Effects of a social network HIV/STD prevention intervention for MSM in Russia and Hungary

Abstract

Objective To test a novel social network HIV risk reduction intervention for MSM in Russia and Hungary, where same-sex behavior is stigmatized and men may best be reached through their social network connections. Design A 2-arm trial with 18 sociocentric networks of MSM randomized to the social network intervention or standard HIV/STD testing/counseling. Setting St. Petersburg, Russia and Budapest, Hungary. Participants 18 “seeds” from community venues invited the participation of their MSM friends who, in turn, invited their own MSM friends into the study, a process that continued outward until eighteen 3-ring sociocentric networks (mean size=35 members, n=626) were recruited. Intervention Empirically-identified network leaders were trained and guided to convey HIV prevention advice to other network members. Main Outcome and Measures Changes in sexual behavior from baseline to 3- and 12-month followup, with composite HIV/STD incidence measured at 12-months to corroborate behavior changes. Results There were significant reductions between baseline, first followup, and second followup in the intervention versus comparison arm for proportion of men engaging in any unprotected anal intercourse (P=.04); UAI with a nonmain partner (P=.04); and UAI with multiple partners (P=.002). The mean percentage of unprotected AI acts significantly declined (P=.001), as well as the mean number of UAI acts among men who initially had multiple partners (P=.05). Biological HIV/STD incidence was 15% in comparison condition networks and 9% in intervention condition networks. Conclusions Even where same-sex behavior is stigmatized, it is possible to reach MSM and deliver HIV prevention through their social networks.

HCV epidemiology in high-risk groups and the risk of reinfection

“…Nevertheless, all patients should be offered information, education and counselling about the risk of reinfection associated with high-risk sexual practices and unsafe drug use [37,155]. Repeated safe sex counselling from health care providers and peers may be considered for HIV-infected MSM with high-risk behaviour [7,[97][98][99][100]. Combined harm reduction interventions should be optimized for all active injectors and HCV care should preferably be integrated in multidisciplinary settings [37,156,157].…”

“…Repeated risk counselling on HCV transmission before, during, and after HCV treatment might also be beneficial for HCV prevention [7]. A recent randomized trial has shown that a reduction in high-risk sexual practices after a social network intervention led to a decline in the incidence of sexually transmitted diseases/HIV from 15% to 9% [100].…”

Leading by Example: Web-Based Sexual Health Influencers Among Men Who Have Sex With Men Have Higher HIV and Syphilis Testing Rates in China (Preprint)

“…Influencers additionally contribute by being well positioned in social networks to spread behavior change. Interventions that operate through social networks hold promise for reaching vulnerable communities, particularly when formal prevention infrastructure supports are limited [17,47]. 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 …”

Emerging opportunities and challenges for HIV prevention, treatment and care for MSM in the former Soviet Union and other post-communist states in Eastern Europe

“…Two surveillance studies among MSM in Moscow and St. Petersburg showed 6% HIV prevalence. [5,6] However, the true prevalence may be higher. A recent large, respondent-driven sample of over 1,300 MSM in Moscow showed biologically-identified HIV prevalence of up to 15.6% (with a population level estimate of 11.6%).…”