An HIV prevention intervention for ethnically diverse men in substance abuse treatment: Pilot study findings.

The National Drug Abuse Treatment Clinical Trials Network (CTN) recently completed a randomized clinical trial evaluating the utility of Real Men Are Safe (REMAS), an HIV prevention intervention for men in substance abuse treatment (protocol CTN-0018). Analysis of the data with a focus on racial/ethnicity-related differences found a differential effect for white versus minority men. This study aimed to determine the acceptability, participants’ receptivity, and effectiveness of a culturally adapted version of Real Men Are Safe (REMAS-CA). In 2010 and 2011, the authors compared participants who attended at least 1 (of 5) REMAS-CA session (n=66) with participants in the original REMAS study (n=136). Participants completed an assessment battery at baseline and at 3-month follow-up with measures of substance abuse, HIV risk behaviors, perceived condom barriers, and demographics. Post-intervention focus groups were conducted at each clinic. Results found that minority REMAS-CA participants were more likely to have attended 3 or more sessions (87%), meeting the study definition of “intervention completion,” than were minority participants in the REMAS study (75.1%; odds ratio: 2.1). For REMAS-CA participants with casual partners (n=25), the number of unprotected sexual occasions in the past 90 days declined (6.2 vs. 1.6). Among minority men in the REMAS study (n=36), the number of unprotected sexual occasions with casual partners changed little (9.4 vs. 8.4).

Conclusions: REMAS-CA was effective across ethnic groups and appears to be more appealing to minorities than the original REMAS intervention. The finding that REMAS-CA was appealing across ethnic groups is especially important because many HIV risk reduction programs serve a diverse clientele and lack the resources to target an intervention solely to one ethnic group.