Real Men are Safe (REMAS)

Sexually active men in drug treatment have been identified as a social group with a high prevalence of sexually transmitted infections (STIs) including HIV. Reducing the frequency with which these men engage in unprotected sexual intercourse will reduce the transmission of STIs and HIV in the broader community as well as increase the health of men in drug treatment.

Based on the Information-Motivation-Behavioral Change (IMB) Model, the REMAS sexual health intervention is designed specifically for men in drug treatment. The intervention consists of a workshop of 5 group sessions lasting 1.5 hours. Groups of 3 to 8 men attend and participate in lectures, role-plays, peer group discussions and motivational self-assessment exercises. Information delivery and skill building are the prominent themes of these activities and the underlying theme is motivation. Materials have been developed for men who have sex exclusively with women, as well as men who have sex with men.

Topics include HIV/AIDS information, risky sexual behaviors, risky injection practices, condom demonstration, identifying triggers for risky behavior, risk reduction problem solving, enhancing sex without drugs, and techniques for open communication with sexual partners.

To reduce the frequency of unprotected vaginal and anal sexual intercourse among sexually active men in drug treatment.

The effectiveness of the REMAs intervention was evaluated using a randomized study design. Participants were randomly assigned to either REMAS (five sessions containing information, motivational exercises, and skills training) or HIV education (one session containing HIV prevention information). Men in methadone maintenance (n = 288) or outpatient psychosocial treatment (n = 302) completed assessments at baseline, 2 weeks, 3 months, and 6 months post-intervention. REMAS participants engaged in significantly fewer unprotected vaginal and anal sexual intercourse occasions during the 90 days prior to the 3- and 6-month follow-ups than men who participated in the HIV education intervention. Overall, completers reduced their number of USO by 21%.