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Coleman JL, Jones M, Washington D, Almirol E, Forberg P, Dyer TV, Spieldenner A, Martinez O, Rodriguez-Diaz CE, Parker SD, Schneider JA, Brewer R. Using the Meaningful Involvement of People Living with HIV/AIDS (MIPA) Framework to Assess the Engagement of Sexual Minority Men of Color in the US HIV Response: a Literature Review. J Racial Ethn Health Disparities 2023; 10:2374-2396. [PMID: 36171496 PMCID: PMC10098811 DOI: 10.1007/s40615-022-01417-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 11/29/2022]
Abstract
Black and Latino sexual minority men (SMM) continue to be disproportionately impacted by HIV. We utilized eight components of the Meaningful Involvement of People Living with HIV/AIDS (MIPA) framework to assess the engagement of Black and Latino SMM. Thirty-six (36) studies were included in the literature review. Forty-two percent of studies were Black SMM-specific, followed by Latino SMM-specific (31%) studies. Twenty-eight percent of studies were conducted among both groups. Most studies (72%) were intervention-related and focused on HIV prevention. The top five most common methods of community engagement were focus groups (39%), followed by interviews (36%), community-based participatory research (14%), the utilization of community advisory boards or peer mentorship (11%), and the establishment of multi-stakeholder coalitions, observations, or surveys (8%). We documented at least 7 MIPA components in 47% of the included studies. Community-based participatory research was more commonly utilized to engage Latino SMM. Researchers were more likely to initiate the engagement across all included studies. Few studies documented how Black and Latino SMM perceived the engagement. Engagement responsiveness was a well-documented MIPA component. In terms of engagement power dynamics, there were several examples of power imbalances, especially among Black SMM-specific studies. The inclusion of Black and Latino SMM had robust impacts on HIV research and interventions. There were limited examples of engagement capacity and maintenance. This is one of the first studies focused on utilizing MIPA to document the engagement of SMM of color. MIPA served as a useful framework for understanding the engagement of SMM of color in the US HIV response. The engagement of SMM of color is critical to reducing health inequities.
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Affiliation(s)
| | - Mickaya Jones
- Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA
| | | | - Ellen Almirol
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, MC 5065, Chicago, IL, 60637, USA
| | | | - Typhanye V Dyer
- Department of Epidemiology and Biostatistics, University of Maryland, College Park, MD, USA
| | - Andrew Spieldenner
- MPact Global, Oakland, CA, USA
- California State University-San Marcos, San Marcos, CA, USA
| | - Omar Martinez
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Carlos E Rodriguez-Diaz
- Department of Prevention and Community Health, George Washington University - Milken Institute School of Public Health, Washington, DC, USA
| | - Sharon D Parker
- North Carolina Agricultural and Technical State University, Greensboro, NC, USA
| | - John A Schneider
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, MC 5065, Chicago, IL, 60637, USA
| | - Russell Brewer
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, MC 5065, Chicago, IL, 60637, USA.
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2
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Martinez O, Fernandez MI, Yang C, Wu E, Valentin O, Johnson M. Feasibility and Acceptability Pilot Test of Connecting Latinos en Parejas: A Couples-Based HIV Prevention Intervention for Latino Male Couples. Am J Mens Health 2023; 17:15579883231167106. [PMID: 37096329 PMCID: PMC10141303 DOI: 10.1177/15579883231167106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/10/2023] [Accepted: 03/15/2023] [Indexed: 04/26/2023] Open
Abstract
Despite recent emphasis on couples-based HIV prevention interventions, efficacious interventions for Latino male couples have yet to be tested. The study examined the feasibility and acceptability of the Connecting Latinos en Pareja (CLP) intervention, a couples-based HIV prevention intervention for Latino male couples. This pilot demonstrated high feasibility, meeting targets for recruitment, retention, and intervention completion. We recruited a diverse cohort of 46 individuals/23 couples with a retention rate of 80% over 6 months and a 100% intervention completion rate in both conditions (four structured couple sessions in each condition). This pilot RCT was not powered to detect significant intervention impact on the primary outcome; however, there was a significant increase in relationship functioning among couples in the intervention group relative to controls and promising trends in changes in several key outcome and mediating variables. Secondary analysis documented trends in the expected directions for several other key hypothesized mechanisms of action (stimulant use, psychological symptoms, quality of life) as well as the primary outcome of proportion of protected sex acts (overall and broken out by main vs. outside partners). Qualitative exit interviews revealed high levels of acceptability of the CLP intervention. Participants highlighted affective component of the intervention and perceived effectiveness in improving dyadic communication skills and safer sex practices. Our findings show that a pilot trial of CLP is highly feasible and acceptable, with CLP demonstrating promising evidence of changes in key intervention mechanisms.
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Affiliation(s)
- Omar Martinez
- College of Medicine, University of
Central Florida, Orlando, FL, USA
| | - M. Isabel Fernandez
- College of Osteopathic Medicine, Nova
Southeastern University, Fort Lauderdale, FL, USA
| | - Cui Yang
- College of Public Health, Rutgers
University, Piscataway, NJ, USA
| | - Elwin Wu
- School of Social Work, Columbia
University, New York, NY, USA
| | - Omar Valentin
- College of Medicine, University of
Miami, Coral Gables, FL, USA
| | - Mallory Johnson
- School of Medicine, University of
California San Francisco, San Francisco, CA, USA
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3
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Robles G, Hong C, Yu M, Starks TJ. Intersecting Communities and PrEP Uptake among US-based Latinx Sexual Minority Men. J Racial Ethn Health Disparities 2022; 9:2157-2163. [PMID: 34554441 PMCID: PMC9034471 DOI: 10.1007/s40615-021-01154-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 05/28/2021] [Accepted: 09/14/2021] [Indexed: 12/29/2022]
Abstract
The Latinx community in the USA continues to be disproportionately burdened by the HIV epidemic, especially among Latinx sexual minority men (LSMM). Research indicates that up to two-thirds of new HIV infections occur among men who have sex with men (MSM) within primary partnerships. One promising biomedical approach for HIV prevention includes community scale-up of pre-exposure prophylaxis (PrEP) among LSMM. We examine the relationship between community connectedness (with the Latinx and gay communities) and PrEP uptake among 307 partnered LSMM who reported casual partner sex (i.e., non-monogamous relationships). Within the sample, approximately thirty percent (29.7%) of participants were on PrEP, and 43.3% reported partner approval for PrEP (i.e., my partner is in favor of PrEP generally), while only 7.2% were opposed to PrEP. Insurance status and income levels were significantly associated with PrEP uptake. There was a significant interaction term (gay community connectedness and Latinx group membership), which was positively associated with PrEP uptake (OR = 2.18; p = .007). Findings suggest that there may be structural barriers preventing this population from seeking and initiating PrEP care. Results point to the utility of integrating culturally relevant content related to intersecting identities and their corresponding communities when conceptualizing community-based and culturally informed interventions to improve the PrEP care cascade among LSMM.
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Affiliation(s)
- Gabriel Robles
- School of Social Work, Rutgers University, 390 George Street, Room 606, New Brunswick, NJ, 08901, USA.
| | - Chenglin Hong
- Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA
| | - Melanie Yu
- School of Social Work, Rutgers University, 390 George Street, Room 606, New Brunswick, NJ, 08901, USA
| | - Tyrel J Starks
- Department of Psychology, Hunter College, New York, NY, USA
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4
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Rhodes SD, Tanner AE, Mann-Jackson L, Alonzo J, Aviles LR, Galindo CA, Bessler PA, Courtenay-Quirk C, Smart BD, Garcia M, Goldenberg T, Sucaldito AD, Reboussin BA. Adapting a Group-Level PrEP Promotion Intervention Trial for Transgender Latinas During the COVID-19 Pandemic. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2022; 34:481-495. [PMID: 36454131 PMCID: PMC10552717 DOI: 10.1521/aeap.2022.34.6.481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic has profoundly affected the conduct of community-based and community-engaged research. Prior to the pandemic, our community-based participatory research partnership was testing ChiCAS, an in-person, group-level behavioral intervention designed to promote uptake of pre-exposure prophylaxis (PrEP), condom use, and medically supervised gender-affirming hormone therapy among Spanish-speaking transgender Latinas. However, the pandemic required adaptations to ensure the safe conduct of the ChiCAS intervention trial. In this article, we describe adaptations to the trial within five domains. Transgender women are disproportionately affected by HIV, and it is essential to find ways to continue research designed to support their health within the context of the COVID-19 pandemic and future infectious disease outbreaks, epidemics, and pandemics. These adaptations offer guidance for ongoing and future community-based and community-engaged research during the COVID-19 pandemic and/or potential subsequent outbreaks (e.g., monkeypox), epidemics, and pandemics, particularly within under-served marginalized and minoritized communities.
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Affiliation(s)
| | | | | | - Jorge Alonzo
- Wake Forest School of Medicine, Winston-Salem, NC
| | | | | | | | | | | | | | | | | | - Beth A. Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC
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5
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Moore SJ, Wood-Palmer DK, Jones MD, Doraivelu K, Newman Jr A, Harper GW, Camacho-González A, del Río C, Sutton MY, Hussen SA. Feasibility and acceptability of B6: a social capital program for young Black gay, bisexual and other men who have sex with men living with HIV. HEALTH EDUCATION RESEARCH 2022; 37:405-419. [PMID: 36200434 PMCID: PMC9677235 DOI: 10.1093/her/cyac028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Young Black gay, bisexual and other men who have sex with men (YB-GBMSM) are disproportionately burdened by HIV and often exhibit suboptimal engagement in HIV care. With the goal of increasing engagement in HIV care, we designed a culturally specific, theory-based group-level program, Brothers Building Brothers by Breaking Barriers (B6), which aimed to strengthen resilience and social capital among YB-GBMSM living with HIV. We conducted a pilot trial to evaluate the program's acceptability and feasibility. Through clinic-based recruitment and community outreach events, we recruited and enrolled 71 YB-GBMSM into the study. Participants were randomized to either the B6 program or a control comparison program. Post-session evaluation surveys and in-depth qualitative interviews showed B6 to have high levels of acceptability and satisfaction. Specifically, participants described benefits to interacting in a group with other YB-GBMSM, and several described increased comfort with their own gay identities after participation. No adverse events or safety concerns were reported. However, there were challenges to feasibility, as reflected in recruitment and retention rates. The B6 program was highly acceptable among YB-GBMSM living with HIV; however, innovative program delivery methods and implementation strategies will be needed to improve recruitment and retention in future implementation of B6.
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Affiliation(s)
- Shamia J Moore
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Drew K Wood-Palmer
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Marxavian D Jones
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Kamini Doraivelu
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Antonio Newman Jr
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Gary W Harper
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Andrés Camacho-González
- Department of Pediatrics, Division of Infectious Diseases, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA 30322, USA
| | - Carlos del Río
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA
| | - Madeline Y Sutton
- Department of Obstetrics and Gynecology, Morehouse University School of Medicine, 720 Westview Drive, Atlanta, GA 30310, Georgia
| | - Sophia A Hussen
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA
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6
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Parchem B, Aguayo-Romero RA, del Río-González AM, Calabrese SK, Poppen PJ, Zea MC. Perceptions of power and sexual pleasure associated with sexual behaviour profiles among Latino sexual minority men. CULTURE, HEALTH & SEXUALITY 2021; 23:1344-1360. [PMID: 32744462 PMCID: PMC7855680 DOI: 10.1080/13691058.2020.1781263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Abstract
In a body of research typically focused on risk reduction and disease prevention, other factors motivating the sexual behaviours of Latino sexual minority men, such as resource-based power and sexual pleasure, are less well understood. To this end, Latino immigrant sexual minority men living in New York City were surveyed about their sexual behaviours, perceived power differentials, and pleasure from insertive and receptive anal intercourse. Power and pleasure were examined as associations with behavioural profiles identified through latent class analysis, adjusting for age and partner type. Four latent classes of Latino sexual minority men were identified based on behaviours reported during the most recent sexual event: behaviourally insertive (14.2%), behaviourally versatile (25.9%), behaviourally receptive (29.2%), and limited penetrative behaviour (30.7%). Participants who derived pleasure from insertive and receptive anal intercourse had higher odds of belonging in the behaviourally insertive and behaviourally receptive class, respectively. Perceptions of resource-based power were not associated with class membership. Findings highlight the importance of sexual pleasure as a driver of sexual behaviour, irrespective of power dynamics. Sexual health curricula and interventions for sexual minority men should consider sexual pleasure and sex-affirmative frameworks when providing sexuality education and promoting sexual wellbeing.
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Affiliation(s)
- Benjamin Parchem
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Rodrigo A. Aguayo-Romero
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
- Brigham and Women’s Hospital, Harvard Medical School, The Fenway Institute, Boston, MA, USA
| | | | - Sarah K. Calabrese
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Paul J. Poppen
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Maria Cecilia Zea
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
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7
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Rhodes SD, Kuhns LM, Alexander J, Alonzo J, Bessler PA, Courtenay-Quirk C, Denson DJ, Evans K, Galindo CA, Garofalo R, Gelaude DJ, Hotton AL, Johnson AK, Mann-Jackson L, Muldoon A, Ortiz R, Paul JL, Perloff J, Pleasant K, Reboussin BA, Refugio Aviles L, Song EY, Tanner AE, Trent S. Evaluating Locally Developed Interventions to Promote PrEP Among Racially/Ethnically Diverse Transgender Women in the United States: A Unique CDC Initiative. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021. [PMID: 34370565 DOI: 10.1521/aeap.2021.33.4.345]] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
In the United States, transgender women are disproportionately affected by HIV. However, few evidence-based prevention interventions exist for this key population. We describe two promising, locally developed interventions that are currently being implemented and evaluated through the Centers for Disease Control and Prevention Combination HIV Prevention for Transgender Women Project: (a) ChiCAS, designed to promote the uptake of pre-exposure prophylaxis (PrEP), condom use, and medically supervised hormone therapy among Spanish-speaking transgender Latinas, and (b) TransLife Care, designed to address the structural drivers of HIV risk through access to housing, employment, legal services, and medical services, including HIV preventive care (e.g., PrEP use) among racially/ethnically diverse urban transgender women. If the evaluation trials determine that these interventions are effective, they will be among the first such interventions for use with transgender women incorporating PrEP, thereby contributing to the evidence-based resources that may be used to reduce HIV risk among this population.
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Affiliation(s)
- Scott D Rhodes
- Department of Social Sciences and Health Policy and CTSI Program in Community-Engaged Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Lisa M Kuhns
- Northwestern University, Department of Pediatrics, Feinberg School of Medicine, and the Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | | | - Jorge Alonzo
- Department of Social Sciences and Health Policy and CTSI Program in Community-Engaged Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | | | - Damian J Denson
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kaiji Evans
- Chicago House and Social Service Agency, Chicago, Illinois
| | - Carla A Galindo
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Robert Garofalo
- Northwestern University, Department of Pediatrics, Feinberg School of Medicine, and the Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | | | - Anna L Hotton
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Amy K Johnson
- Northwestern University, Department of Pediatrics, Feinberg School of Medicine, and the Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy and CTSI Program in Community-Engaged Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Abigail Muldoon
- Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | - Reyna Ortiz
- Chicago House and Social Service Agency, Chicago, Illinois
| | | | - Judy Perloff
- Chicago House and Social Service Agency, Chicago, Illinois
| | - Kevin Pleasant
- Chicago House and Social Service Agency, Chicago, Illinois
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | | | - Amanda E Tanner
- University of North Carolina Greensboro, Greensboro, North Carolina
| | - Scott Trent
- Triad Health Project, Greensboro, North Carolina
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8
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Rhodes SD, Kuhns LM, Alexander J, Alonzo J, Bessler PA, Courtenay-Quirk C, Denson DJ, Evans K, Galindo CA, Garofalo R, Gelaude DJ, Hotton AL, Johnson AK, Mann-Jackson L, Muldoon A, Ortiz R, Paul JL, Perloff J, Pleasant K, Reboussin BA, Refugio Aviles L, Song EY, Tanner AE, Trent S. Evaluating Locally Developed Interventions to Promote PrEP Among Racially/Ethnically Diverse Transgender Women in the United States: A Unique CDC Initiative. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021; 33:345-360. [PMID: 34370565 PMCID: PMC8565450 DOI: 10.1521/aeap.2021.33.4.345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In the United States, transgender women are disproportionately affected by HIV. However, few evidence-based prevention interventions exist for this key population. We describe two promising, locally developed interventions that are currently being implemented and evaluated through the Centers for Disease Control and Prevention Combination HIV Prevention for Transgender Women Project: (a) ChiCAS, designed to promote the uptake of pre-exposure prophylaxis (PrEP), condom use, and medically supervised hormone therapy among Spanish-speaking transgender Latinas, and (b) TransLife Care, designed to address the structural drivers of HIV risk through access to housing, employment, legal services, and medical services, including HIV preventive care (e.g., PrEP use) among racially/ethnically diverse urban transgender women. If the evaluation trials determine that these interventions are effective, they will be among the first such interventions for use with transgender women incorporating PrEP, thereby contributing to the evidence-based resources that may be used to reduce HIV risk among this population.
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Affiliation(s)
- Scott D Rhodes
- Department of Social Sciences and Health Policy and CTSI Program in Community-Engaged Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Lisa M Kuhns
- Northwestern University, Department of Pediatrics, Feinberg School of Medicine, and the Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | | | - Jorge Alonzo
- Department of Social Sciences and Health Policy and CTSI Program in Community-Engaged Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | | | - Damian J Denson
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kaiji Evans
- Chicago House and Social Service Agency, Chicago, Illinois
| | - Carla A Galindo
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Robert Garofalo
- Northwestern University, Department of Pediatrics, Feinberg School of Medicine, and the Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | | | - Anna L Hotton
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Amy K Johnson
- Northwestern University, Department of Pediatrics, Feinberg School of Medicine, and the Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy and CTSI Program in Community-Engaged Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Abigail Muldoon
- Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | - Reyna Ortiz
- Chicago House and Social Service Agency, Chicago, Illinois
| | | | - Judy Perloff
- Chicago House and Social Service Agency, Chicago, Illinois
| | - Kevin Pleasant
- Chicago House and Social Service Agency, Chicago, Illinois
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | | | - Amanda E Tanner
- University of North Carolina Greensboro, Greensboro, North Carolina
| | - Scott Trent
- Triad Health Project, Greensboro, North Carolina
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Ramos SR, Nelson LE, Jones SG, Ni Z, Turpin RE, Portillo CJ. A State of the Science on HIV Prevention Over 40 Years Among Black and Hispanic/Latinx Communities. J Assoc Nurses AIDS Care 2021; 32:253-263. [PMID: 33929978 PMCID: PMC8223201 DOI: 10.1097/jnc.0000000000000266] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT We present a state of the science on HIV behavioral prevention interventions in Black and Hispanic/Latinx communities. The purpose of this article is threefold: (a) highlight the early documented underlying social and political barriers that constrained interventions to prevent new HIV infections; (b) address the structural inequities in HIV prevention and treatment; and (c) describe the need for increasing HIV multilevel prevention interventions that support greater HIV testing and pre-exposure prophylaxis uptake. To address HIV prevention, multilevel interventions that address individual, structural, and social level components have demonstrated more sustainable outcomes. Implications for research and clinical practice include (a) updating antiquated curricula in nursing, medicine, and public health that perpetuate racial, structural-level inequities and (b) increasing the pipeline for Black and Hispanic/Latinx persons to pursue research or clinical-focused doctorate degrees.
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Affiliation(s)
- S. Raquel Ramos
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | | | - Sandra Gracia Jones
- Chronic Disease Prevention and Care, Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami, Florida, USA
| | - Zhao Ni
- Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Rodman E. Turpin
- Department of Epidemiology and Biostatistics, University of Maryland College Park, School of Public Health, College Park, Maryland, USA
| | - Carmen J. Portillo
- Yale University School of Nursing, Yale University, New Haven, Connecticut, USA
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10
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Alonzo J, Mann-Jackson L, Garcia M, Tanner AE, Rhodes SD. Meeting the needs of young Latino gay, bisexual, and other men who have sex with men (MSM) and transgender women living with HIV through the weCare intervention in the United States (US). EHQUIDAD 2021; 15:209-232. [PMID: 33681870 PMCID: PMC7935230 DOI: 10.15257/ehquidad.2021.0009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVE Young gay, bisexual, and other MSM (men who have sex with men) and transgender women in the United States (US) who are living with HIV, and particularly those who are Latino, have low rates of viral suppression. The weCare intervention uses social media to increase HIV care engagement. METHOD We used community-based participatory research to develop the intervention as well as theory-based social media messages tailored to each participant's unique context. We analyzed elements and characteristics of weCare, messages sent by the Cyber Health Educator (CHE), and lessons learned to meet the needs of Latino participants living with HIV. RESULTS We identified 6 core elements, 5 key characteristics, effective social media messages used in implementation, and 8 important lessons regarding relationships between the CHE and HIV clinics, the CHE and participants, and participants and the health system. CONCLUSIONS Social media offers a promising platform to retain young Latino gay bisexual and other MSM and transgender women living with HIV in care and achieve viral suppression.
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Affiliation(s)
- Jorge Alonzo
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC USA 27157
- CTSI Program in Community-Engaged Research, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC USA 27157
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC USA 27157
- CTSI Program in Community-Engaged Research, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC USA 27157
| | - Manuel Garcia
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC USA 27157
| | - Amanda E. Tanner
- University of North Carolina Greensboro, Department of Public Health Education, 1400 Spring Garden St., Greensboro, NC USA 27412
| | - Scott D. Rhodes
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC USA 27157
- CTSI Program in Community-Engaged Research, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC USA 27157
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Handlovsky I, Bungay V, Johnson J, Oliffe J. Overcoming adversity: a grounded theory of health management among middle-aged and older gay men. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:1566-1580. [PMID: 32579289 DOI: 10.1111/1467-9566.13145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This article presents findings from a grounded theory study in which we explored how self-identifying gay men between 40 and 76 years of age manage their health in the context of homophobia, heteronormativity and discrimination. Data were collected with 25 men over a 6-month period in a large urban setting in Western Canada. A preliminary theory of health management is discussed, consisting of the central phenomenon of overcoming adversity. Three thematic processes are considered that illustrate how adversity and health management are situated within the interrelationships of historical and ongoing discrimination inclusive of and external to the healthcare encounter, the complexity of men's illnesses, and the temporal aspects of HIV epidemics and treatments that occurred throughout their lives. These themes include: advocating for health needs, knowing about health issues and treatments, and engaging in health promoting practices. These findings help to address a gap in knowledge concerning health management among older gay men and support that initiatives aimed at health care with gay men must appreciate the systemic role of discrimination, while supporting men's individual efforts in actively managing their health.
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Affiliation(s)
| | | | - Joy Johnson
- Simon Fraser Faculty of Health Sciences, Burnaby, BC, Canada
| | - John Oliffe
- UBC School of Nursing, Vancouver, BC, Canada
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Painter TM, Song EY, Mullins MM, Mann-Jackson L, Alonzo J, Reboussin BA, Rhodes SD. Social Support and Other Factors Associated with HIV Testing by Hispanic/Latino Gay, Bisexual, and Other Men Who Have Sex with Men in the U.S. South. AIDS Behav 2019; 23:251-265. [PMID: 31102108 PMCID: PMC6800592 DOI: 10.1007/s10461-019-02540-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Cognitive-psychosocial and other factors may affect participation in HIV testing, particularly by Hispanic/Latino gay, bisexual, and other men who have sex with men (MSM) in the U.S. South, a region hard-hit by HIV. We used univariate and multivariable logistic regression analyses to examine the association between social support and other cognitive-psychosocial factors; sociodemographic characteristics; risk behaviors; and self-reported HIV testing in a sample of 304 Hispanic/Latino MSM in North Carolina. In the multivariable logistic regression analysis, general and HIV-related social support and HIV-related knowledge were associated with greater odds of testing; speaking only Spanish was associated with reduced odds of testing. Social support and aspects of social connectedness may constitute community-based resources for use in HIV prevention efforts with Hispanic/Latino MSM. However, harnessing these resources for HIV prevention will require a better understanding of how social support relationships and processes shape HIV risks and protective actions by these vulnerable MSM.
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Affiliation(s)
- Thomas M Painter
- Prevention Research Branch, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS E-37, Atlanta, GA, 30329, USA.
| | - Eunyoung Y Song
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mary M Mullins
- Prevention Research Branch, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS E-37, Atlanta, GA, 30329, USA
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Scott D Rhodes
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Insurance Status and Access to Sexual Health Services Among At-Risk Men: A Qualitative Study. J Assoc Nurses AIDS Care 2019; 30:e122-e131. [DOI: 10.1097/jnc.0000000000000063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Pérez A, Santamaria EK, Operario D. A Systematic Review of Behavioral Interventions to Reduce Condomless Sex and Increase HIV Testing for Latino MSM. J Immigr Minor Health 2019; 20:1261-1276. [PMID: 29247266 DOI: 10.1007/s10903-017-0682-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Latino men who have sex with men (MSM) in the United States are disproportionately affected by HIV, and there have been calls to improve availability of culturally sensitive HIV prevention programs for this population. This article provides a systematic review of intervention programs to reduce condomless sex and/or increase HIV testing among Latino MSM. We searched four electronic databases using a systematic review protocol, screened 1777 unique records, and identified ten interventions analyzing data from 2871 Latino MSM. Four studies reported reductions in condomless anal intercourse, and one reported reductions in number of sexual partners. All studies incorporated surface structure cultural features such as bilingual study recruitment, but the incorporation of deep structure cultural features, such as machismo and sexual silence, was lacking. There is a need for rigorously designed interventions that incorporate deep structure cultural features in order to reduce HIV among Latino MSM.
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Affiliation(s)
- Ashley Pérez
- Department of Social and Behavioral Sciences, Brown University School of Public Health, 121 South Main Street, Box G-S121-3, Providence, RI, 02912, USA.
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA.
| | - E Karina Santamaria
- Department of Social and Behavioral Sciences, Brown University School of Public Health, 121 South Main Street, Box G-S121-3, Providence, RI, 02912, USA
| | - Don Operario
- Department of Social and Behavioral Sciences, Brown University School of Public Health, 121 South Main Street, Box G-S121-3, Providence, RI, 02912, USA
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
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15
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Reback CJ, Clark K, Fletcher JB. TransAction: A homegrown, theory-based, HIV risk reduction intervention for transgender women experiencing multiple health disparities. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2018; 16:408-418. [PMID: 33133300 PMCID: PMC7597668 DOI: 10.1007/s13178-018-0356-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
HIV vulnerability among transgender women is symptomatic of numerous syndemic psychosocial and structural co-factors that attribute to and exacerbate HIV risk. From February 2010 to December 2017, 514 transgender women enrolled in a 'homegrown' theory-based, HIV risk reduction program, TransAction, specifically designed to intervene with trans women who experience numerous co-occurring health disparities. Increased attendance in TransAction intervention sessions was associated with significant reductions in the number of male sexual partners (coef. = -0.20), anonymous male sexual partners (-0.30), exchange male sexual partners (-0.25), engagement in drug/alcohol use (-0.37), engagement in injection drug use (-0.20), engagement in unmonitored injection hormone use (-0.55), engagement in sex while high (-0.23), and engagement in sex work (-0.20; all coefficient estimates p ≤ 0.05). Results demonstrated that the homegrown HIV risk reduction intervention was successful in working with transgender women who experience multiple co-occurring syndemic conditions. Given that there has been a dearth of evidence-based interventions for this population that are designed to be delivered in resource limited settings, TransAction can serve as a model HIV risk reduction program for guiding public health departments and community-based organizations.
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Affiliation(s)
- Cathy J. Reback
- Friends Research Institute, Inc., Los Angeles, CA
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA
- Center for HIV Identification, Prevention and Treatment Services, University of California, Los Angeles, CA
| | - Kirsty Clark
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA
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Use of a Systematic Consultation Process to Facilitate Nursing Research Projects: An Exemplar. CLIN NURSE SPEC 2018; 32:249-259. [PMID: 30095524 DOI: 10.1097/nur.0000000000000396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE/OBJECTIVES The purpose of this article is to describe the use of a well-established, 5-stage consultation process, to advise a research team on planning strategies to engage domestic violence shelters (DVSs) as community partners in their study. The research team is testing a health promotion intervention for teens living in shelters with their parent and needed to enlist shelters as sites to recruit teens and conduct the intervention. Consultation aims were to (a) identify highly promising strategies described in peer-reviewed literature for identifying, recruiting, and collaborating with community organizations in research and (b) identify DVSs that would potentially serve as effective community partners for the study. METHODS A clinical nurse specialist and a public health master's degree student led the consultation. The consultation process included (a) a systematic review of 29 peer-reviewed articles about research or program evaluation studies that engaged community partners and (b) a comprehensive online search of information about DVSs. OUTCOMES Consultants identified 104 strategies used in studies to engage community partners and 10 specific DVSs most likely to effectively engage in the study. CONCLUSION Clinical nurse specialists are well situated to provide consultation to research teams and should follow well-established consultation processes and systematic data collection procedures.
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Mitchell J, Torres MB, Asmar L, Danh T, Horvath KJ. Developing Sustainable and Impactful Mobile Phone HIV Testing Interventions for Spanish-Speaking Men Who Have Sex With Men in the United States: Lessons Learned From Informative Interviews. JMIR Public Health Surveill 2018; 4:e45. [PMID: 29691205 PMCID: PMC5957266 DOI: 10.2196/publichealth.8992] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 01/11/2018] [Accepted: 02/18/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although many men who have sex with men (MSM) test for HIV at least once in their lifetime, opportunities to improve regular HIV testing, particularly among Hispanic or Latino MSM, is needed. Many mHealth interventions in development, including the ones on HIV testing, have primarily focused on English-speaking white, black, and MSM of other races. To date, no studies have assessed app use, attitudes, and motivations for downloading and sustaining use of mobile apps and preferences with respect to HIV prevention among Spanish-speaking, Hispanic MSM in the United States. OBJECTIVE The primary aims of this study were to determine what features and functions of smartphone apps do Hispanic, Spanish-speaking MSM believe are associated with downloading apps to their smartphones, (2) what features and functions of smartphone apps are most likely to influence men's sustained use of apps over time, and (3) what features and functions do men prefer in a smartphone app aimed to promote regular testing for HIV. METHODS Interviews (N=15) were conducted with a racially diverse group of sexually active, HIV-negative, Spanish-speaking, Hispanic MSM in Miami, Florida. Interviews were digitally recorded, transcribed verbatim, translated back to English, and de-identified for analysis. A constant-comparison method (ie, grounded theory coding) was employed to examine themes that emerged from the interviews. RESULTS Personal interest was the primary reason associated with whether men downloaded an app. Keeping personal information secure, cost, influence by peers and posted reviews, ease of use, and functionality affected whether they downloaded and used the app over time. Men also reported that entertainment value and frequency of updates influenced whether they kept and continued to use an app over time. There were 4 reasons why participants chose to delete an app-dislike, lack of use, cost, and lack of memory or space. Participants also shared their preferences for an app to encourage regular HIV testing by providing feedback on test reminders, tailored testing interval recommendations, HIV test locator, and monitoring of personal sexual behaviors. CONCLUSIONS The features and functions of mobile apps that Spanish-speaking MSM in this study believed were associated with downloading and/or sustained engagement of an app generally reflected the priorities mentioned in an earlier study with English-speaking MSM. Unlike the earlier study, Spanish-speaking MSM prioritized personal interest in a mobile app and de-emphasized the efficiency of an app to make their lives easier in their decision to download an app to their mobile device. Tailoring mobile apps to the language and needs of Spanish-speaking MSM is critical to help increase their willingness to download a mobile app. Despite the growing number of HIV-prevention apps in development, few are tailored to Spanish-speaking MSM, representing an important gap that should be addressed in future research.
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Affiliation(s)
- Jason Mitchell
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Maria Beatriz Torres
- Department of Communication Studies, Gustavus Adolphus College, St Peter, MN, United States
| | - Lucy Asmar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Thu Danh
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Keith J Horvath
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
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Martinez O, Isabel Fernandez M, Wu E, Carballo-Diéguez A, Prado G, Davey A, Levine E, Mattera B, Lopez N, Valentin O, Murray A, Sutton M. A couple-based HIV prevention intervention for Latino men who have sex with men: study protocol for a randomized controlled trial. Trials 2018; 19:218. [PMID: 29622045 PMCID: PMC5887179 DOI: 10.1186/s13063-018-2582-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 02/16/2018] [Indexed: 11/19/2022] Open
Abstract
Background Latino men who have sex with men (MSM) experienced a 13% increase in HIV diagnoses from 2010 to 2014, more than any other racial/ethnic subgroup of MSM in the United States. If current HIV diagnoses rates persist, about one in four Latino MSM in the United States will be diagnosed with HIV during their lifetime. Although some efficacious HIV prevention interventions for Latino MSM exist, none have focused on couples. This paper describes the protocol of a randomized controlled trial (RCT) to test the preliminary efficacy of a couple-based HIV prevention intervention that is culturally tailored for Latino men and their same-sex partners. Methods The RCT will determine the preliminary efficacy of Connecting Latinos en Pareja (CLP) to increase the proportion of anal sex acts that are HIV protected (i.e., anal sex acts in which condoms, pre-exposure prophylaxis (PrEP), treatment as prevention (TasP), or a combination thereof, are used to reduce risk of HIV transmission). CLP builds upon previous couple-based interventions with white and black MSM by incorporating biomedical prevention techniques, such as PrEP and TasP, implementing a framework responsive to the couple’s serostatus, and addressing the socio-cultural factors that influence HIV risk among Latino MSM. We also include input from community stakeholders, members of the target population, and a community advisory board as part of intervention development. Assessments will be conducted at baseline, and 3- and 6-months post-intervention to examine the intervention effects on outcomes (HIV-protected sex acts), and factors potentially mediating or moderating intervention effects. Discussion This paper describes an innovative RCT that incorporates multiple HIV prevention techniques for Latino MSM in couples, regardless of serostatus. The ongoing involvement of community stakeholders, members of the target population, and a community advisory board is emphasized, and plans for widespread dissemination and application of findings into practice are discussed. Trial registration Trial registration: NCT03048838. Registered on 3 February 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-2582-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Omar Martinez
- Temple University's School of Social Work, 1301 Cecil B. Moore Avenue, Ritter Annex, 505, Philadelphia, PA, 19122, USA.
| | - M Isabel Fernandez
- Nova Southeastern University, 2000 South Dixie Highway, Miami, FL, 33133, USA
| | - Elwin Wu
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027-5927, USA
| | - Alex Carballo-Diéguez
- New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA
| | - Guillermo Prado
- University of Miami, 1320 S Dixie Hwy, Coral Gables, Miami, FL, 33146, USA
| | - Adam Davey
- University of Delaware, 540 S College Ave, Newark, DE, 19713, USA
| | - Ethan Levine
- Temple University's School of Social Work, 1301 Cecil B. Moore Avenue, Ritter Annex, 505, Philadelphia, PA, 19122, USA
| | - Brian Mattera
- Temple University's School of Social Work, 1301 Cecil B. Moore Avenue, Ritter Annex, 505, Philadelphia, PA, 19122, USA
| | - Nikki Lopez
- GALAEI, 149 W Susquehanna Ave, Philadelphia, PA, 19122, USA
| | - Omar Valentin
- Temple University's School of Social Work, 1301 Cecil B. Moore Avenue, Ritter Annex, 505, Philadelphia, PA, 19122, USA
| | - Ashley Murray
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, National Center for HIV/AIDS Prevention, TB, Hepatitis, Epidemiology Branch, 1600 Clifton Road, MS E-45, Atlanta, GA, 3029, USA
| | - Madeline Sutton
- Minority HIV/AIDS Research Initiative, Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, National Center for HIV/AIDS Prevention, TB, Hepatitis, Epidemiology Branch, 1600 Clifton Road, MS E-45, Atlanta, GA, 3029, USA
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Rhodes SD, Tanner AE, Mann-Jackson L, Alonzo J, Simán FM, Song EY, Bell J, Irby MB, Vissman AT, Aronson RE. Promoting Community and Population Health in Public Health and Medicine: A Stepwise Guide to Initiating and Conducting Community-engaged Research. JOURNAL OF HEALTH DISPARITIES RESEARCH AND PRACTICE 2018; 11:16-31. [PMID: 31428533 PMCID: PMC6699784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Various methods, approaches, and strategies designed to understand and reduce health disparities, increase health equity, and promote community and population health have emerged within public health and medicine. One such approach is community-engaged research. While the literature describing the theory, principles, and rationale underlying community engagement is broad, few models or frameworks exist to guide its implementation. We abstracted, analyzed, and interpreted data from existing project documentation including proposal documents, project-specific logic models, research team and partnership meeting notes, and other materials from 24 funded community-engaged research projects conducted over the past 17 years. We developed a 15-step process designed to guide the community-engaged research process. The process includes steps such as: networking and partnership establishment and expansion; building and maintaining trust; identifying health priorities; conducting background research, prioritizing "what to take on"; building consensus, identifying research goals, and developing research questions; developing a conceptual model; formulating a study design; developing an analysis plan; implementing the study; collecting and analyzing data; reviewing and interpreting results; and disseminating and translating findings broadly through multiple channels. Here, we outline and describe each of these steps.
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Rhodes SD, Mann-Jackson L, Alonzo J, Simán FM, Vissman AT, Nall J, Abraham C, Aronson RE, Tanner AE. Engaged for Change: A Community-Engaged Process for Developing Interventions to Reduce Health Disparities. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2017; 29:491-502. [PMID: 29283276 PMCID: PMC5798238 DOI: 10.1521/aeap.2017.29.6.491] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The science underlying the development of individual, community, system, and policy interventions designed to reduce health disparities has lagged behind other innovations. Few models, theoretical frameworks, or processes exist to guide intervention development. Our community-engaged research partnership has been developing, implementing, and evaluating efficacious interventions to reduce HIV disparities for over 15 years. Based on our intervention research experiences, we propose a novel 13-step process designed to demystify and guide intervention development. Our intervention development process includes steps such as establishing an intervention team to manage the details of intervention development; assessing community needs, priorities, and assets; generating intervention priorities; evaluating and incorporating theory; developing a conceptual or logic model; crafting activities; honing materials; administering a pilot, noting its process, and gathering feedback from all those involved; and editing the intervention based on what was learned. Here, we outline and describe each of these 13 steps.
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Affiliation(s)
- Scott D. Rhodes
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, and the CTSI Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, NC
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, and the CTSI Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, NC
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, and the CTSI Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, NC
| | | | - Aaron T. Vissman
- Center for Health and Human Services Research, Talbert House, Cincinnati, OH
| | - Jennifer Nall
- Forsyth County Department of Public Health, Winston-Salem, NC
| | | | | | - Amanda E. Tanner
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC
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Rhodes SD, Alonzo J, Mann L, Song EY, Tanner AE, Arellano JE, Rodriguez-Celedon R, Garcia M, Freeman A, Reboussin BA, Painter TM. Small-Group Randomized Controlled Trial to Increase Condom Use and HIV Testing Among Hispanic/Latino Gay, Bisexual, and Other Men Who Have Sex With Men. Am J Public Health 2017; 107:969-976. [PMID: 28426301 DOI: 10.2105/ajph.2017.303814] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To evaluate the HOLA en Grupos intervention, a Spanish-language small-group behavioral HIV prevention intervention designed to increase condom use and HIV testing among Hispanic/Latino gay, bisexual, and other men who have sex with men. METHODS In 2012 to 2015, we recruited and randomized 304 Hispanic/Latino men who have sex with men, aged 18 to 55 years in North Carolina, to the 4-session HOLA en Grupos intervention or an attention-equivalent general health education comparison intervention. Participants completed structured assessments at baseline and 6-month follow-up. Follow-up retention was 100%. RESULTS At follow-up, relative to comparison participants, HOLA en Grupos participants reported increased consistent condom use during the past 3 months (adjusted odds ratio [AOR] = 4.1; 95% confidence interval [CI] = 2.2, 7.9; P < .001) and HIV testing during the past 6 months (AOR = 13.8; 95% CI = 7.6, 25.3; P < .001). HOLA en Grupos participants also reported increased knowledge of HIV (P < .001) and sexually transmitted infections (P < .001); condom use skills (P < .001), self-efficacy (P < .001), expectancies (P < .001), and intentions (P < .001); sexual communication skills (P < .01); and decreased fatalism (P < .001). CONCLUSIONS The HOLA en Grupos intervention is efficacious for reducing HIV risk behaviors among Hispanic/Latino men who have sex with men.
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Affiliation(s)
- Scott D Rhodes
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Jorge Alonzo
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Lilli Mann
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Eunyoung Y Song
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Amanda E Tanner
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Jorge Elias Arellano
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Rodrigo Rodriguez-Celedon
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Manuel Garcia
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Arin Freeman
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Beth A Reboussin
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Thomas M Painter
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
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Martinez O, Arreola S, Wu E, Muñoz-Laboy M, Levine E, Rutledge SE, Hausmann-Stabile C, Icard L, Rhodes SD, Carballo-Diéguez A, Rodríguez-Díaz CE, Fernandez MI, Sandfort T. Syndemic factors associated with adult sexual HIV risk behaviors in a sample of Latino men who have sex with men in New York City. Drug Alcohol Depend 2016; 166:258-62. [PMID: 27449272 PMCID: PMC4983513 DOI: 10.1016/j.drugalcdep.2016.06.033] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 06/08/2016] [Accepted: 06/27/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Syndemic theory has been proposed as a framework for understanding the role of multiple risk factors driving the HIV epidemic among sexual and gender minority individuals. As yet, the framework has been relatively absent in research on Latinos/as. METHODS We used logistic regression to assess relationships among cumulative syndemic conditions - including clinically significant depression, high-risk alcohol consumption, discrimination, and childhood sexual abuse - engagement with multiple partners and condomless anal intercourse (CAI) in a sample of 176 Latino men who have sex with men (MSM) in New York City. RESULTS In bivariate analyses, an increase in the number of syndemic factors experienced was associated with an increased likelihood of reporting multiple partners and CAI. In multivariable analyses, participants with 2, 3, and 4 factors were significantly more likely to report multiple partners than those with 0 (aOR=4.66, 95% CI [1.29, 16.85); aOR=7.28, 95% CI [1.94, 27.28] and aOR=8.25, 95% CI [1.74, 39.24] respectively; p<0.05. Regarding CAI, only participants with 3 and 4 factors differed from those with 0 aOR=7.35, 95% CI [1.64, 32.83] and OR=8.06, 95% CI [1.39, 46.73] respectively. CONCLUSIONS Comprehensive approaches that address syndemic factors, and capitalize on resiliency, are needed to address the sexual health needs of Latino MSM.
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Affiliation(s)
- Omar Martinez
- School of Social Work, College of Public Health, Temple University, 1301 Cecil B. Moore Avenue, Ritter Annex, 505, Philadelphia, PA 19122, United States.
| | - Sonya Arreola
- Global Forum on MSM and HIV, 436 14th Street, Suite 100, Oakland, CA 94612, United States.
| | - Elwin Wu
- School of Social Work at Columbia University, 1255 Amsterdam Avenue, New York, NY 10027, United States.
| | - Miguel Muñoz-Laboy
- School of Social Work, College of Public Health, Temple University, 1301 Cecil B. Moore Avenue, Ritter Annex, 551, Philadelphia, PA 19122, United States.
| | - Ethan Levine
- Department College of Liberal Arts at Temple University, Ritter Annex, 505, Philadelphia, PA, 19122
| | - Scott Edward Rutledge
- College of Public Health, Temple University, 1101 W. Montgomery Ave. 3rd Floor, Philadelphia, PA 19122, United States.
| | - Carolina Hausmann-Stabile
- School of Social Work, College of Public Health, Temple University, 1301 Cecil B. Moore Avenue, Ritter Annex, Philadelphia, PA 19122, United States.
| | - Larry Icard
- School of Social Work, College of Public Health, Temple University, Ritter Annex, Philadelphia, PA, United States.
| | - Scott D. Rhodes
- Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, N.C. 27157
| | - Alex Carballo-Diéguez
- HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY 10032, United States.
| | - Carlos E. Rodríguez-Díaz
- University of Puerto Rico - Medical Sciences Campus, School of Public Health, PO Box 365067, San Juan, Puerto Rico 00936-5067
| | - M. Isabel Fernandez
- Department of Public Health at Nova Southeastern University, 2000 South Dixie Highway, Fort Lauderdale, FL, 33133
| | - Theo Sandfort
- Clinical Sociomedical Sciences (in Psychiatry), Columbia University, 1051 Riverside Drive, Unit 15, NY, NY 10032, United States.
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Equality in sexual health promotion: a systematic review of effective interventions for black and minority ethnic men who have sex with men. BMC Public Health 2016; 16:810. [PMID: 27534390 PMCID: PMC4989329 DOI: 10.1186/s12889-016-3418-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 06/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Over the past decade, new diagnoses of HIV have increased eightfold among men who have sex with men (MSM) of other or of mixed ethnicity in the UK. Yet there is little intervention research on HIV among black and minority ethnic (BME) MSM. This article aimed to identify effective HIV and sexual health prevention strategies for BME MSM. METHODS We searched three databases PubMed, Scopus and PsychInfo using a combination of search terms: MSM or men who have sex with men and women (MSMW); Black and Minority Ethnic; HIV or sexual health; and evaluation, intervention, program* or implementation. We identified a total of 19 studies to include in the review including those which used randomised control, pre/post-test and cross-sectional design; in addition, we included intervention development studies. RESULTS A total of 12 studies reported statistically significant results in at least one of the behavioural outcomes assessed; one study reported significant increases in HIV knowledge and changes in safer sex practices. In 10 studies, reductions were reported in unprotected anal intercourse (UAI), number of sexual partners, or in both of these measures. Six out of the 13 studies reported reductions in UAI; while seven reported reductions in number of sexual partners. Seven were intervention development studies. CONCLUSIONS Research into the mechanisms and underpinnings of future sexual health interventions is urgently needed in order to reduce HIV and other sexually transmitted infection (STI) among UK BME MSM. The design of interventions should be informed by the members of these groups for whom they are targeted to ensure the cultural and linguistic sensitivity of the tools and approaches generated.
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24
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Tanner AE, Mann L, Song E, Alonzo J, Schafer K, Arellano E, Garcia JM, Rhodes SD. weCARE: A Social Media-Based Intervention Designed to Increase HIV Care Linkage, Retention, and Health Outcomes for Racially and Ethnically Diverse Young MSM. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2016; 28:216-30. [PMID: 27244190 PMCID: PMC5010783 DOI: 10.1521/aeap.2016.28.3.216] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Estimates suggest that only about 30% of all individuals living with HIV in the U.S. have achieved viral suppression. Men who have sex with men (MSM), particularly racial/ethnic minority young MSM, are at increased risk for HIV infection and may have even lower viral suppression rates. HIV testing rates among MSM are low, and when tested, racial/ethnic minority young MSM have disproportionately lower rates of retention in care and viral suppression compared to other subgroups. This article describes the design and development of weCare, our social media-based intervention to improve care linkage and retention and health outcomes among racially and ethnically diverse MSM, ages 13-34, living with HIV that will be implemented and evaluated beginning in late 2016. The intervention harnesses established social media that MSM between these ages commonly use, including Facebook, text messaging, and established GPS-based mobile applications (apps). We are using community-based participatory research (CBPR) to enhance the quality and validity of weCare, equitably involving community members, organization representatives, healthcare providers, clinic staff, and academic researchers.
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Affiliation(s)
- Amanda E. Tanner
- Department of Public Health Education, University of North Carolina Greensboro
| | - Lilli Mann
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Eunyoung Song
- Department of Social Sciences & Health Policy and Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Jorge Alonzo
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Katherine Schafer
- Section on Infectious Diseases, Wake Forest University Health Sciences
| | - Elías Arellano
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Jesus M. Garcia
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Scott D. Rhodes
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
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25
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Alonzo J, Mann L, Tanner AE, Sun CJ, Painter TM, Freeman A, Reboussin BA, Song E, Rhodes SD. Reducing HIV risk among Hispanic/Latino men who have sex with men: Qualitative analysis of behavior change intentions by participants in a small-group intervention. ACTA ACUST UNITED AC 2016; 7. [PMID: 27468361 DOI: 10.4172/2155-6113.1000572] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The southeastern United States has the fastest-growing Hispanic/Latino population in the country and carries a disproportionate HIV burden. Among Hispanics/Latinos, men, and men who have sex with men (MSM) in particular, are at elevated risk of HIV infection; however, very few efficacious behavioral HIV prevention interventions are available for use with this vulnerable population. To address this shortage of prevention resources, our community-based participatory research (CBPR) partnership developed and is currently evaluating the efficacy of the HOLA en Grupos intervention to increase condom use and HIV testing among Hispanic/Latino MSM. METHODS We recruited 304 Hispanic/Latino MSM who were randomized to receive the small group HOLA en Grupos intervention that was implemented during four 4-hour long sessions over four consecutive Sundays, or a 4-session small group general health education comparison intervention. At the end of the fourth session of the HOLA en Grupos intervention, the intervention facilitators asked participants to write down the sexual health-related behaviors they intended to change as a result of their participation. RESULTS Qualitative analysis of the participants' responses identified six types of intended behavior changes: increasing and maintaining condom use; identifying strategies to support correct and consistent condom use; increasing communication and negotiation with sexual partners about condom use; getting tested for HIV and other sexually transmitted infections; applying other sexual health promotion strategies; and sharing newly learned sexual health information with their peers. CONCLUSION Most risk-reduction intentions aligned with the intervention's key messages of using condoms consistently and getting tested for HIV. However, participants' stated intentions may have also depended on which behavior changes they perceived as most salient after participating in the intervention. Participants' intentions to share information with their peers may result in elements of the intervention content reaching others within their social networks, and potentially contributing to a broader community-level impact.
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Affiliation(s)
- Jorge Alonzo
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Winston-Salem, NC, USA; ; Tel: 336-713-5048
| | - Lilli Mann
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Winston-Salem, NC, USA; ; Tel: 336-716-7441
| | - Amanda E Tanner
- University of North Carolina at Greensboro, Department of Public Health Education, Greensboro, NC, USA; ; Tel: 336-334-5389
| | - Christina J Sun
- Portland State University, School of Community Health, OR, USA; ; Tel: 503-725-3616
| | - Thomas M Painter
- Prevention Research Branch Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta GA, USA; ; Tel: 404-639-6113
| | - Arin Freeman
- Prevention Research Branch Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta GA, USA; ; Tel: 404-639-8432
| | - Beth A Reboussin
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Winston-Salem, NC, USA; ; Tel: 336-713-5213
| | - Eunyoung Song
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Winston-Salem, NC, USA; ; Tel: 336-716-9280
| | - Scott D Rhodes
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Winston-Salem, NC, USA 27157; ; Tel: 336-713-5080
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26
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Alonzo J, Mann L, Simán F, Sun CJ, Andrade M, Villatoro G, Rhodes SD. [Perspectives to improve the sexual health of sexual and gender identity minorities in Guatemala]. EHQUIDAD 2016; 5:51-70. [PMID: 27494000 PMCID: PMC4970757 DOI: 10.15257/ehquidad.2016.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Sexual and gender identity minorities in Guatemala are disproportionally affected by HIV and other sexually transmitted infections (STI). However, little is known about the health determinants among these minorities that contribute to infection risk. Health researchers from the United States and Guatemala sought to explore sexual health needs and identify characteristics of HIV/STI prevention programs for these minorities.Our partnership conducted 8 focus groups with gay and bisexual men, men who have sex with men, and transgender women; and 10 in-depth interviews with community leaders. We analyzed transcripts of the focus groups and in-depth interviews using constant comparison.We identified 24 factors that influence sexual health which we organized into 5 ecological domains and 16 characteristics of potentially successful programs to reduce HIV/STI risk.The identification of sexual risk factors and characteristics of potentially successful programs offers great potential to develop interventions to help reduce the risk of HIV/STI infection among these minorities in Guatemala.
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Affiliation(s)
- Jorge Alonzo
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Division of Public Health Sciences, Medical Center Blvd., Winston-Salem, NC USA 27157
| | - Lilli Mann
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Division of Public Health Sciences, Medical Center Blvd., Winston-Salem, NC USA 27157
| | - Florence Simán
- El Pueblo, Inc., 2321 Crabtree Blvd., Suite 105, Raleigh NC USA 27604
| | - Christina J. Sun
- Portland State University, 1825 SW Broadway, Portland, OR USA 9720
| | - Mario Andrade
- APAES-Solidaridad, 2Ave. 11-40, zona 1, Guatemala, Guatemala
| | - Guillermo Villatoro
- Hospital Roosevelt, Unidad de Epidemiologia, Calzada Roosevelt, Zona 11, Guatemala City, Guatemala
| | - Scott D. Rhodes
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Division of Public Health Sciences, Medical Center Blvd., Winston-Salem, NC USA 27157
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