The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #73734

Frederick R. Bloom, RN, PhD, NCHSTP/DSTD/BIRB, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Mailstop E-44, Atlanta, GA 30333, (404) 498-3429, fcb8@cdc.gov

Since 1999, increased rates of STDs, have been noted for gay men. There is an emerging discourse attributing this trend to complacency of those at risk for STD transmission. This paper makes a complimentary hypothesis that although some individuals may lack concern regarding HIV and STD infection, factors influencing this change in disease and behavior are more complex. The greater concern may be the complacency of those who believed that sustained and dynamic effort was not an essential element of prevention and control.

Data from 5 rapid ethnographic assessments provide ethnographic observations and interview data from gay men and their service providers. Preliminary analysis focuses on identification of system level and behavioral efforts to reduce risky sexual behaviors of gay men. Preliminary findings relating social stress to risk behavior were found in all projects. Key results include: 1) community fragmentation and 2) unintended consequences of system level and behavioral risk reduction strategies.

The impact of attributing complacency to those at risk for STD and HIV infection is addressed. Such assumptions place the burden of behavior change on the individual. Multi-level interventions may be more successful in maintaining protective practices over time in a population whose membership is often fluid and difficult to identify. Sustainable interventions, while essential, will also need ongoing evaluation to assess efficacy and unintended consequences as the context of risk changes over time.

Learning Objectives:

At the conclusion of the session, the participant in this session will be able to:
• list three or more efforts to reduce risky sexual behavior in gay men
• identify intended and unintended consequences of two or more risk reduction efforts
• recognize the need for ongoing evaluation and sustainability of sexually transmitted disease interventions

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.