Abstract
African American men who have sex with men and women (MSMW) are among the populations with the highest need for HIV prevention programs in the USA. We tested a theory-based, community participatory behavioral intervention aiming to reduce sexual risk for HIV transmission in this population. A randomized clinical trial involving 396 African American MSMW who were assigned to a 4-session intervention involving HIV testing and counseling (n = 199) or to a HIV testing and counseling only (n = 197) control. In the 4-session intervention program, counselors provided education on HIV and STI risk, condom use, HIV testing, interpersonal sexual dynamics with both male and female partners, and motivational “triggers” of condomless sex. Participants completed baseline, 6-month, and 9-month assessments, and changes in HIV behavioral risk indicators were examined by condition and time. There were no statistically significant differences in sexual risk between the intervention condition and the control condition. Regardless of condition, participants reported significant reductions in mean number of condomless sex events with female casual partners from baseline (6.04) to 6 months (2.58) and 9 months (1.47), and with male casual partners from baseline (2.61) to 6 months (1.18) and 9 months (0.60). Condition-by-time interaction effects and condition main effects were non-significant. Although there were no significant differences by condition, findings support the effects of brief behavioral counseling and HIV testing on reducing condomless sex with casual female and male partners among African American MSMW. Future research should examine further the potential for brief behavioral counseling to promote biomedical HIV prevention and to reduce co-morbid health issues such as substance use among African American MSMW.
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Acknowledgments
We would like to thank our study participants, and Raysean Ford, Michael Arnold, Elizabeth Bartmess, and Stuart Gaffney for their contributions to this study.
Funding
Funding was received from the National Institutes of Health to conduct this study, NIH/NIMH R01 MH090899 (PI: Arnold); NIH/NCRR CTSI UTLITR00004. The funders had no role in the design, execution, or decision to publish this research.
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EA conceived the study, oversaw data collection and analyses, and drafted and revised the paper. SK helped design the intervention, helped supervise the trial, and revised the paper, LP and TN supervised quantitative data collection, conducted analyses, and drafted and revised the paper, JW and WS collected the data, and revised the paper. MB provided the intervention, and revised the draft paper, SC, GL, and CDS helped supervise the trial, and revised the draft paper. DO helped design the study, helped supervise the trial, and drafted and revised the paper. All authors read and approved the final manuscript.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was reviewed and approved by the University of California San Francisco Committee on Human Research.
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Written informed consent was obtained from all individual participants included in the study.
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Arnold, E.A., Kegeles, S.M., Pollack, L.M. et al. A Randomized Controlled Trial to Reduce HIV-Related Risk in African American Men Who Have Sex with Men and Women: the Bruthas Project. Prev Sci 20, 115–125 (2019). https://doi.org/10.1007/s11121-018-0965-7
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DOI: https://doi.org/10.1007/s11121-018-0965-7