Efficacy of a culturally congruent HIV risk-reduction intervention for behaviorally bisexual black men: Results of a randomized trial

Nina T. Harawa, John K. Williams, W. J. McCuller, Hema C. Ramamurthi, Martin Lee, Martin F. Shapiro, Keith C. Norris, William E. Cunningham

Research output: Contribution to journalArticle

Abstract

Objectives: Black men who have sex with men and women (MSMW) experience high HIV rates and may not respond to interventions targeting gay-identified men. We tested the efficacy of the Men of African American Legacy Empowering Self (MAALES), a multisession, small-group holistically framed intervention designed to build skills, address sociocultural issues, and reduce risk behaviors in black MSMW. Design: From 2007 to 2011, we enrolled 437 black MSMW into a parallel randomized controlled trial that compared MAALES to the control condition, a single, individualized HIV risk-reduction session. Methods: Participants completed surveys at baseline, 3 months, and 6 months postintervention. We used multiple regressions to compare risk behaviors at follow-up between the intervention and control groups while adjusting for baseline risk behaviors, time between assessments, other covariates, and clustering. We used inverse probability weighting (IPW) to adjust for loss-to-follow-up while carrying out these regressions with the 291 (76.4%) randomized participants who completed at least one follow-up. Results: Participants were largely low-income (55% reported monthly incomes <$1000); nearly half had previously tested HIV positive. At 6 months of follow-up, unadjusted within-group analyses demonstrated reduced risk behaviors for the MAALES but not the control group. Adjusted results indicated significant intervention-associated reductions in the numbers of total anal or vaginal sex acts [risk ratio=0.61; 95% confidence interval (CI) 0.49-0.76], unprotected sex acts with women (risk ratio=0.50; 95% CI 0.37-0.66), and female partners (risk ratio=0.56; 95% CI 0.44-0.72). Near significant reductions were observed for number of male intercourse partners. Conclusion: The MAALES intervention was efficacious at reducing HIV risk behaviors in black MSMW.

Original languageEnglish (US)
Pages (from-to)1979-1988
Number of pages10
JournalAIDS
Volume27
Issue number12
DOIs
StatePublished - Jul 31 2013
Externally publishedYes

Keywords

  • African-Americans/ethnology/psychology
  • Bisexuality
  • Black/African-American
  • HIV infections/epidemiology/ethnology/ prevention & control
  • Homosexuality
  • Risk-reduction behavior

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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    Harawa, N. T., Williams, J. K., McCuller, W. J., Ramamurthi, H. C., Lee, M., Shapiro, M. F., Norris, K. C., & Cunningham, W. E. (2013). Efficacy of a culturally congruent HIV risk-reduction intervention for behaviorally bisexual black men: Results of a randomized trial. AIDS, 27(12), 1979-1988. https://doi.org/10.1097/QAD.0b013e3283617500