title: Effects of a social network HIV/STD prevention intervention for MSM in Russia and Hungary: a randomized controlled trial.
abstract: OBJECTIVE
  To test a novel social network HIV risk-reduction intervention for MSM in Russia and Hungary, where same-sex behavior is stigmatized and men may best be reached through their social network connections.
  
  
  METHODS
  A two-arm trial with 18 sociocentric networks of MSM randomized to the social network intervention or standard HIV/STD testing/counseling.
  
  
  METHODS
  St. Petersburg, Russia and Budapest, Hungary.
  
  
  METHODS
  Eighteen 'seeds' from community venues invited the participation of their MSM friends who, in turn, invited their own MSM friends into the study, a process that continued outward until eighteen three-ring sociocentric networks (mean size = 35 members, n = 626) were recruited.
  
  
  METHODS
  Empirically identified network leaders were trained and guided to convey HIV prevention advice to other network members.
  
  
  METHODS
  Changes in sexual behavior from baseline to 3-month and 12-month follow-up, with composite HIV/STD incidence, measured at 12 months to corroborate behavior changes.
  
  
  RESULTS
  There were significant reductions between baseline, first follow-up, and second follow-up in the intervention versus comparison arm for proportion of men engaging in any unprotected anal intercourse (UAI) (P = 0.04); UAI with a nonmain partner (P = 0.04); and UAI with multiple partners (P = 0.002). The mean percentage of unprotected anal intercourse acts significantly declined (P = 0.001), as well as the mean number of UAI acts among men who initially had multiple partners (P = 0.05). Biological HIV/STD incidence was 15% in comparison condition networks and 9% in intervention condition networks.
  
  
  CONCLUSIONS
  Even where same-sex behavior is stigmatized, it is possible to reach MSM and deliver HIV prevention through their social networks.
authors.affiliation: aCenter for AIDS Intervention Research (CAIR), Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA bBotkin Hospital for Infectious Diseases, St. Petersburg, Russia cCentre for Social Sciences, Hungarian Academy of Sciences dHatter Society for LGBT People, Budapest, Hungary.
authors.forename: Yuri A
authors.initials: YA
authors.lastname: Amirkhanian
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Kelly
authors.forename: Judit
authors.initials: J
authors.lastname: Takacs
authors.forename: Timothy L
authors.initials: TL
authors.lastname: McAuliffe
authors.forename: Anna V
authors.initials: AV
authors.lastname: Kuznetsova
authors.forename: Tamas P
authors.initials: TP
authors.lastname: Toth
authors.forename: Laszlo
authors.initials: L
authors.lastname: Mocsonaki
authors.forename: Wayne J
authors.initials: WJ
authors.lastname: DiFranceisco
authors.forename: Anastasia
authors.initials: A
authors.lastname: Meylakhs
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D018451:Homosexuality, Male; D006801:Humans; D006814:Hungary; D008297:Male; D012426:Russia; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D012944:Social Support; D055815:Young Adult