The Bruthas Project: Testing and Disseminating a RCT for HIV Prevention with African American Men Who Have Sex with Men and Women (AAMSMW) in a Community Setting in Oakland, CA

Introduction: 

Both the CDC and National HIV/AIDS Prevention Strategy have called for strategies that address the elevated risk for both acquiring and transmitting HIV among African American men who have sex with both men and women (AAMSMW)^{1, 2}.  Interventions focusing on HIV prevention strategies for men who have sex with men (MSM) that are structured around behaviors and identities are often not congruent with the experiences of AAMSMW.   The Bruthas Project was designed to address this need through a partnership between a community-based organization with three decades of experience providing HIV prevention services to the African American community alongside university researchers in order to develop an intervention that is responsive to the experiences of AAMSMW.

Methods:

Within a community-based participatory research (CBPR) framework, a Randomized Control Trial (RCT) was developed and tested collaboratively between community and academic partners with the input of a Community Advisory Board (CAB) that reflected the AAMSMW community throughout the project.  The CAB, which evolved over time, was instrumental in designing the intervention and survey measures, and ensured accountability. 

Results:

Use of a CBPR framework impacted three key areas of the RCT: 1) inclusion and exclusion; 2) sustainability; and 3) project priorities.  Within each area, community and academic partners experienced specific benefits and challenges, such as competing priorities and varied levels of training and approaches to working with this population. Using a CBPR approach to test a RCT, while more labor intensive for academic partners, increased capacity building, helped to establish credibility, and increased training opportunities for community partners.  However, the realities of funding and programmatic needs of a CBO provided challenges to participating in a research project.

Conclusions:

The collaborative nature of the development of this intervention ensured that it was culturally appropriate and theoretically grounded by involving the AAMSMW community from the inception.  Further, it underscored important lessons about being thoughtful and proactive regarding participation of researchers, community members, and CBOs in each stage of the research.  Despite the challenges we faced, our project also illustrated the feasibility of utilizing a CBPR framework for the development, implementation, and dissemination of a RCT.

1. The White House Office of National AIDS Policy. (2010). National HIV/AIDS Strategy for the United States. Washington, DC.

2. Centers for Disease Control and Prevention. (2011). HIV among youth: National Center for HIV/AIDS VH, STD, and TB Prevention.