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What We Have Learned...1990-1995

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COMMUNITY-BASED FORMATIVE AND INTERVENTION RESEARCH

The operating assumption of community-based research is that persons acquire information, form attitudes, develop beliefs, acquire skills, and practice behaviors within the normative context of the social networks or systems of which they are a part. The shared social networks or systems (communities) can be defined geographically, behaviorally, and/or culturally.

Community-based formative research identifies and describes structural, environmental, behavioral, social, and psychological factors influencing the STD/HIV infection risk of a target population. The norms of the community in which the target population participates are determined. Formative research also identifies social and communications networks and gatekeepers within the community.

Community-based intervention research develops and evaluates methods to promote healthy behaviors among persons in a community who share risk behaviors for STD/HIV infection by influencing social norms and using social networks to consistently deliver HIV risk reduction interventions to the subpopulations at risk. Community-based interventions involve members of the community as the agents as well as the audience for the intervention, employ explicit messages tailored to the specific community, and are provided primarily in the audience's own environment. The interventions can take several forms (i.e., persuasive behavior change messages, skills building training, behavioral risk assessment) and can be delivered within a community in several ways (i.e., role model stories, street outreach, peer education, counseling). Community-based intervention research is sometimes referred to as community-level research.

Project: #14 The AIDS Community Demonstration Projects (ACDP)

Purpose:

To determine the effectiveness of a theory-based, community-level intervention for promoting risk reduction behaviors among several populations at high risk for HIV infection: injecting drug users (IDU), female sex partners of IDU, men who have sex with men but do not self-identify as gay, sex traders (women who trade sex for money or drugs), street youth, and communities with high rates of sexually transmitted diseases.

Results:

Implementation

In each of five cities, pamphlets were produced which featured role model stories based on the experiences of actual community members who were trying to practice safer behaviors (consistent condom use with main or other partners or, among IDU, consistent use of bleach to clean injecting equipment). These media materials, condoms, and bleach kits were distributed within the communities and their message reinforced by persons recruited by the projects including peers, other community residents, and local businesses. Content of the stories was influenced by behavioral theory and data that was collected in the intervention communities. During the final year of intervention, across cities the average per month of materials distributed in the intervention communities ranged from 1300 to 8000. In some cities, peers were recruited to distribute all or the majority of materials, while in others most of the materials were distributed at local businesses. The length of time individuals participated in the peer networks ranged from 3 weeks to more than 2 years, with an average of 3-6 months. According to project staff, individuals said they participated in the project to help the community, to receive the incentives offered by the project, and to spend time with staff.

Outcome

To date, baseline data and outcome data from the first two years of the project (July 1991-August 1993) have been analyzed. During the firstyear, less than 20% of respondents in the intervention communities reported seeing something or talking to someone related to the projects. In the second year, the percentage of respondents reporting exposure to the intervention ranged from 21% of non-gay identifying men who have sex with men, to 54% of sex traders.

Preliminary results using the stage of change (SOC) model indicate that more progress was made in the intervention areas than in the comparison areas toward adopting consistent condom use with main and other partners as well as toward consistent bleach use among IDU. The proportion of respondents carrying condoms also increased faster in the intervention areas than in the comparison areas. The divergence was statistically significant for condom carrying, condom use for vaginal sex with other partners, and bleach use.

Furthermore, it appears reasonable to attribute this divergence to the intervention, since intervention area respondents who recall exposure to the ACDP intervention are further along the stages of change toward consistent condom use, and are more likely to be carrying a condom at the time of interview, than those who do not recall exposure. The difference is statistically significant for carrying condoms, for condom use with main and other partners, and for bleach use.

Analysis of final outcome data (September 1993-June 1994) and site-specific outcomes are in progress.

Implications:

Community-level interventions using peers are feasible and appear to be effective at promoting HIV risk reduction behaviors. It is possible to recruit and retain persons in high risk populations to deliver HIV prevention messages within their community. Volunteers initially were recruited by outreach workers and later by current volunteers through word-of-mouth. Incentives (both monetary and non-monetary) and frequent positive reinforcement from program staff may be important in maintaining their participation. However, because the average duration of participation in these projects was 3-6 months, programs using this model may need to allow for continuous recruitment of new persons to deliver intervention messages.

A substantial proportion of at-risk individuals who are often considered hard-to-access can be successfully reached and motivated to change their behavior using this approach. However, it takes time to establish exposure to the intervention among community members, and saturation of the intervention communities with prevention messages about practicing specific protective behaviors (e.g., consistent condom use with non-main partners) appears to be important for success.

The development, implementation, and evaluation of HIV prevention interventions should be guided by behavioral and social science theory as well as formative research data collected prior to the intervention. Qualitative and quantitative data on the implementation of the intervention is useful for modifying the intervention to be responsive to changes in the community as well as for evaluating the effectiveness of the intervention.

Publications:

CDC. NCPS AIDS Community Demonstration Projects: What We Have Learned, 1985-1990. 1992. Atlanta: US Department of Health and Human Services, Public Health Service.

Corby NH, Wolitski RJ, Thornton-Johnson S, Tanner WM. AIDS knowledge, perception of risk, and behaviors among female sex partners of injection drug users. AIDS Education and Prevention 1991; 3:353-366.

Freeman A, Krepcho M. A Community-level intervention program for HIV prevention. Dallas Medical Journal 1993;(January):39-41.

Guenther-Grey C, Tross S, McAlister A, Freeman A, et al. AIDS Community Demonstration Projects: implementation of volunteer networks for HIV prevention programs--selected sites, 1991-1992. MMWR 1992; 41(46):868-69, 875-76.

Krepcho M, Fernandez-Esquer ME, Freeman AC, et al. Predictors of bleach use among current African-American injecting drug users: a community study. Journal of Psychoactive Drugs 1993;25(2):135-141.

Krepcho M, Smerick M, Freeman A, Alfaro A. Harnessing the energy of the mass media: HIV awareness in Dallas. American Journal of Public Health 1993; 83(2):283-285.

O'Reilly K, Higgins DL. AIDS community demonstration projects for HIV prevention among hard-to-reach groups. Public Health Reports 1991;106(6):714-720.

Rietmeijer CA, Kane MS, Simons PZ, Cohn DL. Increased use of condom and bleach among injection drug users in Denver: outcome of a community-level HIV prevention program. Abstract 157, 1994, STD/HIVP Grantee Meeting, Washington, DC.

Rhodes F, Corby NH, Wolitski RJ, Tashima N, et al. Risk behaviors and perceptions of AIDS among street injection drug users. Journal of Drug Education 1990;20:271-288.

Schnell D, Sheridan J, Magee E. A regression method for analyzing ordinal data from intervention trials. Statistics in Medicine 1995;14:1177-1189.

Seibt A, McAlister A, Freeman A, et al. Condom use and sexual identity among men who have sex with men--Dallas 1991. MMWR 1993;7:13-14.

Seibt A, Ross M, Freeman A, et al. Relationships between safe sex and acculturation into the gay subculture. AIDS Care 1995;7:87-90.

Wolitski RJ, Radziszewska B. Self-reported HIV antibody testing among persons with selected risk behaviors--southern Los Angeles County, 1991-1992. MMWR 1993;42(40):786-789. Reprinted in Journal of the American Medical Association 1993;270(17):2033-2034.

CDC. Community level prevention of HIV infection among high-risk populations: Methodology and preliminary findings from the AIDS Community Demonstration Projects. MMWR Supplement (in press).

Corby NH, Enguidanos SM, Kay LS. Development and use of role-model stories in a community-level risk-reduction intervention. Public Health Reports (in press).

Corby NH, Wolitski RJ. Condom use with main and other partners among high-risk women: intervention outcome and correlates of behavior. Drugs and Society (in press).

Fishbein M, Guenther-Grey C, Johnson W D, et al. Using a theory-based community intervention to reduce AIDS risk behaviors: the CDC's AIDS Community Demonstration Projects. In S. Oskamp & S. Thompson (Eds.) Safer Sex in the '90s: Understanding and Preventing HIV Risk Behavior (in press).

Goldbaum GM, Perdue T, Higgins D. Non-gay-identifying men who have sex with men: formative research results from Seattle, Washington. Public Health Reports (in press).

Guenther-Grey CA, Schnell D, Fishbein M, the AIDS Community Demonstration Projects. Sources of HIV/AIDS information among female sex traders. Health Education Research (in press).

Guenther-Grey, Noroian D, Fonseka J, The AIDS Community Demonstration Projects. Developing community networks to deliver HIV prevention interventions: The AIDS Community Demonstration Projects. Public Health Reports (in press).

Higgins DL, O'Reilly K, Tashima N, et al. Using formative research to lay the foundation for community-level HIV prevention efforts: the AIDS Community Demonstration Projects. Public Health Reports (in press).

Pulley L, McAlister A, the AIDS Community Demonstration Projects. Prevention campaigns for hard-to-reach populations at risk for HIV infection: theory and implementation. Health Education Quarterly (in press).

Simons PZ, Rietmeijer CA, Kane MS, et al. Building a peer network for a community level HIV prevention program among injecting drug users in Denver. Public Health Reports (in press).

Products:

The projects are currently compiling a complete set of the role model stories produced across sites for this study. When completed, the set will be made available through the AIDS Clearinghouse. A reference document describing the common theoretical background and methodology of this and two other projects (the WIDP and HBIEB) is in progress.

Key Words:

Adolescents, commercial sex workers, female sex partners of IDUs, injection drug users, men who have sex with men, behavior change, bleach, condoms, risk behaviors, bleach distribution, condom distribution, peers, role model stories, Long Beach, Ca, Denver, CO, New York City, Dallas, Seattle, WA., sexual exchange, outreach-street and storefront, community level interventions.

Project: #15 Alexandra Youth Project (Republic of South Africa)

Purpose:

To provide training and technical assistance in conduct of formative research in Alexandra Township; to assist South African collaborators in the planning and evaluation of a community-based STD/HIV intervention targeting Township youth.

Results:

During March-December, 1993, 41 qualitative interviews with providers, 3 focus groups, and 39 interviews with Alexandran youth were conducted by researchers employed by the Alexandra Health Center. Interview data were analyzed and compiled in collaboration with CDC researchers; a detailed final report of findings and recommendations was prepared for Township providers and community groups. Formative data suggest that Township youth are at high risk for sexually transmitted infection because of early sexual debut, multiple partners, "survival prostitution," use of alcohol and non-injecting drugs, and inadequate information about STDs and HIV. Perceived risk for STDs is high, especially among young women, who can neither trust their partners to be faithful nor insist on condom use. STDs are perceived by some youth as the young woman's "shame" but as status-conferring evidence of the young man's sexual activity. Youth are either skeptical about the existence of AIDS or believe infection can be avoided through partner selection (e.g., not having sex with recent immigrants). Condoms are rarely used and viewed as "unnatural" and unpleasant, as difficult to obtain, and as socially disapproved.

Implications:

The formative research findings indicate the need for a community-level intervention which explicitly focuses on community norms influencing young people's sexual behavior. However, the resources to conduct such an intervention are not currently available. Two interim interventions have been proposed, focusing on young men and women attending Alexandra Health Center's STD clinic and antenatal clinic. The intervention approach being considered is group-based, peer- and professionally-facilitated education and skill training, with random assignment to intervention and ordinary care conditions.

Publications:

Shongwe T, Fernandes A, Beeker C, Valentine J, Schmid G. STD/HIV risk reduction in Township youth: formative research findings. Abstract published in Abstract Book, VIII International Conference on AIDS and STDs in Africa, 12-16 December 1993., Morocco.

A summary of formative research findings for professional journal submission is in progress.

Products:

Shongwe T, Fernandes A, Beeker C, Valentine J, Schmid G. Alexandra Youth Project: Community Needs Assessment and STD/HIV Prevention, Final Report. Institute of Urban Primary Health Care based in Alexandra Health Care Centre (South Africa) and Centers for Disease Control and Prevention, Behavioral Intervention Research Branch (USA), 1994.

Key Words:

Adolescents, formative research, Alexandra, South Africa, risk behaviors, sexual exchange, drugs, condoms, education, skill-training, peers.

Project: #16 Behaviors of Crack Cocaine Users and their Impact on Early Syphilis Intervention

Purpose:

To evaluate the impact of crack cocaine use on syphilis control efforts by analyzing data from records of persons diagnosed with early syphilis when voluntarily attending County Health Department clinics in Detroit, Michigan and Dallas, Texas between August 1989 and August 1990.

Results:

Crack cocaine use is associated with three interrelated mechanisms associated with the spread of syphilis: multiple partners, failure to provide enough information for contact tracing, and delay in seeking treatment. Compared with men who did not use crack, male crack users were more likely to report having four or more sex partners during their critical period for acquiring or transmitting infection (OR=4.33; 95% CI=2.08,8.99). Among men, having a large number of sex partners during this period was associated with a lower percentage of contacts being examined (OR=11.8; 95% CI=2.91,47.5). Among women, having four or more sex partners during their critical period and a lower partner examination rate were both associated with crack use; crack use was strongly associated with exchanging sex for money or drugs. We conclude that crack use has the largest impact on syphilis intervention through its association with having large numbers of sex partners.

Implications:

Expansion of traditional case-finding methods, as currently implemented, is unlikely to have significant benefit in curtailing the spread of syphilis in crack-using, inner-city populations. Partner notification must be supplemented with other strategies because of the high number of unlocatable partners associated with syphilis patients who use drugs. Such alternatives include rapid, on-site, syphilis screening in high risk settings such as crack motels and using substance abuse outreach workers to locate and refer persons at risk. The portion of the interview process aimed at obtaining information for location of casual sex partners should also be strengthened.

Publications:

Greenberg J, Schnell D, Conlon R. Behaviors of crack cocaine users and their impact on early syphilis intervention. Sexually Transmitted Diseases 1992;19:346-350.

Products:

None.

Key Words:

Syphilis, risk behavior, Detroit, MI., Dallas, TX., drugs, partner notification, sexual exchange, screening.

Project: #17 Development and Pretest of HIV/STD Intervention Strategies of Targeting Minority Heterosexual Males

Purpose:

To develop and pretest a culturally appropriate HIV/STD risk reduction intervention for minority heterosexual males attending an STD clinic.

Results:

Qualitative findings from focus groups showed that employment, housing, and relationships with significant others are of greater concern than contracting STD/AIDS. Misinformation and embarrassment regarding STD, AIDS, and condoms is prevalent within the population. Hispanic participants are more family-oriented than African Americans, and tend to be members of an extended family from which they derive support; African Americans tend to have more fluid family and sexual relationships. Many respondents have developed a method to discern who and what places them at high risk for infection. Many African American participants believe diseases are spread by "eating or drinking behind," i.e., picking up germs from a person by drinking out of his beer bottle. This belief is spreading to injection drug use and some injection drug users are not "fixing behind" others.

A three session, culturally appropriate, risk reduction interventions was developed and pilot tested on participants recruited from the local community and the STD clinic which serves it. The intervention used small group discussion with information sharing, skills building, and role plays. Participants rated the session highly and reported that they would use the skills and information they acquired in the groups. Attrition rates over the three sessions was low.

Implications:

The concept of not eating, drinking, or fixing "behind" someone else as a method to avoid diseases can be used and expanded upon in designing culturally relevant interventions for this population, i.e., don't "fix behind" someone--have your own, don't "fix behind" unless you've cleaned the works with bleach, and don't "f__k behind" someone either.

Publications:

Ramos R, Shain R, Johnson L. "Men I mess with don't have anything to do with AIDS:" using ethno-theory to understand sexual risk perception. Sociological Quarterly 1995;36(3): (in press).

Products:

The curriculum for the three session STD/HIV risk reduction intervention is available from Rochelle Shain Ph.D., University of Texas Health Sciences Center, Dept. OB/GYN, 7703 Floyd Curl Drive, San Antonio, TX 78284-7836.

Key Words:

African Americans, Hispanics, condoms, behavior change-barriers, focus groups, small group discussion, IDUs, attitudes, knowledge, STD clinic clients, skills building, role plays, education, San Antonio, TX., injecting drug equipment (paraphernalia).

Project: #18 Evaluation of HIV Prevention Street Outreach Program for IDUs and Youth at High Risk (AESOP)

Purpose:

To evaluate the coverage, cost, and impact of currently operating street and/or community HIV prevention outreach on injecting drug users. To develop and test the effectiveness of enhancements to these activities. To assist agencies serving injecting drug users and youth at high risk in improving the effectiveness of their outreach efforts.

Results:

Initial rounds of survey research indicate that the populations surveyed engaged in high levels of sexual risk behavior than found in general population surveys. For example, 21-28% of the IDU respondents and 20-46% of youth respondents reported 2 or more sex partners in the last month. The majority (62-97%) knew someone infected with HIV. From 41-59% of IDU respondents and 49-58% of youth respondents stated they were at least somewhat likely to get infected with HIV. Reported condom use rates approach national health promotion goals for non-steady partners, but not for steady or main partners. Having a condom at time of interview was the strongest and most consistent predictor of condom use at last intercourse. Obtaining condoms from outreach workers was indirectly associated with condom use since this factor was strongly related to carrying condoms.

Implications:

Many of the high risk respondents have been in contact with street outreach programs and many acknowledged some personal risk for HIV infection. However, most of the IDUs and high risk youth interviewed (and their sex partners) were still at risk through unprotected sex. Enhancements to street outreach interventions were associated with increases in receiving street outreach services among representative on-the-street risk populations in some settings. Specific enhancements, including use of peer outreach workers and mobile vans, can have a measurable impact on the amount of services delivered in high risk, out-of-treatment populations. Street outreach also has a consistent indirect association with lower levels of risk behavior in these populations. Having a condom at interview was the strongest, most consistent predictor of using condoms. Exposure to street outreach was strongly associated with having condoms at the time of interview.

Publications:

CDC. Assessment of street outreach for HIV prevention--selected sites, 1991-1993. MMWR 1993;42(45):873, 879-880.

Kipke MD, O'Connor S, Palmer R, MacKenzie RG. Street youth in Los Angeles, profile of a group at high risk for Human Immunodeficiency Virus Infection. Archives of Pediatric and Adolescent Medicine 1995;149:513-519.

Anderson JE, Cheney R, Clatts M, et al. HIV risk behavior, street outreach and condom use in 8 high risk populations. AIDS Education and Prevention, accepted for publication July 1994.

Anderson JE, Cheney R, Faruque S, et al. Stages of change for HIV risk behavior: injecting drug users in five cities. Drugs and Society, accepted for publication January 1995.

Wright-deAguero LK, Gorsky RD, Seeman GM. Cost of outreach for HIV prevention among drug users and youth at risk. Drugs and Society, accepted for publication January 1995.

Kipke MD, Clatts MC, Garcia D, et al. Substance use and injection drug use among street youth in four U.S. cities. Submitted to the American Journal of Public Health, 1995.

Kipke MD, O'Connor S, Nelson B. Assessing the effectiveness of outreach targeted to street youth using probability sampling. Submitted to Public Health Reports, 1995.

Kipke MD, Palmer RF, LaFrance S, O'Connor S. Homeless youths' descriptions of their parents' childrearing patterns. Submitted to Youth and Society, 1995.

Kipke MD, Unger JB, Palmer RF, O'Connor S. Sex, drugs, and rock and roll: street youth's risk behaviors according to self-identified peer group affiliation. Submitted to AIDS Education and Prevention, 1995.

Anderson JE, et al. Condom use in 8 high risk populations. Session 1189. 1994, American Public Health Association Meeting.

Bresnahan MP, Clatts MC, Davis WR. Building community-based outreach services for homeless youth in NYC: a systems perspective in AIDS prevention planning. 1994, American Public Health Association Meeting.

Cheney R. Access and feasibility: aspects of needle risk behavior among street IDUs in Philadelphia. Session 1189. 1994, American Public Health Association Meeting.

Cheney R, Anderson JE, Faruque S, et al. A four city behavioral and demographic profile of street based IDUs: implications for HIV interventions. 1994, American Public Health Association Meeting.

Faruque S, Fernando D, et al. Needle risk behaviors among injecting drug users in the South Bronx, NYC: the role of bleach. Session 1189. 1994, American Public Health Association Meeting.

Faruque S, Fernando D, El-Bassel N, et al. AIDS outreach among injecting drug users in the South Bronx, New York City: what does it do? 1994, American Public Health Association Meeting.

Faruque S, Fernando D, El-Bassel N, et al. Predictors of condom use with main partners among injecting drug users in South Bronx, New York City. 1994, American Public Health Association Meeting.

Faruque S, Fernando D, El-Bassel N, et al. Predictors of needle risk behavior among male injecting drug users in the South Bronx, New York City. 1994, American Public Health Association Meeting.

Garcia D, Mills S, Symons A, et al. Deadhead youth--no hallucinations! the effects of social marketing and HIV prevention. (Poster) 1994, American Public Health Association Meeting.

Furst RT, Nettey R, Wiebel W. The social components of 'trust' and the efficacy of outreach intervention. 1994, American Public Health Association Meeting.

Kennedy M, Greenberg J, et al. High-risk behaviors in street youth: the tendency to run multiple risks. Session 1189. 1994, American Public Health Association Meeting.

Kipke MD, Nelson B, O'Connor S. Probability sampling of homeless street youth. 1994, American Public Health Association Meeting.

Kipke M, O'Connor S, Palmer R. Developing and HIV risk profile of street youth in Los Angeles." (Poster) 1994, American Public Health Association Meeting.

Long A, Bonilla G, Schunoff J. Street outreach programs: HIV risk reduction among active drug users in Los Angeles County. Session 1189. 1994, American Public Health Association Meeting.

Long AM, Bonilla G, Weathers R, et al. Crack cocaine use and HIV risk behaviors of injecting drug users in Los Angeles. (Poster) 1994, American Public Health Association Meeting.

Long A, Bonilla G, Weathers R, Rodriguez M. Ethnic diversity, perceived risk, and perceptions of control and HIV risk behavior among injecting drug users in Los Angeles County. 1994, American Public Health Association Meeting.

Williams WC, Burnett MN, Jenkins L. Patterns of sexual and drug risk behavior for injecting drug users in the Atlanta area. Session 1189. 1994, American Public Health Association Meeting.

Products:

Guidance for Street Outreach Evaluation, distributed by the Division of STD/HIV Prevention.

Key Words:

IDUs, street outreach, adolescents, survey-targeted, condoms, risk behaviors, peers, service enhancement, service delivery, storefront, street encounter, Los Angeles,CA., San Francisco, CA., Atlanta, GA., Chicago, IL., Philadelphia, PA., NYC.

Project: #19 Evaluation of the Experience of African American and Latina Women with Sexual Decision Making and the Female Condom: An Ethnographic Study

Purpose:

To describe individual and cultural differences in how young Latina and African American women choose methods for reducing their risk for sexually transmitted infections; negotiate method use with primary partners; and evaluate the female condom after trial adoption.

Results:

Since notification of award in September, 1994, Project staff have been hired and trained; interview protocols have been developed; and data collection is underway. Data is insufficient, at this time, for determining preliminary results.

Implications:

The findings from this qualitative study are expected to provide information pertinent to the design and delivery of sexual risk reduction interventions tailored to the cultural and economic realities of inner-city women of color.

Publications:

Several publications are planned, pending completion of data collection and analysis.

Products:

None

Key Words:

African American, women, condom-female, Hispanic, risk behaviors, formative research, Springfield, MA.

Project: #20 Men Who Have Sex With Men Minority Behavioral Assessment Project

Purpose:

To describe sociodemographic characteristics, sexual behavior, and HIV-related attitudes among Hispanic nongay-identified men who have sex with other men and to assess the need for and feasibility of targeted HIV interventions.

Results:

During 1991-1992, project staff at 2 community-based organizations (in Texas and California) conducted 85 qualitative interviews with providers and other community members, as well as 29 interviews with Hispanic men intercepted at "public sex environments" (parks and adult bookstores identified as venues for the solicitation of male-to-male sex). Although such venues were quickly identified and sexual activity easily verified through direct observation, target group members were very resistant to being interviewed. Those men who did agree to talk often denied high risk sexual behavior (which they defined as unprotected receptive anal sex), did not identify as homosexual, and attributed their HIV risk to sex with female rather than male partners. Alcohol and drug use were acknowledged by most men; heavy use, by those engaged in hustling or "survival sex". Several men admitted using penicillin or other home remedies, or avoiding gay-identified partners, as strategies for reducing their risk for HIV.

Implications:

Secrecy, denial, and suspicion of outsiders (including indigenous outreach workers) can be formidable barriers to outreach with Hispanic nongay-identified men who have sex with men. Especially in rural settings, outreach workers may require several months to establish a non-threatening, consistent presence at outreach sites, as well as a flexible array of strategies for engaging the target population. Intervention messages should address erroneous beliefs about HIV transmission, the importance of consistent condom use with both male and female partners, and locally-available resources for service and support.

Publications:

Beeker C. 1993. Final report: Hispanic Nongay-Identified Men Who Have Sex With Other Men: A Formative Research Study. Internal document: CDC/NCPS/DSTD-HIVP/BPRB

Products:

None

Key Words:

Risk behaviors, Hispanics, men who have sex with men, formative research, Texas, California, sexual exchange, behavior change-barriers, outreach-street, knowledge, referral.

Project: #21 Sociocultural Factors and HIV/AIDS Risk Reduction Programs in Young African American Homosexual and Bisexual Men

Purpose:

To describe the social context in which young (under 30 years old) African American men have sex with other men, identify the sociocultural factors associated with sexual risk behavior, and locate community partners and resources for future community-level interventions.

Results:

Research funding began in September, 1994. At each of the two research sites (Atlanta and Chicago), more than 30 semi-structured qualitative interviews have been conducted with service providers, agency representatives, and other community members who interact formally or informally with young African American men who have sex with men. Data are now being analyzed using Tally, a computer software program. Planning is underway for the next phase of formative research: qualitative interviews with young men who have sex with men recruited from multiple venues, which are currently being identified.

Implications:

The formative research findings are expected to provide information pertinent to the design and delivery of HIV prevention programs tailored to the social and cultural context of risky sex among young African American men who have sex with men.

Publications:

Several publications are planned, pending completion of data collection and analysis.

Products:

None.

Key Words:

Risk behaviors, African American, formative research, men who have sex with men, Atlanta, GA., Chicago, IL.

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