Mobilizing young gay and bisexual men for HIV prevention: a two-community study

Background: To develop, implement and evaluate a community-level HIV preven tion program (the Mpowerment Project) for young gay men in two US communiti es. Design: Using a multiple baseline design, a cohort of young gay men was rec ruited independently of the intervention in each community and surveyed twi ce (1 year apart) regarding sexual risk behavior and psychosexual variables . The intervention was then implemented sequentially in each community. The cohorts were resurveyed immediately post- and 1-year post-intervention. Si nce there were few differences between the two communities, data were poole d to increase statistical power. Intervention: The program had four components: peer outreach, whereby young gay men encouraged other men to engage in safer sex; peer-led small groups ; a publicity campaign; and a young men's center. Results: Baseline rates of unprotected anal intercourse were stable. Follow ing intervention, the proportion of men who engaged in unprotected anal int ercourse decreased from 38.3 to 30.9 (-19.3% relative reduction), with a re duction from 19.2 to 13.6% (-29.2%:, relative reduction):with non-primary p artners, and a reduction from 57.7 to 41.8% (-27.6% relative reduction) wit h boyfriends. Reductions were sustained 1 year later with non-primary partn ers, but mixed results were found regarding sex with boyfriends. Conclusions: Mobilizing young gay men to support each other about safer sex is an effective approach to HIV prevention, but programs must be sustained . To reach young gay men, HIV prevention activities must be embedded into t he satisfaction of needs for social and community belonging. (C) 1999 Lippi ncott Williams & Wilkins.