Compendium of Evidence-Based HIV Behavioral Interventions
Young gay men
Goals of Intervention
- Eliminate or reduce sexual risk behaviors
- Increase condom use
The Mpowerment Project is a community-level intervention based on an empowerment model where a core group of 10-15 young gay men design and carry out all project activities. The intervention consists of four integrated activities: formal and informal outreach, “M-groups,” and an ongoing publicity campaign. For formal outreach, teams of young gay men go to locations frequented by young gay men to discuss and promote safer sex, deliver appealing informational literature on HIV risk reduction, and distribute condoms. The team also creates their own social events (e.g., dances, video parties, picnics, discussion groups) to attract young gay men. M-groups are peer-led, 2-3 hour meetings of 8-10 young gay men who discuss factors that contribute to unsafe sex (misconceptions, beliefs that safer sex is not enjoyable, poor sexual communication skills). Through skills-building exercises, the men practice correct condom use and safer sex negotiation. Participants receive free condoms and lubricant and are trained to conduct informal outreach, where they are encouraged to discuss safer sex with their friends. The ongoing publicity campaign attracts men to the project by word of mouth and through articles and advertisements in gay newspapers.
- Diffusion of Innovations theory
Public areas and the project’s own space where most social events and meetings are held and which serve as drop-in centers where young men can meet and socialize during specified hours.
Outreach teams of young gay men
- Social events
- Printed materials
- Risk-reduction supplies (condoms)
An intervention package was developed with funding from CDC’s Replicating Effective Programs (REP) Project. The intervention package and training are available through CDC’s Diffusion of Effective Behavioral Interventions (DEBI) project.
The original evaluation study was conducted in Eugene, Oregon, and Santa Barbara, California.
Key Intervention Effects
- Reduced unprotected anal intercourse
The baseline study sample of 268 men is characterized by the following:
- 81% White, 7% Asian or Pacific Islander, 6% Latino, 4% African-American, 2% Other
- 100% Male
- 86% gay, 14% bisexual
- Mean age of 23 years
- Median education level – some college
Locations frequented by young gay men, including bars, university and community events, and project social events
- The eligible communities were ones that were comparable in the following characteristics: contains a large state university; attracts young people from the surrounding county; has a similar population size; has an AIDS community-based organization, with no programs or activities explicitly for young gay men; contains 1 or 2 gay bars; is 1 to 2 hours away from a larger community; and has fewer AIDS cases than in larger AIDS epicenters.
- Young gay men were eligible for assessment if they were 18-29 years old and resided in the intervention and comparison communities at the time of assessments.
Two communities were assigned to 1 of 2 groups: Mpowerment Intervention (Eugene, Oregon; 159 participants) and Wait List Control (Santa Barbara, California; 109 participants). Eugene, Oregon was randomly selected to receive the intervention first.
The wait list control community received no specific intervention, but AIDS prevention brochures and posters were available at the bars, at HIV-antibody test sites and on campus.
Relevant Outcomes Measured and Follow-up Time
- Sex behavior during past 2 months (including any unprotected anal intercourse, unprotected anal intercourse with nonprimary partners or boyfriends, number of sex partners) were measured at baseline and 12 months post-baseline (4 months after the 8-month intervention period).
- Mpowerment Intervention:
65% retained at 12 months post-baseline (4 months post-intervention)
- Wait List Control:
81% retained at 12 months post-baseline
- The Mpowerment intervention community showed a significant decrease in the proportion of men engaging in any unprotected anal intercourse at the follow-up assessment compared to the Wait List control community (p < .03, one-tailed test).
- The proportion of men engaging in any unprotected anal intercourse significantly reduced from the baseline to the follow-up in the Mpowerment Intervention community compared to the Wait List control community (p < .05, one-tailed test).
- This intervention did not meet best-evidence criteria due to having only one community per study arm, a low retention rate (<70%) in the intervention arm and differential retention rate (16%).
- Thirty-two men who moved from the intervention community before the start of the intervention were not included in the calculation of retention rate.
- Kegeles, S.M., Hays, R.B., Coates, T.J. (1996). The Mpowerment Project: A Community-level HIV Prevention Intervention for Young Gay Men [see comments]. American Journal of Public Health, 86, 1129 – 1136.
Susan M. Kegeles, PhD
Center for AIDS Prevention Studies
University of California
74 New Montgomery, Suite 600
San Francisco, CA 94105