Skip directly to local search Skip directly to A to Z list Skip directly to navigation Skip directly to site content Skip directly to page options
CDC Home

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

Real Men Are Safe (REMAS)


Intervention Description

Target Population
Sexually active men in drug treatment

Goals of Intervention

  • Reduce unprotected vaginal and anal sexual intercourse occasions

Brief Description

The REMAS intervention is a workshop of 5 group sessions (90 min each, 3 to 8 men per group). Lectures, role-plays, peer group discussions and motivational self-assessment exercises are conducted with almost equal focus on information delivery and skill building and a lesser focus on motivation. Intervention materials are appropriate for men who have sex exclusively with women, as well as men who have sex with men. Topics include HIV/AIDS information, HIV risky behaviors (both sexual and injection practices), condom demonstration, identifying triggers, risk reduction problem solving, enhancing sex without drugs, and responsibility and communication in sexual relationships.

Theoretic Basis

  • Information-Motivation-Behavioral Change (IMB) Model

Intervention Duration
Five 90-minute group sessions

Intervention Settings
Methadone clinics, psychosocial outpatient clinics

Male counselors

Delivery Methods

  • Counseling
  • Demonstration
  • Discussion
  • Exercises
  • Lecture
  • Practice
  • Role play

Top of Page

Intervention Package Information

An intervention package is currently available for download. Please contact Dr. Donald A. Calsyn, Alcohol and Drug Abuse Institute, University of Washington, 1107 NE 45th St., Ste. 120, Box 354805 Seattle, WA 98105-4631, email: with any questions regarding the intervention materials.

Top of Page

Evaluation Study and Results

The original evaluation was conducted in Hartford, CT; New York, NY; Philadelphia, PA; Raleigh, NC; Seattle, WA; San Francisco, CA; Norwalk, CT; Huntington, WV; High Point, NC; Columbia, SC; Toledo, OH; Santa Fe, NM; and Rancho Cucamonga, CA between 2004 and 2006.

Key Intervention Effects

  • Reduced unprotected sex

Study Sample
The analytic study sample of 417 men was characterized by the following:

  • 56% White, 28% African American, 13% Hispanic, 2% American Indian, 1% Asian, 1% Other
  • 100% Male (% MSM not reported)
  • Mean age of 40 years
  • Mean education of 12.2 years

Recruitment Settings
Methadone clinics and psychosocial outpatient clinics

Eligibility Criteria
Men were eligible if they were at least 18 years of age, currently in methadone treatment for 30 days or more at a participating clinic, engaging in unprotected vaginal or anal intercourse during the past 6 months (with women or men or both), able to speak and understand English, free of observable gross mental status impairment, and did not have a primary sexual partner intending to get pregnant during the study period.

Assignment Method
Cohorts of 3 to 8 men (N = 590 men) were randomly assigned to 1 of 2 groups: REMAS intervention (n = 291) or HIV Education comparison (n = 299).

Comparison Group
The HIV Education comparison group received 1 session (60 minutes) that represented a standardized treatment-as-usual intervention. It covered only the information component of the IMB Model and consisted of selected educational material from the first 2 sessions of the REMAS intervention, including HIV/AIDS definitions, transmission, testing and counseling, treatment, and prevention. Counselors delivered this session using flip charts and informational and resource hand out materials.

Relevant Outcomes Measured and Follow-up Time

  • Sex behaviors (including frequency of unprotected vaginal and anal sexual occasions by partner type during the last 90 days and condom use by partner type) were measured at 3 and 6 months post-intervention.

Participant Retention

  • Intervention:

    75% retained at 3 months
    65% retained at 6 months

  • Control:

    75% retained at 3 months
    70% retained at 6 months

Significant Findings

  • Intervention participants reported significantly fewer unprotected sexual occasions in past 90 days than comparison participants at 3-month (p < .001) and 6-month follow-ups (p < .001).
  • In subset analyses, intervention participants who attended at least 3 REMAS intervention sessions (completers) reported significantly fewer unprotected sexual occasions with any partner at 3-month (p < .0001) and 6-month follow-ups (p < .0001) than participants who attended the single HIV Education session.
  • Additional significant intervention effects among completers were reported for the following outcomes: unprotected sexual occasions with regular partners at 3-month follow-up (p < .0001) and 6-month follow-up (p < .0001); unprotected sexual occasions with casual partners at 3-month follow-up (p < .0002).
  • This intervention fails to meet the best-evidence criteria due to the fact that cohorts of 3-8 men were allocated to treatment groups, but analyses were at the individual level without analytic adjustment.

Top of Page

References and Contact Information

  • Calsyn, D. A., Hatch-Maillette, M., Tross, S., Doyle, S. R., Crits-Christoph, P., Song, Y. S., et al. (2009). Motivational and skills training HIV/sexually transmitted infection sexual risk reduction groups for men. Journal of Substance Abuse Treatment, 37, 138-150.

Researcher: Dr. Donald A. Calsyn
Alcohol and Drug Abuse Institute
University of Washington
1107 NE 45th St., Ste. 120
Box 354805
Seattle, WA 98105-4631

Top of Page


Get Tested

Find an HIV testing site near you.

Search location, such as: "Atlanta, GA", or "30033".

For more information, please visit

Please contact with any comments, suggestions, or concerns.

Syndicate This Content Podcast button Tell us what you think button CDC-INFO The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Road Atlanta, GA 30329-4027, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC–INFO