Demonstration and Evaluation of a Peer-Delivered, Individually-Tailored, HIV Prevention Intervention for HIV-Infected MSM in their Primary Care Setting Authors
First Online: 18 September 2010 DOI:
Cite this article as: Safren, S.A., O’Cleirigh, C., Skeer, M.R. et al. AIDS Behav (2011) 15: 949. doi:10.1007/s10461-010-9807-8 Abstract
Employing HIV-infected peer counselors in secondary prevention interventions for MSM is appealing for scalable interventions. One-hundred-seventy-six HIV-infected MSM at their primary care facility participated in a secondary HIV-prevention study delivered by HIV-infected MSM peers. Of those who entered the intervention and completed the initial intake, 62% completed all four of the intervention sessions, and 93% completed at least one. While there was no overall change in transmission risk behavior (TRB) for the whole sample, among those who reported HIV TRB at baseline (
n = 29), there were significant reductions in TRB over the next year. Themes that emerged in qualitative exit interviews conducted with a subset of participants centered on peer counselor quality, intervention implications, and intervention experience. This demonstration project provides initial evidence for the ability to recruit HIV-infected MSM in care into a peer-based intervention study, and shows how a peer-based intervention can be delivered in the context of HIV care. Keywords Secondary prevention Peer-based Prevention in treatment settings HIV transmission risk behavior Electronic supplementary material
The online version of this article (doi:
) contains supplementary material, which is available to authorized users. 10.1007/s10461-010-9807-8 References
Centers for Disease Control and Prevention. HIV/AIDS surveillance report, 2005, vol 17, Rev ed. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta; 2007.
Gay CL, Kashuba AD, Cohen MS. Using antiretrovials to prevent HIV transmission. In: Mayer KH, Pizer HF, editors. HIV prevention: a comprehensive approach. Amsterdam, Netherlands: Academic Press, Elsevier Inc; 2009.
Marks G, Crepaz N, Janssen R. Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA. AIDS. 2006;20:1447–50.
Klitzman R. Self-disclosure of HIV serostatus to sexual partners: A qualitative study of issues faced by gay men. J Gay Lesbian Med Assoc. 1999;3:39–49.
Klitzman R, Bayer R. Mortal secrets: truth and lies in the age of AIDS. Baltimore, MD: Johns Hopkins University Press; 2003.
Sheon N, Crosby GM. Ambivalent tales of HIV disclosure in San Francisco. Soc Sci Med. 2004;58(11):2105–18.
Driskell JR, Salomon E, Mayer K, Capistrant B, Safren SA. Barriers and facilitators of HIV disclosure: perspectives from HIV-infected men who have sex with men. J HIV AIDS Soc Serv. 2008;7(2):135–56.
Wolitski RJ, Bailey CJ, O’Leary A, Gomez C, Parsons JT, Seropositive Urban Men’s Study (SUMS). Self-perceived responsibility of HIV-seropositive men who have sex with men for preventing HIV transmission. AIDS Behav. 2003;7(4):363–72.
Romanelli F, Smith KM, Pomeroy C. Use of club drugs by HIV-seropositive and HIV-seronegative gay and bisexual men. Top HIV Med. 2003;11(1):25–32.
Drumright LN, Little SJ, Strathdee SA, Slymen D, et al. Unprotected anal intercourse and substance use among men who have sex with men with recent HIV infection. J Acquir Immune Defic Syndr. 2006;43(3):344–50.
Parsons JT, Halkitis PN, Wolitski RJ, Gómez CA, Seropositive Urban Men’s Study Team. Correlates of sexual risk behaviors among HIV-positive men who have sex with men. AIDS Educ Prev. 2003;15(5):383–400.
Niccolai LM, D’Entremont D, Pritchett EN, Wagner K. Unprotected intercourse among people living with HIV/AIDS: the importance of partnership characteristics. AIDS Care. 2006;18(7):801–7.
Elwood W, Greene K, Carter K. Gentlemen don’t speak: communication norms and condom use in bathhouses. J Appl Commun Res. 2003;31(4):277–97.
Kelly BC, Bimbi DS, Izienicki H, Parsons JT. Stress and coping among HIV-positive barebackers. AIDS Behav. 2009;13(4):792–7.
Gorbach PM, Holmes KK. Transmission of STIs/HIV at the partnership level: beyond individual-level analyses. J Urban Health. 2003;80(Suppl 3):iii15–25.
Mayer KH, Safren SA, Gordon CM. HIV care providers and prevention: opportunities and challenges. J Acquir Immune Defic Syndr. 2004;37(Suppl 2):S130–2.
Hammer SM, Eron JJ Jr, Reiss P, et al. Antiretroviral treatment of adult HIV infection: 2008 recommendations of the International AIDS Society-USA panel. JAMA. 2008;300(5):555–70.
Crepaz N, Lyles CN, Wolitski RJ, et al. Do prevention interventions reduce HIV risk behaviours among people living with HIV? A meta-analytic review of controlled trials. AIDS. 2006;20(2):143–57.
Fogarty LA, Heilig CM, Armstrong K, et al. Long-term effectiveness of a peer-based intervention to promote condom and contraceptive use among HIV-positive and at-risk women. Public Health Rep. 2001;116(Suppl 1):103–19.
Wolitski RJ, Gómez CA, Parsons JT. Effects of a peer-led behavioral intervention to reduce HIV transmission and promote serostatus disclosure among HIV-seropositive gay and bisexual men. AIDS. 2005;19(Suppl 1):S99–109.
Bradford JB, Coleman S, Cunningham W. HIV system navigation: an emerging model to improve HIV care access. AIDS Patient Care STDs. 2007;21(Suppl 1):S49–58.
West SG, Duan N, Pequegnat W, et al. Alternatives to the randomized controlled trial. Am J Public Health. 2008;98(8):1359–66.
Bonell CP, Hargreaves JR, Cousens SN, et al. Alternatives to randomization in the evaluation of public-health interventions: design challenges and solutions.
J Epidemiol Community Health. 2009 Feb 12. [Epub ahead of print].
Fisher JD, Fisher WA. Changing AIDS-risk behavior. Psychol Bull. 1992;111(3):455–74. Review.
Mayer K, Appelbaum J, Rogers T, Lo W, Bradford J, Boswell S. The evolution of the Fenway community health model. Am J Public Health. 2001;91:892–4.
Knauz RO, Safren SA, O’Cleirigh C, et al. Developing an HIV-prevention intervention for HIV-infected men who have sex with men in HIV care: project enhance. AIDS Behav. 2007;11(Suppl 5):S117–26. Epub 2007 Jun 26.
Koblin BA, Chesney MA, Husnik MJ, et al. High-risk behaviors among men who have sex with men in 6 US cities: baseline data from the EXPLORE study.
Am J Public Health. 2003;93(6):926–32. Erratum in: Am J Public Health. 2003;93(8):1203.
Hilbe JM. Negative binomial regression. Cambridge, UK: Cambridge University Press; 2007.
Strauss A, Corbin JM. Basics of qualitative research: grounded theory procedures and techniques. Thousand Oaks CA, US: Sage Publications Inc; 1990.
Padgett DK. Qualitative methods in social work research: challenges and rewards. Thousand Oaks, CA: Sage Publications Inc; 1998.
Denzin NK. The research act: a theoretical introduction to sociological methods. 2nd ed. New York, NY: McGraw-Hill; 1978.
Padgett DK. Qualitative methods in social work research. 2nd ed. Thousand Oaks, CA: Sage Publications Inc; 2008.
O’Cleirigh C, Skeer MR, Mayer KH, Ripton J, Safren SA. Mental health and substance abuse problems among HIV-infected men who have sex with men. Manuscript under review.
Skeer MR, Mimiaga MJ, Mayer KH, O’Cleirigh C, Covahey C, Safren SA. Patterns of substance use among a large urban cohort of HIV-infected men who have sex with men in primary care. Manuscript under review.
Driskell JR, O’Cleirigh CO, Covahey C, Ripton J, Mayer KH, Perry D, et al. Building program acceptability: Perceptions of gay and bisexual men to peer or prevention case manager relationships in secondary HIV prevention counseling. J Gay Lesbian Soc Serv. 2010;22(3):269–96.
CrossRef Copyright information
© Springer Science+Business Media, LLC 2010