Addressing Young Men's Substance Use and HIV Risk
Condition: HIV
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      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.
    

Detailed description: 
      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.
    

Intervention name(s): community-level intervention for young MSM
Intervention type(s): Behavioral
Intervention description(s): The community-level intervention includes small media in the form of role model stories, peer outreach and web-based intervention
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: HIV; prevention