ABSTRACT
BACKGROUND: This article describes the process our community-academic partnership used to lay the groundwork for successful implementation of an adolescent-focused, evidence-based HIV/AIDS prevention curriculum in two Black churches. OBJECTIVES: We highlight the challenges encountered and lessons learned in building a relationship with two churches, garnering the pastor's support, and implementing the curriculum within church youth groups. METHODS: We engaged a Community Advisory Board (CAB) made up of youth, parents, and diverse faith leaders to ensure community relevance and guide project development, implementation, and evaluation. LESSONS LEARNED: Using a community-based participatory research (CBPR) approach helped us to (1) engage diverse, intergenerational community members, (2) initiate a "culturally humble" process to build relationships with faith leaders, (3) remain responsive to stakeholder concerns, and (4) open the door to HIV prevention in the Black church. CONCLUSIONS: Finding effective and responsive ways to implement HIV/AIDS prevention in faith settings is facilitated by engaging diverse partners throughout the research process.
Subject(s)
Black or African American , Community-Institutional Relations , HIV Infections/ethnology , HIV Infections/prevention & control , Health Promotion/organization & administration , Universities/organization & administration , Adolescent , Adolescent Health Services , Community-Based Participatory Research , Humans , Inservice Training , North Carolina , Pilot Projects , Religion , Socioeconomic FactorsABSTRACT
OBJECTIVES: We assessed the efficacy of an HIV behavioral intervention adapted for Black men who have sex with men (MSM). METHODS: We conducted serial cross-sectional surveys, 1 baseline measurement followed by initiation of an intervention and 3 follow-up measurements, among Black MSM in 3 North Carolina cities over 1 year. RESULTS: We observed significant decreases in unprotected receptive anal intercourse at 4 months (by 23.8%, n=287) and 8 months (by 24.7%, n=299), and in unprotected insertive anal intercourse (by 35.2%), unprotected receptive anal intercourse (by 44.1%), and any unprotected anal intercourse (by 31.8%) at 12 months (n=268). Additionally, at 12 months, the mean number of partners for unprotected receptive anal intercourse decreased by 40.5%. The mean number of episodes decreased by 53.0% for unprotected insertive anal intercourse, and by 56.8% for unprotected receptive anal intercourse. The percentage of respondents reporting always using condoms for insertive and receptive anal intercourse increased by 23.0% and 30.3%, respectively. CONCLUSIONS: Adapting previously proven interventions designed for other MSM can significantly reduce HIV risk behaviors of Black MSM.
Subject(s)
Bisexuality , Black People , HIV Infections/prevention & control , Homosexuality, Male , Sexual Behavior , Adolescent , Adult , Cross-Sectional Studies , Health Behavior , Humans , Interviews as Topic , Logistic Models , Male , North Carolina , Risk Reduction Behavior , Surveys and QuestionnairesABSTRACT
Black men who have sex with men (BMSM) are at considerable risk for HIV infection. A convenience sample of BMSM (n=252) attending nightclubs in three North Carolina cities was surveyed to investigate factors associated with unprotected anal intercourse (UAI). About 45% reported UAI in the past 2 months. BMSM who strongly agreed that their male friends used condoms for anal sex were significantly less likely to report any UAI. Recently incarcerated men were significantly more likely to report unprotected insertive anal sex. In secondary analyses, men who reported experiencing discrimination based on their race and nongay identified men reported more favorable peer norms for condom use. Men who reported that their family disapproved of their being gay were more likely to have been incarcerated in the past 2 months. HIV prevention for BMSM must promote supportive peer norms for condom use and address incarceration, racial discrimination, and family disapproval.
