Community Building Reduces Young Gay Men's HIV Risk Behavior

A group of Albuquerque gay men ages 18 to 28 reported a 12 percent decrease in risky sexual behavior as a result of a community-building HIV prevention intervention, according to researchers from the University of California-San Francisco Center for AIDS Prevention Studies (UCSF's CAPS).

The baseline data from the study were collected in 1996, prior to widespread use of highly active antiretroviral therapy (HAART), from young gay men recruited from gay bars and social networks and through advertising in Albuquerque, N.M., Austin, Texas, and Phoenix, Ariz. They were surveyed independently of the intervention in 1996 and again in 1998/1999 with additional men recruited for the follow-up survey. Unprotected anal intercourse (UAI) with a nonprimary partner was the measure for risky sexual behavior. In 1996, 28 percent of young gay men in Albuquerque, 23 percent in Austin and 25 percent in Phoenix reported UAI.

A peer-led, community-level, HIV prevention intervention was implemented in Albuquerque for 12 months in 1997-98. Its components were a young gay men's community center; informal outreach conducted among friends; formal outreach conducted at gay venues and social events; small peer-led groups that teach safer sex through discussions about dating and relationships and that encourage participants to assist in community building; and a small publicity campaign about the project.

In 1999, 33 percent of young gay men in Austin reported UAI, a 42 percent increase from baseline. In Phoenix, 32 percent reported UAI, a 26 percent increase. But in Albuquerque, 24.5 percent reported UAI, a 12 percent decrease.

"With AIDS deaths down dramatically -- and along with that, visible reminders of the deadly consequences of AIDS -- just handing out condoms or discussing safer sex is not going to do the job," said study author Susan M. Kegeles, PhD, UCSF professor of medicine and associate director of UCSF's CAPS. "You need to establish places that are not gay bars or cruising areas where young gay men can create a community that supports them in all aspects of their lives," said Kegeles, who presented the findings at the 14th International AIDS Conference in Barcelona.

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