterventionMultimedia was used to address HIV knowledge and motivate safer behaviors. The control condition reflected existing online HIV information.Main Outcome MeasuresPrimary outcomes were incident gonorrhea or chlamydia at 12-month follow-up and self-reported condomless anal sex with casual partners at 3-, 6-, and 12-month follow-up.ResultsIn 2017, data were analyzed from 445 (49%) participants randomized to the intervention and 456 (51%) to the control. Participants were primarily racial/ethnic minorities (63%). Sexually transmitted infections at Month 12 was 40% lower for intervention participants (risk ratio=0.60, 95% CI=0.38, 0.95, p=0.01). For the primary behavioral outcome, both arms showed reductions over time with 44% of control and 37% of intervention participants reporting condomless anal sex at Month 12 (prevalence ratio=0.83, 95% CI=0.70, 0.99, p=0.04).ConclusionsThe Keep It Up! intervention resulted in significantly lower sexually transmitted infection incidence and a small but significant decrease in condomless anal sex 12 months post-intervention relative to an online HIV knowledge condition. In addition, this study demonstrated the feasibility and acceptability of at-home sexually transmitted infection testing as part of an eHealth intervention.Trial RegistrationThis study is registered at www.clinicaltrials.gov NCT01836445.Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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