New intervention reduces risky sex among bisexual African-American men

August 21, 2013, University of California, Los Angeles

A culturally tailored HIV prevention program developed and tested by investigators at UCLA and the Charles R. Drew University of Medicine and Science has been shown to significantly reduce unprotected sex among bisexual black men.

The innovative approach, called Men of African American Legacy Empowering Self, or MAALES, is described in an article in the peer-reviewed journal AIDS.

The rate of HIV/AIDS among African-Americans is significantly higher than it is among any other ethnic or . (According to the Centers for Disease Control and Prevention, African-Americans accounted for an estimated 44 percent of new U.S. HIV diagnoses in 2010.) Among who have with men, black men account for the largest estimated number of HIV infections. Yet there are few interventions available to reduce those rates, said the study's principal investigator, Nina Harawa, adjunct assistant professor of epidemiology at UCLA and associate professor of research at the Charles R. Drew University of Science and Medicine.

MAALES takes a holistic approach to minimizing behaviors that could put men at risk for HIV, engaging participants in small-group discussions about popular media, exercises such as negotiating condom use with sexual partners and activities to improve the participants' knowledge of sexual health. Importantly, the intervention is also culturally relevant, addressing participants' shared legacies, including of African-American men, historical discrimination and disenfranchisement, and on individual health and -making.

"When we first set out in 2004 to develop an intervention for behaviorally bisexual African-American men, the gap between documented need and services was staggering," Harawa said. "Up to that point, just one prevention intervention tailored for African-American men who had sex with men had been developed and no interventions designed for behaviorally bisexual men of any race or ethnicity had been published."

That gap has since narrowed, but only slightly, she noted. For instance, studies on four other interventions for African-American men who have sex with men have been published. Of those, only two showed evidence of efficacy. In addition, only two of the four studies specifically targeted any specific race or ethnicity.

The Drew-UCLA MAALES study was based on previous research by the authors and others which indicated that African-American men who have sex with men and women have different experiences and concerns from those of men who only have sex with men or men who only have sex with women.

Researchers surveyed 437 bisexual black men, assessing key characteristics and behaviors such as socio-demographics, incarceration history, self-reported HIV status, , gender role expectations, experiences with racism, and use of drugs and alcohol. The surveys were completed at baseline, and again at three months and six months after completing the intervention.

Participants were randomly assigned either to the six-session MAALES intervention or to a control group that provided one session on HIV risk reduction education.

Compared with those randomized to the control intervention, individuals in MAALES reported 49 percent fewer episodes of unprotected intercourse with partners of either gender after six months, as well as 50 percent fewer episodes of unprotected vaginal intercourse with females, and 44 percent fewer female partners.

There were some study limitations that could lessen the generalizability of the study's findings. Participants tended to be over 35 years of age and to report low socioeconomic status. Also, despite efforts to engage men of diverse sexual identities, men who identify as heterosexual may have been less willing than other men who have sex with men and women to engage in a group intervention. Finally, even with intensive retention efforts, loss to follow-up was significant, perhaps due to significant incarceration rates. At least 16 percent of participants who were not retained were incarcerated at their six-month follow-up interview.

"Despite these study limitations, our statistically significant findings demonstrate not only the promise of this intervention but also the ability to bring about important behavioral change through culturally tailored behavioral intervention approaches," said Dr. John K. Williams, associate professor in residence of psychiatry and biobehavioral sciences at UCLA's Semel Institute for Neuroscience and Human Behavior, and the study's co-principal investigator.

"Health interventions that address more than just physical, mental and sexual health may be vital for groups like who have sex with men and women whose concerns regarding HIV stigma, biphobia, homophobia and financial hardship may complicate engagement in HIV biomedical prevention and treatment," Williams said.

Explore further: Male on male consensual sex and sexual assault common in South Africa

Related Stories

Male on male consensual sex and sexual assault common in South Africa

June 18, 2013
A survey of adult South African men published in this week's PLOS Medicine, shows that while overlapping sexual relationships with women appear to be common, roughly one in 20 men reported consensual sexual contact with a ...

Rate of new HIV infections drops for first time among black women, CDC reports

December 21, 2012
(HealthDay)—For the first time, the rate of new HIV infections among black American women declined between 2008 and 2010, according to a report released Wednesday by the U.S. Centers for Disease Control and Prevention.

Higher HIV risk in black gay men linked to partner choice, risk perception

May 2, 2011
Young black men who have sex with men (MSM) get infected with HIV nearly five times more often than MSM from other races, even though they don't have more unprotected sex.

Social media may prove useful in prevention of HIV, STDs, study shows

February 6, 2013
(Medical Xpress)— Facebook and other social networking technologies could serve as effective tools for preventing HIV infection among at-risk groups, new UCLA research suggests.

Study shows men as likely as women to distinguish between desire and arousal

July 23, 2013
The theory is that men and women are completely different in the way that they experience arousal and express desire. But the first large-scale study trying to tease apart what goes on in the minds and bodies of men and women ...

Marital status reduces risk of death from HIV/AIDS for men

July 12, 2013
(Medical Xpress)—At the height of the AIDS epidemic in the 1980s men who were married were significantly less likely to die of HIV/AIDS than their divorced or otherwise single counterparts, according to a University of ...

Recommended for you

War in Ukraine has escalated HIV spread in the country: study

January 15, 2018
Conflict in Ukraine has increased the risk of HIV outbreaks throughout the country as displaced HIV-infected people move from war-affected regions to areas with higher risk of transmission, according to analysis by scientists.

Researchers offer new model for uncovering true HIV mortality rates in Zambia

January 12, 2018
A new study that seeks to better ascertain HIV mortality rates in Zambia could provide a model for improved national and regional surveillance approaches, and ultimately, more effective HIV treatment strategies.

New drug capsule may allow weekly HIV treatment

January 9, 2018
Researchers at MIT and Brigham and Women's Hospital have developed a capsule that can deliver a week's worth of HIV drugs in a single dose. This advance could make it much easier for patients to adhere to the strict schedule ...

New long-acting, less-toxic HIV drug suppresses virus in humanized mice

January 8, 2018
A team of Yale researchers tested a new chemical compound that suppresses HIV, protects immune cells, and remains effective for weeks with a single dose. In animal experiments, the compound proved to be a promising new candidate ...

Usage remains low for pill that can prevent HIV infection

January 8, 2018
From gritty neighborhoods in New York and Los Angeles to clinics in Kenya and Brazil, health workers are trying to popularize a pill that has proven highly effective in preventing HIV but which—in their view—remains woefully ...

Researchers find clues to AIDS resistance in sooty mangabey genome

January 3, 2018
Peaceful co-existence, rather than war: that's how sooty mangabeys, a monkey species found in West Africa, handle infection by SIV, a relative of HIV, and avoid developing AIDS-like disease.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.