The current study used baseline data from the EXPLORE cohort to test the empirical foundation of the intervention's design. A large, multicity, multiethnic cohort of men who have sex with men enrolled in EXPLORE, a randomized clinical trial designed to evaluate the impact of a 10-session, individually delivered cognitive-behavioral intervention followed by quarterly maintenance sessions has on HIV incidence rates. The authors tested "both the salience of the factors targeted by the intervention as correlates of self-reported risk and the need to individualize delivery of the intervention because of the heterogeneous clustering of factors among at-risk men," according to the study.

Participants used audio computer-assisted self-interviewing technology to complete 22 items scored on a 6-point Likert scale (agree to strongly disagree) that measured self-efficacy regarding risk reduction, communication skills, and social norms about safer sex. They also answered questions about enjoyment of unsafe sexual practices and about alcohol and noninjection drug use.

Of the roughly 4,300 MSM surveyed, one-third reported low communication skills, twice the percentage that reported low self-efficacy or weak social norms. Seventy-five percent of the participants reported enjoying insertive anal sex without a condom, and 53 percent and 52 percent reported enjoying receptive anal sex and oral sex without a condom, respectively. "The majority of the study population (57 percent) exhibited combinations of factors, such an enjoyment of risk-related behavior, low communication skills and use of noninjection drugs (7 percent). In all, 62 combinations of risk were observed out of a possible 64, indicating that in this cohort of MSM, there was considerable heterogeneity in terms of combinations of risk-related factors," the researchers wrote.

"The EXPLORE baseline data support the relevance to at-risk MSM of the factors targeted by the study's counseling methods and the content of the behavioral intervention. In addition, the heterogeneity with which these factors were shown to be distributed among the cohort members reinforces the importance of a tailored approach in which structured modules are selected and implemented in a manner consistent with individuals' unique characteristics which predispose them to engage in risk behavior," the authors concluded.

Back to other news for August 26, 2003

Search the Newsroom archive