YMSM in relationships with other men face unique and compounded risk factors for both drug use and HIV infection. Their vulnerability is unique from older MSM, unpartnered MSM and their heterosexual peers. This enhanced vulnerability emerges as exactly the developmental period when the establishment of romantic relationships emerges as salient. Despite their unique vulnerability for HIV infection and challenges related to drug use, there are very few couples- based intervention options for YMSM. There are presently no brief, couples-based interventions which integrate a focus on drug use and HIV prevention. The proposed study is geared toward the development of such an intervention. The only individually delivered intervention for YMSM to show significant reductions in both drug use and sexual HIV transmission risk behavior, the Young Men?s Health Project (YMHP) was developed by members of this research team. YMHP focused on sexual risk in the context of casual partners. Beginning with this framework, our team has completed the initial stages of revising YMHP for use with couples, resulting in the creation of the Couple?s Health Project (CHP). Our formative work suggests that the prototype intervention is feasible and acceptable to participants. The next step is to develop components of the intervention which address pre- exposure prophylaxis (PrEP) uptake and to determine how best to integrate biological testing for STI?s and drug use into the study. The new intervention will be informed by qualitative data gathered from intervention sessions delivered in our formative work and from qualitative interviews conducted with 20 HIV negative partnered YMSM. The final 28 months of the project are devoted to a randomized controlled trial (RCT) comparing CHP to an attention-matched educational control condition. The study team is led by Dr. Tyrel J. Starks (PI), a new investigator with substantial experience in the study of gay male couples. He has collaborated on numerous projects examining the nature of sexual agreements and their association with substance use and HIV transmission risk behavior. He is supported by a study team which includes Dr. Jeffrey Parsons, the PI of the original YMHP study. The team brings extensive experience in quantitative and qualitative data analysis, HIV prevention research, and specifically intervention development.
? Public Health Significance HIV prevention strategies that address the specific needs of YMSM in stable relationships with other men are needed in response to accumulating evidence which points to the unique vulnerability of these men. The proposed project builds upon an effective individual intervention, the Young Men?s Health Project, to develop a couples-based intervention which addresses drug use and sexual HIV transmission risk among partnered HIV negative YMSM (ages 18-29). Preliminary work by our research team has produced a prototype manual, and provided compelling evidence of feasibility and acceptability. The proposed project will revise this prototype manual to enhance the focus on pre-exposure prophylaxis (PrEP) and to incorporate biological testing for drug use and STIs into the study. During Phase II, a small randomized controlled trial (RCT) involving 50 couples will test the feasibility, acceptability, and preliminary efficacy of the new intervention relative to an attention-matched educational control.
|Starks, Tyrel J; Doyle, Kendell M; Shalhav, Ore et al. (2018) An Examination of Gay Couples' Motivations to Use (or Forego) Pre-exposure Prophylaxis Expressed During Couples HIV Testing and Counseling (CHTC) Sessions. Prev Sci :|
|Starks, Tyrel J; Millar, Brett M; Doyle, Kendell M et al. (2018) Motivational interviewing with couples: A theoretical framework for clinical practice illustrated in substance use and HIV prevention intervention with gay male couples. Psychol Sex Orientat Gend Divers 5:490-502|