Adaptation, feasibility and performance of a brief clinic-based intervention to improve prevention practices among sexual minority men

Abstract

Gay, bisexual, and other men who have sex with men (GBM) are disproportionately affected by sexually transmitted and blood-borne infections (STBBIs). Originally efficacious with young Black GBM in the United States, Focus on the Future (FoF) is a clinic-based, single session intervention aimed at improving prevention practices. We examined the applicability and acceptability of the program for ethnoracially diverse GBM. Participants were recruited from a GBM sexual health clinic in Vancouver. A pre-test, post-test repeated measures design was used with a single intervention arm. Twenty-five HIV-negative participants received the intervention and retention at 90-day follow-up was 92%. Mean age was 27.8 years (SD = 3.53), 54.2% were non-white. The intervention was highly acceptable: 86.9% liked it and 91.3% would recommend it to others. A number of positive outcomes were observed post-intervention such as higher scores on the correct condom-use self-efficacy scales (p = 0.03) and increased condom-use frequency with primary partners (p = 0.03). The main outcome was number of condom-protected anal intercourse events for both insertive and receptive sexual positions; there was no significant difference for either the insertive (p = 0.62) or receptive (p = 0.36) partner. However, when restricted to participants who were not using PrEP, there was a significant increase in the number of condom-protected receptive anal sex events (p = 0.02). Although not an intended effect of the intervention program, 30% (n = 6/20) of PrEP-naïve participants initiated PrEP during the 90-day follow-up. This adapted low-cost intervention was rated highly acceptable by participants and demonstrates promise for increasing STBBI prevention practices. Expanded intervention testing and implementation research is warranted.