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Effects of a social network HIV/STD prevention intervention for MSM in Russia and Hungary: a randomized controlled trial.

ABSTRACT: To test a novel social network HIV risk-reduction intervention for MSM in Russia and Hungary, where same-sex behavior is stigmatized and men may best be reached through their social network connections.A two-arm trial with 18 sociocentric networks of MSM randomized to the social network intervention or standard HIV/STD testing/counseling.St. Petersburg, Russia and Budapest, Hungary.Eighteen 'seeds' from community venues invited the participation of their MSM friends who, in turn, invited their own MSM friends into the study, a process that continued outward until eighteen three-ring sociocentric networks (mean size?=?35 members, n?=?626) were recruited.Empirically identified network leaders were trained and guided to convey HIV prevention advice to other network members.Changes in sexual behavior from baseline to 3-month and 12-month follow-up, with composite HIV/STD incidence, measured at 12 months to corroborate behavior changes.There were significant reductions between baseline, first follow-up, and second follow-up in the intervention versus comparison arm for proportion of men engaging in any unprotected anal intercourse (UAI) (P?=?0.04); UAI with a nonmain partner (P?=?0.04); and UAI with multiple partners (P?=?0.002). The mean percentage of unprotected anal intercourse acts significantly declined (P?=?0.001), as well as the mean number of UAI acts among men who initially had multiple partners (P?=?0.05). Biological HIV/STD incidence was 15% in comparison condition networks and 9% in intervention condition networks.Even where same-sex behavior is stigmatized, it is possible to reach MSM and deliver HIV prevention through their social networks.

SUBMITTER: Amirkhanian YA

PROVIDER: S-EPMC4497559 | biostudies-literature | 2015 Mar

REPOSITORIES: biostudies-literature

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Effects of a social network HIV/STD prevention intervention for MSM in Russia and Hungary: a randomized controlled trial.

Amirkhanian Yuri A YA Kelly Jeffrey A JA Takacs Judit J McAuliffe Timothy L TL Kuznetsova Anna V AV Toth Tamas P TP Mocsonaki Laszlo L DiFranceisco Wayne J WJ Meylakhs Anastasia A

AIDS (London, England) 20150301 5

<h4>Objective</h4>To test a novel social network HIV risk-reduction intervention for MSM in Russia and Hungary, where same-sex behavior is stigmatized and men may best be reached through their social network connections.<h4>Design</h4>A two-arm trial with 18 sociocentric networks of MSM randomized to the social network intervention or standard HIV/STD testing/counseling.<h4>Setting</h4>St. Petersburg, Russia and Budapest, Hungary.<h4>Participants</h4>Eighteen 'seeds' from community venues invite ...[more]

PMID: 25565495

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Project description:Human immunodeficiency virus (HIV) has disproportionately affected African Americans. Couple-level interventions may be a promising intervention strategy.To determine if a behavioral intervention can reduce HIV/sexually transmitted disease (STD) risk behaviors among African American HIV serodiscordant couples, a cluster randomized controlled trial (Eban) was conducted in Atlanta, Georgia; Los Angeles, California; New York, New York; and Philadelphia, Pennsylvania; with African American HIV serodiscordant heterosexual couples who were eligible if both partners were at least 18 years old and reported unprotected intercourse in the previous 90 days and awareness of each other's serostatus. One thousand seventy participants were enrolled (mean age, 43 years; 40% of male participants were HIV positive). Couples were randomized to 1 of 2 interventions: couple-focused Eban HIV/STD risk-reduction intervention or attention-matched individual-focused health promotion comparison. The primary outcomes were the proportion of condom-protected intercourse acts and cumulative incidence of STDs (chlamydia, gonorrhea, or trichomonas). Data were collected preintervention and postintervention, and at 6- and 12-month follow-ups.Data were analyzed for 535 randomized couples: 260 in the intervention group and 275 in the comparison group; 81.9% were retained at the 12-month follow-up. Generalized estimating equation analyses revealed that the proportion of condom-protected intercourse acts was larger among couples in the intervention group (0.77) than in the comparison group (0.47; risk ratio, 1.24; 95% confidence interval [CI], 1.09 to 1.41; P = .006) when adjusted for the baseline criterion measure. The adjusted percentage of couples using condoms consistently was higher in the intervention group (63%) than in the comparison group (48%; risk ratio, 1.45; 95% CI, 1.24 to 1.70; P < .001). The adjusted mean number of (log)unprotected intercourse acts was lower in the intervention group than in the comparison group (mean difference, -1.52; 95% CI, -2.07 to -0.98; P < .001). The cumulative STD incidence over the 12-month follow-up did not differ between couples in the intervention and comparison groups. The overall HIV seroconversion at the 12-month follow-up was 5 (2 in the intervention group, 3 in the comparison group) of 535 individuals, which translates to 935 per 100,000 population.To our knowledge, this is the first randomized controlled intervention trial to report significant reductions in HIV/STD risk behaviors among African American HIV serodiscordant couples.clinicaltrials.gov Identifier: NCT00644163.

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Effects of a social network HIV/STD prevention intervention for MSM in Russia and Hungary: a randomized controlled trial.

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Effects of a social network HIV/STD prevention intervention for MSM in Russia and Hungary: a randomized controlled trial.

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