Virtual Learning: Using Interactive Video (IAV) To Reduce Risky Sexual Behavior

1. Virtual Learning: Using Interactive Video (IAV) To Reduce Risky Sexual Behavior Lynn Miller, Stephen Read, Robert Appleby, Johnnie Christensen, Mary Nwosu, & Carlos Godoy

2. How Can We Reduce Risky Sex for a High Risk Population of Men who Have Sex with Men (MSM)? • MSM have heard Safer-Sex Messages for decades. How do we engage men who may have already “tuned out” standard HIV prevention messages? Need a Targeted and Tailored Intervention for them that will get their attention. • Furthermore, learning “what to do” and reducing the probability of risky decision making does not typically take into account the emotional nature of real life sexual encounters (e.g., sexual arousal) and its impact on information encoding, processing and retrieval. Would learning and reduced risk in real-life be more likely if safe sex “practice” occurred in a physically and emotionally similar context? • Could we use new communication technology (Interactive Video-- IAV) to create realistic and culturally sensitive sexual scenarios that would reduce HIV risk? • Aimed at a target population • Within which people made tailored choices • Men could get tailored messages/feedback customized to their choices. • We could also include “Peer Counselors”

3. Our Possible Solution: Create a Virtual Date • To enhance sexual decision making in real life contexts, participants assume the role of a character on a “virtual date” in which their choices guide what happens next. • They will be given and may seek out peer guidance and their behavior (and their risk taking choices) will be summarized at the end of the date (with suggestions for what they could have done to reduce risk).

4. Virtualized Social Learning • Active and eclectic learning in an emotional and psychological context as similar as possible to the “real life context” in which the actor will perform the behavior. Here, MSM are making “dating choices” on which they are provided feedback in an interactive, virtual environment -- a realistic potential sexual encounter. • The incorporation of these many elements with emotional similitude, it is hoped, will enhance encoding and subsequent retrieval in a similar context with similar “situated” or “contextualized” cues.

5. Development of the Simulation • Extensive research to develop the scripts, simulated sex, choices and dialogue (to be relevant to the target population-- white MSM) • Extensive collaborations with community based groups. • Extensive collaboration between cinematographers, scientists, & community members to enhance the realistic nature of the virtual date, its production quality, its research- based components, and population acceptability. Play Video

6. Assessment • A randomized design was used to examine changes in sexual behavior (weekly phone ins of sexual behavior over 8 weeks) for men who experienced the interactive video compared to those who received only the standard post-negative HIV test counseling. • Participants: 136 men who have sex with men, who went to the GLCSC for an AIDS test and who received a negative result.

7. Frequency of Protected And Unprotected Anal Sex

8. Virtual Sex: Realizing Real Risk Reduction for MSM • Recently secured $3.6 M from NIH to develop a “template” for developing DVD IAV for behavioral risk reduction. We are developing two venues (e.g., internet, bar) for each of three at risk ethnic populations (African-American, Caucasian, & Latino/Hispanic) of MSM. We expect to use this template for other Risk Populations for HIV and other Health Problems. • We hope to empower local communities to develop their own IAV’s sensitive to their own local community health needs.

9. Future Directions for IAV • Lynn Miller, Stephen Read, & P. Robert Appleby-- • Recently secured $3.6 M from NIH to develop a “template” for developing DVD IAV for behavioral risk reduction. We propose to develop two venues (e.g., internet, bar) for each of three at risk ethnic populations (African-American, Caucasian, & Latino/Hispanic) of MSM. Will be able to use this template for other Risk Populations for HIV and other Health Problems. • We hope to empower local communities to develop their own IAV’s sensitive to their own local community health needs.