On the Efficacy and Mediation of a One-on-One HIV Risk-Reduction Intervention for African American Men Who Have Sex with Men: A Randomized Controlled Trial

Details

• Alternative Title:
  AIDS Behav
• Personal Author:
  Jemmott III, John B. ; Jemmott, Loretta Sweet ; O’Leary, Ann ; Icard, Larry D. ; Rutledge, Scott E. ; Stevens, Robin ; Hsu, Janet ; Stephens, Alisa J.
• Description:
  We examined the efficacy and mediation of Being Responsible for Ourselves (BRO), an HIV/STI risk-reduction intervention for African American men who have sex with men (MSM), the population with the highest HIV-diagnosis rate in the US. We randomized African American MSM to one of two interventions: BRO HIV/STI risk-reduction, targeting condom use; or attention-matched control, targeting physical activity and healthy diet. The interventions were based on social cognitive theory, the reasoned-action approach, and qualitative research. Men reporting anal intercourse with other men in the past 90 days were eligible and completed pre-intervention, immediately post-intervention, and 6 and 12 months post-intervention surveys. Of 595 participants, 503 (85 %) completed the 12-month follow-up. Generalized-estimating-equations analysis indicated that, compared with the attention-matched control intervention, the BRO intervention did not increase consistent condom use averaged over the 6- and 12-month follow-ups, which was the primary outcome. Although BRO did not affect the proportion of condom-protected intercourse acts, unprotected sexual intercourse, multiple partners, or insertive anal intercourse, it did reduce receptive anal intercourse compared with the control, a behavior linked to incident HIV infection. Mediation analysis using the product-of-coefficients approach revealed that although BRO increased seven of nine theoretical constructs it was designed to affect, it increased only one of three theoretical constructs that predicted consistent condom use: condom-use impulse-control self-efficacy. Thus, BRO indirectly increased consistent condom use through condom-use impulse-control self-efficacy. In conclusion, although BRO increased several theoretical constructs, most of those constructs did not predict consistent condom use; hence, the intervention did not increase it. Theoretical constructs that interventions should target to increase African American MSM's condom use are discussed.
• Subjects:
  Adult Black Or African American/psychology Condoms Follow-Up Studies Health Knowledge, Attitudes, Practice Health Promotion HIV Infections/epidemiology HIV Infections/prevention & Control Homosexuality, Male Humans Male Models, Psychological Negotiating Risk-Taking Risk Reduction Behavior Safe Sex Sexual Behavior/psychology Sexual Partners Young Adult

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• Source:
  AIDS Behav. 19(7):1247-1262.
• Pubmed ID:
  25449552
• Pubmed Central ID:
  PMC4503868
• Document Type:
  Journal Article
• Funding:
  R01 MH079736/MH/NIMH NIH HHS/United States
• Place as Subject:
  United States
• Volume:
  19
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:0d87eb0e8183570d3586f2deab8055d48f9949d5ec16fab825cdc388eaca8786
• Download URL:
  https://stacks.cdc.gov/view/cdc/32098/cdc_32098_DS1.pdf
• File Type:
  [PDF - 527.86 KB ]