Motivating Changes in Condom, Methamphetamine Use During MSM Sexual Encounters

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DESCRIPTION (provided by applicant): Methamphetamine use among men who have sex with men (MSM) has been associated with participation in a variety of high-risk sexual behaviors and increased HIV incidence rates. However, few, if any, effective interventions targeting methamphetamine use among MSM have been developed and tested with this population. Methamphetamine use among MSM was initially considered a problem primarily in large western cities, such as San Francisco and Los Angeles, and the majority of research on its use among MSM has been conducted in these areas. More recently, methamphetamine use has become a significant problem in smaller cities and in other parts of the country. Yet less is known about methamphetamine use among MSM and its association with HIV risk in these other areas. This proposed 2-year study will be conducted in the Raleigh-Durham area in North Carolina. The study will be conducted in two phases. Year 1 will consist of a formative phase to (a) increase our understanding of the relationship between methamphetamine use and risky sexual behavior among MSM, (b) evaluate different strategies for recruiting methamphetamine-using MSM, (c) identify barriers to safer sex among methamphetamine-using MSM, and (d) assess the acceptability of a range of behavioral change objectives for reducing HIV risk behaviors among methamphetamine-using MSM. An intervention mapping approach will be used to develop an intervention based on motivational interviewing (Ml) and instruments for measuring outcomes. In Year 2, we will test the intervention with 80 methamphetamine-using MSM using a pre-post test design, analyze the results, and disseminate findings. The specific aims are to (1) conduct formative work to understand the context of HIV risk for methamphetamine-using MSM, evaluate the feasibility (e.g., recruitment and retention strategies) and acceptability of behavioral change objectives for an intervention to reduce HIV risk among methamphetamine-using MSM, and identify barriers to change (e.g., skills deficits, perceived risk, perceived self-efficacy); we will also conduct a literature review and secondary data analysis of existing data sets to better understand the issues surrounding methamphetamine use and risky sexual behavior; (2) develop and pretest a motivational interviewing HIV prevention intervention based on the findings from the formative Phase; and (3) pilot test the intervention through a one-group pretest-posttest design to determine efficacy of he intervention to increase readiness to change and reduce sexual risk behaviors.