The HIV prevalence in men who have sex with men (MSM) has been on an upward trend over the last several decades. Indeed, the global HIV epidemic in MSM remains unabated. In Alabama, the prevalence of HIV and other sexually transmitted diseases (STDs) among MSM remains high. This epidemic could be attributed to low level of awareness among MSM of the dangers associated certain sex-related behaviors such as engaging in unprotected sex and having many sexual partners. Furthermore, low level of awareness of condom use and HIV risk factors contribute to the high prevalence of HIV among MSM. Indeed, studies show that MSM exhibits a high prevalence of unprotected sex. Besides, MSM tends to harbor misleading perceptions of the route of transmission of HIV and the use of condoms. For instance, many of them are not aware that engaging in unprotected sexual intercourse with a fellow man is a risk factor for HIV infection. In the study conducted by Choi and colleagues (2004) to investigate the factors associated with high unprotected sex in MSM found, 49% of the participants reported having engaged in unprotected sex with fellow men. Furthermore, on 15% of the participants perceived that they are at a high risk of HIV infection if they participate in unprotected sex with fellow men (Choi, Gibson, Han, & Guo, 2004).
Even though few studies have been conducted in Alabama concerning the level of behaviors that predispose people to HIV infection among the residents who are MSM, the perceptions held by the participants that took part in the study conducted by Choi and colleagues are likely to be shared by MSM living in Alabama. Several other studies show that there is a high level of misleading perceptions of the route of transmission of HIV in MSM. In Alabama, the level in which MSM take HIV test remains low despite high availability of such services. Thrive Alabama embarked on a program to increase the awareness among MSM. The program aimed at increasing the awareness of various aspects of HIV and other STDs in MSM living in Jefferson County, Alabama. The program sought to achieve the following goals:
high level of use of protection in sexual intercourse among MSM
low prevalence of HIV among MSM
Low level of multiple sexual partners among MSM
The program involved many activities that include the following: designing a schedule for the program; developing HIV education messages; designing and distributing fliers, pamphlets, and posters; conducting talks in schools, churches, and various workplaces in Jefferson County; counseling MSM; conducting HIV tests, distributing condoms, and holding community meetings in the various townships of Jefferson County. I was assigned the role of conducting talks and community meetings, and distributing condoms across the county. In this case, once the talks are scheduled, I would prepare presentations concerning all aspects of HIV. My presentations dwelled on the risk factors for HIV infection to which MSM are prone. Furthermore, my presentations also focused on the approaches that can be pursued to combat the high prevalence of HIV among MSM in the state. I delivered the presentations in community meetings held in all the townships of Jefferson County. I also took part in distributing condoms in schools, colleges, Universities, and workplaces that we visited.
During the implementation of the program, various challenges emerged. First, few people turned up for the community meetings held in the various parks since the meetings took place during rainy seasons. Therefore, most people preferred to stay indoors. This challenge was addressed by changing the venue for subsequent community meetings. For instance, some meetings were conducted at the recreational centers in the county. Another challenge encountered during the implementation exercise of the program is that we could not tell that the people who turned up for the test were MSM. Most people in this category were not willing to declare their sexual orientation. This challenge was addressed by issuing all individuals who took HIV test with a form where they could indicate whether they are MSM and are willing to attend the counseling sessions organized in the program. Another challenge encountered is that some resources for the program were availed late. Consequently, the program activities delayed. This challenge was avoided in the second phase of the program by ensuring that all resources are availed before proceeding with various activities of the program.
Program evaluation is necessary for determining whether a program has achieved its goals or not. Besides, program evaluation helps in determining the impact of the program on the society. In this program, I would focus on changes in sex-related behaviors among the residents of the county. In this case, I would use appropriate tools to measure the level of the use of protection in sexual intercourse among MSM before and after the program implementation exercise to determine if the program has an impact on it. If the level of the use of protection during sexual intercourse is found to have increased after the program is implemented, the program would be said to have succeeded. The success of the program will also be confirmed if the incidence and prevalence rate of HIV among MSM increases after the implementation of the program. The evaluation would also focus on the number of people with multiple sexual partners. The number of individuals with multiple sexual partners should reduce after the program is implemented.
References
Choi, K. H., Gibson, D. R., Han, L., & Guo, Y. (2004). High levels of unprotected sex with men and women among men who have sex with men: a potential bridge of HIV transmission in Beijing, China. AIDS education and Prevention, 16(1: Special issue), 19.
