RESUMO
Black men who have sex with men and women (MSMW) are among the populations at highest risk for HIV infection. We describe the evaluation of Project RISE, a six-session individual-level intervention developed for black MSMW using an ecosystems approach. A randomized controlled trial was used to test the effect of the intervention on sexual risk outcomes. Eligibility criteria included having both male and female sex partners in the past 12 months. Complete data at 5-month follow-up were collected from 86.7% of the 165 participants. In analyses controlling for HIV status, age, and baseline risk, intervention participants were found to have significantly greater reductions in number of female partners (p < 0.05) and total male and female partners (p < 0.05) at follow-up, compared to the control group. Intervention participants also were significantly more likely to report a reduction in number of sex episodes without a condom with female partners (p < 0.05) and with all partners (p < 0.02) at follow-up, compared to the control group.
Assuntos
Bissexualidade/etnologia , Negro ou Afro-Americano/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Parceiros Sexuais , Adulto , Negro ou Afro-Americano/psicologia , Bissexualidade/estatística & dados numéricos , Preservativos , Ecossistema , Feminino , HIV , Infecções por HIV/etnologia , Humanos , Masculino , Comportamento Sexual , Minorias Sexuais e de Gênero , Adulto JovemRESUMO
African Americans account for 45% of new HIV infections in the United States. Little empirical research investigates African American community leaders' normative recommendations for addressing these disparities. Philadelphia's HIV infection rate is 5 times the national average, nearly 70% of new infections are among African Americans, and 2% of African Americans in Philadelphia are living with HIV/AIDS. Using a community-based participatory research approach, we convened focus groups among 52 African American community leaders from diverse backgrounds to solicit normative recommendations for reducing Philadelphia's racial disparities in HIV infection. Leaders recommended that (a) Philadelphia's city government should raise awareness about HIV/AIDS with media campaigns featuring local leaders, (b) local HIV-prevention interventions should address social and structural factors influencing HIV risks rather than focus exclusively on mode of HIV transmission, (c) resources should be distributed to the most heavily affected neighborhoods of Philadelphia, and (d) faith institutions should play a critical role in HIV testing, treatment, and prevention efforts. We developed a policy memo highlighting these normative recommendations for how to enhance local HIV prevention policy. This policy memo led to Philadelphia City Council hearings about HIV/AIDS in October 2010 and subsequently informed local HIV/AIDS prevention policy and development of local HIV prevention interventions. This community-based participatory research case study offers important lessons for effectively engaging community leaders in research to promote HIV/AIDS policy change.
Assuntos
Negro ou Afro-Americano , Infecções por HIV/etnologia , Infecções por HIV/terapia , Síndrome da Imunodeficiência Adquirida/etnologia , Síndrome da Imunodeficiência Adquirida/terapia , Pesquisa Participativa Baseada na Comunidade , Grupos Focais , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Disparidades nos Níveis de Saúde , Humanos , Philadelphia , Religião , Estados UnidosRESUMO
Black men "on the down low" have been considered prime agents of HIV transmission in the Black community despite little empirical evidence. We assessed the relationship between down-low identification and sexual risk outcomes among 1151 Black MSM. Down-low Identification was not associated with unprotected anal or vaginal sex with male or female partners. Future HIV prevention programs and research should target sexual risk behaviors of Black men, irrespective of identity, and not focus on the "down low."
Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Infecções por HIV/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Preconceito , Assunção de Riscos , Adolescente , Adulto , Feminino , Infecções por HIV/transmissão , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Medição de Risco , Comportamento Sexual , Estados Unidos/epidemiologia , Adulto JovemRESUMO
Young men who have sex with men (YMSM) have high rates of recreational drug use and binge drinking that are related to increases in unprotected sex and HIV risk. We describe the development of a community-level intervention focused on MSM ages 15 to 29 who identify as Black or White and who reported episodic use of alcohol and/or drugs. Intervention content included culturally-relevant role model stories and peer outreach. Outcome measures, including number of partners and a risk score indicating risk for HIV from protected or unprotected insertive or receptive anal sex, were examined over 36 months in a sample of YMSM in Philadelphia, the intervention site, and Baltimore, the comparison site. Decreases in risk scores over time were significantly larger in the intervention sample than in the comparison sample. Effects were greater for YMSM who engaged in binge drinking and/or marijuana use, compared to those who used other drugs.