A randomized social network HIV prevention trial with young men who have sex with men in Russia and Bulgaria
| Autor: | Judit Takács, Timothy L. McAuliffe, Jeffrey A. Kelly, Yuri A. Amirkhanian, Laszlo Mocsonaki, Sylvia Vassileva, Elena Kabakchieva, Wayne DiFranceisco, Anna V Kirsanova, Roman A. Khoursine |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Gerontology Immunology Population Psychological intervention HIV Infections Russia Men who have sex with men Condoms Social support Risk-Taking Patient Education as Topic Acquired immunodeficiency syndrome (AIDS) Risk Factors Humans Immunology and Allergy Medicine Homosexuality Male Bulgaria education education.field_of_study Unsafe Sex Social network business.industry Behavior change Social Support Patient Acceptance of Health Care medicine.disease Infectious Diseases business Risk assessment Attitude to Health |
| Zdroj: | AIDS. 19:1897-1905 |
| ISSN: | 0269-9370 |
| Popis: | Objective: To evaluate the effects of an HIV prevention intervention with social networks of young men who have sex with men (YMSM) in St. Petersburg Russia and Sofia Bulgaria. Design: A two-arm randomized trial with a longitudinally-followed community cohort. Methods: Fifty-two MSM social networks were recruited through access points in high-risk community venues. Network members (n = 276) were assessed to determine risk characteristics administered sociometric measures to empirically identify the social leader of each network and counseled in risk reduction. The leaders of 25 experimental condition networks attended a nine-session program that provided training and guidance in delivering ongoing theory-based HIV prevention advice to other network members. Leaders successively targeted network members’ AIDS risk- related knowledge and risk reduction norms attitudes intentions and self- efficacy. Participants were re-administered risk assessment measures at 3- and 12-month follow-ups. Results: Among changes produced the percentage of experimental network members reporting unprotected intercourse (UI) declined from 71.8 to 48.4% at 3-month follow up (P = 0.0001). The percentage who engaged in UI with multiple partners reduced from 31.5 to 12.9% (P = 0.02). After 12 months the effects became attenuated but remained among participants who had multiple recent sexual partners the most vulnerable group. Little change was found in control group networks. Conclusions: Interventions that engage the identified influence leaders of at-risk YMSM social networks to communicate theory-based counseling and advice can produce significant sexual risk behavior change. This model is culturally pertinent for HIV prevention efforts in former socialist countries as well as elsewhere for other hard-to-reach vulnerable community populations. (authors) |
| Databáze: | OpenAIRE |
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