Pilot evaluation of the Making Employment Needs [MEN] Count intervention: Addressing behavioral and structural HIV risks in heterosexual Black men

Abstract

Few community-based HIV interventions exist for Black men at heterosexual risk for HIV. None focus on structural HIV risks such as unemployment and unstable housing. This study involved a pilot evaluation of the MEN (Making Employment Needs) Count HIV intervention, a three session peer counselor-delivered program of HIV risk reduction and gender-equity counseling, and employment and housing case management. A single-arm intervention trial of MEN Count was conducted with Black men recruited from a community men's clinic and social services program. Eligible men were those who reported two or more sex partners in the past six months and current unemployment and/or recent homelessness. Most participants (68%) had a history of incarceration. Participants (N = 50) were surveyed on outcomes at baseline (Time 1), posttest (Time 2; 60–90 days after baseline), and two-month follow-up (Time 3). The majority of participants were retained in the program (86%) and the final follow-up survey (76%). McNemar tests revealed significant reductions in the past 30-day unprotected sex from Time 1 (74%) to Time 2 (47%) and to Time 3 (47%), and in homelessness from Time 1 (58%) to Time 3 (32%). Significant increases in employment from Time 1 (8%) to Time 2 (29%) and Time 3 (32%) were also seen. Participants completed a brief participant satisfaction survey at posttest. Most (n=28, 65%) rated the program as excellent, and an additional 10 (23%) rated it as good. Although there was no significant reduction in multiple sex partners, a trend was observed from Time 1 (56%) to Time 2 (44%) and Time 3 (42%). Findings suggest that the MEN Count model is a feasible and promising HIV prevention program for Black men at heterosexual risk for HIV. Larger scale implementation and more rigorous evaluation of MEN Count are needed to confirm the study findings.

Keywords:

• HIV/AIDS
• Black men
• heterosexual risk
• structural interventions
• behavioral interventions

Acknowledgments

We would like to thank the staff and patients of Whittier Street Health Center for supporting this study, as well as our MEN Count participants for providing their time and insight into the project. We would also like to acknowledge the contributions of Elizabeth Reed, Lisa Bowleg, and Wanda Allen in helping us interpret and disseminate study findings within the communities in which this research occurred. This study was funded by the National Institute of Mental Health Grant R21MH085614 (Principal Investigator: Anita Raj); additional support for authors' time to develop this paper also came from the National Institute of Mental Health Grant R01MH096657 (PI: Anita Raj), and the National Institute on Drug Abuse Grant T32DA023356 (pre-doctoral training grant; PI: Steffanie Strathdee).