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    On the Efficacy and Mediation of a One-on-One HIV Risk-Reduction Intervention for African American Men Who Have Sex with Men: A Randomized Controlled Trial

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    On the Efficacy and Mediation ...
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    Genre
    Journal Article
    Date
    2015-07-25
    Author
    Jemmott, JB
    Jemmott, LS
    O’Leary, A
    Icard, LD
    Rutledge, SE
    Stevens, R
    Hsu, J
    Stephens, AJ
    Subject
    HIV
    Men who have sex with men
    African Americans
    Intervention
    Sexual behavior
    Permanent link to this record
    http://hdl.handle.net/20.500.12613/5279
    
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    DOI
    10.1007/s10461-014-0961-2
    Abstract
    © 2014, The Author(s). We examined the efficacy and mediation of Being Responsible for Ourselves (BRO), an HIV/STI risk-reduction intervention for African American men who have sex with men (MSM), the population with the highest HIV-diagnosis rate in the US. We randomized African American MSM to one of two interventions: BRO HIV/STI risk-reduction, targeting condom use; or attention-matched control, targeting physical activity and healthy diet. The interventions were based on social cognitive theory, the reasoned-action approach, and qualitative research. Men reporting anal intercourse with other men in the past 90 days were eligible and completed pre-intervention, immediately post-intervention, and 6 and 12 months post-intervention surveys. Of 595 participants, 503 (85 %) completed the 12-month follow-up. Generalized-estimating-equations analysis indicated that, compared with the attention-matched control intervention, the BRO intervention did not increase consistent condom use averaged over the 6- and 12-month follow-ups, which was the primary outcome. Although BRO did not affect the proportion of condom-protected intercourse acts, unprotected sexual intercourse, multiple partners, or insertive anal intercourse, it did reduce receptive anal intercourse compared with the control, a behavior linked to incident HIV infection. Mediation analysis using the product-of-coefficients approach revealed that although BRO increased seven of nine theoretical constructs it was designed to affect, it increased only one of three theoretical constructs that predicted consistent condom use: condom-use impulse-control self-efficacy. Thus, BRO indirectly increased consistent condom use through condom-use impulse-control self-efficacy. In conclusion, although BRO increased several theoretical constructs, most of those constructs did not predict consistent condom use; hence, the intervention did not increase it. Theoretical constructs that interventions should target to increase African American MSM’s condom use are discussed.
    Citation to related work
    Springer Science and Business Media LLC
    Has part
    AIDS and Behavior
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    ae974a485f413a2113503eed53cd6c53
    http://dx.doi.org/10.34944/dspace/5261
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