In the US, the highest rates of HIV infection are among Black men who have sex with men (MSM). According to the CDC National HIV Behavioral Surveillance system (NHBS) in 2004-5, Baltimore had the highest HIV rates among Black MSM with prevalence of 51% and an incidence rates estimated to be 8% per year. In the 2008 NHBS survey of Black MSM, 45% were positive. There is also an alarmingly high rate of seropositive Black MSM who are not aware of their positive HIV status. The percent of positive Black MSM in the Baltimore NHBS survey who reported that they were unaware of their serostatus was 64% in 2004-5 and 77% in 2008. There is a dearth of Interventions that have demonstrated efficacy or effectiveness in reducing HIV risk behaviors among Black MSM. Many researchers have documented the importance of developing and tailoring HIV prevention programs to issues unique to Black MSM. Based on the process evaluation findings from our recent pilot HIV prevention intervention for Black MSM and using a randomized clinical trial design, we plan to randomize 360 Black MSM to either a 6-session Peer Health Educator intervention condition or an equal attention control condition. We have designed the experimental intervention to provide Black MSM an opportunity to perform a positive social role of peer health educator. This role allows for HIV preventive advocacy and practices without focusing on stigmatizing identities or behaviors, such as HIV seropositive or current drug use status. The primary goal of the proposed intervention is to increase HIV risk reduction among Black MSM and increase VCT, risk reduction, and access to HIV medical care among their risk network members. Peer Health Educators will be encouraged to recruit up to 5 sex partners and other Black MSM for VCT. The first 2 network members who receive VCT will be invited to the longitudinal study. It is anticipated that on average 1.5 risk network members will enroll in the longitudinal study. Thus, the sample will be 360 Index participants and 540 network members. We will follow-up both index and network participants' in six- month intervals for 18 months. The main outcomes will be HIV sexual risk behaviors and number of network members recruited for VCT. Mediating social environmental and individual level factors will also be assessed. As illicit drug use among Black MSM is a risk factor for HIV and there are high rates of drug use among MSM in Baltimore, we propose stratifying recruitment by drug use, with half of the index participants being current users of cocaine, crack, methamphetamines or non-prescription opiates.

Public Health Relevance

There is an urgent need for effective behavioral interventions for HIV prevention, testing, and medical care for Black MSM. The proposed intervention is designed to promote and diffuse HIV risk reduction and VCT and reach a diverse group of Black MSM and their risk partners. This intervention has been designed to be low cost, sustainable, and feasible for health departments and community-based organizations to implement. It is also designed to be culturally appropriate for Black urban MSM and their network members.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA031030-05
Application #
8812785
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Jenkins, Richard A
Project Start
2011-04-01
Project End
2017-03-31
Budget Start
2015-04-01
Budget End
2017-03-31
Support Year
5
Fiscal Year
2015
Total Cost
Indirect Cost
Name
Johns Hopkins University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21205
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Tobin, Karin; Edwards, Catie; Flath, Natalie et al. (2018) Acceptability and feasibility of a Peer Mentor program to train young Black men who have sex with men to promote HIV and STI home-testing to their social network members. AIDS Care 30:896-902
Sun, Christina J; Tobin, Karin; Spikes, Pilgrim et al. (2018) Correlates of same-sex behavior disclosure to health care providers among Black MSM in the United States: implications for HIV prevention. AIDS Care :1-8
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Jennings, Jacky M; Reilly, Meredith L; Perin, Jamie et al. (2015) Sex Partner Meeting Places Over Time Among Newly HIV-Diagnosed Men Who Have Sex With Men in Baltimore, Maryland. Sex Transm Dis 42:549-53
King, Kelly M; Latkin, Carl A; Davey-Rothwell, Melissa A (2015) Love on lockdown: how social network characteristics predict separational concurrency among low income African-American women. J Urban Health 92:460-71

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