Exploring Acceptability & Potential Reach of Game-Based & Social Network Strategies for Improving PrEP & HIV Self-Testing Uptake among Latinx Sexual Minority Men Living in an EHE Priority Jurisdiction - PROJECT SUMMARY/ABSTRACT The goal of this F31-Diversity application, submitted by a predoctoral investigator from a disadvantaged background, is to examine the configurations of the online gaming and offline friendship networks of Latinx men who have sex with men (LMSM) and the extent to which these network structures and characteristics can influence LMSM access to pre-exposure prophylaxis (PrEP) information and the distribution of HIV self-testing (HIVST) kits. Despite the field’s infancy, online game-based interventions have been found to be acceptable among sexual and gender minority adolescents and adults and have positive effects for increasing knowledge, and improving attitudes and behaviors related to HIV prevention. Few studies have investigated the combined use of online game-based and offline friendship network approaches to increase awareness and uptake of PrEP/HIVST in the LMSM community. This mixed-methods social network study will analyze and integrate two data sources collected specifically for this F31-Diversity project as part of Dr. Mariano Kanamori’s (Main Sponsor) R01 entitled, “PrEParados: A Social Network Study of Latino MSM for Facilitating Progress in the PrEP Cascade” from April 2022 to August 2023 (R01MH12572). First data source: egocentric and two-mode network data (N=73 egos and 153 alters). Second data source: qualitative data including 90-minute semi-structured individual interviews with LMSM online gamers (N=40). Both data sources include information from LMSM living in Miami- Dade County, Florida, (MDC), the metropolitan statistical area with the highest HIV incidence (42.4 per 100,000) and second highest HIV prevalence (979.9 per 100,000) rates in the nation. Among incident HIV cases in MDC, 64.4% are attributed to Latinx individuals, and 81.5% are attributed to MSM. Design. The Network Flow Model and Social Contagion Theory will guide the following research aims: Aim 1: Characterize social networks of LMSM online gamers. It will include the description of network size, type of games played, frequency of gameplay with others, format of gameplay, and the sociodemographic characteristics of their online gaming partners. Aim 2: Understand the potential reach of LMSM online gamers to promote PrEP messaging and disseminate HIVST kits in their offline friendship networks. Egocentric and two-mode network analyses will be used to: (A) determine the structures of offline friendship and affiliation networks of LMSM online gamers, and (B) identify specific characteristics of these structures (e.g., type of games played, homogeneity, homophily) associated with the dissemination of PrEP information and distribution of HIVST kits. Aim 3: Explore the acceptability of a combined online game and offline friendship networks-based approach to promote PrEP information and HIVST kit dissemination. Qualitative findings will inform the design of an intervention that bundles social network and online game-based approaches to increase PrEP/HIVST awareness and uptake. Implications. This F31 study will inform the development and implementation of culturally-tailored game- and social network-based interventions to enhance HIV prevention services for LMSM and the applicant’s future K99/R00 award development.
