Faculty Collaboration Database

A randomized social network HIV prevention trial with young men who have sex with men in Russia and Bulgaria. AIDS 2005 Nov 04;19(16):1897-905

Date

10/18/2005

Pubmed ID

16227798

DOI

10.1097/01.aids.0000189867.74806.fb

Scopus ID

2-s2.0-27544475390 (requires institutional sign-in at Scopus site)   96 Citations

Abstract

OBJECTIVE: To evaluate the effects of an HIV prevention intervention with social networks of young men who have sex with men (YMSM) in St. Petersburg, Russia and Sofia, Bulgaria.

DESIGN: A two-arm randomized trial with a longitudinally-followed community cohort.

METHODS: Fifty-two MSM social networks were recruited through access points in high-risk community venues. Network members (n = 276) were assessed to determine risk characteristics, administered sociometric measures to empirically identify the social leader of each network, and counseled in risk reduction. The leaders of 25 experimental condition networks attended a nine-session program that provided training and guidance in delivering ongoing theory-based HIV prevention advice to other network members. Leaders successively targeted network members' AIDS risk-related knowledge and risk reduction norms, attitudes, intentions, and self-efficacy. Participants were re-administered risk assessment measures at 3- and 12-month follow-ups.

RESULTS: Among changes produced, the percentage of experimental network members reporting unprotected intercourse (UI) declined from 71.8 to 48.4% at 3-month follow up (P = 0.0001). The percentage who engaged in UI with multiple partners reduced from 31.5 to 12.9% (P = 0.02). After 12 months, the effects became attenuated but remained among participants who had multiple recent sexual partners, the most vulnerable group. Little change was found in control group networks.

CONCLUSIONS: Interventions that engage the identified influence leaders of at-risk YMSM social networks to communicate theory-based counseling and advice can produce significant sexual risk behavior change. This model is culturally pertinent for HIV prevention efforts in former socialist countries, as well as elsewhere for other hard-to-reach vulnerable community populations.

Author List

Amirkhanian YA, Kelly JA, Kabakchieva E, Kirsanova AV, Vassileva S, Takacs J, DiFranceisco WJ, McAuliffe TL, Khoursine RA, Mocsonaki L

Authors

Yuri A. Amirkhanian PhD Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
Wayne J. DiFranceisco Research Scientist II in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
Jeffrey A. Kelly PhD Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
Timothy L. McAuliffe PhD Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Attitude to Health
Bulgaria
Condoms
HIV Infections
Homosexuality, Male
Humans
Male
Patient Acceptance of Health Care
Patient Education as Topic
Risk Factors
Risk-Taking
Russia
Social Support
Unsafe Sex