A novel approach to prevention for at-risk HIV-negative men who have sex with men: Creatinga teachable moment to promote informed sexual decision-making

Objectives. As a result of the impact of HIV among men who have sex with men (MSM), multiple strategies for reducing HIV risks have emerged from within the gay community. One common HIV risk reduction strategy limits unprotected sex partners to those who are of the same HIV status (serosorting). We tested a novel, brief, one-on-one intervention, based on informed decision-making and delivered by peer counselors, designed to address the limitations of serosorting (e.g., risk for HIV transmission). Methods. In 2009, we recruited a group of 149 at-risk men living in Atlanta Georgia, and randomly assigned them to an intervention condition addressing serosorting or a standard-of-care control condition. Results. Men in the serosorting intervention reported fewer sexual partners (Wald χ2=8.79, P<.01) at the study follow-ups. Behavioral results were also consistent with changes in psychosocial variables, including condom use selfefficacy and perceptions of risk for HIV transmission. Conclusions. With the current intervention, service providers can offer risk reduction for men arguably at the highest risk for HIV infection in the United States. Addressing risks associated with serosorting in a feasible, low-cost intervention has the potential to significantly affect the HIV epidemic.