GAY RESPECT with Methamphetamine-use Assessments: HIV Intervention for Well-informed, Hard-to-reach, Gay & Other MSM in Long Beach, CA

Background:Despite many HIV risk-reduction interventions targeting Gay and other men-who-have-sex-with-men(MSM), this population's familiarity with HIV issues challenges health educators to tailor interventions to Gay cultural behavior patterns, and Gay identity-constructions. Objective:We present GAY RESPECT, a modified, effective evidence-based model intervention (from RESPECT/RESPECT II) for hard-to-recruit, at-risk Gay/MSM populations. This intervention is designed to: (1)recruit reluctant populations already highly exposed to HIV education; (2)beginning in year three, assess craving and dependence for meth-using Gay men; (3)identify target populations' risks; and (4)reduce HIV associated risk. Methods:Program materials and marketing emphasized Gay culture rather than HIV. Recruitment was through ethnographically driven outreach. Outreach encounters included documented risk-assessments and education. Participants volunteered for a three-part intervention-delivered-to-individuals(IDI), and two one-month follow-ups. Findings:3933 outreach encounters(1/1/05-12/3/07) resulted in 346 high-risk participants in the individual-level intervention (Ages19-79, M=41/SD10.88; Black 91/26.3%, White 155/44.8%, Latino 69/20%, Asian 15/4.3%, AI/AN 6/1.7%, Other 10/2.9%; HIV+ 66%). 181 were retained for at least three sessions. We present three years cumulative data, and compare year three meth-using(n=31; HIV+11/ 36%) and non-meth-using (n=78: HIV+16/21% )subpopulations. Qualitative/Quantitative data analyses elicited descriptive data; identified themes of change-resistance; indexed target populations' risk-behaviors and associated achievable, risk-reduction responses/actions. Conclusions: 1.Outreach successfully targeted and enrolled hard-to-recruit populations, members of which generally considered themselves well-informed. 2. Project elicited indices of risk behaviors. 3. Project elicited specific meth-related risks for individually targeted intervention 4.Counseling assisted participants in implementing and maintaining risk-reduction strategies (100% of multiple-session participants [n=225] maintained at least one risk-reduction objective). 5. The intervention is replicable.