We read with interest the recent Commentary by Peterson and Jones on HIV prevention for Black men who have sex with men (MSM) in the United States.1 The authors state that, “According to the Centers for Disease Control and Prevention (CDC) criteria, no interventions exist or have been identified with proven effectiveness for Black MSM.”1
We wish to call the attention of the Journal's readership to a study published in June 2009 demonstrating the efficacy of an intervention developed to prevent HIV and other sexually transmitted infections (STIs) among Black MSM.2 In so doing, we wish to provide a needed update to the aforementioned Commentary.
The group-level intervention, Many Men, Many Voices (3MV), was developed by community-based organizations and a university-based STI/HIV prevention training center with strong involvement of the Black MSM community. 3MV focuses on the effects of racism and homophobia on the sexual, substance use, and health promotion behaviors of Black MSM, and participants select from a menu of options to reduce HIV/STI transmission based on known factors of HIV infectivity.
The efficacy study included 338 Black MSM of HIV-negative or unknown serostatus in New York City.2 Relative to comparison participants, 3MV participants reported a 25% greater reduction in the number of male sexual partners, a 66% greater reduction in any unprotected anal intercourse with casual male partners, a 51% greater reduction in any insertive unprotected anal intercourse, and a 33% greater likelihood of testing for HIV. A trend for more consistent condom use during receptive anal intercourse with casual male partners was also noted. This is the first randomized trial to demonstrate the efficacy of an HIV/STI prevention intervention designed by and for Black MSM. Based on the results of the efficacy study, 3MV has been included in the CDC's “Updated Compendium of Evidence-based HIV Prevention Interventions.”3
We concur with Peterson and Jones that there is an urgent need to increase the number of efficacious interventions for Black MSM, and support the authors’ suggestion that future interventions incorporate innovative strategies that can contribute to a reduction in existing HIV-related health disparities between Black and White MSM.4 Furthermore, interventions for Black MSM need to address sociocultural factors, including racism and homophobia, that contribute to increased risk among Black MSM.5 Finally, future research must address the pervasive role of STIs in acquiring and transmitting HIV among Black MSM, and identifying and assessing innovative strategies to increase STI testing and treatment among Black MSM.6
Acknowledgments
Funding for the efficacy study was provided by the Centers for Disease Control and Prevention to People of Color in Crisis, Brooklyn, NY (cooperative agreements U65/CCU224517 and U65/CCU223830). The study was registered on clinicaltrials.gov (NCT00137631).
References
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