Safe-Sex Workshops Backed by Barbers Could Help Prevent HIV

By Manas Mishra

August 02, 2019

(Reuters Heath) - Barbershops can partner with healthcare providers to help reduce transmission of HIV in high-risk communities, a new report shows.

In the New York City borough of Brooklyn, in a neighborhood with high rates of HIV infection, barbershops partnered with a local hospital to encourage straight black men to enroll in an HIV prevention program. Months afterward, customers who participated in the program were more likely to be practicing safer sex behaviors than men who didn't attend such a program, researchers found.

"The barbershop was a natural place for us to go because barbers talk to customers about everything . . . customers usually follow their barbers from one barbershop to the next if a barber leaves one setting and goes somewhere else," said co-author Dr. Marilyn Fraser from the Arthur Ashe Institute for Urban Health in Brooklyn.

The 53 barbershops that participated in the "Barbershop Talk with Brothers" program were randomly assigned to refer customers to either the HIV prevention sessions or to a program on cancer prevention.

Barbers, owners and managers of the shops were coached on key messages about the programs; afterward, barbers would suggest to eligible men that they talk to the researchers about participating.

Between 2012 and 2016, 860 heterosexual black men were enrolled in either the HIV prevention training or the cancer prevention program. They were included in the study if at the time of enrollment they had reported having at least two sexual partners and sex without protection in the past six months.

The HIV prevention program, moderated by men familiar with the neighborhood, included educational messages, role-playing activities and messages centered around reducing sexual risk.

Participants were also given the option of getting tested for HIV infection. Condoms were periodically distributed at all of the barbershops.

Six months later, the researchers were able to track down and interview 352 men in the HIV prevention group and 305 men in the cancer education group.

Men in the HIV program reported fewer sexually risky behaviors compared to men in the control group, the researchers found. In particular, they were significantly less likely to have had condomless sex in the past 90 days: 64.4% who participated in the HIV prevention workshop reported no instances of unprotected sex, compared with 54.1% who attended the cancer prevention program. (At the start of the study, rates of condomless sex had been similar in the two groups.)

Tracey Wilson of the State University of New York Downstate Medical Center in Brooklyn, who led the study, told Reuters Health the burden of HIV among straight men and women living near her hospital is among the worst in the city, and in the nation.

Of the participants in the current study, 52% had a history of incarceration, 23.5% were living in places that indicated housing instability like shelters or treatments facilities, 76% reported drinking alcohol in the past 90 days, 48% reported using marijuana and 13% reported using other drugs.

"Many of these men value the opportunity to have conversations about these important health topics and . . . we created this face to face program to share this information," said coauthor Michael Joseph, also from Downstate.

In their report online July 3 in the American Journal of Public Health, the authors acknowledge that the shift towards safer sex could have been due to the distribution of condoms at the barbershops.

Still, they conclude, "Our study supports the feasibility of reaching black heterosexual men at risk for HIV infection through (barbershops) . . . Expansion of programs such as Barbershop Talk with Brothers holds promise for reducing HIV health inequities."


Am J Publ Health 2019.