Adaptation of a Couple-Based HIV/STI Prevention Intervention for Latino Men Who Have Sex With Men in New York City

Abstract

Predominantly Spanish-speaking Latino men who have sex with men (MSM) and their same-sex partners continue to be at high risk for HIV and STIs. Behavioral research has identified how relationship dynamics for male couples are associated with sexual risk behavior. Connect ‘n Unite (CNU), an evidence-based HIV/STI prevention intervention originally created for Black MSM and their same-sex partners, was adapted for predominantly Spanish-speaking Latino MSM and their same-sex partners on the assumption that its key elements would be translatable while its efficacy would be retained. A systematic adaptation process utilizing qualitative methods was used, including intervention adaptation sessions with 20 predominantly Spanish-speaking Latino gay couples and 10 health service providers. The process included five steps: (1) engaging community stakeholders, (2) capturing the lived experiences of Latino gay couples, (3) identifying intervention priorities, (4) integrating the original intervention’s social cognitive theory into a relationship-oriented, ecological framework for Latino gay couples, and (5) adapting intervention activities and materials. The adapted intervention, which we called Latinos en Pareja or Latinos in a Relationship, incorporates elements that effective HIV prevention interventions share, including: a solid theoretical foundation; emphasis on increasing risk reduction norms, sexual communication skills and social support for protection; and guidance on how to utilize available, culturally and linguistically appropriate services. The systematic adaptation approach used for a couples-based HIV prevention intervention also can be employed by other researchers and community stakeholders to adapt evidence-based interventions that promote wellness, linkage to care, and disease prevention for populations not originally targeted.

Syndemic factors associated with adult sexual HIV risk behaviors in a sample of Latino men who have sex with men in New York City

“…First, our small sample of Latino MSM may not represent Latino MSM or other urban-based MSM, generally. However, we used a purposive stratified sampling strategy to diversify in terms of country of origin, HIV status, HIV/STI testing history, and previous involvement in HIV research (Martinez et al, 2015, 2014b). Second, the survey was interviewer-administered and all measures were self-reported; therefore, there may be biases due to imperfect recall, social desirability, embarrassment, etc.…”

“…We used a purposive stratified sampling strategy to diversify the sample in terms of country of origin, HIV status, HIV/STI testing history, and previous involvement in HIV research. Recruitment was guided by a community advisory board (CAB); recruitment venues included social media (e.g., Facebook; Martinez et al, 2014), community-based organizations, and word-of-mouth referrals (Martinez et al, 2015). Most of the participants were recruited through social media.…”

Friends, Sisters, and Wives: Social Support and Social Risks in Peer Relationships Among Men Who Have Sex With Men (MSM) in India

“…A recent review has identified the lack of sufficient attention to MSM in couple-based HIV interventions (Jiwatram-Negrón & El-Bassel, 2014). Following similar efforts in the U.S. (Martinez et al., 2015), couple-based interventions for MSM in India can address norms for HIV-risk reduction, sexual communication skills and support for consistent condom use, as well as HIV-service utilization within the context of local sociocultural norms and with the support of MSM-centered NGOs and outreach organizations. At the same time, the danger of disclosure of same-sex sexual behavior (especially for MSM married to women), social exclusion based on HIV-status, and exploitation (for kothis and feminine DDs ) warrants that these efforts explicitly address unwanted disclosure and provide additional resources for support in case MSM peer relationships are compromised.…”

A couple-based HIV prevention intervention for Latino men who have sex with men: study protocol for a randomized controlled trial

“…Similar to CLP’s parent interventions, Connect and Connect ‘n Unite , CLP is grounded in social cognitive theory (SCT) and a relationship-oriented ecological framework [ 8 , 9 ]. In concert with SCT, the content and activities utilized in CLP are designed to (1) provide information and knowledge to promote accurate risk appraisal; (2) build social and self-regulatory skills through problem solving, role plays, and other cognitive behavioral strategies; (3) increase self-efficacy to engage in HIV-protected sex and reduce risk behaviors; (4) increase positive outcome expectancies regarding HIV protection strategies; and (5) build and sustain social support networks for practicing HIV-protected sex.…”