Catalyzing a Perfect Storm:
Mobile Phone-Based
HIV-Prevention
Behavioral Interventions
Woodrow W. Winchester, III

Virginia Tech | wwwinche@vt.edu

[ 1] CDC Division of
Adolescent and School
Health “HIV/AIDS
and Young Men Who
Have Sex with Men.”
http://www.cdc.gov/
HealthyYouth/sexual-
behaviors/pdf/hiv_fact-
sheet_ymsm.pdf

November + December 2009

[ 2] Shumaker, S. A. The Handbook of Health Behavior Change. New York: Springer Publising Company, 2009.

interactions

As the global war on HIV/AIDS continues to grow, there have been focused efforts in HIV-transmission prevention work and preventative intervention design and implementation in the developing world. However, domestic needs are also ever present and rising. In published remarks made during the 2009 National HIV Prevention Conference held in Atlanta, GA, Kathleen Sebelius, the U.S. Secretary of Health and Human Services, stated that “while we’ve made strides in Africa and around the world, our progress here in the US has stalled.”

Reflective of this stalled progress are recently observed upticks in domestic HIV infection rates, specifically across several demographic (risk) groups. During the conference plenary Dr. Amy Lansky of the CDC stated that overall, gay and bisexual men— commonly referred to as Men who have Sex with Men (MSM)—account for half of the new HIV infections in the US. Furthermore, within the MSM risk group, dramatic transmission rate increases have been observed among young ( 13-24) MSM and, specifically, young

African-American MSM [ 1], with African-Americans,— disproportionally as a racial/ ethnic group (inclusive of some alarming trends amongst African-American women)— accounting for nearly half of all new HIV infections.

Further elucidating domestic HIV/AIDS challenges, a March 2009 Washington Post article reported that at least 3 percent of the residents in the District of Columbia have HIV or AIDS. This rate rivals infection rates in parts of West Africa and exceeds the threshold that constitutes a “generalized and severe” epidemic. Although prevention—such as practicing safe sex behaviors—is the primary defense against HIV transmission, this trend in domestic infection rates is occurring despite the design and deployment of myriad HIV-prevention behavioral interventions, including computer technology–based designs. But opportunity does exist.

Influencing Behavior through Technology Conceptually, the purpose of a behavioral intervention is to create “healthful behavior(s).”

Examples of behavioral interventions range from education and training programs to behavioral modification therapies. Technology-based interventions use computers as the sole or primary medium of delivering the behavioral intervention.

As the sophistication of computing technologies and devices has grown, so has the proliferation of technology-based behavioral intervention designs. An entire chapter of the third edition (2009) of The Handbook of Health Behavior Change is dedicated to examining “e-health” strategies—“health services and information delivered or enhanced through the Internet and related technologies”—in promoting adherence to healthy behaviors [ 2]. Researchers are exploring the potential of these technologies, which are still evolving and being demonstrated in support of a number of health conditions.

The June 15, 2009, issue of TIME Magazine highlighted a study of the ALIVE! Intervention (A Lifestyle Intervention via Email), which demonstrates how simple email reminders can impact recipi-