Objective To test a novel social network HIV risk reduction intervention for MSM in Russia and Hungary where same-sex behavior is stigmatized and men may best be reached through their social network connections. to other network members. Main Outcome and Measures Changes in sexual behavior from baseline to 3- and 12-month followup with composite HIV/STD incidence measured at 12-months to corroborate behavior changes. Results There were significant reductions between baseline first followup and second followup in the intervention versus comparison arm for proportion of men engaging in any unprotected anal intercourse (P=.04); UAI with a nonmain partner (P=.04); and UAI with multiple partners (P=.002). The mean percentage of unprotected AI acts significantly declined (P=.001) as well as the mean number of UAI acts Fulvestrant (Faslodex) among men who initially had multiple partners (P=.05). Biological HIV/STD incidence was 15% in comparison condition networks and 9% in intervention condition networks. Conclusions Even where same-sex behavior is stigmatized it is possible to reach MSM and deliver HIV prevention FA-H through their social networks. Introduction Men who have sex with men (MSM) are disproportionately vulnerable to HIV disease throughout the world 1 including in regions where the disease can be mainly heterosexual or due to shot medication use2 such as for example Subsaharan Africa 3 4 countries from the previous Soviet Union 5 6 and China.7-9 Small is well known about interventions that may reduce intimate HIV risk in regions where same-sex behavior is stigmatized and MSM are improbable to search out HIV prevention services even if indeed they were available. Although substantial attention is currently being appropriately aimed to the usage of biomedical approaches for avoidance interventions to lessen intimate risk behavior among MSM Fulvestrant (Faslodex) also stay critical. Politics support open up and tolerant cultural policies well-established non-governmental agencies (NGOs) and the current presence of visible gay areas in the Western facilitate the usage of an array of specific- group- and community-level HIV avoidance applications for MSM.10 11 The problem is a lot more difficult in countries which are much less tolerant of same-sex behavior. There’s been recent movement in Russia toward intolerance of gay reputation and rights. Efforts to attain MSM face politics legal and execution challenges because males are improbable to openly promote themselves as gay or bisexual. Traditional trends far away in your community including Hungary also have lessened tolerance toward minorities.12 13 New techniques are essential in this area to attain MSM and deliver interventions to lessen HIV risk behavior. Interventions that operate through internet sites hold Fulvestrant (Faslodex) guarantee for reaching susceptible areas even though formal avoidance infrastructure helps are limited.14 Network methods possess always been used to attain and decrease injection risk methods in community examples of medication users.15-17 Network choices for reducing intimate risk practices have not often been studied but are promising because MSM can potentially be reached through their social networks.18-20 This approach is especially culturally pertinent to Eastern Europe where pronouncements from Soviet era authorities were often seen as untrustworthy and people relied on their personal networks to gain trusted information Fulvestrant (Faslodex) and mutual support.21 22 Informal network connections among individuals who are personally known and trusted continue to play a vital function in helping people in the region handle everyday challenges and determine best courses of action.23 AIDS research in Russia has shown that the social network to which gay or bisexual men belong influences whether they engage in high-risk sex.24 Prior research in the United States demonstrated that “popular opinion leaders” (POLs) within populations of gay men in small cities can be Fulvestrant (Faslodex) engaged to shift the risk behavior practices of other MSM in the same communities.25 26 In contrast to the POL community intervention model the present approach sought to recruit networks of interconnected friends and train Fulvestrant (Faslodex) empirically-identified leaders within each network to deliver personally-tailored ongoing risk reduction counseling to their close friends. Such a process can serve to strengthen norms attitudes intentions and skills for risk reduction in one’s immediate social environment. The present study also grows from a previous randomized HIV prevention social network intervention trial in Eastern Europe that recruited small clusters of friends (“egocentric” networks) and trained the single leader of each network to counsel.