Archives of Sexual Behavior

, Volume 48, Issue 4, pp 1059–1071 | Cite as

A Randomized Pilot Study of a Group-Delivered HIV Risk Reduction Intervention for At-Risk Urban Men Who Have Sex with Men Who Regularly Attend Private Sex Events

  • Matthew J. MimiagaEmail author
  • Jaclyn M. W. Hughto
  • Sari L. Reisner
Original Paper


Across HIV prevention studies, as many as 25% of men who have sex with men (MSM) report meeting male partners at private sex events and attendance is associated with increased number of sexual partners, condomless anal sex (CAS), and HIV infection. Despite the need for effective HIV prevention interventions, no risk reduction interventions have been tested to reduce HIV sexual risk of MSM that regularly engage in sexual risk at private sex events. This randomized pilot study assessed the feasibility and acceptability of an HIV risk reduction intervention to reduce CAS among urban MSM (N = 14) reporting risk at a private sex event in the prior 12 months. The intervention arm received four group sessions (2 h/session) focusing on HIV risk reduction education and skills building. Both the intervention (n = 8) and control (n = 6) conditions received HIV testing and pre- and posttest risk reduction counseling and completed a sexual risk and psychosocial assessment visit at baseline and 3 months post-intervention. In addition, intervention participants completed a brief exit interview post-intervention. Mean age was 37 years, and 57% were racial/ethnic minorities. At follow-up, the intervention group reported greater reductions in sexual risk behavior in the past 3 months including number of CAS episodes, number of partners at private sex events, and CAS episodes at private sex events. The intervention group also reported reduced sexual compulsivity, increases in HIV disclosure, and reduced drug use at private sex events over study follow-up. Exit interviews revealed that participants found the intervention to be highly acceptable. Findings demonstrate feasibility of procedures, participant acceptability, and initial promise of a group-delivered HIV risk reduction intervention for MSM who attend and engage in CAS at private sex events. Further testing of this intervention in a larger pilot randomized controlled trial is warranted.


HIV MSM Private sex events Gay venues Sexual risk behavior Sexual orientation 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all participants included in the study.


  1. Adam, B. D., Husbands, W., Murray, J., & Maxwell, J. (2005). AIDS optimism, condom fatigue, or self-esteem? Explaining unsafe sex among gay and bisexual men. Journal of Sex Research, 42(3), 238–248.PubMedCrossRefGoogle Scholar
  2. Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897.PubMedCrossRefGoogle Scholar
  3. Beck, A. T., & Steer, R. A. (1993). Beck Anxiety Inventory Manual. San Antonio, TX: The Psychological Corporation.Google Scholar
  4. Beyrer, C. (2008). Hidden yet happening: The epidemics of sexually transmitted infections and HIV among men who have sex with men in developing countries. Sexually Transmitted Infections, 84(6), 410–412.PubMedCrossRefGoogle Scholar
  5. Binson, D., Woods, W. J., Pollack, L., Paul, J., Stall, R., & Catania, J. A. (2001). Differential HIV risk in bathhouses and public cruising areas. American Journal of Public Health, 91(9), 1482–1486. Scholar
  6. Bouhnik, A.-D., Préau, M., Schiltz, M.-A., Peretti-Watel, P., Obadia, Y., Lert, F., & Spire, B. (2006). Unsafe sex with casual partners and quality of life among HIV-infected gay men: Evidence from a large representative sample of outpatients attending French hospitals (ANRS-EN12-VESPA). Journal of Acquired Immune Deficiency Syndromes, 42(5), 597–603.PubMedCrossRefGoogle Scholar
  7. Buffum, J. (1988). Substance abuse and high-risk sexual behavior: Drugs and sex—The dark side. Journal of Psychoactive Drugs, 20(2), 165–168.PubMedCrossRefGoogle Scholar
  8. Cassels, S., Menza, T. W., Goodreau, S. M., & Golden, M. R. (2009). HIV serostorting as a harm reduction strategy: Evidence from Seattle, Washington. AIDS, 23, 2497–2506.PubMedPubMedCentralCrossRefGoogle Scholar
  9. Centers for Disease Control and Prevention. (2017). HIV in the United States: At a glance. Retrieved 21 May, 2018 from
  10. Clatts, M. C., Goldsamt, L. A., & Yi, H. (2005). An emerging HIV risk environment: A preliminary epidemiological profile of an MSM POZ Party in New York City. Sexually Transmitted Infections, 81(5), 373–376. Scholar
  11. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.Google Scholar
  12. Denning, P. (2001). Strategies for implementation of harm reduction in treatment settings. Journal of Psychoactive Drugs, 33(1), 23–26.PubMedCrossRefGoogle Scholar
  13. Denning, P. (2004). Practicing harm reduction therapy: An alternative approach to addictions. New York: Guilford Press.Google Scholar
  14. DiClemente, C. C., Schlundt, D., & Gemmell, L. (2004). Readiness and stages of change in addiction treatment. American Journal on Addictions, 13(2), 103–119.PubMedCrossRefGoogle Scholar
  15. Drucker, E., Lurie, P., Wodak, A., & Alcabes, P. (1998). Measuring harm reduction: The effects of needle and syringe exchange programs and methadone maintenance on the ecology of HIV. AIDS, 12(Suppl. A), S217–230.PubMedGoogle Scholar
  16. Drumright, L. N., Little, S. J., Strathdee, S. A., Slymen, D. J., Araneta, M. R. G., Malcarne, V. L., et al. (2006). Unprotected anal intercourse and substance use among men who have sex with men with recent HIV infection. Journal of Acquired Immune Deficiency Syndromes, 43(3), 344–350.PubMedCrossRefGoogle Scholar
  17. Duru, O., Collins, R., Ciccarone, D., Morton, S., Stall, R., Beckman, R., et al. (2006). Correlates of sex without serostatus disclosure among a national probability sample of HIV patients. AIDS and Behavior, 10(5), 495–507. Scholar
  18. Elwood, W. N., Greene, K., & Carter, K. K. (2003). Gentlemen don’t speak: Communication norms and condom use in bathhouses. Journal of Applied Communication Research, 31(4), 277–297. Scholar
  19. Emmons, K. M., & Rollnick, S. (2001). Motivational interviewing in health care settings: Opportunities and limitations. American Journal of Preventive Medicine, 20(1), 68–74. Scholar
  20. Fleming, M. F., Barry, K. L., & MacDonald, R. (1991). The Alcohol Use Disorders Identification Test (AUDIT) in a college sample. International Journal of the Addictions, 26(11), 1173–1185.PubMedCrossRefGoogle Scholar
  21. Frye, V., Latka, M., Koblin, B., Halkitis, P., Putnam, S., Galea, S., & Vlahov, D. (2006). The urban environment and sexual risk behavior among men who have sex with men. Journal of Urban Health, 83(2), 308–324. Scholar
  22. Greenwood, G. L., White, E. W., Page-Shafer, K., Bein, E., Osmond, D. H., Paul, J., & Stall, R. D. (2001). Correlates of heavy substance use among young gay and bisexual men: The San Francisco Young Men’s Health Study. Drug and Alcohol Dependence, 61(2), 105–112. Scholar
  23. Grov, C., Parsons, J., & Bimbi, D. (2007). Sexual risk behavior and venues for meeting sex partners: An intercept survey of gay and bisexual men in LA and NYC. AIDS and Behavior, 11(6), 915–926. Scholar
  24. Grov, C., Parsons, J. T., & Bimbi, D. S. (2010). Sexual compulsivity and sexual risk in gay and bisexual men. Archives of Sexual Behavior, 39(4), 940–949.PubMedCrossRefGoogle Scholar
  25. Hall, H. I., Song, R., Rhodes, P., Prejean, J., An, Q., Lee, L. M., et al. (2008). Estimation of HIV incidence in the United States. Journal of the American Medical Association, 300(5), 520–529.PubMedCrossRefGoogle Scholar
  26. Hatzenbuehler, M. L. (2009). How does sexual minority stigma “get under the skin”? A psychological mediation framework. Psychological Bulletin, 135(5), 707–730.PubMedPubMedCentralCrossRefGoogle Scholar
  27. Hays, R., Merz, J., & Nicholas, R. (1995). Response burden, reliability, and validity of the CAGE, Short MAST, and AUDIT alcohol screening measures. Behavior Research Methods, 27(2), 277–280. Scholar
  28. Herbst, J. H., Beeker, C., Mathew, A., McNally, T., Passin, W., Kay, L. S., et al. (2007). The effectiveness of individual-, group-, and community-level HIV behavioral risk-reduction interventions for adult men who have sex with men: A systematic review. American Journal of Preventive Medicine, 32(4 Suppl.), S38–S67.PubMedCrossRefGoogle Scholar
  29. Herek, G. M., Gillis, J. R., & Cogan, J. C. (2009). Internalized stigma among sexual minority adults: Insights from a social psychological perspective. Journal of Counseling Psychology, 56(1), 32–43.CrossRefGoogle Scholar
  30. Kalichman, S. C., & Rompa, D. (1995). Sexual sensation seeking and sexual compulsivity scales: Validity, and predicting HIV risk behavior. Journal of Personality Assessment, 65(3), 586–601. Scholar
  31. Kelly, J., Murphy, D., Sikkema, K., McAuliffe, T., Roffman, R., Solomon, L., et al. (1997). Randomised, controlled, community-level HIV-prevention intervention for sexual-risk behaviour among homosexual men in US cities. Lancet, 350(9090), 1500–1505.PubMedCrossRefGoogle Scholar
  32. Klausner, J. D., Wolf, W., Fischer-Ponce, L., Zolt, I., & Katz, M. H. (2000). Tracing a syphilis outbreak through cyberspace. Journal of the American Medical Association, 284(4), 447–449. Scholar
  33. Lewis, M. A., DeVellis, B. M., & Sleath, B. (2002). Social influence and interpersonal communication in health behavior. In K. Glanz, B. K. Rimer, & F. M. Lewis (Eds.), Health behavior and health education: Theory, research, and practice (3rd ed., pp. 240–264). San Francisco: Wiley.Google Scholar
  34. Lyles, C. M., Kay, L. S., Crepaz, N., Herbst, J. H., Passin, W. F., Kim, A. S., et al. (2007). Best-evidence interventions: Findings from a systematic review of HIV behavioral interventions for US populations at high risk, 2000–2004. American Journal of Public Health, 97(1), 133–143.PubMedPubMedCentralCrossRefGoogle Scholar
  35. Marlatt, G. A. (1998). Harm reduction: Pragmatic strategies for managing high-risk behaviors. New York: Guilford Press.Google Scholar
  36. Marlatt, G. A., Larimer, M. E., & Witkiewitz, K. (2011). Harm reduction, Second edition: Pragmatic strategies for managing high-risk behaviors. New York: Guilford Press.Google Scholar
  37. Mayer, K. H., Mimiaga, M. J., Cohen, D., Grasso, C., Bill, R., VanDerwarker, R., & Fisher, A. (2008). Tenofovir DF plus lamivudine or emtricitabine for nonoccupational postexposure prophylaxis (NPEP) in a Boston community health center. Journal of Acquired Immune Deficiency Syndromes, 47(4), 494–499.PubMedCrossRefGoogle Scholar
  38. McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Education Quarterly, 15(4), 351–377.PubMedCrossRefGoogle Scholar
  39. Miller, W. R., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change (2nd ed.). New York: Guilford Press.Google Scholar
  40. Mimiaga, M. J., Case, P., Johnson, C. V., Safren, S. A., & Mayer, K. H. (2009a). Pre-exposure antiretroviral prophylaxis (PrEP) attitudes in high risk Boston area MSM: Limited knowledge and experience, but potential for increased utilization after education. Journal of Acquired Immune Deficiency Syndromes, 50(1), 77.PubMedCrossRefGoogle Scholar
  41. Mimiaga, M. J., Goldhammer, H., Belanoff, C., Tetu, A. M., & Mayer, K. H. (2007). Men who have sex with men: Perceptions about sexual risk, HIV and sexually transmitted disease testing, and provider communication. Sexually Transmitted Diseases, 34, 113–119.PubMedCrossRefGoogle Scholar
  42. Mimiaga, M. J., Reisner, S. L., Bland, S., Cranston, K., Isenberg, D., Driscoll, M. A., et al. (2010a). “It’s a quick way to get what you want”: A formative exploration of HIV risk among urban Massachusetts men who have sex with men who attend sex parties. AIDS Patient Care and STDS, 24(10), 659–674.PubMedCrossRefGoogle Scholar
  43. Mimiaga, M. J., Reisner, S. L., Bland, S. E., Driscoll, M. A., Cranston, K., Isenberg, D., et al. (2011). Sex parties among urban MSM: An emerging culture and HIV risk environment. AIDS and Behavior, 15(2), 305–318.PubMedCrossRefGoogle Scholar
  44. Mimiaga, M. J., Reisner, S. L., Cranston, K., Isenberg, D., Bright, D., Daffin, G., et al. (2009b). Sexual mixing patterns and partner characteristics of Black MSM in Massachusetts at increased for HIV risk for HIV infection and transmission. Journal of Urban Health, 86(4), 602–623.PubMedPubMedCentralCrossRefGoogle Scholar
  45. Mimiaga, M. J., Reisner, S. L., Fontaine, Y.-M., Bland, S. E., Driscoll, M. A., Isenberg, D., et al. (2010b). Walking the line: Stimulant use during sex and HIV risk behavior among Black urban MSM. Drug and Alcohol Dependence, 110(1), 30.PubMedPubMedCentralCrossRefGoogle Scholar
  46. Mimiaga, M. J., Reisner, S. L., Tetu, A. M., Bonafide, K. E., Cranston, K., Bertrand, T., et al. (2009c). Partner notification after STD and HIV exposures and infections: Knowledge, attitudes, and experiences of Massachusetts men who have sex with men. Public Health Reports, 124(1), 111–119.PubMedPubMedCentralCrossRefGoogle Scholar
  47. Mimiaga, M. J., Reisner, S., Tetu, A., Cranston, K., Bertrand, T., Novak, D., & Mayer, K. (2009d). Psychosocial and behavioral predictors of partner notification after HIV and STI exposure and infection among MSM. AIDS and Behavior, 13(4), 738–745.PubMedCrossRefGoogle Scholar
  48. Parsons, J. T., Schrimshaw, E. W., Wolitski, R. J., Halkitis, P. N., Purcell, D. W., Hoff, C. C., & Gómez, C. A. (2005). Sexual harm reduction practices of HIV-seropositive gay and bisexual men: Serosorting, strategic positioning, and withdrawal before ejaculation. AIDS, 19(Suppl. 1), S13–S25.PubMedPubMedCentralCrossRefGoogle Scholar
  49. Peterson, J. L., & Bakeman, R. (2006). Impact of beliefs about HIV treatment and peer condom norms on risky sexual behavior among gay and bisexual men. Journal of Community Psychology, 34(1), 37–46. Scholar
  50. Pollack, L. M., Osmond, D. H., Paul, J. P., & Catania, J. A. (2005). Evaluation of the Center for Disease Control and Prevention’s HIV behavioral surveillance of men who have sex with men: Sampling issues. Sexually Transmitted Diseases, 32(9), 581–589.PubMedCrossRefGoogle Scholar
  51. Poppen, P. J., Reisen, C. A., Zea, M. C., Bianchi, F. T., & Echeverry, J. J. (2004). Predictors of unprotected anal intercourse among HIV-positive Latino gay and bisexual men. AIDS and Behavior, 8(4), 379–389.PubMedCrossRefGoogle Scholar
  52. Preston, D. B., D’Augelli, A. R., Kassab, C. D., & Starks, M. T. (2007). The relationship of stigma to the sexual risk behavior of rural men who have sex with men. AIDS Education and Prevention, 19(3), 218–230. Scholar
  53. Prochaska, J. O., & Velicer, W. F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12(1), 38–48.PubMedCrossRefGoogle Scholar
  54. Purcell, D. W., Johnson, C. H., Lansky, A., Prejean, J., Stein, R., Denning, P., … Crepaz, N. (2012). Suppl 1: Estimating the population size of men who have sex with men in the United States to obtain HIV and syphilis rates. The Open AIDS Journal, 6, 98–107. Scholar
  55. Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
  56. Reisner, S. L., Mimiaga, M. J., Case, P., Johnson, C. V., Safren, S. A., & Mayer, K. H. (2009a). Predictors of identifying as a barebacker among high-risk New England HIV seronegative men who have sex with men. Journal of Urban Health, 86(2), 250–262.PubMedCrossRefGoogle Scholar
  57. Reisner, S. L., Mimiaga, M. J., Skeer, M., Vanderwarker, R., Gaucher, M. J., O’Connor, C. A., et al. (2009b). Differential HIV risk behavior among men who have sex with men seeking health-related mobile van services at diverse gay-specific venues. AIDS and Behavior, 13, 822–831.PubMedCrossRefGoogle Scholar
  58. Rollnick, S., & Miller, W. R. (1995). What is motivational interviewing? Behavioural and Cognitive Psychotherapy, 23, 325–334.CrossRefGoogle Scholar
  59. Rose, V. J., Raymond, H. F., Kellogg, T. A., & McFarland, W. (2006). Assessing the feasibility of harm reduction services for MSM: The Late Night Breakfast Buffet Study. Harm Reduction Journal, 3, 29. Scholar
  60. Sallis, J. F., Owen, N., & Fisher, E. B. (2008). Ecological models of health behavior. In K. Glanz, B. K. Rimer, & K. Viswanath (Eds.), Health education and health education: Theory, research, and practice (pp. 465–486). San Francisco: Wiley.Google Scholar
  61. Sanchez, T., Finlayson, T., Drake, A., Behel, S., Cribbin, M., Dinenno, E., et al. (2006). Human immunodeficiency virus (HIV) risk, prevention, and testing behaviors—United States, National HIV Behavioral Surveillance System: Men who have sex with men, November 2003–April 2005. Morbidity and Mortality Weekly Report (MMWR), 55(SS6), 1–16.Google Scholar
  62. Semple, S. J., Patterson, T. L., & Grant, I. (2002). Motivations associated with methamphetamine use among HIV men who have sex with men. Journal of Substance Abuse Treatment, 22(3), 149–156.PubMedCrossRefGoogle Scholar
  63. Shadish, W. R., Cook, T. D., & Campbell, D. T. (2002). Experimental and quasi-experimental designs for generalized causal inference. New York: Houghton Mifflin.Google Scholar
  64. Sinclair, M., McRee, B., & Babor, T. F. (1992). Evaluation of the reliability of AUDIT. Farmington: University of Connecticut School of Medicine, Alcohol Research Center.Google Scholar
  65. Taylor, M., Aynalem, G., Smith, L., Bemis, C., Kenney, K., & Kerndt, P. (2004). Correlates of internet use to meet sex partners among men who have sex with men diagnosed with early syphilis in Los Angeles county. Sexually Transmitted Diseases, 31(9), 552–556.PubMedCrossRefGoogle Scholar
  66. U.S. Department of Health and Human Services. (2004). CES-D Scale. Bethesda, MD: Department of Health and Human Services, National Institute of Health.Google Scholar
  67. Willoughby, B., Lai, B. S., Doty, N. D., Mackey, E. R., & Malik, N. M. (2008). Peer crowd affiliations of adult gay men: Linkages with health risk behaviors. Psychology of Men and Masculinity, 9(4), 235–247. Scholar
  68. Wilson, P. A., Cook, S., McGaskey, J., Rowe, M., & Dennis, N. (2008). Situational predictors of sexual risk episodes among men with HIV who have sex with men. Sexually Transmitted Infections, 84(6), 506–508. Scholar
  69. Xia, Q., Tholandi, M., Osmond, D. H., Pollack, L. M., Zhou, W., Ruiz, J. D., & Catania, J. A. (2006). The effect of venue sampling on estimates of HIV prevalence and sexual risk behaviors in men who have sex With men. Sexually Transmitted Diseases, 33(9), 545–550.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Matthew J. Mimiaga
    • 1
    • 2
    • 3
    Email author
  • Jaclyn M. W. Hughto
    • 1
    • 2
    • 3
  • Sari L. Reisner
    • 4
    • 5
  1. 1.Center for Health Equity ResearchBrown UniversityProvidenceUSA
  2. 2.Departments of Behavioral and Social Health Sciences and EpidemiologyBrown University School of Public HealthProvidenceUSA
  3. 3.Department of Psychiatry and Human BehaviorBrown University Alpert Medical SchoolProvidenceUSA
  4. 4.Department of PediatricsHarvard Medical School/Boston Children’s HospitalBostonUSA
  5. 5.Department of EpidemiologyHarvard School of Public HealthBostonUSA

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