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Evaluation of a social network HIV prevention intervention program for young men who have sex with men in Russia and Bulgaria.

https://arctichealth.org/en/permalink/ahliterature184449
Source
AIDS Educ Prev. 2003 Jun;15(3):205-20
Publication Type
Article
Date
Jun-2003
Author
Yuri A Amirkhanian
Jeffrey A Kelly
Elena Kabakchieva
Timothy L McAuliffe
Sylvia Vassileva
Author Affiliation
Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 2017 N Summit Avenue, Milwaukee 53202, USA. yuri@mcw.edu
Source
AIDS Educ Prev. 2003 Jun;15(3):205-20
Date
Jun-2003
Language
English
Publication Type
Article
Keywords
Adult
Bulgaria
Condoms - utilization
Follow-Up Studies
HIV Infections - prevention & control
Health Planning - methods
Homosexuality, Male - statistics & numerical data
Humans
Leadership
Male
Program Evaluation
Risk Reduction Behavior
Russia
Safe Sex - statistics & numerical data
Sex Education - organization & administration
Social Support
Sociometric Techniques
Abstract
HIV prevention, by intervening within social networks, is potentially important but highly understudied. Approaches that systematically identify, train, and enlist known social influence leaders to advise members of their own networks in risk reduction constitute ways to reach hidden population segments, persons who are distrustful of authorities but trust their peers, and those who cannot be reached through traditional professionally delivered counseling. This article illustrates and provides evaluation data on a program that recruited 14 intact social networks of young men who have sex with men (YMSM) in St. Petersburg, Russia, and Sofia, Bulgaria. Sociometric measures were used to identify the social leader of each network, and baseline risk assessment measures were administered to all members of each social network. The sociometrically determined leaders then attended a six-session group program that provided training and guidance in how to carry out theory-based and tailored HIV prevention conversations with members of their own social networks. Four months after leaders completed the program, all network members were readministered risk assessment measures. Pre- to postintervention data revealed that the program produced: (1) increases in the level and comfort with which network members talked about AIDS prevention topics in their daily conversations; (2) increased network-level AIDS risk reduction knowledge and improved risk reduction norm perceptions, attitudes, behavioral intentions, and self-efficacy; and (3) increased condom use levels among network members. Although not a controlled, randomized trial, these program evaluation findings strongly support the feasibility of social network-level HIV prevention approaches.
PubMed ID
12866833 View in PubMed
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A randomized social network HIV prevention trial with young men who have sex with men in Russia and Bulgaria.

https://arctichealth.org/en/permalink/ahliterature172403
Source
AIDS. 2005 Nov 4;19(16):1897-905
Publication Type
Article
Date
Nov-4-2005
Author
Yuri A Amirkhanian
Jeffrey A Kelly
Elena Kabakchieva
Anna V Kirsanova
Sylvia Vassileva
Judit Takacs
Wayne J DiFranceisco
Timothy L McAuliffe
Roman A Khoursine
Laszlo Mocsonaki
Author Affiliation
Center for AIDS Intervention Research (CAIR), Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin 53202, USA. yuri@mcw.edu
Source
AIDS. 2005 Nov 4;19(16):1897-905
Date
Nov-4-2005
Language
English
Publication Type
Article
Keywords
Adult
Attitude to Health
Bulgaria
Condoms - utilization
HIV Infections - prevention & control
Homosexuality, Male
Humans
Male
Patient Acceptance of Health Care
Patient Education as Topic - methods
Risk factors
Risk-Taking
Russia
Social Support
Unsafe Sex
Abstract
To evaluate the effects of an HIV prevention intervention with social networks of young men who have sex with men (YMSM) in St. Petersburg, Russia and Sofia, Bulgaria.
A two-arm randomized trial with a longitudinally-followed community cohort.
Fifty-two MSM social networks were recruited through access points in high-risk community venues. Network members (n = 276) were assessed to determine risk characteristics, administered sociometric measures to empirically identify the social leader of each network, and counseled in risk reduction. The leaders of 25 experimental condition networks attended a nine-session program that provided training and guidance in delivering ongoing theory-based HIV prevention advice to other network members. Leaders successively targeted network members' AIDS risk-related knowledge and risk reduction norms, attitudes, intentions, and self-efficacy. Participants were re-administered risk assessment measures at 3- and 12-month follow-ups.
Among changes produced, the percentage of experimental network members reporting unprotected intercourse (UI) declined from 71.8 to 48.4% at 3-month follow up (P = 0.0001). The percentage who engaged in UI with multiple partners reduced from 31.5 to 12.9% (P = 0.02). After 12 months, the effects became attenuated but remained among participants who had multiple recent sexual partners, the most vulnerable group. Little change was found in control group networks.
Interventions that engage the identified influence leaders of at-risk YMSM social networks to communicate theory-based counseling and advice can produce significant sexual risk behavior change. This model is culturally pertinent for HIV prevention efforts in former socialist countries, as well as elsewhere for other hard-to-reach vulnerable community populations.
PubMed ID
16227798 View in PubMed
Less detail