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Using the Knocking Out Infections through Safer Sex and Screening (KISS) Adapted Behavioral Intervention to Reduce Sexually Transmitted Infections in U.S. Army Medical Beneficiaries: Study Protocol for a Randomized Controlled Trial

Brennan R Cebula*, Addison Walling, Alexus Reynolds, Adam Yates, Heather L Follen, Shannon Clark, Maureen M Sevilla, Paul M Faestel, Gina M Wingood, Ralph J DiClemente, Trevor A Crowell, Julie A Ake, Tatjana P Calvano, Anjali Kunz, Donn J Colby

Background: Sexually Transmitted Infections (STIs) and Human Immunodeficiency Virus (HIV) in the U.S. Military population impair servicemembers’ ability to perform their duties, negatively impacting a unit’s operational capability in support of national defense. As such, the increasing incidence of STIs in the U.S Military is of significant concern. Sexual behaviors are a key driver of STI incidence, and the U.S. Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force recommend evidence-based behavioral interventions targeting the reduction of health risk behaviors as part of a comprehensive approach to STI/HIV prevention. However, there is no behavioral intervention with demonstrated efficacy in reducing high-risk sexual behaviors and the incidence of STI/HIV in the military population.

Methods: A prior pilot study of an evidence-based behavioral intervention adapted for the military population, the Knocking-out Infections through Safer-sex and Screening (KISS) intervention, demonstrated initial feasibility and acceptability in active-duty U.S. Army personnel and their medical beneficiaries. Based on pilot findings, we designed and implemented a multi-site randomized controlled trial to reduce high-risk sexual behaviors and STI/ HIV incidence in a behaviorally vulnerable population of U.S. Army personnel and their medical beneficiaries. Here we describe the design and implementation of the randomized controlled trial.

Conclusion: The results of this study will inform best-practices and policy regarding STI/HIV prevention in the U.S. Military population to potentially provide a much-needed evidence-based intervention to temper the increasing incidence of STI/HIV among the U.S. Military population.

Clinical trials registration number: NCT04547413