Development of an HIV risk reduction intervention for older seropositive African American men

The purpose of this study was to assess the feasibility and acceptability of an HIV risk reduction intervention to increase consistent condom use in a sample of older HIV-positive African American men who have sex with men (MSM). Repeated measures were used at baseline, immediate postintervention, and 3 months postintervention to collect data. The development of the intervention was implemented in four phases: focus groups, pilot testing of the questionnaire, modifying the intervention, and executing the intervention. Sixty HIV-positive African American MSM were randomized to either an HIV risk condition or a health condition. Each condition consisted of four 120-minute sessions delivered over a 4-week period in a classroom-like setting using interactive approaches. The primary outcome was consistent condom use during every instance of anal intercourse. In unadjusted analyses, men in the risk reduction group were twice as likely to use condoms consistently (odds ratio [OR] = 2.04; 95% confidence interval [CI] = 0.48-8.77; p = 0.336), although this did not reach statistical significance. All participants reporting consistent condom use at baseline reported consistent use at 3 months giving perfect prediction for the sample. Among men not reporting consistent condom use at baseline, those in the risk reduction group were 5 times more likely to report consistent condom use at 3 months than were those in the health condition (OR = 5.18; 95% CI = 0.97-27.78; p = 0.054). The findings suggest that an HIV risk-reduction condition may increase consistent condom use among HIV-positive African American MSM 50 years and older.