The G.U.Y.S. Program
(Guys Understanding Your Situation)

The G.U.Y.S. program was designed in 1995 by Dr. Cathy Reback to meet the needs of a very specific disenfranchised and vulnerable high-risk population of sexual minority men in the urban core of the Hollywood/West Hollywood area in LAC. The G.U.Y.S. program consists of culturally appropriate, individual risk reduction and group sessions designed to reduce HIV sexual risk behaviors and substance use. A full meal was served prior to each group. Art Exploration Groups were conducted on Mondays and Wednesdays. The Art Exploration Groups provided a context for creative expression and an art medium for participants to identify their feelings and triggers, and work towards understanding their high-risk behaviors. Skills-building Groups were facilitated on Tuesdays and Thursdays. The Skills-building Group topics included:  Emotions, Depression and Substance Use; Entering the Work Force or Continuing Your Education; Preparing for Change; Hepatitis and Sexually Transmitted Infections; Self-esteem and Homophobia; Sex, Drugs, and Risks; Ending the HIV Epidemic. Open Discussion Groups were facilitated on Fridays. A central focus of all program components was the link between HIV sexual behaviors, substance use, and the participants’ experience of living publically, on the streets. HIV risk co-factors and health disparities such as homophobia, stigma, racism and discrimination were addressed in each group format.  Condoms and other risk reduction supplies were available at the site and referrals were made to needed services.

From February 2010 through December 2014, 585 sexual minority men who use substances were enrolled in the G.U.Y.S. intervention. Participants evidenced significant iterative factor reductions in the odds of substance use including alcohol (AOR=0.79) and marijuana (AOR=0.78; both p≤0.05) and marginally significant reductions in the odds of methamphetamine use (AOR=0.83; p≤0.07). Participants also evidenced significant reductions in sexual risks including the odds of reporting drug/alcohol use before or during sex (AOR=0.80) and of condomless anal intercourse (AOR=0.72; all significant at p≤0.05). Results demonstrate that the homegrown intervention was effective at reducing HIV risk behaviors among sexual minority men who use substances.

Reback, C.J. & Fletcher, J.B. (2017). Outcomes from a Homegrown HIV Prevention Program for Extremely High-risk, Substance-using Men who have Sex with Men with Multiple Health Disparities. Journal of Gay and Lesbian Social Services. 29(2): 167-181. DOI: 10.1080/10538720.2017.1296394