Skip to main content

Advertisement

SpringerLink
Log in

A Randomized Pilot Study of a Group-Delivered HIV Risk Reduction Intervention for At-Risk Urban Men Who Have Sex with Men Who Regularly Attend Private Sex Events

  • Original Paper
  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript

Abstract

Across HIV prevention studies, as many as 25% of men who have sex with men (MSM) report meeting male partners at private sex events and attendance is associated with increased number of sexual partners, condomless anal sex (CAS), and HIV infection. Despite the need for effective HIV prevention interventions, no risk reduction interventions have been tested to reduce HIV sexual risk of MSM that regularly engage in sexual risk at private sex events. This randomized pilot study assessed the feasibility and acceptability of an HIV risk reduction intervention to reduce CAS among urban MSM (N = 14) reporting risk at a private sex event in the prior 12 months. The intervention arm received four group sessions (2 h/session) focusing on HIV risk reduction education and skills building. Both the intervention (n = 8) and control (n = 6) conditions received HIV testing and pre- and posttest risk reduction counseling and completed a sexual risk and psychosocial assessment visit at baseline and 3 months post-intervention. In addition, intervention participants completed a brief exit interview post-intervention. Mean age was 37 years, and 57% were racial/ethnic minorities. At follow-up, the intervention group reported greater reductions in sexual risk behavior in the past 3 months including number of CAS episodes, number of partners at private sex events, and CAS episodes at private sex events. The intervention group also reported reduced sexual compulsivity, increases in HIV disclosure, and reduced drug use at private sex events over study follow-up. Exit interviews revealed that participants found the intervention to be highly acceptable. Findings demonstrate feasibility of procedures, participant acceptability, and initial promise of a group-delivered HIV risk reduction intervention for MSM who attend and engage in CAS at private sex events. Further testing of this intervention in a larger pilot randomized controlled trial is warranted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Adam, B. D., Husbands, W., Murray, J., & Maxwell, J. (2005). AIDS optimism, condom fatigue, or self-esteem? Explaining unsafe sex among gay and bisexual men. Journal of Sex Research, 42(3), 238–248.

    Article  PubMed  Google Scholar 

  • Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897.

    Article  PubMed  Google Scholar 

  • Beck, A. T., & Steer, R. A. (1993). Beck Anxiety Inventory Manual. San Antonio, TX: The Psychological Corporation.

    Google Scholar 

  • Beyrer, C. (2008). Hidden yet happening: The epidemics of sexually transmitted infections and HIV among men who have sex with men in developing countries. Sexually Transmitted Infections, 84(6), 410–412.

    Article  PubMed  Google Scholar 

  • Binson, D., Woods, W. J., Pollack, L., Paul, J., Stall, R., & Catania, J. A. (2001). Differential HIV risk in bathhouses and public cruising areas. American Journal of Public Health, 91(9), 1482–1486. https://doi.org/10.2105/ajph.91.9.1482.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bouhnik, A.-D., Préau, M., Schiltz, M.-A., Peretti-Watel, P., Obadia, Y., Lert, F., & Spire, B. (2006). Unsafe sex with casual partners and quality of life among HIV-infected gay men: Evidence from a large representative sample of outpatients attending French hospitals (ANRS-EN12-VESPA). Journal of Acquired Immune Deficiency Syndromes, 42(5), 597–603.

    Article  PubMed  Google Scholar 

  • Buffum, J. (1988). Substance abuse and high-risk sexual behavior: Drugs and sex—The dark side. Journal of Psychoactive Drugs, 20(2), 165–168.

    Article  PubMed  Google Scholar 

  • Cassels, S., Menza, T. W., Goodreau, S. M., & Golden, M. R. (2009). HIV serostorting as a harm reduction strategy: Evidence from Seattle, Washington. AIDS, 23, 2497–2506.

    Article  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (2017). HIV in the United States: At a glance. Retrieved 21 May, 2018 from https://www.cdc.gov/hiv/statistics/overview/ataglance.html.

  • Clatts, M. C., Goldsamt, L. A., & Yi, H. (2005). An emerging HIV risk environment: A preliminary epidemiological profile of an MSM POZ Party in New York City. Sexually Transmitted Infections, 81(5), 373–376. https://doi.org/10.1136/sti.2005.014894.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Denning, P. (2001). Strategies for implementation of harm reduction in treatment settings. Journal of Psychoactive Drugs, 33(1), 23–26.

    Article  PubMed  Google Scholar 

  • Denning, P. (2004). Practicing harm reduction therapy: An alternative approach to addictions. New York: Guilford Press.

    Google Scholar 

  • DiClemente, C. C., Schlundt, D., & Gemmell, L. (2004). Readiness and stages of change in addiction treatment. American Journal on Addictions, 13(2), 103–119.

    Article  PubMed  Google Scholar 

  • Drucker, E., Lurie, P., Wodak, A., & Alcabes, P. (1998). Measuring harm reduction: The effects of needle and syringe exchange programs and methadone maintenance on the ecology of HIV. AIDS, 12(Suppl. A), S217–230.

    PubMed  Google Scholar 

  • Drumright, L. N., Little, S. J., Strathdee, S. A., Slymen, D. J., Araneta, M. R. G., Malcarne, V. L., et al. (2006). Unprotected anal intercourse and substance use among men who have sex with men with recent HIV infection. Journal of Acquired Immune Deficiency Syndromes, 43(3), 344–350.

    Article  PubMed  Google Scholar 

  • Duru, O., Collins, R., Ciccarone, D., Morton, S., Stall, R., Beckman, R., et al. (2006). Correlates of sex without serostatus disclosure among a national probability sample of HIV patients. AIDS and Behavior, 10(5), 495–507. https://doi.org/10.1007/s10461-006-9089-3.

    Article  PubMed  PubMed Central  Google Scholar 

  • Elwood, W. N., Greene, K., & Carter, K. K. (2003). Gentlemen don’t speak: Communication norms and condom use in bathhouses. Journal of Applied Communication Research, 31(4), 277–297. https://doi.org/10.1080/1369681032000132564.

    Article  Google Scholar 

  • Emmons, K. M., & Rollnick, S. (2001). Motivational interviewing in health care settings: Opportunities and limitations. American Journal of Preventive Medicine, 20(1), 68–74. https://doi.org/10.1016/s0749-3797(00)00254-3.

    Article  PubMed  Google Scholar 

  • Fleming, M. F., Barry, K. L., & MacDonald, R. (1991). The Alcohol Use Disorders Identification Test (AUDIT) in a college sample. International Journal of the Addictions, 26(11), 1173–1185.

    Article  PubMed  Google Scholar 

  • Frye, V., Latka, M., Koblin, B., Halkitis, P., Putnam, S., Galea, S., & Vlahov, D. (2006). The urban environment and sexual risk behavior among men who have sex with men. Journal of Urban Health, 83(2), 308–324. https://doi.org/10.1007/s11524-006-9033-x.

    Article  PubMed  PubMed Central  Google Scholar 

  • Greenwood, G. L., White, E. W., Page-Shafer, K., Bein, E., Osmond, D. H., Paul, J., & Stall, R. D. (2001). Correlates of heavy substance use among young gay and bisexual men: The San Francisco Young Men’s Health Study. Drug and Alcohol Dependence, 61(2), 105–112. https://doi.org/10.1016/s0376-8716(00)00129-0.

    Article  PubMed  Google Scholar 

  • Grov, C., Parsons, J., & Bimbi, D. (2007). Sexual risk behavior and venues for meeting sex partners: An intercept survey of gay and bisexual men in LA and NYC. AIDS and Behavior, 11(6), 915–926. https://doi.org/10.1007/s10461-006-9199-y.

    Article  PubMed  Google Scholar 

  • Grov, C., Parsons, J. T., & Bimbi, D. S. (2010). Sexual compulsivity and sexual risk in gay and bisexual men. Archives of Sexual Behavior, 39(4), 940–949.

    Article  PubMed  Google Scholar 

  • Hall, H. I., Song, R., Rhodes, P., Prejean, J., An, Q., Lee, L. M., et al. (2008). Estimation of HIV incidence in the United States. Journal of the American Medical Association, 300(5), 520–529.

    Article  PubMed  Google Scholar 

  • Hatzenbuehler, M. L. (2009). How does sexual minority stigma “get under the skin”? A psychological mediation framework. Psychological Bulletin, 135(5), 707–730.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hays, R., Merz, J., & Nicholas, R. (1995). Response burden, reliability, and validity of the CAGE, Short MAST, and AUDIT alcohol screening measures. Behavior Research Methods, 27(2), 277–280. https://doi.org/10.3758/bf03204745.

    Article  Google Scholar 

  • Herbst, J. H., Beeker, C., Mathew, A., McNally, T., Passin, W., Kay, L. S., et al. (2007). The effectiveness of individual-, group-, and community-level HIV behavioral risk-reduction interventions for adult men who have sex with men: A systematic review. American Journal of Preventive Medicine, 32(4 Suppl.), S38–S67.

    Article  PubMed  Google Scholar 

  • Herek, G. M., Gillis, J. R., & Cogan, J. C. (2009). Internalized stigma among sexual minority adults: Insights from a social psychological perspective. Journal of Counseling Psychology, 56(1), 32–43.

    Article  Google Scholar 

  • Kalichman, S. C., & Rompa, D. (1995). Sexual sensation seeking and sexual compulsivity scales: Validity, and predicting HIV risk behavior. Journal of Personality Assessment, 65(3), 586–601. https://doi.org/10.1207/s15327752jpa6503_16.

    Article  PubMed  Google Scholar 

  • Kelly, J., Murphy, D., Sikkema, K., McAuliffe, T., Roffman, R., Solomon, L., et al. (1997). Randomised, controlled, community-level HIV-prevention intervention for sexual-risk behaviour among homosexual men in US cities. Lancet, 350(9090), 1500–1505.

    Article  PubMed  Google Scholar 

  • Klausner, J. D., Wolf, W., Fischer-Ponce, L., Zolt, I., & Katz, M. H. (2000). Tracing a syphilis outbreak through cyberspace. Journal of the American Medical Association, 284(4), 447–449. https://doi.org/10.1001/jama.284.4.447.

    Article  PubMed  Google Scholar 

  • Lewis, M. A., DeVellis, B. M., & Sleath, B. (2002). Social influence and interpersonal communication in health behavior. In K. Glanz, B. K. Rimer, & F. M. Lewis (Eds.), Health behavior and health education: Theory, research, and practice (3rd ed., pp. 240–264). San Francisco: Wiley.

    Google Scholar 

  • Lyles, C. M., Kay, L. S., Crepaz, N., Herbst, J. H., Passin, W. F., Kim, A. S., et al. (2007). Best-evidence interventions: Findings from a systematic review of HIV behavioral interventions for US populations at high risk, 2000–2004. American Journal of Public Health, 97(1), 133–143.

    Article  PubMed  PubMed Central  Google Scholar 

  • Marlatt, G. A. (1998). Harm reduction: Pragmatic strategies for managing high-risk behaviors. New York: Guilford Press.

    Google Scholar 

  • Marlatt, G. A., Larimer, M. E., & Witkiewitz, K. (2011). Harm reduction, Second edition: Pragmatic strategies for managing high-risk behaviors. New York: Guilford Press.

    Google Scholar 

  • Mayer, K. H., Mimiaga, M. J., Cohen, D., Grasso, C., Bill, R., VanDerwarker, R., & Fisher, A. (2008). Tenofovir DF plus lamivudine or emtricitabine for nonoccupational postexposure prophylaxis (NPEP) in a Boston community health center. Journal of Acquired Immune Deficiency Syndromes, 47(4), 494–499.

    Article  PubMed  Google Scholar 

  • McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Education Quarterly, 15(4), 351–377.

    Article  PubMed  Google Scholar 

  • Miller, W. R., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change (2nd ed.). New York: Guilford Press.

    Google Scholar 

  • Mimiaga, M. J., Case, P., Johnson, C. V., Safren, S. A., & Mayer, K. H. (2009a). Pre-exposure antiretroviral prophylaxis (PrEP) attitudes in high risk Boston area MSM: Limited knowledge and experience, but potential for increased utilization after education. Journal of Acquired Immune Deficiency Syndromes, 50(1), 77.

    Article  PubMed  Google Scholar 

  • Mimiaga, M. J., Goldhammer, H., Belanoff, C., Tetu, A. M., & Mayer, K. H. (2007). Men who have sex with men: Perceptions about sexual risk, HIV and sexually transmitted disease testing, and provider communication. Sexually Transmitted Diseases, 34, 113–119.

    Article  PubMed  Google Scholar 

  • Mimiaga, M. J., Reisner, S. L., Bland, S., Cranston, K., Isenberg, D., Driscoll, M. A., et al. (2010a). “It’s a quick way to get what you want”: A formative exploration of HIV risk among urban Massachusetts men who have sex with men who attend sex parties. AIDS Patient Care and STDS, 24(10), 659–674.

    Article  PubMed  Google Scholar 

  • Mimiaga, M. J., Reisner, S. L., Bland, S. E., Driscoll, M. A., Cranston, K., Isenberg, D., et al. (2011). Sex parties among urban MSM: An emerging culture and HIV risk environment. AIDS and Behavior, 15(2), 305–318.

    Article  PubMed  Google Scholar 

  • Mimiaga, M. J., Reisner, S. L., Cranston, K., Isenberg, D., Bright, D., Daffin, G., et al. (2009b). Sexual mixing patterns and partner characteristics of Black MSM in Massachusetts at increased for HIV risk for HIV infection and transmission. Journal of Urban Health, 86(4), 602–623.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mimiaga, M. J., Reisner, S. L., Fontaine, Y.-M., Bland, S. E., Driscoll, M. A., Isenberg, D., et al. (2010b). Walking the line: Stimulant use during sex and HIV risk behavior among Black urban MSM. Drug and Alcohol Dependence, 110(1), 30.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mimiaga, M. J., Reisner, S. L., Tetu, A. M., Bonafide, K. E., Cranston, K., Bertrand, T., et al. (2009c). Partner notification after STD and HIV exposures and infections: Knowledge, attitudes, and experiences of Massachusetts men who have sex with men. Public Health Reports, 124(1), 111–119.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mimiaga, M. J., Reisner, S., Tetu, A., Cranston, K., Bertrand, T., Novak, D., & Mayer, K. (2009d). Psychosocial and behavioral predictors of partner notification after HIV and STI exposure and infection among MSM. AIDS and Behavior, 13(4), 738–745.

    Article  PubMed  Google Scholar 

  • Parsons, J. T., Schrimshaw, E. W., Wolitski, R. J., Halkitis, P. N., Purcell, D. W., Hoff, C. C., & Gómez, C. A. (2005). Sexual harm reduction practices of HIV-seropositive gay and bisexual men: Serosorting, strategic positioning, and withdrawal before ejaculation. AIDS, 19(Suppl. 1), S13–S25.

    Article  PubMed  Google Scholar 

  • Peterson, J. L., & Bakeman, R. (2006). Impact of beliefs about HIV treatment and peer condom norms on risky sexual behavior among gay and bisexual men. Journal of Community Psychology, 34(1), 37–46. https://doi.org/10.1002/jcop.20082.

    Article  Google Scholar 

  • Pollack, L. M., Osmond, D. H., Paul, J. P., & Catania, J. A. (2005). Evaluation of the Center for Disease Control and Prevention’s HIV behavioral surveillance of men who have sex with men: Sampling issues. Sexually Transmitted Diseases, 32(9), 581–589.

    Article  PubMed  Google Scholar 

  • Poppen, P. J., Reisen, C. A., Zea, M. C., Bianchi, F. T., & Echeverry, J. J. (2004). Predictors of unprotected anal intercourse among HIV-positive Latino gay and bisexual men. AIDS and Behavior, 8(4), 379–389.

    Article  PubMed  Google Scholar 

  • Preston, D. B., D’Augelli, A. R., Kassab, C. D., & Starks, M. T. (2007). The relationship of stigma to the sexual risk behavior of rural men who have sex with men. AIDS Education and Prevention, 19(3), 218–230. https://doi.org/10.1521/aeap.2007.19.3.218.

    Article  PubMed  Google Scholar 

  • Prochaska, J. O., & Velicer, W. F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12(1), 38–48.

    Article  PubMed  Google Scholar 

  • Purcell, D. W., Johnson, C. H., Lansky, A., Prejean, J., Stein, R., Denning, P., … Crepaz, N. (2012). Suppl 1: Estimating the population size of men who have sex with men in the United States to obtain HIV and syphilis rates. The Open AIDS Journal, 6, 98–107. https://doi.org/10.2174/1874613601206010098.

    Article  PubMed  PubMed Central  Google Scholar 

  • Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.

    Article  Google Scholar 

  • Reisner, S. L., Mimiaga, M. J., Case, P., Johnson, C. V., Safren, S. A., & Mayer, K. H. (2009a). Predictors of identifying as a barebacker among high-risk New England HIV seronegative men who have sex with men. Journal of Urban Health, 86(2), 250–262.

    Article  PubMed  Google Scholar 

  • Reisner, S. L., Mimiaga, M. J., Skeer, M., Vanderwarker, R., Gaucher, M. J., O’Connor, C. A., et al. (2009b). Differential HIV risk behavior among men who have sex with men seeking health-related mobile van services at diverse gay-specific venues. AIDS and Behavior, 13, 822–831.

    Article  PubMed  Google Scholar 

  • Rollnick, S., & Miller, W. R. (1995). What is motivational interviewing? Behavioural and Cognitive Psychotherapy, 23, 325–334.

    Article  Google Scholar 

  • Rose, V. J., Raymond, H. F., Kellogg, T. A., & McFarland, W. (2006). Assessing the feasibility of harm reduction services for MSM: The Late Night Breakfast Buffet Study. Harm Reduction Journal, 3, 29. https://doi.org/10.1186/1477-7517-3-29.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sallis, J. F., Owen, N., & Fisher, E. B. (2008). Ecological models of health behavior. In K. Glanz, B. K. Rimer, & K. Viswanath (Eds.), Health education and health education: Theory, research, and practice (pp. 465–486). San Francisco: Wiley.

    Google Scholar 

  • Sanchez, T., Finlayson, T., Drake, A., Behel, S., Cribbin, M., Dinenno, E., et al. (2006). Human immunodeficiency virus (HIV) risk, prevention, and testing behaviors—United States, National HIV Behavioral Surveillance System: Men who have sex with men, November 2003–April 2005. Morbidity and Mortality Weekly Report (MMWR), 55(SS6), 1–16.

    Google Scholar 

  • Semple, S. J., Patterson, T. L., & Grant, I. (2002). Motivations associated with methamphetamine use among HIV men who have sex with men. Journal of Substance Abuse Treatment, 22(3), 149–156.

    Article  PubMed  Google Scholar 

  • Shadish, W. R., Cook, T. D., & Campbell, D. T. (2002). Experimental and quasi-experimental designs for generalized causal inference. New York: Houghton Mifflin.

    Google Scholar 

  • Sinclair, M., McRee, B., & Babor, T. F. (1992). Evaluation of the reliability of AUDIT. Farmington: University of Connecticut School of Medicine, Alcohol Research Center.

    Google Scholar 

  • Taylor, M., Aynalem, G., Smith, L., Bemis, C., Kenney, K., & Kerndt, P. (2004). Correlates of internet use to meet sex partners among men who have sex with men diagnosed with early syphilis in Los Angeles county. Sexually Transmitted Diseases, 31(9), 552–556.

    Article  PubMed  PubMed Central  Google Scholar 

  • U.S. Department of Health and Human Services. (2004). CES-D Scale. Bethesda, MD: Department of Health and Human Services, National Institute of Health.

    Google Scholar 

  • Willoughby, B., Lai, B. S., Doty, N. D., Mackey, E. R., & Malik, N. M. (2008). Peer crowd affiliations of adult gay men: Linkages with health risk behaviors. Psychology of Men and Masculinity, 9(4), 235–247. https://doi.org/10.1037/1524-9220.9.4.235.

    Article  Google Scholar 

  • Wilson, P. A., Cook, S., McGaskey, J., Rowe, M., & Dennis, N. (2008). Situational predictors of sexual risk episodes among men with HIV who have sex with men. Sexually Transmitted Infections, 84(6), 506–508. https://doi.org/10.1136/sti.2008.031583.

    Article  PubMed  Google Scholar 

  • Xia, Q., Tholandi, M., Osmond, D. H., Pollack, L. M., Zhou, W., Ruiz, J. D., & Catania, J. A. (2006). The effect of venue sampling on estimates of HIV prevalence and sexual risk behaviors in men who have sex With men. Sexually Transmitted Diseases, 33(9), 545–550.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for Health Equity Research, Brown University, Providence, RI, USA

    Matthew J. Mimiaga & Jaclyn M. W. Hughto

  2. Departments of Behavioral and Social Health Sciences and Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA

    Matthew J. Mimiaga & Jaclyn M. W. Hughto

  3. Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, Providence, RI, USA

    Matthew J. Mimiaga & Jaclyn M. W. Hughto

  4. Department of Pediatrics, Harvard Medical School/Boston Children’s Hospital, Boston, MA, USA

    Sari L. Reisner

  5. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Sari L. Reisner

Authors
  1. Matthew J. Mimiaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jaclyn M. W. Hughto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sari L. Reisner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Matthew J. Mimiaga.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mimiaga, M.J., Hughto, J.M.W. & Reisner, S.L. A Randomized Pilot Study of a Group-Delivered HIV Risk Reduction Intervention for At-Risk Urban Men Who Have Sex with Men Who Regularly Attend Private Sex Events. Arch Sex Behav 48, 1059–1071 (2019). https://doi.org/10.1007/s10508-018-1326-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-018-1326-0

Keywords

Search

Navigation