Evaluation of an HIV prevention intervention
Smith, Bryce David
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The spread of HIV and AIDS has become one of the most significant public health threats in the United States, particularly for men who have sex with men (MSM). As of December, 2004, The Centers for Disease Control and Prevention (CDC) estimated that MSM account for 48.4% of all deaths due to AIDS in the U.S. In 2003, the CDC estimated that 63% of all new cases of HIV were among MSM. Despite these statistics there is a dearth of proven state-of-the-art interventions designed to prevent HIV infections for MSM. This study evaluated an HIV prevention intervention designed for MSM. It was hypothesized that the participants in the intervention would have the following outcomes: Decreased unprotected anal intercourse, fewer anal sex partners, increased comfort with communication about wearing condoms, increased comfort in putting condoms on self and others, increased HIV prevention knowledge, and increased acquisition of HIV testing. Based on Minority Stress Theory, it was further hypothesized that internalized homophobia would negatively effect the outcomes of the intervention. The intervention is a group level workshop focused on issues of relationships, communication, dating, internalized homophobia, self-esteem, and HIV/STD prevention information. It is unique in that it is highly interactive and focuses on sex in a positive and non-shaming way while exploring methods to decrease HIV risk behaviors. The intervention is highly correlated with the Sexual Health Model. The intervention was evaluated using a quasi-experimental non-equivalent no-treatment comparison group design. Analyses of covariance indicated a significant decrease in unprotected anal intercourse and a significant increase HIV prevention knowledge in the treatment group (n=73) relative to the comparison group (n=46). A further finding of practical, yet not statistical, significance was that 44.4% of HIV-negative men in the treatment group acquired HIV tests in the 30 days after the workshop, compared to 15.4% of the comparison group. Internalized homophobia was not found to effect intervention outcomes. Recommendations for refinements of the intervention and future evaluation and research are discussed.