Barcelona 2013
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| Abstract #81 - Psychological state | ||||
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Session: 6.5: Psychological state (Parallel) on Monday @ 11.00-13.00 in Auditorio Chaired by Barbara Hedge, Susannah Allison Authors: Presenting Author: Prof Steven Kurtz - Nova Southeastern University, United States |
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| Additional Authors: | ||||
| Aim: Men who have sex with men (MSM) account for over 60% of new HIV infections in the US; recent analyses found that 1/3 of such infections are attributable to non-injection substance use. Recent work has suggested that the syndemic model of health disparities among MSM be expanded to include research into resilience processes by which many MSM exposed to syndemic risk are able to use strengths and resources to overcome risk. In a sample of highly vulnerable substance using MSM, we examined the relationship between safe sex behaviors and improved scores on measures of resilience at 12 months following participation in behavioral interventions. | ||||
| Method / Issue: Data are drawn from a two-armed randomized controlled trial comparing the efficacy of a four-session small group empowerment theory-based intervention to a single session individual resilience counseling (enhancing individual strengths and protective factors) condition. We recruited 515 MSM ages 18-55 who reported recent unprotected anal intercourse (UAI) and substance use. 88 participants (?safer men?) reported no UAI at their 3-, 6- and 12-month follow-up interviews. We examined the relationship between measures of resilience at 12 month follow-up and this sexual risk outcome using logistic regression models. Resilience measures included personal mastery, positive coping skills, coping self-efficacy, and involvement in pro-social activities. | ||||
| Results / Comments: Mean age was 39; 46.4% were HIV-positive. Race/ethnicity: 48.5% White, 25.8% Latino, 21.0% Black, 4.7% other. Past 90 day substance use: 82% heavy alcohol, 45% powder cocaine, 20% crack, 26% methamphetamine, 53% amyl nitrites, 34% benzodiazepines, 25% prescription opioids. The sample averaged over 17 UAI events and over 13 anal sex partners in the past 90 days at baseline. Safer men were more likely to be Black and less likely to be White than men who continued to report UAI in the 12 months after intervention. Age, sexual risk behaviors, and resilience measures were not different at baseline between safer men and men who continued to report UAI after baseline. At 12 month follow up, safer men reported higher levels of personal mastery (p=.049), positive coping skills (p=.026), coping self-efficacy (p=.015) and pro-social activities (p=.046) than men who continued to report UAI after intervention. | ||||
| Discussion: Generally, participants in both intervention conditions reported large reductions in substance use and sexual risk behaviors, as well as improved scores on resilience measures, post-intervention, and these changes were maintained at 12-month follow-up. The analyses presented here found that the men who consistently abstained from UAI for 12 months post-intervention also reported the greatest improvement in resilience measures during that period. These findings suggest that behavioral interventions that target enhancing individual strengths and protective factors, and increasing access to resources, are well-suited to high risk substance using MSM. Research is needed to understand the differential effects of such interventions across individuals in order to increase the potency of such approaches. | ||||
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