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Compendium of Evidence-Based Interventions and
Best Practices for HIV Prevention

Mpowerment

GOOD-EVIDENCE

Intervention Description

Target Population
Young gay men

Goals of Intervention

  • Eliminate or reduce sexual risk behaviors
  • Increase condom use

Brief Description

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.

Theoretic Basis

  • Diffusion of Innovations theory

Intervention Duration
Ongoing

Intervention Settings
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.

Deliverer
Outreach teams of young gay men

Delivery Methods

  • Demonstration/Modeling
  • Discussion
  • Role-playing
  • Social events
  • Performance
  • Printed materials
  • Risk-reduction supplies (condoms)
  • Video

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Intervention Package Information

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.

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Evaluation Study and Results

The original evaluation study was conducted in Eugene, Oregon, and Santa Barbara, California.

Key Intervention Effects

  • Reduced unprotected anal intercourse

Study Sample
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

Recruitment Settings
Locations frequented by young gay men, including bars, university and community events, and project social events

Eligibility Criteria

  • 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.

Assignment Method
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.

Comparison Group
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).

Participant Retention

  • Mpowerment Intervention:

    65% retained at 12 months post-baseline (4 months post-intervention)

  • Wait List Control:

    81% retained at 12 months post-baseline

Significant Findings

  • 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).

Considerations

  • 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.

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References and Contact Information

  • 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.

    Researcher:
    Susan M. Kegeles, PhD
    Center for AIDS Prevention Studies
    University of California
    74 New Montgomery, Suite 600
    San Francisco, CA 94105

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