DESCRIPTION (provided by applicant): HIV prevention programs for men who have sex with men (MSM) and who use cocaine and/or methamphetamine have proven to be limited. Effective community based interventions for out of treatment users are needed that can break the bond between stimulant use and risky sex. In partnership with a community based health center in Chicago, this project will develop a group-based behavioral intervention for a broad population of MSM who engage in high-risk sex in the context of stimulant use, and who are contemplating or attempting to reduce or stop drug use. A six-week small group curriculum will address the mutually reinforcing factors that have been shown to predict meth and cocaine use and risky sex among MSM, including childhood and adolescent socialization, minority stressors, and the nature of social networks. Facilitators will be trained on techniques of group process --including establishment of group norms, mindfulness, and a "here and now" process orientation--adapted for open-format community based groups. We hypothesize that therapeutic processes and education in healthy sexuality and ways to decouple the sex-stimulant use link, will reduce use of stimulants in the context of sex. We will then recruit 75 stimulant users who are either in treatment for at least one month, or abstaining from use for at least one month, and who report at least one instance of unprotected anal sex while using stimulants in the previous six months. They will be assessed on drug use and sexual risk behavior, mental health, and sexual health, and will be enrolled in the intervention as part of an uncontrolled formative evaluation. Followup at six weeks and six months post intervention will measure changes in self-reported sexual behavior and drug use, as well as intermediate psychosocial and sexual health variables. PUBLIC HEALTH RELEVANCE: HIV incidence rates in the United States remain high among men who have sex with men, and use of psychostimulants during sex has been shown to contribute to the rise in risky behaviors. Tailored, community based interventions to break the bond between risky sex and stimulant use by promoting healthy sexuality are urgently needed given the rise in seroincidence attributable to stimulant use.

Public Health Relevance: HIV incidence rates in the United States remain high among men who have sex with men, and use of psychostimulants during sex has been shown to contribute to the rise in risky behaviors. Tailored, community based interventions to break the bond between risky sex and stimulant use by promoting healthy sexuality are urgently needed given the rise in seroincidence attributable to stimulant use.