A randomized trial of a behavioral intervention for black MSM: the DiSH study.

OBJECTIVE: To test a new behavioral intervention for black MSM in reducing sexual risk and increasing social support and intentions to use condoms. DESIGN: A single-site, unblinded randomized trial in New York City with 3-month follow-up. METHODS: Participants (n = 283) reporting at least two sexual partners and unprotected anal intercourse with a man in the past 3 months were enrolled and randomized to a social-cognitive theory-based intervention or control comparison. Men in the intervention group participated in five 2-h group sessions focused on creating a group environment with sexual risk-reduction information and exercises woven into joint meal preparation and sharing activities, while exploring self-efficacy perceptions and outcome expectancies. Intervention (n = 142) and control (n = 141) groups received standard HIV counseling and testing at baseline. RESULTS: No significant differences were found between study arms at 3 months in number of male partners, number of unprotected anal intercourse partners, proportion reporting unprotected sex, number of acts protected by condoms, self-efficacy, condom attitudes, condom intentions, social isolation and psychological distress. In both arms combined, declines from baseline to 3 months were observed in sexual risk behaviors, social isolation and psychological distress, whereas self-efficacy, condom attitudes and condom intentions improved. CONCLUSION: As the HIV epidemic continues to have a dramatic impact on black MSM in the USA, the urgency to design innovative interventions continues.