Efficacy of a Small-Group Intervention for Post-Incarcerated Black Men Who Have Sex with Men and Women (MSMW)
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We conducted a randomized controlled trial of a six-session behavioral intervention designed to reduce frequency of condomless sex and numbers of sex partners among recently incarcerated, bisexual Black men. One hundred participants were assigned to the small-group intervention, Men in Life Environments (MILE), and 112 were assigned to the control condition. Among those assigned to MILE, 69% attended at least one session, 88% of whom attended all sessions. At 3-months’ follow-up, large reductions in risk behaviors were reported by both groups. Means for episodes of condomless sex in the previous 3 months declined from 27.7 to 8.0 for the intervention and 25.6 to 6.7 for the control group. Reductions were not greater for the intervention than those of the control group. Regression to the mean, respondent burden, and implementation issues, such as moving from office-based to field-based survey administration at follow-up, may have contributed to the large declines reported by both groups.
KeywordsBehavioral intervention HIV risk behavior Bisexual Black/African American men Incarceration
Compliance with Ethical Standards
Study procedures were approved by the institutional review boards at University of Southern California and the Charles R. Drew University of Medicine and Science. Interested and eligible individuals completed the consent process and baseline interviews at the study offices located in CHJ. They provided written informed consent using an IRB-approved consent form that outlined study procedures; potential risks, benefits, and compensation; protection related to our Certificate to Confidentiality; and limits to confidentiality. Those initially contacted in jail provided verbal consent for collection of their locator information in jails for potential study enrollment post-release, using IRB approved forms and processes for this purpose.
- 1.Centers for Disease Control and Prevention. HIV surveillance report. 2015;27. Published November 2016.Google Scholar
- 2.Harawa NT, Williams JK, McCuller WJ, Ramamurthi HC, Lee M, Shapiro MF, et al. Efficacy of a culturally congruent HIV risk-reduction intervention for behaviorally bisexual black men: results of a randomized trial. AIDS. 2013;27(12):1979–88. https://doi.org/10.1097/QAD.0b013e3283617500.CrossRefPubMedPubMedCentralGoogle Scholar
- 4.Williams JK, Glover DA, Wyatt GE, Kisler K, Liu H, Zhang M. A sexual risk and stress reduction intervention designed for HIV-positive bisexual African American men with childhood sexual abuse histories. Am J Public Health. 2013;103(8):1476–84. https://doi.org/10.2105/AJPH.2012.301121.CrossRefPubMedPubMedCentralGoogle Scholar
- 9.Williams JK, Ramamurthi HC, Manago C, Harawa NT. Learning from successful interventions: a culturally congruent HIV risk-reduction intervention for African American men who have sex with men and women. Am J Public Health. 2009;99(6):1008–12. https://doi.org/10.2105/AJPH.2008.140558.CrossRefPubMedPubMedCentralGoogle Scholar
- 10.Brewer RA, Magnus M, Kuo I, Wang L, Liu TY, KH M. The high prevalence of incarceration history among Black men who have sex with men in the United States: associations and implications. Am J Public Health. 2014;104(3):448–54. https://doi.org/10.2105/AJPH.2013.301786.CrossRefPubMedPubMedCentralGoogle Scholar
- 14.Levy ME, Wilton L, Phillips G 2nd, et al. Understanding structural barriers to accessing HIV testing and prevention services among black men who have sex with men (BMSM) in the United States. AIDS Behav. 2014;18(5):972–96. https://doi.org/10.1007/s10461-014-0719-x.CrossRefPubMedPubMedCentralGoogle Scholar
- 16.Maruschak L, Berzofsky M, Unangst J. Medical problems of state and federal prisoners and jail inmates 2011–12. U.S. Department of Justice; 2015.Google Scholar
- 18.Weinbaum CM, Sabin KM, Santibanez SS. Hepatitis B, hepatitis C, and HIV in correctional populations: a review of epidemiology and prevention. AIDS. 2005;19(Suppl 3):S41–6. https://doi.org/10.1097/01.aids.0000192069.95819.aa.CrossRefPubMedGoogle Scholar
- 20.Sabol W, Minton T, Harrison P. Prison and jail inmates at midyear 2006. U.S. Department of Justice, Bureau of Justice Statistics Bulletin. 2007;NCJ 217675.Google Scholar
- 21.Brewer RA, Magnus M, Kuo I, Wang L, Liu TY, Mayer KH. Exploring the relationship between incarceration and HIV among black men who have sex with men in the United States. J Acquir Immune Defic Syndr. 2014;65(2):218–25. https://doi.org/10.1097/01.qai.0000434953.65620.3d.CrossRefPubMedPubMedCentralGoogle Scholar
- 22.Spaulding AC, Seals RM, Page MJ, Brzozowski AK, Rhodes W, Hammett TM. HIV/AIDS among inmates of and releases from US correctional facilities, 2006: declining share of epidemic but persistent public health opportunity. PLoS One. 2009;4(11):e7558. https://doi.org/10.1371/journal.pone.0007558.CrossRefPubMedPubMedCentralGoogle Scholar
- 25.Wohl DA, Scheyett A, Golin CE, White B, Matuszewski J, Bowling M, et al. Intensive case management before and after prison release is no more effective than comprehensive pre-release discharge planning in linking HIV-infected prisoners to care: a randomized trial. AIDS Behav. 2011;15(2):356–64. https://doi.org/10.1007/s10461-010-9843-4.CrossRefPubMedPubMedCentralGoogle Scholar
- 26.Petersilia J. When prisoners come home: parole and prisoner reentry. New York, New York: Oxford University Press; 2003.Google Scholar
- 28.Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. Special Issue: Theories of cognitive self-regulation. 1991;50(2):179–211.Google Scholar
- 29.Manago C. A critical thinking and cultural affirmation (CTCA) approach to HIV prevention and risk reduction, consciousness, and practice for African American males at HIV sexual risk. Los Angeles: The AmASSI Center; 1996.Google Scholar
- 30.Freire P. Pedagogy of the oppressed, vol. 183. New York, NY: Continuum; 1983.Google Scholar
- 34.NIMH Multisite HIV/STD Prevention Trial for African American Couples Group. Supervision of facilitators in a multisite study: goals, process, and outcomes. J Acquir Immune Defic Syndr. 2008;49(Suppl 1):S59–67.Google Scholar
- 35.Perris C. Cognitive psychotherapy and training supervisors. J Cogn Psychother. 1994;8(2):83–102.Google Scholar
- 37.Hopkins W. Regression to the mean. In: A new view of statistics. Available at: http://www.sportsci.org/resource/stats/. Accessed Feb 2016.
- 38.Trochim M. Regression to the mean. In: The research methods knowledge base, 2nd ed. Available at: http://www.socialresearchmethods.net/kb/. Accessed Nov 2015.
- 39.Hughes JP, Haley DF, Frew PM, Golin CE, Adimora AA, Kuo I, et al. Regression to the mean and changes in risk behavior following study enrollment in a cohort of U.S. women at risk for HIV. Ann Epidemiol. 2015;25(6):439–44. https://doi.org/10.1016/j.annepidem.2015.03.013.CrossRefPubMedPubMedCentralGoogle Scholar
- 42.Okwundu CI, Uthman OA, Okoromah CA. Antiretroviral pre-exposure prophylaxis (PrEP) for preventing HIV in high-risk individuals. Cochrane Database Syst Rev. 2012;7:CD007189.Google Scholar
- 45.Sorensen SW, Sansom SL, Brooks JT, Marks G, Begier EM, Buchacz K, et al. A mathematical model of comprehensive test-and-treat services and HIV incidence among men who have sex with men in the United States. PLoS One. 2012;7(2):e29098. https://doi.org/10.1371/journal.pone.0029098.CrossRefPubMedPubMedCentralGoogle Scholar
- 46.Rotheram-Borus MJ, Swendeman D, Chovnick G. The past, present, and future of HIV prevention: integrating behavioral, biomedical, and structural intervention strategies for the next generation of HIV prevention. Annu Rev Clin Psychol. 2009;5(1):143–67. https://doi.org/10.1146/annurev.clinpsy.032408.153530.CrossRefPubMedPubMedCentralGoogle Scholar
- 47.Koblin BA, Andrasik M, Austin J. Preparing for the unexpected: the pivotal role of social and behavioral sciences in trials of biomedical HIV prevention interventions. J Acquir Immune Defic Syndr. 2013;63(Suppl 2):S183–6. https://doi.org/10.1097/QAI.0b013e31829a3a4d.CrossRefPubMedPubMedCentralGoogle Scholar