2010

Gay Poz Sex (GPS), A Community-based Counselling

Intervention for HIV-Positive Gay and Bisexual Men

GPS(Gay Poz Sex): Finding your own way

• Plain language: a sexual health program for gay men who are HIV-positive to help decrease risk and improve sex and sexual health.

• Research: a poz prevention intervention for MSM engaging in UAI and UAR with partners of unknown or sero-discordant status.

Rick Julien, BSc, AIDS Committee of Toronto (ACT)Trevor A. Hart, Ph.D. Ryerson University; University of Toronto, Scott Simpson, BA, ACTAdina-Ioana Berindean-Coroiu, BA, Ryerson University,Barry D. Adam, Ph.D., University of Windsor and OHTN, John Maxwell, B.A., ACT; Positive Prevention Working Group (PPWG), Rob MacKay, PPWG, David Hoe, B.S.W., PPWG, Bob Leahy, PPWG, Herbert Co, B.A., B.Sc., PPWG, Eleanor Maticka-Tyndale, Ph.D., University of Windsor,James Murray, MA, AIDS BureauMona Loutfy, MD, MPH, Women’s College Hospital and University of Toronto.

What We Are Doing

• HIV Prevention for HIV+ Gay Men • Community-Based Research• Theoretical Model - Information, Motivation,

Behavioral Skills model (IMB; Fisher & Fisher, 1992)

• Implementation Model – Motivational Interviewing• Facilitators are Peers• Program Administered at ACT

The Transtheoretical Model

• Called this because cuts across other models• Prochaska et al.’s (1992) stage theory

– Precontemplation– Contemplation– Preparation– Action– Maintenance

The IMB Model

Information

Motivation

Behavioural Skills

Sexual Health Behaviour

The GPS Program

• Session 1 focuses on building information on advanced topics for HIV+ gay men– STI transmission– Viral load in the blood vs. in semen

• Session 2

- HIV Disclosure and the law • Sessions 3-7 focus on MI

– Identifying each participant’s goals– Resolving ambivalence– Experimenting with new strategies to achieve goals– Implementing strategies to achieve goals– Identifying strategies to maintain progress

Sexual Behaviour Diary

Date Time Where Activity Before Activity

Stress Before

Stress After

Goal of activity

e. g. 14/06

1:00 AM Baths Bottom Without condom

Had 3 beers and poppers; felt lonely

8 4 To be less horny and to be with men

How My Current Sexual Activity Fits Into My Life

Current Sexual Habits 1) Good Things 2) Not So Good Things

Anonymous sex at the baths

No talking=no need to discloseConvenientVariety

No emotional intimacyFeel bad and guiltySTDsLeaves me feeling lonelierFuels drug useStill get rejectedAlways the same

New Sexual Habit 4) Hopes 3) Challenges

Join a gym and try dating To be my true selfTo have intimacyTo go out to new placesWork outFeel healthierTo meet a guy

How to feel more comfortable disclosingWhere to meet menWorried how I look

Health Counselling Program Research Evaluation

• Step 1 - identifying need for the program• Step 2 – test if program is

– Feasible– Useful to participants

• Step 3 – pilot data on effect size of the program (current CIHR grant)

• Step 4 – test program vs. standard-of-care• Step 5 – test in community settings

Our Participants Tell Us GPS Is Useful

Participants said they experienced:• Increased social interactions both inside and

outside of the program. • Increased self-efficacy in sexual health risk-

assessment, sexual negotiation and disclosure. • Increased use of community supports. • The confidence to make healthier lifestyle

choices and they continuously refer their friends to GPS

GPS Preliminary Quantitative Data

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10%

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30%

40%

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70%

80%

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100%

Baseline Post 3-Month FU

Axi

s Tit

le

Proportion Engaging In Unprotected Anal Intercourse (UAI)

Any UAI

High Risk UAI

UAI with POZ partners