HIV Clinical Trial
Official title:
Addressing Young Men's Substance Use and HIV Risk
This project will develop, implement, and evaluate a community-level intervention for Black
and White substance-using MSM between the ages of 15 and 29. The intervention is designed to
change both social norms and risk behavior using persuasive media communication and
interpersonal networking as primary intervention strategies.
Qualitative data from focus groups and interviews will inform the development of the
intervention. The effects of the intervention will be assessed through annual interviews with
young Black and White MSM in Philadelphia where the intervention will be implemented and in
Baltimore, our comparison community.
Young men who have sex with men (YMSM) have unique needs for targeted and tailored HIV
prevention messages. HIV infection rates among MSM remain high, particularly among men under
the age of 30 and for Black YMSM, whose HIV infection rates are over four times those of
White YMSM. The use of drugs and alcohol has been linked to increased sexual risk for HIV
among MSM yet no intervention addressing substance use and sexual risk within this population
has been rigorously evaluated.
This project will develop, implement, and evaluate a community-level intervention for Black
and White substance-using MSM between the ages of 15 and 29. The intervention, implemented
with the collaboration of a community service organization, the Mazzoni Center, will be
designed to change both social norms and risk behavior using persuasive media communication
and interpersonal networking as primary intervention strategies. The proposed project aims
to: 1) examine patterns and contexts of episodic substance use among YMSM; 2) compare
patterns of substance use for Black and White YMSM, and differences by age, sexual identity
and socio-economic status; 3) clarify the association between patterns and contexts of
substance use and sexual risk behaviors; 4) evaluate the efficacy of a community-level
intervention for substance-using YMSM to decrease sexual risk for HIV, through strengthening
social norms, increasing perceived risk, and enhancing self-efficacy and positive attitudes
to HIV prevention; 5) measure the differential impact of intervention messages on sexual risk
behavior for subgroups of YMSM; 6) determine if a reduction in substance use leads to a
decrease in sexual risk behaviors.
During the formative research phase, qualitative data will be obtained through focus groups
and in-depth interviews to refine the conceptual model and the media materials. The
intervention evaluation will collect quantitative data from YMSM in both Philadelphia PA and
the comparison community of Baltimore MD, using geocoding and census tract data to control
for demographic and socio-economic differences. A Solomon four-group design will be used to
collect data from panel and cross-sectional samples in intervention and comparison
communities. Four annual waves of interviews (baseline, 12, 24, and 36 months) will enable us
to examine exposure to the intervention, changes in norms and behavior, and long-term
intervention effects. A total of 650 men will be interviewed in Philadelphia and 400 in
Baltimore. The data will be analyzed using multivariate techniques, including generalized
linear model (GLM) repeated measures analysis and cumulative logit models. The study results
will provide needed information on substance use and sexual risk of Black and White YMSM and
have direct implications for implementing effective interventions to this high-risk
population.
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