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What predicts participation in community based HIV prevention programs for MSM?

What predicts participation in community based HIV prevention programs for MSM?. David M. Huebner, PhD, MPH Rae Jean Proescholdbell, PhD Diana Formoso, PhD Carol J. Nemeroff, PhD University of California, San Francisco Arizona State University. Background.

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What predicts participation in community based HIV prevention programs for MSM?

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  1. What predicts participation in community based HIV prevention programs for MSM? David M. Huebner, PhD, MPH Rae Jean Proescholdbell, PhD Diana Formoso, PhD Carol J. Nemeroff, PhD University of California, San Francisco Arizona State University

  2. Background • Several HIV prevention interventions for MSM have been developed and empirically supported • Community based organizations (CBOs) around the country are implementing interventions for MSM • Little is known about who these interventions reach and what predicts participation in them

  3. Phase I -- Qualitative What services are being offered and what are the barriers and facilitators to participation in those services? • Interviews and focus groups with a total of 23 diverse MSM • Special efforts to reach young, minority, IDU, and guys in rural counties • Interviews with representatives from 9 CBOS

  4. What kinds of service use occurs? Passive Services Information Seeking HIV Counseling and Testing Structured Services Volunteer Opportunities

  5. Barriers and Facilitators to Service Use • Positive expectations • Services will be fun and interesting • You would learn something new • Staff will be respectful • Negative Expectations • Information about you would be spread to others • Your health insurance would be affected • People would assume you are doing risky things

  6. Barriers and Facilitators to Service Use • Personal Discomfort Being uncomfortable with… • Talking to a stranger about HIV • Talking to someone who is not gay about HIV • Being seen going into an HIV-related CBO

  7. Barriers and Facilitators to Service Use • Cues to Action • Having a friend test HIV+ • Getting sick • Being asked by a friend to get tested • Ending or starting a relationship

  8. Phase II -- Quantitative Do our qualitative findings bear out in a large sample of MSM?

  9. Recruitment • Paper copies of survey distributed in local, free gay magazine • Outreach to venues and events • Advertisements in gay and mainstream press, and on local websites • Emphasis on oversampling underrepresented groups

  10. Participation • Paper, online, or over the phone • 30 page questionnaire, requiring approximately 1 hour to complete • Anonymous or confidential • $25 compensation or entry into a raffel

  11. Sample Wave 1 (n = 709) • Mean age 33, 13% were 21 or under • 71% White, 13% Latino, 8% African-American, 6% Native American • 85% high school grad, 40% college grad • 20% out to “no one” or “just a few people” Wave 2 (n = 399) • 647 gave contact information (62% response) • Somewhat older, more out, and fewer African-Americans

  12. What gets MSM to use services? Intentions To Use Services (Time 1) Demographics were also included in models

  13. What gets MSM to use services? Actual Service Use (Time 2) Demographics and prior service use were included in models

  14. What does this mean for ASOs? Personal Discomfort • Make private counseling available • Choose ASO location that considers privacy of client • Hire gay staff • Hire ethnically diverse staff when serving ethnically diverse populations

  15. What does this mean for ASOs? Positive Expectations • Public relations matter! • Publicize strengths of agency • Remedy negative perceptions and public misconceptions

  16. What does this mean for ASOs? Cues to Action: Men plan to and actually use services when. . . • They are sick -Advertise at doctor’s offices and cold remedy aisles -Educate physicians about availability of services

  17. What does this mean for ASOs? Cues to Action: Men plan to and actually use services when. . . • A friend encourages them to -Bring a friend meeting or party • Someone close to them finds out they have HIV or dies from AIDS -HIV positive men discuss their illness with others

  18. What does this mean for ASOs? Cues to Action: Men plan to and actually use services when. . . • A friend has engaged in risky behavior • They end a relationship or start a new relationship -Pitch ads toward these events

  19. Contact David M. Huebner Center for AIDS Prevention Studies University of California, San Francisco Dhuebner@psg.ucsf.edu 415-597-8122

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