Serosorting Intervention for HIV Negative MSM
| Status: | Completed |
|---|---|
| Conditions: | Infectious Disease |
| Therapuetic Areas: | Immunology / Infectious Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 7/11/2015 |
| Start Date: | January 2012 |
| End Date: | February 2016 |
| Contact: | Daniel D Driffin, BA |
| Email: | daniel.driffin@uconn.edu |
| Phone: | 404-892-3500 |
Men who have sex with men make up a majority of incident HIV infections, however few
effective interventions to prevent HIV transmission among this group exist. African American
men who have sex with men (AAMSM) are disproportionately infected with STI/HIV and little is
understood about how the role of stigma impacts their linkage and retention to health care
during treatment. Effective strategies for reducing HIV related risk taking are urgently
needed to prevent further spread of the HIV epidemic. The proposed research will test a
behavioral intervention, which can be used during routine public health services, designed
to reduce HIV risks posed by sexual partner selection strategies. The proposed research
will also identify treatment barriers among MSM who test HIV/STI positive. Effective
strategies for reducing social barriers to health care treatment rely on a comprehensive and
thorough investigation into social barriers that affect AAMSM to effectively engage in
medical care. These areas of research will be focused on for the current trial.
effective interventions to prevent HIV transmission among this group exist. African American
men who have sex with men (AAMSM) are disproportionately infected with STI/HIV and little is
understood about how the role of stigma impacts their linkage and retention to health care
during treatment. Effective strategies for reducing HIV related risk taking are urgently
needed to prevent further spread of the HIV epidemic. The proposed research will test a
behavioral intervention, which can be used during routine public health services, designed
to reduce HIV risks posed by sexual partner selection strategies. The proposed research
will also identify treatment barriers among MSM who test HIV/STI positive. Effective
strategies for reducing social barriers to health care treatment rely on a comprehensive and
thorough investigation into social barriers that affect AAMSM to effectively engage in
medical care. These areas of research will be focused on for the current trial.
Men who have sex with men continue to make up a majority of incident HIV infections. Despite
alarmingly high rates of HIV infection, there are few effective interventions to prevent HIV
transmission among these men. This five year study, proposed by a New/Early Stage
Investigator, consists of a randomized controlled trial to test a behavioral intervention
designed to reduce risks for HIV/AIDS posed by sexual partner selection strategies,
specifically serosorting, among at-risk HIV negative men who have sex with men in Atlanta,
GA. Serosorting - limiting unprotected sexual partners to those of the same HIV status- has
emerged as a risk reduction strategy with little input from public health agencies. It is
commonly practiced among men who have sex with men to avoid HIV infection. However, engaging
in serosorting is a predictor of HIV transmission rather than a reliable form of prevention.
Serosorting is ineffective due to several factors, including: multiple flaws in the ability
to be certain of own or partner's HIV statuses, the failure of routine HIV tests to detect
acute HIV infection, elevated infectiousness due to acute HIV infection, and increased risk
for contracting other STIs that can facilitate HIV transmission. We are therefore proposing
to test a brief, single-session, Conflict Theory of Decision Making based intervention for
use in public health settings. This project uses a novel theory of informed decision making
to guide an intervention designed for use in routine services, i.e., HIV post-test
counseling. An intervention to address the needs of men who test HIV negative fits well with
current efforts to scale up HIV testing, also referred to as seek, test and treat. The
proposed research builds on the strengths of a pilot tested, behavioral intervention for
addressing serosorting among men who have sex with men. Following screening, informed
consent, baseline assessments, and HIV testing (we predict 70 men will test HIV positive),
600 HIV-negative participants will be randomly assigned to receive one of two intervention
arms: (a) a serosorting, partner selection intervention, or (b) a time-match, CDC based,
post-HIV test counseling, standard-of-care. Participants will be followed over 12-months and
assessments will include measures of serosorting beliefs, decisional balance, knowledge of
acute HIV infection, HIV status disclosure, and biological (incident STI) and behavioral
outcomes (sexual behaviors). This study will test the hypotheses that a brief, single
session, serosorting intervention will result in less risk-related serosorting beliefs,
greater knowledge/awareness of HIV transmission risk taking, increased HIV status
disclosure, reductions in number of sex partners, unprotected sex acts, and incident STIs
among intervention participants more so than the control group participants. Moreover, we
will test the hypothesis that the intervention will be cost saving when tested in
cost-effectiveness analyses. If shown effective, the intervention model will be ready for
immediate dissemination to HIV testing services. In a subset of participants, we will test
how stigma affects linkage, engagement and retention in care for participants who test
HIV/STI positive.
alarmingly high rates of HIV infection, there are few effective interventions to prevent HIV
transmission among these men. This five year study, proposed by a New/Early Stage
Investigator, consists of a randomized controlled trial to test a behavioral intervention
designed to reduce risks for HIV/AIDS posed by sexual partner selection strategies,
specifically serosorting, among at-risk HIV negative men who have sex with men in Atlanta,
GA. Serosorting - limiting unprotected sexual partners to those of the same HIV status- has
emerged as a risk reduction strategy with little input from public health agencies. It is
commonly practiced among men who have sex with men to avoid HIV infection. However, engaging
in serosorting is a predictor of HIV transmission rather than a reliable form of prevention.
Serosorting is ineffective due to several factors, including: multiple flaws in the ability
to be certain of own or partner's HIV statuses, the failure of routine HIV tests to detect
acute HIV infection, elevated infectiousness due to acute HIV infection, and increased risk
for contracting other STIs that can facilitate HIV transmission. We are therefore proposing
to test a brief, single-session, Conflict Theory of Decision Making based intervention for
use in public health settings. This project uses a novel theory of informed decision making
to guide an intervention designed for use in routine services, i.e., HIV post-test
counseling. An intervention to address the needs of men who test HIV negative fits well with
current efforts to scale up HIV testing, also referred to as seek, test and treat. The
proposed research builds on the strengths of a pilot tested, behavioral intervention for
addressing serosorting among men who have sex with men. Following screening, informed
consent, baseline assessments, and HIV testing (we predict 70 men will test HIV positive),
600 HIV-negative participants will be randomly assigned to receive one of two intervention
arms: (a) a serosorting, partner selection intervention, or (b) a time-match, CDC based,
post-HIV test counseling, standard-of-care. Participants will be followed over 12-months and
assessments will include measures of serosorting beliefs, decisional balance, knowledge of
acute HIV infection, HIV status disclosure, and biological (incident STI) and behavioral
outcomes (sexual behaviors). This study will test the hypotheses that a brief, single
session, serosorting intervention will result in less risk-related serosorting beliefs,
greater knowledge/awareness of HIV transmission risk taking, increased HIV status
disclosure, reductions in number of sex partners, unprotected sex acts, and incident STIs
among intervention participants more so than the control group participants. Moreover, we
will test the hypothesis that the intervention will be cost saving when tested in
cost-effectiveness analyses. If shown effective, the intervention model will be ready for
immediate dissemination to HIV testing services. In a subset of participants, we will test
how stigma affects linkage, engagement and retention in care for participants who test
HIV/STI positive.
Inclusion Criteria:
- Men who have sex with men
- Reside in study area (Atlanta, GA)
- At least 18 years of age
- Other criteria may apply
Exclusion Criteria:
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