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Efficacy of a Clinic-Based Safer Sex Program for Human Immunodeficiency Virus–Uninfected and Human Immunodeficiency Virus–Infected Young Black Men Who Have Sex With Men: A Randomized Controlled Trial

Crosby, Richard A. PhD*†‡; Mena, Leandro MD‡§; Salazar, Laura F. PhD; Hardin, James W. PhD; Brown, Tim MPH*; Vickers Smith, Rachel PhD**

Sexually Transmitted Diseases: March 2018 - Volume 45 - Issue 3 - p 169–176
doi: 10.1097/OLQ.0000000000000721
Original Studies

Objective To test the efficacy of a single-session, clinic-based intervention designed to promote condom use among young black men who have sex with men (YBMSM).

Methods Six hundred YBMSM were enrolled in a randomized controlled trial, using a 12-month observation period. An intent-to-treat analysis was performed, with multiple imputation for missing data.

Results Compared with the reference group, human immunodeficiency virus (HIV)–infected men in the intervention group had 64% greater odds of reporting consistent condom use for anal receptive sex over 12 months (estimated odds ratio, 1.64; 95% confidence interval, 1.23–2.17, P = 0.001). Also, compared with the reference group, HIV-uninfected men in the intervention group had more than twice the odds of reporting consistent condom use for anal receptive sex over 12 months (estimated odds ratio, 2.14; 95% confidence interval, 1.74–2.63, P < 0.001). Significant intervention effects relative to incident sexually transmitted diseases were not observed.

Conclusions A single-session, clinic-based, intervention may help protect HIV-uninfected YBMSM against HIV acquisition and HIV-infected YBMSM from transmitting the virus to insertive partners.

This efficacy trial of a single-session intervention, designed for young, black men who have sex with men, found significant 12-month effects relative to reduced condomless receptive sex, for both human immunodeficiency virus–uninfected and human immunodeficiency virus–infected men.

From the *Department of Health Behavior, College of Public Health at the University of Kentucky, Lexington, KY; †Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN; ‡Division of Infectious Diseases, University of Mississippi School of Medicine, Jackson, MS; §Department of Population Health Science, John D. Bower School of Population Health, Jackson, MS; ¶Institute of Public Health at Georgia State University, Atlanta, GA; ∥Arnold School of Public Health at the University of South Carolina, Columbia, SC; and **Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA

Acknowledgments: The authors wish to acknowledge the work of members serving on the Data Safety and Monitoring Board: Drs. Hannah Cooper, Delia Lang, Jessica Sales (Rollins School of Public Health at Emory University) and Dr. John Peterson (Department of Psychology at Georgia State University). The authors also wish to thank the study consultants serving in year 1 of this project: Dr. Manya Magnus (Milken Institute School of Public health at George Washington University) and Dr. Patrick Sullivan (Rollins School of Public Health at Emory University). Finally, the authors are grateful for the assistance of Dr. Susannah Allison at the National Institute of Mental Health and a host of staff members who were employed by this project.

Trial Registration: The study was registered with Clinical (ID: NCT00849823;

Conflict of Interest: None declared.

Source of Funding: This study was funded by a grant from the National Institute of Mental Health to the first author, R01MH092226.

Correspondence: Richard Crosby, PhD, College of Public Health, 111 Washington Ave. Lexington, KY 40506-0003. E-mail:

Received for publication May 27, 2017, and accepted August 20, 2017.

© Copyright 2018 American Sexually Transmitted Diseases Association