Effects of a Critical Media Analysis Intervention on HIV-Related Health Behavior Among HIV Positive Young Black Men Who Have Sex with Men

Background

YBMSM account for approximately 10% of the total HIV infections in the United States but they represent less than 1% of the population. Few interventions exist that address their unique needs, and those that do adopt a narrow, risk-based framework for addressing HIV-related behavior. To address this gap, we developed Mobilizing Our Voices for Empowerment (MOVE), an innovative, critical consciousness-based health enhancement intervention that employs the critical analysis of popular media for HIV-positive YBMSM. In the current study, we piloted MOVE and compared it to a control condition, Health 4 Life (H4L), a general health promotion and life skills intervention, to assess the potential impact on reducing HIV transmission behavior and improving engagement in care.

Methods

57 YBMSM from 4 US cities were enrolled and randomized by site to MOVE (New York City and Los Angeles) or H4L (Memphis and Houston) and followed up with at 4- and 6-months. Both MOVE and H4L consisted of an initial two-day weekend retreat with follow-up session after 1- and 2-months. MOVE specifically addressed increasing engagement in care (having attended an HIV primary care appointment) and reducing HIV transmission behavior (condomless anal intercourse with known HIV positive partners (CAI) and serodiscordant CAI with unknown and/or HIV negative partners (SDCAI)), both in the past 3 months. Chi-squared tests were used to assess statistical significance.

Results

Participants were 22 years old, on average. Nearly a third (30%) were taking antiretroviral therapy (ART). At baseline, 49% of participants reported CAI, 23% reported SDCAI and 86% were engaged in care. At 4-months, CAI was reduced by 21% (p=0.03) and SDCAI by 16% (p=0.03). Engagement in care remained high (81%, p=0.50). At 6-months, CAI remained lower (27%, p=0.02) while 18% reported SDCAI (p=0.48). Fewer participants were engaged in care compared to baseline (67%, p=0.02). Reductions in HIV transmission behavior was similar across interventions. Engagement in care was similar across groups at baseline (p=0.79) and 4-months (p=0.16) but a larger proportion of MOVE participants were engaged in care at 6-months (86% vs 53%, respectively, p=0.01).

Conclusions

The HIV positive YBMSM enrolled in this pilot study reported prevalent HIV transmission behavior at baseline. Participants reported reduced HIV transmission behavior at 4-months and 6-months follow-up; however, no intervention effect was observed compared to the control condition. The majority of participants were initially engaged in HIV care. Participants in MOVE had a higher level of engagement of care compared to the control condition after 6-months. The findings indicate the potential for health interventions to improve HIV-related health behavior among this critical population.