A culturally tailored HIV prevention program developed and tested by investigators at UCLA and the Charles R. Drew University of Medicine and Science has been shown to significantly reduce unprotected sex among bisexual black men.
The innovative approach, called Men of African American Legacy Empowering Self, or MAALES, is described in an article in the peer-reviewed journal AIDS.
The rate of HIV/AIDS among African-Americans is significantly higher than it is among any other ethnic or racial group. (According to the Centers for Disease Control and Prevention, African-Americans accounted for an estimated 44 percent of new U.S. HIV diagnoses in 2010.) Among men who have sex with men, black men account for the largest estimated number of HIV infections. Yet there are few interventions available to reduce those rates, said the study's principal investigator, Nina Harawa, adjunct assistant professor of epidemiology at UCLA and associate professor of research at the Charles R. Drew University of Science and Medicine.
MAALES takes a holistic approach to minimizing behaviors that could put men at risk for HIV, engaging participants in small-group discussions about popular media, exercises such as negotiating condom use with sexual partners and activities to improve the participants' knowledge of sexual health. Importantly, the intervention is also culturally relevant, addressing participants' shared legacies, including social expectations of African-American men, historical discrimination and disenfranchisement, and societal impacts on individual health and sexual decision-making.
"When we first set out in 2004 to develop an intervention for behaviorally bisexual African-American men, the gap between documented need and services was staggering," Harawa said. "Up to that point, just one prevention intervention tailored for African-American men who had sex with men had been developed and no interventions designed for behaviorally bisexual men of any race or ethnicity had been published."
That gap has since narrowed, but only slightly, she noted. For instance, studies on four other interventions for African-American men who have sex with men have been published. Of those, only two showed evidence of efficacy. In addition, only two of the four studies specifically targeted any specific race or ethnicity.
The Drew-UCLA MAALES study was based on previous research by the authors and others which indicated that African-American men who have sex with men and women have different experiences and concerns from those of men who only have sex with men or men who only have sex with women.
Researchers surveyed 437 bisexual black men, assessing key characteristics and behaviors such as socio-demographics, incarceration history, self-reported HIV status, condom use, gender role expectations, experiences with racism, and use of drugs and alcohol. The surveys were completed at baseline, and again at three months and six months after completing the intervention.
Participants were randomly assigned either to the six-session MAALES intervention or to a control group that provided one session on HIV risk reduction education.
Compared with those randomized to the control intervention, individuals in MAALES reported 49 percent fewer episodes of unprotected intercourse with partners of either gender after six months, as well as 50 percent fewer episodes of unprotected vaginal intercourse with females, and 44 percent fewer female partners.
There were some study limitations that could lessen the generalizability of the study's findings. Participants tended to be over 35 years of age and to report low socioeconomic status. Also, despite efforts to engage men of diverse sexual identities, men who identify as heterosexual may have been less willing than other men who have sex with men and women to engage in a group intervention. Finally, even with intensive retention efforts, loss to follow-up was significant, perhaps due to significant incarceration rates. At least 16 percent of participants who were not retained were incarcerated at their six-month follow-up interview.
"Despite these study limitations, our statistically significant findings demonstrate not only the promise of this intervention but also the ability to bring about important behavioral change through culturally tailored behavioral intervention approaches," said Dr. John K. Williams, associate professor in residence of psychiatry and biobehavioral sciences at UCLA's Semel Institute for Neuroscience and Human Behavior, and the study's co-principal investigator.
"Health interventions that address more than just physical, mental and sexual health may be vital for groups like black men who have sex with men and women whose concerns regarding HIV stigma, biphobia, homophobia and financial hardship may complicate engagement in HIV biomedical prevention and treatment," Williams said.
Explore further: Male on male consensual sex and sexual assault common in South Africa
Medical Xpress on facebook
Related Stories
Male on male consensual sex and sexual assault common in South Africa
Jun 18, 2013
A survey of adult South African men published in this week's PLOS Medicine, shows that while overlapping sexual relationships with women appear to be common, roughly one in 20 men reported consensual sexual contact with a ...
Rate of new HIV infections drops for first time among black women, CDC reports
Dec 21, 2012
(HealthDay)—For the first time, the rate of new HIV infections among black American women declined between 2008 and 2010, according to a report released Wednesday by the U.S. Centers for Disease Control ...
Higher HIV risk in black gay men linked to partner choice, risk perception
May 02, 2011
Young black men who have sex with men (MSM) get infected with HIV nearly five times more often than MSM from other races, even though they don't have more unprotected sex.
Social media may prove useful in prevention of HIV, STDs, study shows
Feb 06, 2013
(Medical Xpress)— Facebook and other social networking technologies could serve as effective tools for preventing HIV infection among at-risk groups, new UCLA research suggests.
Study shows men as likely as women to distinguish between desire and arousal
Jul 23, 2013
The theory is that men and women are completely different in the way that they experience arousal and express desire. But the first large-scale study trying to tease apart what goes on in the minds and bodies of men and women ...
Recommended for you
Onset of puberty is delayed in HIV-infected children
Aug 19, 2013
(HealthDay)—Onset of puberty is significantly delayed in perinatally HIV-infected (PHIV) children compared with those who are HIV-exposed but uninfected (HEU), but combination antiretroviral therapy may ...
Britain lifts ban on health workers with HIV
Aug 15, 2013
The British government said Thursday it would lift a ban on staff with HIV working in the state-run National Health Service from carrying out certain procedures on patients.
The first animal model for sexual transmission of HIV
Aug 15, 2013
Infection by human immunodeficiency virus (HIV) causes acquired immunodeficiency syndrome (AIDS), a debilitating disorder in which progressive weakening of the immune system makes affected individuals more susceptible to ...
New drug approved to treat HIV-1
Aug 13, 2013
(HealthDay)—Tivicay (dolutegravir) has been approved by the U.S. Food and Drug Administration to treat infection with HIV-1, a strain of the virus that causes AIDS.
Exercise helps with better brain functioning in HIV-infected adults
Aug 13, 2013
Regular exercise is not only good for health, but can give people living with HIV a significant mental boost. This is according to a study by Dr. David J. Moore and colleagues at the University of California, San Diego (UCSD), ...
FDA approves rapid diagnostic test for HIV antigen, antibodies
Aug 09, 2013
(HealthDay)—The first rapid test to detect the HIV-1 antigen, as well as blood antibodies for the HIV-1 and HIV-2 strains, has been approved by the U.S. Food and Drug Administration.
User comments
© Medical Xpress 2011-2013, Phys.org network
A culturally tailored HIV prevention program developed and tested by investigators at UCLA and the Charles R. Drew University of Medicine and Science has been shown to significantly reduce unprotected sex among bisexual black men.
The innovative approach, called Men of African American Legacy Empowering Self, or MAALES, is described in an article in the peer-reviewed journal AIDS.
The rate of HIV/AIDS among African-Americans is significantly higher than it is among any other ethnic or racial group. (According to the Centers for Disease Control and Prevention, African-Americans accounted for an estimated 44 percent of new U.S. HIV diagnoses in 2010.) Among men who have sex with men, black men account for the largest estimated number of HIV infections. Yet there are few interventions available to reduce those rates, said the study's principal investigator, Nina Harawa, adjunct assistant professor of epidemiology at UCLA and associate professor of research at the Charles R. Drew University of Science and Medicine.
MAALES takes a holistic approach to minimizing behaviors that could put men at risk for HIV, engaging participants in small-group discussions about popular media, exercises such as negotiating condom use with sexual partners and activities to improve the participants' knowledge of sexual health. Importantly, the intervention is also culturally relevant, addressing participants' shared legacies, including social expectations of African-American men, historical discrimination and disenfranchisement, and societal impacts on individual health and sexual decision-making.
"When we first set out in 2004 to develop an intervention for behaviorally bisexual African-American men, the gap between documented need and services was staggering," Harawa said. "Up to that point, just one prevention intervention tailored for African-American men who had sex with men had been developed and no interventions designed for behaviorally bisexual men of any race or ethnicity had been published."
That gap has since narrowed, but only slightly, she noted. For instance, studies on four other interventions for African-American men who have sex with men have been published. Of those, only two showed evidence of efficacy. In addition, only two of the four studies specifically targeted any specific race or ethnicity.
The Drew-UCLA MAALES study was based on previous research by the authors and others which indicated that African-American men who have sex with men and women have different experiences and concerns from those of men who only have sex with men or men who only have sex with women.
Researchers surveyed 437 bisexual black men, assessing key characteristics and behaviors such as socio-demographics, incarceration history, self-reported HIV status, condom use, gender role expectations, experiences with racism, and use of drugs and alcohol. The surveys were completed at baseline, and again at three months and six months after completing the intervention.
Participants were randomly assigned either to the six-session MAALES intervention or to a control group that provided one session on HIV risk reduction education.
Compared with those randomized to the control intervention, individuals in MAALES reported 49 percent fewer episodes of unprotected intercourse with partners of either gender after six months, as well as 50 percent fewer episodes of unprotected vaginal intercourse with females, and 44 percent fewer female partners.
There were some study limitations that could lessen the generalizability of the study's findings. Participants tended to be over 35 years of age and to report low socioeconomic status. Also, despite efforts to engage men of diverse sexual identities, men who identify as heterosexual may have been less willing than other men who have sex with men and women to engage in a group intervention. Finally, even with intensive retention efforts, loss to follow-up was significant, perhaps due to significant incarceration rates. At least 16 percent of participants who were not retained were incarcerated at their six-month follow-up interview.
"Despite these study limitations, our statistically significant findings demonstrate not only the promise of this intervention but also the ability to bring about important behavioral change through culturally tailored behavioral intervention approaches," said Dr. John K. Williams, associate professor in residence of psychiatry and biobehavioral sciences at UCLA's Semel Institute for Neuroscience and Human Behavior, and the study's co-principal investigator.
"Health interventions that address more than just physical, mental and sexual health may be vital for groups like black men who have sex with men and women whose concerns regarding HIV stigma, biphobia, homophobia and financial hardship may complicate engagement in HIV biomedical prevention and treatment," Williams said.
Explore further: Male on male consensual sex and sexual assault common in South Africa
Medical Xpress on facebook
Related Stories
Male on male consensual sex and sexual assault common in South Africa
Jun 18, 2013
A survey of adult South African men published in this week's PLOS Medicine, shows that while overlapping sexual relationships with women appear to be common, roughly one in 20 men reported consensual sexual contact with a ...
Rate of new HIV infections drops for first time among black women, CDC reports
Dec 21, 2012
(HealthDay)—For the first time, the rate of new HIV infections among black American women declined between 2008 and 2010, according to a report released Wednesday by the U.S. Centers for Disease Control ...
Higher HIV risk in black gay men linked to partner choice, risk perception
May 02, 2011
Young black men who have sex with men (MSM) get infected with HIV nearly five times more often than MSM from other races, even though they don't have more unprotected sex.
Social media may prove useful in prevention of HIV, STDs, study shows
Feb 06, 2013
(Medical Xpress)— Facebook and other social networking technologies could serve as effective tools for preventing HIV infection among at-risk groups, new UCLA research suggests.
Study shows men as likely as women to distinguish between desire and arousal
Jul 23, 2013
The theory is that men and women are completely different in the way that they experience arousal and express desire. But the first large-scale study trying to tease apart what goes on in the minds and bodies of men and women ...
Recommended for you
Onset of puberty is delayed in HIV-infected children
Aug 19, 2013
(HealthDay)—Onset of puberty is significantly delayed in perinatally HIV-infected (PHIV) children compared with those who are HIV-exposed but uninfected (HEU), but combination antiretroviral therapy may ...
Britain lifts ban on health workers with HIV
Aug 15, 2013
The British government said Thursday it would lift a ban on staff with HIV working in the state-run National Health Service from carrying out certain procedures on patients.
The first animal model for sexual transmission of HIV
Aug 15, 2013
Infection by human immunodeficiency virus (HIV) causes acquired immunodeficiency syndrome (AIDS), a debilitating disorder in which progressive weakening of the immune system makes affected individuals more susceptible to ...
New drug approved to treat HIV-1
Aug 13, 2013
(HealthDay)—Tivicay (dolutegravir) has been approved by the U.S. Food and Drug Administration to treat infection with HIV-1, a strain of the virus that causes AIDS.
Exercise helps with better brain functioning in HIV-infected adults
Aug 13, 2013
Regular exercise is not only good for health, but can give people living with HIV a significant mental boost. This is according to a study by Dr. David J. Moore and colleagues at the University of California, San Diego (UCSD), ...
FDA approves rapid diagnostic test for HIV antigen, antibodies
Aug 09, 2013
(HealthDay)—The first rapid test to detect the HIV-1 antigen, as well as blood antibodies for the HIV-1 and HIV-2 strains, has been approved by the U.S. Food and Drug Administration.
User comments
© Medical Xpress 2011-2013, Phys.org network
0 comments:
Post a Comment