Barriers to Implementing a Risk-Reduction Plan Among MSM Participating in a Single-Session HIV Prevention Intervention

Background: The Centers for Disease Control and Prevention’s High-Impact Prevention Approach focuses on maximizing the impact of HIV prevention strategies. Knowledge about participants’ perceptions of the effectiveness of risk reduction interventions and participants’ barriers to implementing risk-reduction strategies can help programs improve interventions.

Methods: MSM presenting for HIV testing at a community-based HIV testing site were recruited for a single-session risk-reduction intervention, RESPECT, which aims to increase participants’ perception of HIV risk and help them develop an achievable risk-reduction plan. From December 2012 through August 2013, participant-level information was collected for 104 clients at baseline, and a risk reduction plan was created that could include topics such as condom use, STD testing, and communication with partners. 3- and 6-month post-intervention data included perception of success in achieving risk-reduction plans and descriptions of barriers participants faced.

Results: Of 41 participants returning for the 3-month follow-up (80% of those eligible for 3-month follow-up), 93% (n=38) reported attempting to implement their plan. Of those, 95% felt they were successful at achieving it. 61% reported having no difficulty with their plan. When asked about barriers to implementing their plan, the most frequently reported barriers were being concerned about their partner’s(s’) reactions (12%) and forgetting about their plan (12%). At 6-month follow-up (n=19, 95% of those eligible for 6-month follow-up), 90% said they tried their plan; 94% felt successful. At this time point, only 47% reported having no difficulty with their plan. Again, the most prevalent barriers were concern about partner’s(s’) reactions (21%) and forgetting about the plan (21%).  

Conclusions: Single-session risk-reduction interventions targeting MSM can be successful at helping participants develop an achievable risk-reduction plan. To facilitate behavior change, counselors should reinforce the risk-reduction plan within the session and address the participant’s concerns about their partner’s(s’) reactions.