Sexuality Research and Social Policy: Journal of NSRC, Vol. 3, Issue 2, pp. 52-67 online ISSN 1553-6610. © 2006 by the National
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June 2006 Vol. 3, No. 2
Correspondence concerning this article should be addressed to Gerjo Kok, Department of Experimental Psychology, Maastricht
University, P.O. Box 616, 6200 MD Maastricht, the Netherlands. E-mail: g.kok@psychology.unimaas.nl; Paul Harterink,
Municipal Health Service Rotterdam and Environs, P.O. Box 70032, 3000 LP Rotterdam, the Netherlands. E-mail:
harterinkp@ggdrotterdam.nl; Pjer Vriens, Municipal Health Service Rotterdam and Environs, P.O. Box 70032, 3000 LP
Rotterdam, the Netherlands. E-mail: vriensp@ggdrotterdam.nl; Onno de Zwart, Municipal Health Service Rotterdam and
Environs, P.O. Box 70032, 3000 LP Rotterdam, the Netherlands. E-mail: dezwarto@ggdrotterdam.nl; Harm J. Hospers,
Department of Experimental Psychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands. E-mail:
h.hospers@psychology.unimaas.nl
Sexuality Research & Social Policy
Journal of NSRC http://nsrc.sfsu.edu
The Gay Cruise: Developing a Theory- and Evidence-Based
Internet HIV-Prevention Intervention
Gerjo Kok, Paul Harterink, Pjer Vriens, Onno de Zwart, Harm J. Hospers
Abstract:This article presents the development of a theory- and evidence-based Internet HIV-prevention
program for Dutch men who have sex with men (MSM) they have met on the Internet. The program is
based on a protocol called Intervention Mapping (IM), which includes six steps. In Step 1 of IM, we
conducted a needs assessment. In Step 2 we established program objectives to get e-dating MSM to
use condoms consistently. In Step 3 we translated theoretical methods into practical strategies. In Step
4 we integrated the strategies into an intervention called Gay Cruise in which virtual pursers introduced
participants to the strategies. In Step 5 we discussed large-scale implementation. And in Step 6 we dis-
cussed process and effect evaluation. We conclude that IM can be a helpful tool for developing and
improving Internet HIV-prevention interventions.
Key words: Intervention Mapping; program development; Internet-based; men who have sex with men
(MSM); HIV risk
The Internet has become an increasingly popular
venue for seeking sex partners (e-dating), especially
among men who have sex with men (MSM) (Hospers,
Harterink, Kok, & de Zwart, 2005). Because this popula-
tion has high rates of unprotected anal sex (Hospers et al.,
2005), interventions that target it are important and nec-
essary. So far, though, only a limited number of effect
studies of Internet interventions targeting MSM have
been reported (Bull, Lloyd, Rietmeijer, & McFarlane,
2004; Davidovich, De Wit, & Stroebe, 2004), and they
have shown mixed effects on sexual behavior and deter-
minants of behavior in intervention groups compared
with control groups. The current challenge is to use the
continuously advancing technological possibilities of the
Internet for effective HIV prevention.
In this article, we present the development of a
theory- and evidence-based Internet HIV-prevention pro-
gram for Dutch men who meet men on the Internet. The
development of the program is based on Intervention
Mapping (IM) (Bartholomew, Parcel, Kok, & Gottlieb,
2001, 2006), a systematic process to develop health pro-
motion programs based on theory, empirical evidence, and
additional research (see Figure 1). IM is composed of six
steps, each step providing a foundation for the next. Each
step comprises several tasks that result in a clear end
product. IM enables program planners to make decisions
based on data and theory that have been shown to be
most effective (e.g., Mullen, Green, & Persinger, 1985;
Kelly & Kalichman, 2002).
We do not present the results of the evaluation of the
intervention effects in this article but rather focus on a
description of the program development. The health pro-
motion literature has traditionally consisted largely
of descriptive studies on the psychosocial determinants of
behavior and of evaluation studies on the effectiveness
of programs (with insufficient information on the content

SEXUALITY RESEARCH & SOCIAL POLICY Journal of NSRC
June 2006 Vol. 3, No. 2 53
Establish program
outcomes
Access capacity Conduct needs
assessment
Plan needs
assessment
Step 2
Create
matrices
State expected changes in behavior and
environment
Specify performance objectives
Specify determinants
Create matrices of change objectives
Step 3
Develop
theory-based
methods and
practical strategies
Review program ideas with interested participants
Identify theoretical methods
Choose program methods
Select or design strategies
Assure that strategies match change objectives
Step 4
Design and
create program
Consult with intended participants and
implementers
Create program scope, sequence, theme,
and materials list
Develop design documents and protocols
Review available materials
Develop program materials
Pretest program materials with target
groups and implementers and oversee materials
production
Step 5
Adopt and
implement plan
Identify adopters and users
Specify adoption, implementation, and
sustainability performance objectives
Specify determinants and create matrix
Select methods and strategies
Design interventions to affect program use
Step 6
Develop
evaluation plan
Describe the program
Describe program outcomes and effect
questions
Write questions based on matrix
Write process questions
Develop indicators and measures
Specify evaluation designs
Evaluation
Step 1: Needs assessment
Implementation
Note: From Bartholomew, L. K., Parcel, G. S., Kok, G., & Gottlieb, N. H. (2006). Planning health promotion programs; an Intervention Mapping
approach. San Francisco: Jossey-Bass.
Figure 1. The Intervention Mapping Process