The objective of this proposal is to conduct formative research to aid in the identification and evaluation of effective programs to reduce the risk for HIV among men who have sex with men (MSM) and who are at least 50 years of age (50+ MSM). It will be conducted in the San Francisco Bay Area which has a high prevalence HIV among MSM over 50. These levels are well documented as comparable to other major US cities. The current study tailors and refines for transfer and future fielding and evaluation a theory-driven community-level intervention identified as successful with younger MSM (The Mpowerment Project). It will accomplish these goals by: 1) focusing on samples of 50+ MSM drawn from representative samples of MSM participating in the Urban Men's Health Studies and subsamples of their friendship networks. The current study will expand the representation of MSM of color by oversampling racial/ethnic minority MSM; 2) employing qualitative methods (focus groups and focused interviews) to identify 50+ MSM's unique HIV risks and related contexts, their knowledge/ attitudes about HIV and sexual behavior, pressing concerns in their lives, and their sources and channels of communication; 3) using qualitative methods (focus groups and focused interviews) to develop a structured survey to be used in future community-level prevention intervention outcome studies with this population, and subsequently to test the structured instrument in a representative sample of older MSM; and 4) making use of the Mpowerment Project's principles in tandem with a cultural adaptation framework to guide the qualitative inquiry, structured questionnaire development and intervention transfer.
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