Recorded presentation

Maria Madison, ScD, Public Health, Abt. Associates, Inc., 55 Wheeler St., Cambridge, MA 01742, 617 349-2392, maria_madison@abtassoc.com, Geetha Beauchamp, MS, SCHARP, 1100Fairview Ave. noth MW-500, P.O. Box 19024, Seattle, WA 98109, Margaret Chesney, PhD, Center for AIDS Prevention Studies, University of California, San Francisco, 74 New Montgomery #600, San Francisco, CA 94105, and Beryl Koblin, PhD, New York Blood Center, 310 East 67th Street, New York, NY 10021.

Background: Intensive behavioral counseling (IBC) has been reported as a promising strategy for modifying various HIV related high-risk behaviors among African Americans. No large-scale test of effectiveness of IBC had previously been attempted to reduce high-risk behaviors associated with HIV acquisition among African-American MSM (AAMSM). We determined if IBC was effective in reducing high-risk behaviors and/or HIV acquisition among 281 AAMSM (from six U.S. cities) over 3.25 years of follow-up time, using biological and behavioral outcomes. Methods: First we performed subgroup analysis of IBC effect in HIV seroconversion. Second we investigated proportions engaging in unprotected anal (UA) sex in general, and then with an HIV status unknown or positive partner (serodiscordant unprotected anal sex, SDUA). Results: AAMSM had almost 20% fewer HIV cases in the intervention arm as compared to the control arm (not statistically significant; OR 0.81, 95% CI 0.36-1.85, p=0.814). No significant benefit from the intervention was observed in reduction of SDUA among AAMSM (OR 0.84; 95% CI 0.59 – 1.19, p = 0.328). For SDUA, whites (WMSM) had an OR of 0.86 (95% CI 0.77 – 0.96, p=0.009, n= 3,112). AAMSM received no significant benefit from the intervention regarding reductions in UA (OR 1.06, 95% CI 0.75-1.50. p=0.731) as compared to the benefit observed among WMSM (OR 0.86, 95% CI 0.77-0.95, p=0.005). Conclusion: IBC within this study did not have significant effects in reducing HIV acquisition, UA nor SDUA for AAMSM. IBC significantly reduced UA among WMSM. This suggests that further work in culturally specific IBC is imperative.

Learning Objectives:

• · Participants in this session will learn 5 key theories that contribute to an intensive behavioral counseling therapy (IBC; including, for example, Motivational Interviewing and Cognitive Behavioral Theory) effective in HIV prevention.
• · Participants will understand the strengths and weakness of the theories combined, in general, and as relevant to addressing the needs of ethnic and racial minorities (in particular African American MSM).
• · Participants will also learn how such IBC can be measured within a clinical trial, using biological and behavioral outcomes.
• · Participants will leave the session able to discuss, construct, and evaluate behavioral interventions for further research among AAMSM.
• · Participants will be able to identify components of an effective culturally competent approach as well as incompetent approaches (based upon tests of significance and participant feedback surveys).

Keywords: African American, HIV Interventions

Related Web page: www.explorestudy.org

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: This work is funded through the NIH Division of AIDS with cooperative agreements to Family Health International -subcontracting to Abt Associates (where I am the Abt Associates Protocol Coordinator for this study).

Recorded presentation