News Release: Research , School of Medicine

Mar. 11,  2010

Study Begins on Sexual Risk Behaviors Related to HIV in Black Men

Using a National Institutes of Health (NIH) grant, David J. Malebranche, MD, MPH, assistant professor of medicine, Emory University School of Medicine, will explore how the understudied contexts of mental health and culturally specific coping strategies influence both HIV promoting and protective behaviors among black men in Georgia. The $1.5 million NIH grant is for a three-year study beginning in April.

"HIV rates are high among all black men in this country, regardless of sexual orientation, and hits this group hard in both urban and rural areas, particularly in the Southeast," says Malebranche, an internist practicing at Grady Memorial Hospital. "Georgia ranks seventh in the United States in HIV cases reported through 2007, and is first in HIV cases in nonurban areas.

During the project, which will be carried out in two phases, Malebranche and his team will compare the living situations of black men in three separate areas of Georgia with different population densities but high rates of HIV: metropolitan Atlanta, Columbus and Valdosta.

"We will be specifically looking at how factors such as poverty, experiences with racism/trauma, age and geographic location influences the mental health and stress of these men, and how that may lead them to engage in behaviors that either protect them or put them at risk for HIV infection," says Malebranche.

The Georgia Black Men's Health Study, called "Project Adofo," is named after a Ghanaian boy's name that means "one who loves" or "courageous warrior." According to Malebranche, the intent of giving the study that name is to focus on the affirming qualities of black men in this country, rather than the negative or pathological imagery that is too often portrayed by the media.

Project Adofo is a departure from traditional HIV prevention efforts with black men in the United States that often focus on black men who have sex with men (MSM) in urban settings and compare these men with their white male counterparts.

The study is in collaboration with Morehouse School of Medicine, Drexel University School of Public Health and the University of North Carolina-Chapel Hill. In Georgia, researchers will investigate how black men cope with their social conditions, and how coping may affect their condom use practices, HIV testing behaviors and how they utilize healthcare services and facilities.

To achieve the study's proposed objectives, the investigators will employ a mixed-methods approach involving qualitative one-on-one interviews with 90 men to gain a culturally grounded understanding of the mental health determinants and culturally-specific coping strategies in these men's lives. Focus groups, cognitive interviews and clinical study pilot testing with 30 men to develop survey items from Phase I findings. And finally, quantitative surveys using random digit-dialing (RDD) methods will be used with 1,200 participants to test associations between these domains and sexual behavior and HIV testing outcomes.

"Our long term goals are to identify and understand the unique cultural determinants of the mental health and coping strategies among black men in Georgia that will inform future HIV prevention initiatives," concludes Malebranche.

Project Adofo - the Georgia Black Men's Health Study - begins in April 2010. For more information, contact study program coordinator Brandi Park at (404) 778-1674 or bnpark@emory.edu. 

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