SAN FRANCISCO -- Prevention programs that involve entire social systems to encourage and support young gay men to practice safer sex are successful in reducing HIV risk behavior, according to a UCSF study published in the August issue of the American Journal of Public Health.
The UCSF study is the first controlled study to evaluate HIV prevention programs designed specifically for young gay men, according to Susan M. Kegeles, Ph.D., a researcher at the UCSF Center for AIDS Prevention Studies (CAPS).
"We have found it is far more effective for peers to support and encourage each other in spreading the HIV prevention message through young gay men's social networks," Kegeles said.
"Furthermore, we found that to most effectively reach young gay men who are engaging in high risk activities, programs need to go beyond traditional health education approaches," she added. "HIV prevention efforts need to be conducted within the context of broader issues of importance to young gay men, such as meeting social needs and having a place to get support from each other."
Young gay men are engaging in alarming rates of unsafe sex, according to Kegeles, and HIV rates in this population continue to climb.
"Young gay men are not being effectively reached by HIV prevention efforts," she said. "The HIV prevention program we evaluated in the study should be used as a model for mid-sized communities aiming to reduce HIV-risk behavior among its young gay and bisexual men."
Kegeles and other CAPS researchers developed and implemented an eight-month peer-led HIV prevention program for young gay men in two midsize communities in the United States.
The program involved five elements designed to increase support for safer sex and to change community norms: a young gay men's community center created for the study, a core group of young gay or bisexual men who ran the project, informal outreach conducted among friends, formal outreach conducted at gay venues and social events, and small groups that focused on safer sex and informal outreach.
The study involved 242 gay and bisexual men ages 18 to 27 from both communities (Eugene, Ore., and Santa Barbara, Calif.). Participants were interviewed twice before the program intervention and twice afterward.
Study results showed no significant difference between the levels of unprotected anal sex reported at each interview before the intervention, showing that there was no trend towards risk reduction. Two months after the program intervention, study findings indicated a 26 percent reduction in reported unsafe sex with casual partners and a 28 percent reduction in unsafe sex with boyfriends. The reduction in unsafe sex with casual partners was sustained one year after the intervention, findings showed. There was, however, a return to unsafe sex with boyfriends, many of whom were new relationships, Kegeles said.
"Since new young men will continue to come out as gay each year, it is critical that there be an ongoing system to socialize them about the need for safer sex," Kegeles said. "Additional efforts need to focus on risk reduction among boyfriends."