Community Intervention Trial for Youth (CITY) Study
Condition: HIV Infections
MeSH terms: Infections; HIV Infections; Acquired Immunodeficiency Syndrome
Study type: Interventional
Phase: Phase 2/Phase 3

Summary: 
      The purpose of this study is to test whether a multi-component, community-level,
      HIV-prevention intervention is more effective than existing HIV prevention activities in
      reducing unprotected anal intercourse (UAI) among men ages 15-25 who have sex with men.
    

Detailed description: 
      In recent years, there have been increases in the rates of unprotected anal intercourse (UAI)
      reported by men who have sex with men (MSM) and in the numbers of newly diagnosed HIV
      infections among MSM. Surveys of young MSM (ages 15-29) in numerous U.S. cities from
      1994-2000 found an HIV prevalence of 2.2% to 18%, however, HIV prevalence was higher among
      young MSM of color than among white men. In a survey of 23-29 year-old MSM,nearly 1/3 of
      African-American men and 15% of Hispanic/Latino men were infected with HIV.

      The Community Intervention Trial for Youth (CITY) study is a 13-community randomized control
      trial designed to evaluate a multi-component, community-level intervention for MSM ages 15-25
      (i.e., young MSM or YMSM). All 13 communities have some form of HIV-prevention activities
      naturally occurring in their jurisdiction, but 6 of the 13 communities were randomly assigned
      to also receive the multi-component intervention (1 additional city served as a case study
      and also received the intervention). This intervention includes 4 components: 1) community
      health advisor network (CHAN) consisting of YMSM who conduct outreach to their peers,
      including linking other YMSM to community services and conducting other parts of the
      intervention; 2) social marketing, to include the use media to disseminate HIV risk-reduction
      messages and promote positive norms for safer sex; 3) large group events with an HIV
      prevention theme; and 4) small group activities/workshops that focus on increasing HIV
      prevention skills and enhancing a positive self-identity.

      The study population varies by site based on the specific racial or ethnic groups of YMSM
      that are targeted. African-American YMSM are the study population in Atlanta, Georgia
      (comparison site); Birmingham, Alabama (intervention site); and Chicago, Illinois
      (intervention site). Hispanic/Latino YMSM are the study population in Washington
      Heights/South Bronx, New York (intervention site); Jackson Heights/Queens, New York
      (comparison site); Orange County, California (intervention site); and San Gabriel Valley,
      California (comparison site). Asian and Pacific Islander YMSM are the study population in
      Seattle, Washington (intervention site) and San Diego, California (comparison site). YMSM
      regardless or race/ethnicity are the study population in Milwaukee, Wisconsin (intervention
      site); Detroit, Michigan (comparison site), Minneapolis, Minnesota (comparison site); and
      West Hollywood, California (intervention site).

      The primary goals of the intervention are to 1) decrease UAI with any male partners; 2)
      decrease UAI with main male partners; and 3) decrease UAI with non-main (i.e., casual) male
      partners. Using a venue-based, time/space sampling strategy in each community,
      cross-sectional samples of YMSM were interviewed from May-August across 4 years (1999-2002).
      Data collected in 1999 and 2000 were prior to the implementation of the multi-component
      intervention, and data collected in 2001 and 2002 were during the implementation of the
      intervention.
    

Intervention name(s): Community-Level Intervention
Intervention type(s): Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Homosexuality, Male; Adolescents; Minority Groups; Community Participation; Community Surveys; HIV Seronegativity; HIV