We propose an integrated behavioral intervention aimed at both the promotion of alcohol abstinence and the consistent use of safer sexual behaviors. This intervention will be evaluated with HIV seropositive (HIV+) men who have sex with men (MSM) who are alcohol abusers or alcohol dependent. The overall goal for the proposed study is to reduce the sexual transmission of HIV. The objectives are (1) to recruit and enroll a tri-ethnic (African-American, Latino and White) sample of 300 alcohol abusing/dependent HIV+ MSM in the New York City metropolitan area; (2) to test the efficacy and effectiveness of a theoretically-based alcohol-related HIV risk reduction intervention for eligible participants; (3) to promote two target behaviors (alcohol abstinence and safer sexual behaviors) among treatment group participants; (4) to prevent relapse and temptation to relapse from alcohol abstinence and safer sex behaviors among those participants currently in the maintenance stages for these behaviors; and (5) to impact decisional balance and improve self-efficacy for the target behaviors and to foster peer support for the target behaviors. The proposed intervention will utilize the Transtheoretical Model (TM). The TM recognizes that behavior change is not a dichotomous phenomenon, but instead proceeds through a series of stages of change (SOC). The intervention will consist of 10 weekly sessions designed to promote the two target behaviors. The first two individual counseling sessions will utilize Motivational Enhancement Therapy (MET) and focus on alcohol use. The next six sessions will utilize the TM and HIV risk reduction activities based on processes of change (POC) in a group therapy setting to promote safer sexual behaviors. Participants will then complete two additional individual MET sessions to focus on reinforcement for progression along the SOC and relapse prevention for the two target behaviors. Participants will be recruited through active and passive recruitment strategies from mainstream gay venues, alcohol treatment programs, and AIDS service organizations. Participants will be randomly assigned to the treatment or control conditions. Participants will complete assessment batteries at intake, and at 1-week, 3, 6, 9, and 12 month follow-ups in order to assess short-term and long-term effects.
