A randomized controlled trial to test an HIV-prevention intervention for Latino gay and bisexual men: lessons learned

Abstract

At the time of this writing, no randomized controlled trial (RCT) of an intervention to reduce unsafe sex among Latino gay and bisexual men (LGBM) had been published. We report the results of an RCT conducted in New York City in which 180 LGBM were assigned either to an intervention developed specifically for this population or to a wait-list control group. The intervention was based on empowerment theory and used factors identified in prior research as determinants of unsafe sex. By eligibility criteria, all men had engaged in unprotected anal intercourse (UAI) within two months of the baseline assessment. At first (two months) and second (six months later) follow-up assessments, approximately half of the men in the experimental group reported no UAI. Yet, a similar proportion of the control group also reported no UAI. Baseline data indicate that although the men had been the subject of social oppression and sexual prejudice (homophobia), they did not feel disempowered, externally controlled or fatalistic, and they reported self-efficacy and intentionality to enact safer sex. Lessons learned are discussed, as well as notes of caution for future research employing a similar conceptual framework.

Drug Use and Hispanic Men Who Have Sex with Men in South Florida: Implications for Intervention Development

“…Men who reported polydrug use in the last 3 months were more likely to have had sex under the influence of drugs than did men who used a single drug (Fernández et al, 2005). Studies in other metropolitan areas, such as New York City, San Francisco, and Chicago (Bruce, Ramirez-Valles, & Campbell, 2008;Díaz et al, 2005;Halkitis et al, 2008), corroborate these findings.…”

“…In the final multivariate model, it was less Hispanicism and not more Americanism that was associated with drug use, suggesting a protective role for Hispanic culture. It appears that for HMSM in South Florida, maintaining a high degree of orientation to Hispanic culture buffers the effect of a higher degree of orientation to American culture, which others have found to be associated with increased rates of HIV risk behaviors (Díaz et al, 2005;Dolezal et al, 2000). Our findings suggest that it is being less connected with Hispanic culture that is critical to drug use, not the process of acculturation to the U.S. culture per se.…”

Measuring the Intrapersonal Component of Psychological Empowerment: Confirmatory Factor Analysis of the Sociopolitical Control Scale

“…SPC refers to individuals' beliefs about their capabilities in social and political systems (Paulhus, 1983;Zimmerman & Zahniser, 1991) and involves self-perceptions of their ability to organize a group of people (Smith & Propst, 2001) as well as influence policy decisions in a local community (Itzhaky & York, 2003). Communitybased initiatives such as an urban project to reduce unsafe sex among Latino gay and bisexual men (Carballo-Dieguez et al, 2005), a training program to improve adaptive behaviors among low-income women immigrants (Itzhaky, 2003), and a school-based effort to promote adolescent involvement in health advocacy (Altman et al, 1998) have included SPC as a pivotal facet of intrapersonal PE and a crucial target for intervention. Zimmerman (1990Zimmerman ( , 1995 proposed a framework for PE that included three interrelated components: intrapersonal, interactional, and behavioral.…”

“…Although other conceptual frameworks and operational definitions of empowerment exist (Becker, Israel, Schulz, Parker, & Klem, 2002;Frymier, Shulman, & Houser, 1996;Hardiman & Segal, 2003;Israel, Checkoway, Schulz, & Zimmerman, 1994;Kim, Crutchfield, Williams, & Hepler, 1998;Matthews, Diaz, & Cole, 2003;Segal, Silverman, & Temkin, 1995;Spreitzer, 1995;Wallerstein, 1992Wallerstein, , 2002, the Sociopolitical Control Scale (SPCS) (Zimmerman & Zahniser, 1991) has been widely used in studies of the construct (e.g., Carballo-Dieguez et al, 2005;Hamilton & Fauri, 2001;Holden, Crankshaw, Nimsch, Hinnant, & Hund, 2004;Holden et al, 2005;Itzhaky, 2003;Itzhaky & York, 2000Peterson & Hughey, 2004;Peterson & Reid, 2003;Speer, 2000;Speer, Jackson, & Peterson, 2001;Speer & Peterson, 2000;Smith & Propst, 2001, Zimmerman, Ramirez-Valles, Suarez, de la Rosa, & Castro, 1997. Itzhaky and York (2003), for instance, translated the SPCS into Hebrew to study PE among immigrants participating in community development activities in Israel.…”

Co-occurring Health Risks Among Middle Aged Hispanic Men Who Have Sex With Men (HMSM) in South Florida

“…Additionally, HMSM's family and social support may be absent related to immigration, or severed due to sexual orientation which may cause loneliness and depression resulting in participation in substance use and high risk sexual behaviors (Meyer & Champion, 2008;Carballo-Dieguez, et al, 2005). Therefore, understanding and addressing the causes of STIs and HIV infection health disparities among HMSM can guide interventions aimed at reducing these infection rates.…”