Strategies to prevent HIV transmission among heterosexual African-American men.
BACKGROUND
As part of qualitative research for developing a culturally sensitive and developmentally appropriate videotape-based HIV prevention intervention for heterosexual African- American men, six focus groups were conducted with thirty African-American men to determine their perceptions of AIDS as a threat to the African-American community, characteristics of past situations that have placed African Americans at risk for HIV infection, their personal high risk behaviors, and suggestions on how HIV intervention videotapes could be produced to achieve maximum levels of interest among African-American men in HIV training programs.


METHODS
The groups took place at a low-income housing project in Houston, Texas, a major epicenter for HIV/AIDS. Each group was audiotaped, transcribed, and analyzed using theme and domain analysis.


RESULTS
The results revealed that low-income African-American men perceive HIV/AIDS as a threat to their community and they have placed themselves at risk of HIV infection based on unsafe sex practices, substance abuse, and lack of knowledge. They also cite lack of income to purchase condoms as a barrier to safe sex practice. They believe that HIV training programs should address these risk factors and that videotapes developed for prevention should offer a sensationalized look at the effects of HIV/AIDS on affected persons. They further believe that programs should be held in African-American communities and should include condoms to facilitate reduction of risk behaviors.


CONCLUSIONS
The results indicate that the respondents taking part in this study believe that HIV and AIDS are continued threats to the African-American community because of sexual risk taking behavior, that is, failure to use condoms. Further, African-American men are having sex without condoms when having sex with women often when they are under the influence of alcohol or other mind-altering substances and they are having sex with men while incarcerated and become infected and once released resume unprotected sexual relations with women. According to the men, substance abuse is an important part of the problem of HIV in the African-American community. This is in keeping with research that shows that drug use, especially crack cocaine, is linked to sexual risk taking among African Americans and to increased likelihood of becoming infected with other sexually transmitted diseases (STDs) including HIV. Thus, interventions for men should address condom use, condom availability, skills for using condoms, eroticizing condoms and substance abuse prevention. Men in the present study also strongly recommended that HIV/AIDS videotaped messages should include footage of the sensational effects of the disease.
Essien
Ekere J
EJ
The HIV Prevention Research Group, College of Pharmacy, University of Houston, 1441 Moursund Street, Houston, Texas 77030, USA. EJEssien@uh.edu
Meshack
Angela F
AF
Peters
Ronald J
RJ
Ogungbade
Gbadebo O
GO
Osemene
Nora I
NI
D000328:Adult; D001741:Black or African American / Q000193:education* / Q000523:psychology; D017280:Condoms / Q000706:statistics & numerical data*; D017144:Focus Groups; D015658:HIV Infections / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011203:Poverty / Q000208:ethnology; D011638:Public Housing; D012044:Regression Analysis; D012307:Risk Factors; D012309:Risk-Taking; D021841:Safe Sex / Q000208:ethnology*; D019966:Substance-Related Disorders / Q000208:ethnology; D013781:Texas; D014743:Videotape Recording