PREVENTION FOR AT-RISK MEN: A MIXED SEROSTATUS APPROACH

University Of Delaware, Newark DE

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Abstract

[unreadable] DESCRIPTION (provided by applicant): [unreadable] Drug use and sexual risk-taking remain at very high rates and appear to be increasing among men who have sex with men (MSM) of all ages in Miami. Further, HIV infection, attendant health effects and prevention measures appear to have all but conduct preliminary tests of the feasibility, acceptability and efficacy of a small group intervention intended to reduce drug use and sexual risk behaviors among 120 sexually active, drug-using, not-in-treatment MSM in Miami. The intervention will be designed in recognition of the dramatic effects of medical therapies on the course of the disease and on perceptions of its severity. Grounded in a social public health model of prevention, empowerment theory, and the Health Belief Model of behavior change, the proposed intervention will provide a structured forum for H1V+ and HIV - men to: 1) discuss HIV infection status as an element of social stratification and division; 2) share perceptions of the disease as well as the diverse meanings of nonverbal attempts to communicate infection status; and 3) explore barriers to testing and verbal disclosure. In addition, the intervention will provide a structured forum in which to discuss subcultural norms of drug use, sex practices, friendships and romantic relationships. Pilot research has shown these topics to be of great concern among this population, and also that structured discussion appears to provide opportunities for both questioning norms and changing behaviors. The specific aims of the proposal are: 1) to develop and test the feasibility and acceptability of a small group intervention for both HIV+ and HIV-negative gay men aimed at reducing drug use and HIV sexual risk behaviors; 2) to conduct a preliminary test of the efficacy of the intervention among 120 sexually active, drug-using gay men in Miami; 3) to examine the effects of demographics, HIV status, HIV concern, intimate relationship status, perceived social support, alcohol and drug use, depression and other psychological problems, reactions to homosexuality, and other life events in predicting drug use and sexual risk behaviors in the study sample; and 4) to assess the specific mechanisms through which substance use and sexual risk behaviors are linked, using a series of open-ended questions to record event-level narratives of such experiences and attributed meanings. Preliminary tests will be accomplished by assigning 40 HIV- respondents to the "HIV-negative" arm of the intervention and 40 HIV- and 40 H1V+ respondents to the "mixed serostatus" arm. Extensive baseline interviews, post-intervention debriefings and 3-month follow-ups conducted at the individual level will provide preliminary measures of intervention acceptability and efficacy as well as comparisons of behavior change between the two intervention conditions. [unreadable] [unreadable]