: African Americans are disproportionately affected by HIV/AIDS, and this disparity is further evident among bisexually-active African American men (BAAM).Yet, there is insufficient knowledge regarding sexual risk behaviors of BAAM and the context in which they occur. To date, no interventions in the literature with demonstrated efficacy in reducing HIV-related sexual risk behaviors have been developed and evaluated for BAAM who do not inject drugs. The proposed study will develop and test the efficacy and acceptability of an innovative individually-tailored and culturally-sensitive 6-session online-delivered video intervention that simultaneously targets multiple domains of socio-cultural, structural-level factors, and contextual factors related to HIV risk behavior among BAAM, relative to an attention control (education) condition. This intervention is theoretically informed both in content (using the Information-Motivation-Behavior Skills model) and delivery (using tenets of Social Cognitive theory) and will feature peer BAAM. Both behavioral and biologic outcomes will be measured. Using respondent-driven sampling, a total of 120 BAAM will be enrolled and randomly assigned to either treatment or education-control conditions. They will be longitudinally tracked for six months (assessed at Baseline, month 3, and month 6). In addition to determining the prevalence of lifetime and recent HIV-associated risk behavior among BAAM, this study seeks to evaluate the impact of a brief intervention across three domains over time: (1) intentions/motivations to reduce HIV-associated risk behavior, (2) self-reported HIV-associated risk behavior, and (3) health/prevention knowledge and self-efficacy skills. The long term goal of the proposed project is to develop an empirically validated HIV/STI prevention program that can be delivered online BAAM. Consistent with the R34 mechanism, the final product will be the basis for an R01 application to conduct a large-scale efficacy study in this population. Should this intervention demonstrate effective, it will be a cost feasible approach to preventing HIV transmissions among BAAM, delivered via the medium where many men who have sex with men (including BAAM) actively meet sex partners (i.e., the Internet). Finally, the model for this intervention can easily be adopted by HIV service providers and delivered outside of traditional clinical setting with a variety of populations.
The findings of this study will facilitate a more nuanced understanding of HIV-associated risk behaviors of bisexually-active African American men (BAAM) and the context in which they occur, which will, in turn, inform prevention and intervention efforts. Specifically, the findings will inform HIV prevention, interventions, and treatments designed to reduce HIV associated risk behaviors. And should the intervention demonstrate effective, it will be a cost feasible approach to preventing HIV transmissions that can easily be adopted by HIV service providers and delivered outside of traditional clinical setting with a variety of high-risk populations.
