d-up!: Defend Yourself! is a community-level intervention for Black men who have sex with men (MSM). d-up! is a cultural adaptation of the Popular Opinion Leader intervention and is designed to change social norms and perceptions of Black MSM regarding condom use. d-up! finds and enlists opinion leaders whose advice is respected and trusted by their peers. These opinion leaders are trained to change risky sexual norms in their own social networks and endorse condom use through conversations with their friends and acquaintances.


According to a Centers for Disease Control and Prevention (CDC) fact sheet, d-up! achieved the following results among targeted social networks of Black MSM in three North Carolina cities:

  • Rates of unprotected insertive anal sex decreased 35.2%
  • Rates of unprotected receptive anal sex decreased 44.1%
  • Number of Black MSM reporting always using condoms for insertive anal sex increased 23.0%
  • Number of Black MSM reporting always using condoms for receptive anal sex increased 30.3%
  • Average number of partners for unprotected receptive anal sex decreased by 40.5%
Video Resource

This three-minute overview video from CDC previews and discusses what d-up! is and how it works in the community.

Core Components

Site Activities

  • Identify at-risk target population
  • Host key informants and systematic observation
  • Recruit and train opinion leaders
  • Review target population social and cultural factors
  • Learn effective behavior change messages
  • Instruct, model, role-play, and provide feedback
  • Review, discuss, and reinforce outcomes
  • Brainstorm conversation starters
  • Build skills of opinion leaders to deliver effective messages
  • Set goals for opinion leaders

Participant Activities

  • Have one-on-one conversations with peers about condom use and risk reduction

Basic Training

The free d-up! online training is available through the HIP e-Learning Center and consists of 14 interactive modules with over 200 videos of subject matter, implementation advice, and lessons learned for facilitators.

Organizations can request free capacity building assistance (CBA) through the CBA Request Information System (CRIS). CBA is training, technical assistance, and technology transfer to individuals, communities, community–based organizations, and health departments.

Implementation materials, including manuals, facilitator's guide and PowerPoint presentation, activities/handouts/training aids, are available through CDC's Effective Intervention page and can be downloaded for free.

Page last updated: April 2018