This is a application to conduct a randomized controlled trial of a 4-session behavioral intervention (Project Enhance) to reduce unsafe sexual practices among HIV-infected men who have sex with men (MSM) who are in care at Fenway Community Health (FCH). FCH is the largest provider of HIV care for MSM in New England and has seen an increase in STDs in recent years, signifying continued sexual risk taking in this population. The intervention, delivered by a trained medical social worker, will include education, motivational and behavioral skills enhancement, and will be individualized; participants will undergo an initial assessment and then choose from a set of modules that are most relevant to their needs. Participants who receive the intervention also will receive FCH's standard prevention case management (PCM) from a medical social worker including referrals to specific services they require. The comparison group will receive PCM alone. Consistent with NIH guidelines for intervention development, we propose a staged approach testing the intervention. Building on our qualitative data and experience with risk reduction counseling and interventions for at-risk HIV-uninfected individuals (e.g. Project EXPLORE! and HIV vaccine studies), we will pilot the intervention during a 6-month startup phase. The pilot will evaluate its acceptability, the feasibility of recruitment, and potential for clinically significant results. Sessions will be audio taped and rated, and we will solicit expert consultant feedback on the intervention approach, as well as participant feedback before beginning the efficacy trial. In the efficacy trial, primary HIV-care medical providers will inform participants of the study during their regularly scheduled visit. Interested participants will complete a prescreen assessment with a research assistant about sexual risk taking. Those participants who have engaged in sexual risk taking as defined by any unprotected anal intercourse (except that with a monogamous seroconcordant partner) in the past 3 months will be randomized to either PCM alone or PCM plus the 4-session individualized intervention (the enhanced condition). Participants will then be followed every three months for one year, integrating PCM and/or prevention booster sessions to their HIV care visits.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH068746-05
Application #
7228802
Study Section
Special Emphasis Panel (ZMH1-NRB-W (07))
Program Officer
Grossman, Cynthia I
Project Start
2003-08-01
Project End
2009-04-30
Budget Start
2007-05-01
Budget End
2009-04-30
Support Year
5
Fiscal Year
2007
Total Cost
$532,493
Indirect Cost
Name
Fenway Community Health Center
Department
Type
DUNS #
072366156
City
Boston
State
MA
Country
United States
Zip Code
02215
Harkness, Audrey; Bainter, Sierra A; O'Cleirigh, Conall et al. (2018) Longitudinal Effects of Syndemics on ART Non-adherence Among Sexual Minority Men. AIDS Behav 22:2564-2574
O'Cleirigh, Conall; Magidson, Jessica F; Skeer, Margie R et al. (2015) Prevalence of Psychiatric and Substance Abuse Symptomatology Among HIV-Infected Gay and Bisexual Men in HIV Primary Care. Psychosomatics 56:470-8
O'Cleirigh, Conall; Dale, Sannisha K; Elsesser, Steven et al. (2015) Sexual minority specific and related traumatic experiences are associated with increased risk for smoking among gay and bisexual men. J Psychosom Res 78:472-7
Blashill, Aaron J; Wilson, Johannes M; O'Cleirigh, Conall M et al. (2014) Examining the correspondence between relationship identity and actual sexual risk behavior among HIV-positive men who have sex with men. Arch Sex Behav 43:129-37
Mayer, Kenneth H; Skeer, Margie R; O'Cleirigh, Conall et al. (2014) Factors associated with amplified HIV transmission behavior among American men who have sex with men engaged in care: implications for clinical providers. Ann Behav Med 47:165-71
O'Cleirigh, Conall; Traeger, Lara; Mayer, Kenneth H et al. (2013) Anxiety Specific Pathways to HIV Sexual Transmission Risk Behavior among Young Gay and Bisexual Men. J Gay Lesbian Ment Health 17:314-326
Safren, Steven A; O'Cleirigh, Conall M; Skeer, Margie et al. (2013) Project enhance: a randomized controlled trial of an individualized HIV prevention intervention for HIV-infected men who have sex with men conducted in a primary care setting. Health Psychol 32:171-9
Blashill, Aaron J; O'Cleirigh, Conall; Mayer, Kenneth H et al. (2012) Body mass index, depression and sexual transmission risk behaviors among HIV-positive MSM. AIDS Behav 16:2251-6
Mayer, Kenneth H; Bush, Timothy; Henry, Keith et al. (2012) Ongoing sexually transmitted disease acquisition and risk-taking behavior among US HIV-infected patients in primary care: implications for prevention interventions. Sex Transm Dis 39:1-7
Skeer, Margie R; Mimiaga, Matthew J; Mayer, Kenneth H et al. (2012) Patterns of substance use among a large urban cohort of HIV-infected men who have sex with men in primary care. AIDS Behav 16:676-89

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