Cognitive-Behavioral Intervention Decreases High Risk Behavior and Reduces Distress Among HIV+ MSMW in Haiti

Introduction: In the Caribbean, the highest number of HIV positive persons lives in Haiti. Stigma against men who have sex with men (MSM) and people living with HIV (PLWH) is high, which leads to secrecy and unsafe sex. This behavior places HIV+ men who have sex with both men and women (MSMW) in Haiti to be at particular risk for morbidity.  A small-group cognitive-behavioral (CB) intervention was pilot tested among this group to evaluate efficacy in reducing sexual risk and psychological distress.

Methods: Baseline assessment included measures of risky sexual behavior, depression, post-traumatic stress disorder (PTSD), and alcohol use. A small sample of MSMW (n=10) participated in the pilot study. Paired sample t-test was performed among CB group to assess differences in means at 6-months.

Results: At 6-months post-intervention, the CB group participants showed significant increases in protected sexual activities.  The difference in mean [SD] protected vaginal sex at 6-months was 40.2 [15.1, p< 0.0001], and 89.8 [27.8, p<0.0001] for protected anal sex. At 6-months, the CB group had lower mean [SD] differences in PTSD (-50 [12], p< 0.0001), depression (-9.7 [13.8], p>0.05), and alcohol problems (-7.3 [11.2], p > 0.05) scores.

Conclusion: A pilot test of a CB intervention was found to be effective in increasing safer sex and reducing distress  among HIV+ MSMW in Haiti.  More research is needed to further assess these preliminary findings.