An Intervention to Reduce HIV Risk Behavior of Substance-Using Men Who Have Sex with Men: A Two-Group Randomized Trial with a Nonrandomized Third Group

In a randomized trial of a behavioral intervention among substance-using men who have sex with men, aimed at reducing sexual risk behavior, Mansergh and colleagues fail to find evidence of a reduction in risk from the intervention

HIV Prevention Via Mobile Messaging for Men Who Have Sex With Men (M-Cubed): Protocol for a Randomized Controlled Trial

Background: Men who have sex with men (MSM) continue to be the predominately impacted risk group in the United States HIV epidemic and are a priority group for risk reduction in national strategic goals for HIV prevention. Modeling studies have demonstrated that a comprehensive package of status-tailored HIV prevention and care interventions have the potential to substantially reduce new infections among MSM. However, uptake of basic prevention services, including HIV testing, sexually transmitted infection (STI) testing, condom distribution, condom-compatible lubricant distribution, and preexposure prophylaxis (PrEP), is suboptimal. Further, stronger public health strategies are needed to promote engagement in HIV care and viral load suppression among MSM living with HIV. Mobile health (mHealth) tools can help inform and encourage MSM regarding HIV prevention, care, and treatment, especially among men who lack access to conventional medical services. This protocol details the design and procedures of a randomized controlled trial (RCT) of a novel mHealth intervention that comprises a comprehensive HIV prevention app and brief, tailored text- and video-based messages that are systematically presented to participants based on the participants’ HIV status and level of HIV acquisition risk. Objective: The objective of the RCT was to test the efficacy of the Mobile Messaging for Men (M-Cubed, or M3) app among at least 1200 MSM in Atlanta, Detroit, and New York. The goal was to determine its ability to increase HIV testing (HIV-negative men), STI testing (all men), condom use for anal sex (all men), evaluation for PrEP eligibility, uptake of PrEP (higher risk HIV-negative men), engagement in HIV care (men living with HIV), and uptake of and adherence to antiretroviral medications (men living with HIV). A unique benefit of this approach is the HIV serostatus-inclusiveness of the intervention, which includes both HIV-negative and HIV-positive MSM. Methods: MSM were recruited through online and venue-based approaches in Atlanta, Detroit, and New York City. Men who were eligible and consented were randomized to the intervention (immediate access to the M3 app for a period of three months) or to the waitlist-control (delayed access) group. Outcomes were evaluated immediately post intervention or control period, and again three and six months after the intervention period. Main outcomes will be reported as period prevalence ratios or hazards,depending on the outcome. Where appropriate, serostatus/risk-specific outcomes will be evaluated in relevant subgroups. Men randomized to the control condition were offered the opportunity to use (and evaluate) the M3 app for a three-month period after the final RCT outcome assessment. Results: M3 enrollment began in January 2018 and concluded in November 2018. A total of 1229 MSM were enrolled. Datacollection was completed in September 2019.Conclusions: This RCT of the M3 mobile app seeks to determine the effects of an HIV serostatus–inclusive intervention on the use of multiple HIV prevention and care-related outcomes among MSM. A strength of the design is that it incorporates a large sample and broad range of MSM with differing prevention needs in three cities with high prevalence of HIV among MSM

Challenges for HIV pre-exposure prophylaxis among men who have sex with men in the United States.

In light of recent research, Gordon Mansergh and colleagues discuss barriers to effective implementation of HIV pre-exposure prophylaxis for men who have sex with men

Types of targeted PrEP messaging needed for MSM and health care providers by subgroup.

<p>ARV, antiretroviral medication; MSM, men who have sex with men; PrEP, pre-exposure HIV prophylaxis.</p

Process Evaluation of Community Coalitions for Alcohol and Other Drug Abuse Prevention: A Case Study Comparison of Researcher- and Community-Initiated Models

During the past decade, coalitions have been assumed to be central to the structure and functioning of community health promotion and disease prevention projects. However, there has been little empirical evaluation of community coalitions. The present paper presents case studies of two different coalition models, one a coalition developed to support a community-based drug abuse prevention trial, and the other, a CSAP Community Partnership Demonstration Program site. Comparison of the two coalitions on key characteristics indicated that they were similar except for their impetus for initiation (researcher versus community-initiated) and primary purpose (to support experimental program components versus to coordinate prevention programming and develop new prevention services). Members of the two coalitions (n = 51 in the researcher-initiated, and n = 49 in the community-initiated coalition) responded to a written survey that assessed immediate coalition process and activity outcomes, including perceptions of coalition efficiency, outcome efficacy, interagency coordination, and benefits of involvement. After controlling for demographic differences, the two groups of coalition members were similar, overall, on the measures of immediate outcomes. Univariate analyses indicated only one difference: members of the researcher-initiated coalition had higher ratings of perceived action committee effectiveness than did members of the community-initiated coalition. The results suggest that the impetus for initiation and primary purpose of a coalition may not be as important as other factors in influencing immediate process and activity outcomes

Alcohol-related Outcomes of the Day One Community Partnership

This paper presents the alcohol-related outcomes of the Day One Community Partnership, a coalition located in a diverse urban community in Southern California that implemented comprehensive alcohol abuse prevention activities based on a public health model. The most promising outcome was the adoption and implementation by city government of a comprehensive policy to reduce alcohol availability. A school-based survey indicated that from baseline to three-year follow-up, there was a trend towards reductions in 30-day alcohol use for youth in grades 7, 9, and 12, and a marginally significant decline in 7-day alcohol use among high school seniors. There was an inconsistent pattern of changes in alcohol-related outcomes such as beliefs and behavioral intentions. Possible explanations for the pattern of results are discussed