Development of an HIV risk reduction intervention for older seropositive African American men.

School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6096, USA.
AIDS patient care and STDs (Impact Factor: 3.58). 08/2009; 23(8):647-55. DOI: 10.1089/apc.2008.0276
Source: PubMed

ABSTRACT The purpose of this study was to assess the feasibility and acceptability of an HIV risk reduction intervention to increase consistent condom use in a sample of older HIV-positive African American men who have sex with men (MSM). Repeated measures were used at baseline, immediate postintervention, and 3 months postintervention to collect data. The development of the intervention was implemented in four phases: focus groups, pilot testing of the questionnaire, modifying the intervention, and executing the intervention. Sixty HIV-positive African American MSM were randomized to either an HIV risk condition or a health condition. Each condition consisted of four 120-minute sessions delivered over a 4-week period in a classroom-like setting using interactive approaches. The primary outcome was consistent condom use during every instance of anal intercourse. In unadjusted analyses, men in the risk reduction group were twice as likely to use condoms consistently (odds ratio [OR] = 2.04; 95% confidence interval [CI] = 0.48-8.77; p = 0.336), although this did not reach statistical significance. All participants reporting consistent condom use at baseline reported consistent use at 3 months giving perfect prediction for the sample. Among men not reporting consistent condom use at baseline, those in the risk reduction group were 5 times more likely to report consistent condom use at 3 months than were those in the health condition (OR = 5.18; 95% CI = 0.97-27.78; p = 0.054). The findings suggest that an HIV risk-reduction condition may increase consistent condom use among HIV-positive African American MSM 50 years and older.

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    ABSTRACT: African American/Black men who have sex with men (MSM) in the USA experience health and social disparities at greater rates than MSM of other races/ethnicities, including HIV infection and substance use. This mixed methods paper presents: (1) a quantitative examination of health and social disparities among a sample of substance-using African American/Black MSM (N = 108) compared to Caucasian/White MSM (N = 250) and (2) in-depth qualitative data from a subsample of African American/Black MSM (N = 21) in order to contextualize the quantitative data. Findings indicate that compared to Caucasian/White MSM, African American/Black MSM experienced a wide range of health and social disparities including: substance use and dependence; buying, trading or selling sex; educational attainment; employment; homelessness; identifying as gay; HIV status; arrest history; social support; and satisfaction with one’s living situation. Qualitative data suggests that structural interventions that address homophobia and the social environment would be likely to mitigate many of the health and social disparities experienced by African American/Black MSM.
    03/2014; 2(1). DOI:10.1007/s40615-014-0042-2
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    Edited by ECDC, 02/2013; ECDC., ISBN: 978-92-9193-437-9
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    ABSTRACT: Black men who have sex with men (MSM) are disproportionately burdened by HIV/AIDS. Despite this burden there has been a shortage of research on HIV interventions for black MSM. This article provides a comprehensive review of the literature on interventions for black MSM to identify effective HIV prevention intervention strategies for black MSM. We searched 3 databases: Pubmed, Scopus, and Google Scholar to identify peer-reviewed articles and used the following search terms: African American or black; MSM or men who have sex with men and women (MSMW); HIV; program or intervention; and evaluation or intervention science or implementation research. We included research articles that assessed interventions for black men who have sex with men. We included studies that used an experimental, quasi-experimental, or pre-post test design as well as formative research studies. We also searched the CDC and NIH websites to identify planned and on-going intervention studies. We identified a total of 23 studies to include in the review. We identified 12 completed studies of interventions for black MSM. Eight of these 12 interventions aimed to reduce HIV risk behaviors and 5 found a significant reduction in HIV risk behavior over time. We identified 4 health service intervention studies for young black MSM. Behavior change interventions are effective at reducing HIV risk behaviors among black MSM. However, relying only on behavioral interventions that aim to reduce HIV risk behavior will most likely not have a population-level effect on HIV infection among black MSM. There is a compelling and urgent need to develop and test comprehensive HIV testing, linkage to care, retention in care and adherence interventions for black MSM.
    BMC Public Health 07/2013; 13(1):625. DOI:10.1186/1471-2458-13-625 · 2.32 Impact Factor