17th International AIDS Conference Mexico City, Mexico - August 13 - 18, 2008

SUCCESSFUL IMPLEMENTATION OF A PEER-ADMINISTERED SECONDARY HIV PREVENTION INTERVENTION FOR MSM IN PRIMARY CARE

Int Conf AIDS. 2008 Aug 13-18;17 Abstract No. MOAC0303

C. O'Cleirigh ¹, S. Safren¹, C. Covahey², E. Leidolf², M. Skeer³, R. Vanderwarker², K. Mayer^4
1Fenway Institute/Harvard Medical School, Boston, United States, ²Fenway Institute, Boston, United States, ³Fenway Institute/Harvard School of Public Health, Boston, United States, ⁴Fenway Institute/Brown School of Medicine, Boston, United States

BACKGROUND: Given that MSM constitute the leading risk group for HIV in the U.S., interventions that reduce transmission risk behaviors among this population are of critical importance. The purpose of this study is to evaluate the acceptability/feasibility and utility of a peer-driven IMB (information-motivation-behavioral skills) intervention designed to reduce HIV sexual risk behaviors among MSM in primary care.

METHODS: The 4 session modular-based intervention utilized peers as interventionists. All participants (n = 195) completed an information and assessment session called “Having Sex” and then selected from 7 other modules for the remaining sessions, “Triggers”, “Getting the Relationships you Want”, “Party Drugs”, Cultures Communities and You”, “Disclosure”, and “Stress Management”. Acceptability, feasibility, and utility of the intervention were assessed during the planning, implementation, and evaluation stages.

RESULTS: Evidence for the acceptability of the intervention was provided by positive feedback from the community advisory board, mental health and medical providers with expertise in prevention, and HIV-infected stakeholders. Acceptability was also assessed by qualitative analysis of exit interviews identifying positive themes from 100% of 19 participants interviewed. Evidence of the feasibility of intervention implementation was provided by >97% recruitment of targeted 200 participants and a 75% 12-month retention rate. Utility: For those who reported sexual risk at baseline (n=30) there were statistically significant reductions at 6 month follow-up in a)the proportion reporting sexual risk behavior at 6 month (t (29)=-3.81, OR: 0.66, =0.001), b)the number of transmission risk behaviors (t (29)=-2.42, p=0.02) and c)the proportion of unprotected anal intercourse to all anal intercourse acts (t (29)=-3.11, p=0.01). These results maintained at 12-month follow-up.

CONCLUSIONS: These results suggest that an individually based, peer-implemented, secondary HIV prevention can be successfully implemented among MSM receiving primary care at a large community health clinic. Lessons learned and procedures to implement a peer-delivered intervention will be described.

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2008-08-13
MOAC0303

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