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      Web-Based Behavioral Intervention Utilizing Narrative Persuasion for HIV Prevention Among Chinese Men Who Have Sex With Men (HeHe Talks Project): Intervention Development


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          In the era of potent antiretroviral therapy, a high level of condomless anal intercourse continues to drive increases in HIV incidence in recent years among men who have sex with men. Effective behavior change strategies for promoting HIV-preventive behaviors are warranted. Narrative persuasion is a novel health communication approach that has demonstrated its persuasive advantages in overcoming resistance to counterattitudinal messages. The efficacy of narrative persuasion in promoting health behavior changes has been well documented, but critical research gaps exist for its application to HIV prevention.


          In this study, we aimed to (1) capitalize on narrative persuasion to design a web-based multisession intervention for reducing condomless anal intercourse among men who have sex with men in Hong Kong (the HeHe Talks Project) by following a systematic development process; and (2) describe the main components of the narrative intervention that potentially determine its persuasiveness.


          Persuasive themes and subtopics related to reducing condomless anal intercourse were initially proposed based on epidemiological evidence. The biographic narrative interview method was used to elicit firsthand experiential stories from a maximum variation sample of local men who have sex with men with diverse backgrounds and experiences related to HIV prevention; different types of role models were established accordingly. Framework analysis was used to aggregate the original quotations from narrators into collective narratives under 6 intervention themes. A dedicated website was finally developed for intervention delivery.


          A series of video-based intervention messages in biographic narrative format (firsthand experiential stories shared by men who have sex with men) combined with topic-equivalent argumentative messages were produced and programmed into 6 intervention sessions. The 6-week intervention program can be automatically delivered and monitored online.


          We systematically created a web-based HIV prevention intervention derived from peer-generated stories. Strategies used to enhance the efficacy of the narrative intervention have been discussed within basic communication components. This paper describes the methods and experiences of the rigorous development of a narrative communication intervention for HIV prevention, which enables replication of the intervention in the future.

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            Toward a Theory of Entertainment Persuasion: Explaining the Persuasive Effects of Entertainment-Education Messages

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              Global epidemiology of HIV infection in men who have sex with men.

              Epidemics of HIV in men who have sex with men (MSM) continue to expand in most countries. We sought to understand the epidemiological drivers of the global epidemic in MSM and why it continues unabated. We did a comprehensive review of available data for HIV prevalence, incidence, risk factors, and the molecular epidemiology of HIV in MSM from 2007 to 2011, and modelled the dynamics of HIV transmission with an agent-based simulation. Our findings show that the high probability of transmission per act through receptive anal intercourse has a central role in explaining the disproportionate disease burden in MSM. HIV can be transmitted through large MSM networks at great speed. Molecular epidemiological data show substantial clustering of HIV infections in MSM networks, and higher rates of dual-variant and multiple-variant HIV infection in MSM than in heterosexual people in the same populations. Prevention strategies that lower biological transmission and acquisition risks, such as approaches based on antiretrovirals, offer promise for controlling the expanding epidemic in MSM, but their potential effectiveness is limited by structural factors that contribute to low health-seeking behaviours in populations of MSM in many parts of the world. Copyright © 2012 Elsevier Ltd. All rights reserved.

                Author and article information

                J Med Internet Res
                J Med Internet Res
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                September 2021
                16 September 2021
                : 23
                : 9
                [1 ] Centre for Health Behaviours Research Jockey Club School of Public Health and Primary Care The Chinese University of Hong Kong Hong Kong Hong Kong
                [2 ] School of Medicine University of Nottingham Nottingham United Kingdom
                [3 ] Department of Media and Communication City University of Hong Kong Hong Kong Hong Kong
                [4 ] Department of Psychology Northumbria University Newcastle United Kingdom
                [5 ] AIDS Concern Hong Kong Hong Kong
                [6 ] Health and Care Service Department Hong Kong Red Cross Hong Kong Hong Kong
                [7 ] Department of Psychology The Chinese University of Hong Kong Hong Kong Hong Kong
                Author notes
                Corresponding Author: Phoenix Kit Han Mo phoenix.mo@ 123456cuhk.edu.hk
                ©Meiqi Xin, Neil S Coulson, Crystal Li Jiang, Elizabeth Sillence, Andrew Chidgey, Norman Nok Man Kwan, Winnie W S Mak, William Goggins, Joseph Tak Fai Lau, Phoenix Kit Han Mo. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 16.09.2021.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

                Original Paper
                Original Paper

                narrative persuasion,firsthand experiential stories,online intervention,hiv prevention,sexual behavior,men who have sex with men


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