Adaptation, feasibility and performance of a brief clinic-based intervention to improve prevention practices among sexual minority men

Nathan J. Lachowsky, Karyn Fulcher, Allan Lal, Rick Crosby

Research output: Contribution to journalArticlepeer-review


Gay, bisexual, and other men who have sex with men (GBM) are disproportionately affected by sexually transmitted and blood-borne infections (STBBIs). Originally efficacious with young Black GBM in the United States, Focus on the Future (FoF) is a clinic-based, single session intervention aimed at improving prevention practices. We examined the applicability and acceptability of the program for ethnoracially diverse GBM. Participants were recruited from a GBM sexual health clinic in Vancouver. A pre-test, post-test repeated measures design was used with a single intervention arm. Twenty-five HIV-negative participants received the intervention and retention at 90-day follow-up was 92%. Mean age was 27.8 years (SD = 3.53), 54.2% were non-white. The intervention was highly acceptable: 86.9% liked it and 91.3% would recommend it to others. A number of positive outcomes were observed post-intervention such as higher scores on the correct condom-use self-efficacy scales (p = 0.03) and increased condom-use frequency with primary partners (p = 0.03). The main outcome was number of condom-protected anal intercourse events for both insertive and receptive sexual positions; there was no significant difference for either the insertive (p = 0.62) or receptive (p = 0.36) partner. However, when restricted to participants who were not using PrEP, there was a significant increase in the number of condom-protected receptive anal sex events (p = 0.02). Although not an intended effect of the intervention program, 30% (n = 6/20) of PrEP-naïve participants initiated PrEP during the 90-day follow-up. This adapted low-cost intervention was rated highly acceptable by participants and demonstrates promise for increasing STBBI prevention practices. Expanded intervention testing and implementation research is warranted.

Original languageEnglish
Pages (from-to)355-364
Number of pages10
JournalCanadian Journal of Human Sexuality
Issue number3
StatePublished - Nov 2019

Bibliographical note

Funding Information:
Acknowledgements: Funding for this projected was provided by the University of Kentucky. NJL is supported by a Michael Smith Foundation for Health Research Scholar Award (#16863). Correspondence concerning this article should be addressed to Nathan Lachowsky, University of Victoria, School of Public Health and Social Policy, 3800 Finnerty Road, HSD Building Room B202, Victoria, BC V8P 5C2, Canada. Telephone: 250-472-5739. E-mail:

Publisher Copyright:
© 2019 University of Toronto Press Inc.. All rights reserved.


  • Behaviour change
  • Condoms
  • Gay and bisexual men
  • Intervention
  • Pre-exposure prophylaxis
  • Prevention
  • Sexual health
  • Sexually transmitted infections

ASJC Scopus subject areas

  • Psychology (miscellaneous)
  • Psychiatry and Mental health


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