Enhancement of a Locally Developed HIV Prevention Intervention for Hispanic/Latino MSM: A Partnership of Community-Based Organizations, a University, and the Centers for Disease Control and Prevention

Abstract

Hispanic/Latino men who have sex with men (MSM) in the United States are disproportionately affected by HIV and other sexually transmitted diseases (STDs); however, no efficacious behavioral interventions are currently available for use with this vulnerable population. We describe the development and enhancement of HOLA en Grupos, a community-based behavioral HIV/STD prevention intervention for Spanish-speaking Hispanic/Latino MSM that is currently being implemented and evaluated. Our enhancement process included incorporating local data on risks and context; identifying community priorities; defining intervention core elements and key characteristics; developing a logic model; developing an intervention logo; enhancing intervention activities and materials; scripting intervention delivery; expanding the comparison intervention; and establishing a materials review committee. If efficacious, HOLA en Grupos will be the first behavioral intervention to be identified for potential use with Hispanic/Latino MSM, thereby contributing to the body of evidence-based resources that may be used for preventing HIV/STD infection among these MSM and their sex partners.

Engaged for Change: A Community-Engaged Process for Developing Interventions to Reduce Health Disparities

“…In our work with Latinos in North Carolina, some members from the Latino community were initially hesitant to participate in processes they initially did not understand or trust. Some were documented, others were not, but most feared engagement because of high levels of racism and anti-immigration and anti-Latino sentiment within local communities (Rhodes et al, 2006; Rhodes, Mann, et al, 2015). This is also true when working with sexual and gender minorities.…”

“…Thus, the intervention conceptual or logic model allows partnership members to “see” the logic in their thinking, discuss assumptions, and blend perspectives, insights, and experiences, with science while keeping an eye on concrete health outcomes (Rhodes, Alonzo, Mann, Freeman, et al, 2015). …”

“…To develop the process, we abstracted data from existing project documentation including proposal documents, intervention logic models, research team and meeting notes, and other materials (e.g., summaries of interventions, progress reports, conference presentations, and papers; (Rhodes, 2004; Rhodes, Alonzo, Mann, Freeman, et al, 2015; Rhodes, Daniel, et al, 2013; Rhodes, Duck, Alonzo, Daniel, et al, 2013; Rhodes et al, 2007; Rhodes et al, 2006; Rhodes, Kelley, et al, 2012; Rhodes, Leichliter, Sun, & Bloom, 2016; Rhodes et al, 2011; Tanner et al, 2016). Partnership members examined these documents and used an iterative approach with review, discussion, and re-review of the steps.…”

“…These interventions have been designed to increase: HIV testing; condom use; access to healthcare services, including medically supervised hormone replacement therapy services among transgender persons; and pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) uptake and retention. Generally, we have followed steps of trust building; fostering collaborative co-learning networks with key stakeholders (e.g., community members, organization representatives, and academic researchers); and iteratively developing, pretesting, implementing, and evaluating interventions (Rhodes, Alonzo, Mann, Freeman, et al, 2015; Rhodes, Daniel, et al, 2013; Rhodes, Duck, Alonzo, Daniel, & Aronson, 2013; Rhodes, Duck, Alonzo, Downs, & Aronson, 2013; Rhodes et al, 2007; Rhodes et al, 2006). We often have created a Grid of Resources for Intervention Development (GRID), which outlines currently existing interventions that focus on a prioritized health outcome (e.g., condom use and HIV testing) and deconstructs how intervention activities meet objectives; assists in evaluating whether interventions and activities address community priorities; and initiates the process of thinking creatively and critically about novel intervention strategies, theories, logical model development, messages, and activities (Rhodes et al, 2007; Rhodes et al, 2006; Rhodes, Kelley, et al, 2012).…”

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

“…Despite the disproportionate impact of HIV and other STIs on Hispanic/Latino MSM, very few evidence-based behavioral interventions for HIV and STI prevention have been identified for this vulnerable population, and even fewer have been designed within the context of newer Hispanic/Latino destinations in the South [35–37]. To address the shortage of prevention resources, our CBPR partnership, which includes Hispanic/Latino MSM community members, developed HOLA en Grupos , a small-group four-session Spanish language intervention to increase condom use and HIV testing by Hispanic/Latino MSM [35].…”