1

GAY, BISEXUAL, AND MSM AFRICAN AMERICAN MEN AND HIV

Preventing HIV in Gay, Bisexual, and MSM African American Men in D.C. Program Plan
Everline Atandi/L27218019
HLTH 634
15 May 16

GAY, BISEXUAL, AND MSM AFRICAN AMERICAN MEN AND HIV

Title of project: BlackmenHIV

Author(s): Everline Atandi
A. Problem/Need Statement:
1. Gay, bisexual and MSM African-American men are the populations most affected by
HIV nationwide, accounting for more than half of the over one million people living
with HIV in the United States, and for two-thirds of all new infections each year.1
2. According to the 2014 newly diagnosed HIV cases by modes of transmission in
Washington D.C, men sleeping with men (MSM) bit the largest piece of the pie by
66%. 1
3. AA gay, bisexual, and other MSM have increased with sufficient evidence indicating
that AA MSM of all ages experience racial disparities in health and are more likely
than other gay and bisexual men of other races/ethnicities to encounter broader social
and economic barriers.2
4. Due to the increased prevalence of HIV infection among this groups MSM leads to a
higher possibility of transmission, even with similar frequency of risk behaviors as
other populations.
5. Countless AA MSM with HIV, particularly young MSM are unaware of their HIV
infection status.2-3 Several factors that may reflect this low HIV awareness status
include; recent infection, underestimation of personal risk, fewer opportunities to get
tested, or belief that HIV treatment minimizes their risk of acquiring or transmitting
HIV.2, 3
B. Goals and Objectives
1. Increase the number of HIV positive persons who know their status.
a. Objective: By December 31, 2016, increase the number of tests delivered in
healthcare settings by 10% each year, from 51,043 tests in 2011 to 74,732 tests by
2016.
2. Provide prevention interventions for HIV-positive individuals.
a. Objective: By July, 2016 fund BlackmeHIV to implement risk reduction, treatment
adherence and retention in care interventions for at least 800 HIV-positive gay, bisexual,
and MSM.

GAY, BISEXUAL, AND MSM AFRICAN AMERICAN MEN AND HIV

Activity: Require that the funds provided by HAHSTA are allocated to providing
condoms and condom education to HIV-positive and HIV negative gay, bisexual, and
MSM men.
b. Reduce risk behaviors by high-risk negatives.
a. Objective: Establish new programs by April 1, 2013 to implement risk reduction
interventions for at least 600 high-risk individuals per year.
c. Facilitate voluntary testing for other STDs.
a. Activity: Facilitate voluntary testing for other STIs by assisting HIV testing providers
with identifying BlackmenHIV as a referral site for testing and through the provision
of technical assistance and training designed to assist providers for conducting
universal/routine screening.
b. Activity: Continue to provide STI and HIV testing for gay, bisexual and MSM at the
BlackmenHIV portable trailers.
d. Increase and expand the distribution of condoms to HIV positive individuals, high-risk
negatives gay, bisexual and MSM men in D.C.
a. By December 31, 2016, increase the number of condoms distributed to HIV-positive
individuals, high-risk negatives negative gay, bisexual and MSM men in D.C by 10%
each year, from 5,591,329 by 2015 to 6,450,000 in 2016.
C. Sponsoring agency/Contact person:
1. The campaign will partner with the Washington D.C. Department of
Healths HIV/AIDS, Hepatitis, STD and TB Administration (HAHSTA) in
planning and execution.5
2. HAHSTA partners with health and community-based organizations to offer
testing and counseling, prevention education and intervention, free
condoms, medical support, free medication and insurance, housing,
nutrition, personal care, emergency services, and direct services at its STD
and TB Clinics and more for residents of the District and the metropolitan
region.5
3. Contact Person: Everline Atandi. Email: lynn_bryant_2001@yahoo.com
D. Primary target audience: African American gay, bisexual, men sleeping with men in
D.C.
1 Behavioral & Cultural:

GAY, BISEXUAL, AND MSM AFRICAN AMERICAN MEN AND HIV

Sexual risk behaviors account for most HIV infections in MSM.4

Research indicates that those MSM engaging in unprotected
receptive anal sex behavior carries the highest risk for HIV
acquisition.2, 3

Over 40% of MSM did not use condoms the last time they had sex.

More than one-third of MSM had reported using the Internet to

find a sex partner.3

The CDC recommends that all sexually active MSM be tested

annually for these STIs.5

e
f

Two-thirds of AA gay, bisexual MSM engage in casual sex.

Frequent change of sex partners.

Multiple sex partners.

Unprotected sexual intercourse.

A Demographic:
1

In most cases those people who do not know that they are HIV positive
tend not to seek medical care and can unknowingly infect others.8

Most do not have access to care or cannot afford health insurance.

B Physical:
1

Gay and bisexual African-American (AA) men are the population group
that is mostly affected by Human Immunodeficiency Virus (HIV)
nationwide.1. 2

It accounts for more than half of the over one million people living with
HIV in the United States (U.S), and for two-thirds of all new infections
each year.

According to the 2014 newly diagnosed HIV cases by modes of

transmission in Washington D.C, men sleeping with men (MSM) bit the
largest piece of the pie by 66%.1

C Psychographic:
1

Often stigma and negative attitudes about homosexuality, discriminatory

acts, bullying and violence can make it difficult for some AA MSM to be

GAY, BISEXUAL, AND MSM AFRICAN AMERICAN MEN AND HIV

open about same-sex behaviors with others, which can increase stress,
limit social support, and negatively affect health.
E. Primary and Secondary Target Audience Key Strategies:
2

Audience: Gay and bisexual AA MSM Between ages of 18-40 in the poor
communities of Washington D.C.

Action (message): HIV prevention education and intervention, increasing

knowledge and awareness about the importance of using condoms when
engaging in anal sex with men whose HIV status is unknown, and getting
tested regularly if sexually active.

Barriers: Perceived barriers such as individuals assessment of the

influences that facilitate or discourage adoption of the promoted behavior,
social determinants of health, continued stigma associated with HIV, lack
of trust, poor understanding of the health care system and fear of
disclosure and discrimination.10, 11

Benefits: benefit that the audience will experience is that there are services
specifically available for them. The benefit outweighs the barriers in that
they will have awareness that these services remain available to their
convenience and health benefits. Thus, it is important to keep in mind that
reducing stigma and increasing people living with HIV (PLWH) social
supports are critical to ensuring utilization of prevention, care and
treatment services.

Credentials: D.C Care.

Channel: Mass media to include television, radio, advertising, movies, the

internet, newspapers, PSA, and magazines.9. 10

F. Pretest Strategy:
1

Members from the target audience will be selected

to participate in the brochure pretest questionnaire.

G. Theoretical foundation model:

1. The Health Belief Model (HBM), will be utilized. HBM is used to predict
individual response to screening and other preventive health services and their
use.9, 10
H. Management chart:
Responsible Party

Tasks

Timeline

GAY, BISEXUAL, AND MSM AFRICAN AMERICAN MEN AND HIV

Coordinator Coordinator

Implement HIV prevention program

06/01/2016-06/01/2018

Program directors (5)

Create HIV/STI health education

material

06/01/2016-09/01/2018

Develops and updates the

project strategic plan and
consistent with funder and
relevant stakeholders
priorities.

06/01/2016-09/01/2018

Technical Support for staf

06/01/2016-09/01/2018

HIV/STI Health education

support

06/01/2016-09/01/2018

Administrative Assistants (5)

HIV/STI Health promotion

support

06/01/2016-09/01/2018

I. Budget:
1

Estimated cost
Funds provided by HAHSTA (breakdown will be submitted to organization)
5 mobile trailers
250,000
Equipment
105,000
Furniture 5,000
Insurance
Premium 5,000
Supplies 25,000
Utilities 15,000

Advertising 2,000
Maintenance
2,500
Accreditation 350

Subtotals and total cost

Subtotal 409,850

Total 434,441

A Justification
The mobile trailers will be located at five different locations in order to
provide the services to those target population in hard to reach areas.
Minimum equipment to include refrigerators for lab storage. It is a
requirement by the funders to maintain insurance. Considering this is a
free service campaign, we expect to see a great amount of target
population clients which will require a lot of supplies such as condoms,

GAY, BISEXUAL, AND MSM AFRICAN AMERICAN MEN AND HIV

lab draw kits etc. to keep them coming. Main utilities necessary that we
must have to run the mission will be water and power/generator. In order
for the target population to be informed of the services, funds will be
needed for advertising through all the necessary channels. To ensure
smooth operation, the trailers will need to be well maintained to prevent
lump sum cost. The campaign will need to maintain accreditation under
HAHSTA.
J. Issues of concern/potential problems:
2

Conflict with volunteers regular work schedule.

Perceived barriers such as individuals assessment

of the influences that facilitate or discourage
adoption of the promoted behavior, social
determinants of health, continued stigma associated
with HIV, lack of trust, poor understanding of the
health care system and fear of disclosure and
discrimination.

In this program, qualitative approaches will be used

to help tease out some of the unexpected outcomes
that more structured approaches do not facilitate
Participants will be asked to identify what has
changed for them because of contact with the
program or a particular service, personal stories can
be constructed from the data. 2

Quantitative approach will also be used. The

standardized nature of questionnaires and surveys
will make them very useful for before and after
studies in this case.2

K. Evaluation strategies:

References

1. Centers for Disease Control and Prevention. HIV/AIDS. HIV Among Gay and Bisexual
Men.http://www.cdc.gov/hiv/group/msm/index.html. Updated September 29, 2015.
Accessed April 4, 2016.

GAY, BISEXUAL, AND MSM AFRICAN AMERICAN MEN AND HIV

2. Centers for Disease Control and Prevention. HIV/AIDS. About the Division of
HIV/AIDS Prevention. http://www.cdc.gov/hiv/dhap/about.html. Updated March 31,
2016. Accessed April 4, 2016.
3. Skarbinski J, Rosenberg E, Paz-bailey G, et al. Human immunodeficiency virus
transmission at each step of the care continuum in the United States. JAMA Intern Med.
2015;175(4):588-96.
4. Greenberg AE, Hader SL, Masur H, Young AT, Skillicorn J, Dieffenbach CW. Fighting
HIV/AIDS in Washington, D.C. Health Aff (Millwood). 2009;28(6):1677-87.
5. Centers for Disease Control and Prevention. HIV.
https://www.healthypeople.gov/2020/topics-objectives/topic/hiv. Updated April 6, 2016.
Accessed April 6, 2016.
6. Ward H, Rnn M. Contribution of sexually transmitted infections to the sexual
transmission of HIV. Current Opinion in HIV and AIDS. 2010 Jul;5(4):305-10.
7. Mayer KH, Venkatesh KK. Interactions of HIV, other sexually transmitted diseases, and
genital tract inflammation facilitating local pathogen transmission and acquisition.
American Journal of Reproductive Immunology. 2011 Mar;65(3):308-16.
8. Hammond WP, Matthews D, Corbie-Smith G. Psychosocial Factors Associated With
Routine Health Examination Scheduling and Receipt Among African American Men.
Journal of the National Medical Association. 2010;102(4):276-289.
9. Hall HI, Li J, McKenna MT. HIV in predominantly rural areas of the United States.
Journal of Rural Health. 2005;21:245-253.
10. Peterson JL, Jones KT: HIV prevention for black men who have sex with men in the
United States. Am J Public Health. 2009, 99: 976-980. 10.2105/AJPH.2008.143214.
11. Millett GA, Peterson JL, Wolitski RJ, Stall R: Greater risk for HIV infection of black men

who have sex with men: a critical literature review. Am J Public Health. 2006, 96: 10071019. 10.2105/AJPH.2005.066720.