Understanding and Reducing HIV Risk Behavior and Substance Use Among Self-identified Bisexual Adolescent Men
Condition: HIV/AIDS; Substance Use; Bisexuality
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      Young gay, bisexual, and other men who have sex with men (MSM) are disproportionately
      affected by HIV. Despite this burden, most HIV prevention interventions target adult MSM
      (most of whom identify as gay) and heterosexual youth, creating an urgent need for
      interventions for gay and bisexual adolescents. Further, self-identified bisexual men,
      especially adolescents, have been neglected in research. Therefore, little is known about
      factors that drive engagement in risk behavior among self-identified bisexual adolescent men.
      The goals of this study are to: (1) examine factors that drive engagement in HIV risk
      behavior and substance use among self-identified bisexual adolescent men; and (2) develop and
      pilot test a tailored HIV and substance use prevention intervention for this population.
    

Detailed description: 
      Young gay, bisexual, and other men who have sex with men (MSM) are disproportionately
      affected by HIV. Despite this burden, most HIV prevention interventions target adult MSM
      (most of whom identify as gay) and heterosexual youth, creating an urgent need for
      interventions for gay and bisexual adolescents. Further, self-identified bisexual men,
      especially adolescents, have been neglected in research. This is a critical problem because:
      (1) there are as many, if not more, bisexual adolescent men than gay adolescent men; (2)
      bisexual adolescent men engage in several HIV risk behaviors more than their gay peers; (3)
      bisexual adolescent men are at increased risk for substance use-a robust risk factor for HIV;
      and (4) bisexual men face unique HIV prevention issues. Given that bisexual men are rarely
      included in research and most existing research on them focuses on "behaviorally bisexual"
      adult men, little is known about factors that drive engagement in risk behavior among
      self-identified bisexual adolescent men. Attending to bisexual identity is critical to
      reducing HIV and substance use, because bisexuality is highly stigmatized and stigma-related
      stressors (e.g., concerns about disclosing one's bisexual identity) impact sexual behavior,
      substance use, and healthcare utilization. Interventions are also more effective when
      tailored to populations, underscoring the need for an intervention for self-identified
      bisexual adolescent men. The goals of this study are to: (1) examine factors that drive
      engagement in HIV risk behavior and substance use among self-identified bisexual adolescent
      men; and (2) develop and pilot test a tailored HIV and substance use prevention intervention
      for this population. In Phase 1, interviews will be conducted with 60 diverse self-identified
      bisexual adolescent men ages 14-17 focused on sexual identity, sexual decision-making,
      substance use motivations, and intervention preferences/barriers. In Phase 2, a tailored
      intervention will be developed using findings from Phase 1. In Phase 3, feasibility,
      acceptability, and preliminary efficacy will be tested in a pilot randomized trial (N = 60)
      with a waitlist control and one-month follow-up. In sum, self-identified bisexual adolescent
      men are at increased risk for HIV and substance use, but little is known about factors that
      drive their engagement in risk behavior. By focusing on self-identified bisexual adolescent
      men-an underrepresented, health disparity population-this study can identify prevention
      targets and reduce disparities in HIV and substance use.
    

Intervention name(s): HIV and substance use prevention
Intervention type(s): Behavioral
Intervention description(s): The intervention content will be developed through formative research during the initial phase of the study. However, the intervention will address: bisexual-inclusive sexual health education, unique influences of risk behavior among bisexual adolescents, and skills to cope with bisexual stigma and to increase acceptance of one's bisexual identity.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention