African American men who have sex with men and women (AAMSMW) are at particular risk for contracting and transmitting HIV, and represent a priority population for developing effective interventions. Despite the urgent need for effective prevention approaches for AAMSMW, to our knowledge no evidence-based HIV interventions have been developed and tested for this population. The proposed study is a randomized controlled trial of the Bruthas Project, an individual-level HIV prevention intervention, which builds on standardized HIV counseling and testing. Delivered in a series of four sessions by trained African American male counselors, the BP focuses on reviewing HIV transmission routes for male and female partners, strengthening sexual communication skills with both male and female partners, and improving condom use skills and other safer sex negotiation strategies. A randomized controlled trial of BP is necessary to determine the efficacy of the intervention and can lead to improved public health efforts at reducing HIV risk behavior among AAMSMW and in the African American community more generally. To evaluate the effect of the BP, we will recruit and enroll a cohort of 400 AAMSMW who will be randomly assigned to either the intervention condition, in which they will be offered BP, or to the comparison condition, in which they will receive standardized HIV testing and counseling with referral to case management. We will follow the cohort over 9 months and will assess participants at three time points: baseline, 3 months follow-up, and 6 months follow- up.
The need to respond to the HIV epidemic in the African American community is a national public health priority. Men account for more than half of HIV infections among African Americans. We have worked diligently over the past four years to develop a HIV prevention intervention for African American men who have sex with men and women (AAMSMW), the Bruthas Project. No controlled intervention studies to date have proven to be effective in significantly lowering HIV-related risk behavior for AAMSMW. Given the urgency of the epidemic among African Americans in general, and African American MSM in particular, a large scale randomized controlled trial is urgently needed to test the efficacy of this promising HIV prevention intervention for these men, and if it is found to be effective, to move it quickly into practice.