Community Building Reduces Young Gay Men's Risky Behavior

July 08, 2002
News Office: Jeff Sheehy (415) 597-8165

Young gay men in Albuquerque reported a 12 percent decrease in risky sexual behavior as a result of a community-building HIV-prevention intervention while other communities experienced significant increases after the introduction of HAART (highly active anti-retroviral therapy), say researchers at UCSF's Center for AIDS Prevention Studies (CAPS).

"Due, in part, to changing attitudes about safer sex because of the successfulness of HAART, huge increases in risky behavior by gay men are going on everywhere, not just in the gay meccas," said study author Susan M. Kegeles, UCSF professor of medicine and associate director of UCSF's CAPS. "But we have found that an intensive community-building intervention based on theories of empowerment, diffusion and peer mobilization can reverse this trend by giving young gay men the means to establish healthy communities that provide intimacy, validation and peer support for safer sex."

The peer-led community-level HIV prevention intervention in 1997-98 in Albuquerque included:

  • A young -- ages 18 to 28 -- gay men's community center
  • Informal outreach conducted among friends
  • Formal outreach conducted at gay venues and social events
  • Small peer-led groups that taught safer sex through discussions about dating and relationships
  • A small publicity campaign about the project
  • Similar groups in Austin and Phoenix who did not receive the intervention reported increases of risky behavior in 42 percent and 26 percent respectively, when compared to risky behavior rates prior to the introduction of HAART in 1996.

    "With AIDS deaths down dramatically -- and along with that, visible reminders of the deadly consequences of AIDS -- just handing out condoms or discussing safer sex is not going to do the job," said Kegeles, who will present the findings at the XIV International AIDS Conference in Barcelona, Spain. "You need to establish places that are not gay bars or cruising areas where young gay men can create a community that supports them in all aspects of their lives."

    The baseline data for the study were collected in 1996, prior to widespread HAART use, from gay men ages 18 to 28 recruited from gay bars and social networks and through advertising in Albuquerque, New Mexico; Austin, Texas, and Phoenix, Arizona. They were surveyed independently of the intervention in 1996 and then again in 1998/1999 with additional men recruited for the follow-up survey. Unprotected anal intercourse (UAI) with a non-primary partner was the measure for risky sexual behavior. Twenty-eight percent of young gay men in Albuquerque, 23 percent in Austin and 25 percent in Phoenix reported UAI in 1996.

    In 1999, 33 percent of young gay men in Austin reported unprotected anal intercourse, a 42 percent increase from baseline. In Phoenix, 32 percent reported UAI, a 26 percent increase. In Albuquerque, the intervention city, 24.5 percent reported UAI, a 12 percent decrease.

    Study co-authors are Greg M. Rebchook, research psychologist; the late Robert B. Hays, research psychologist, and Lance Pollack, research specialist, all at UCSF's CAPS.

    The study was funded by a grant from the National Institute for Mental Health.

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