The Southeast has the fastest-growing Latino population in the United States and at the same time carries a disproportionate HIV burden. Few efficacious HIV prevention interventions exist for either Latinos or men who have sex with men (MSM), and none exists for recently arrived, Spanish-speaking, less-acculturated Latino MSM. In response to PA-08-074 "Community Participation in Research," our community-university partnership proposes to jointly conduct a 5-year quasi-experimental study (R01) to refine, fully implement, and rigorously evaluate a lay health advisor (LHA) intervention designed to increase condom use and HIV testing among recently arrived, Spanish-speaking, less-acculturated Latino MSM who are settling in the rural Southeast. The intervention is based on social cognitive theory and theory of empowerment education and was developed using community-based participatory research (CBPR). This study is a result of a long-term community- university partnership that has used and will continue to use CBPR throughout all phases of research. A total of 20 Latino MSM in rural NC will be screened and recruited to serve as LHAs. Our partnership will select LHAs based on qualities of natural helpers and informal leaders and having existing social networks of other Latino MSM. Twelve members of each LHA's social network will be screened and recruited to participate as well. The LHAs, coupled with their social networks, will be randomized to intervention or delayed- intervention groups. LHAs (n=10) in the intervention group will be trained and serve as LHAs within their social networks in Year 2. Delayed-intervention LHAs (n=10) will receive the same LHA training and serve as LHAs within their social networks in Year 3. Quantitative assessment data will be collected from each LHA (n=20) and the 12 members of his social network (n=240) longitudinally at: (1) baseline, (2) immediate post- intervention, and (3) 12-month follow-up. This is an "intent-to-treat" study, in which participant data are analyzed based on their randomization group. We hypothesize that participants in the HIV prevention intervention, relative to those in the delayed- intervention comparison group, will demonstrate (1) increased self-reported use of condoms during sexual intercourse and (2) increased self-reported HIV testing. The results and products from this study will be disseminated to inform public health practice, research, and policy. Results and products will include: (1) a Spanish-language intervention that is: culturally relevant and gender-specific;designed to reduce HIV risk among Latino MSM;and ready for dissemination and adaptation;(2) a deeper understanding of HIV risk and intervention among Latino MSM;and (3) insight into a CBPR process that includes community members, organizational representatives, and academic researchers.

Public Health Relevance

Few efficacious HIV prevention interventions exist for either Latinos or men who have sex with men (MSM), and none exists for recently arrived, Spanish-speaking, less-acculturated Latino MSM. Our community-based participatory research (CBPR) partnership proposes to refine, fully implement, and rigorously evaluate the effectiveness of a culturally relevant intervention designed to reduce the disproportionate HIV burden borne by Latino MSM in the United States (US).

Agency
National Institute of Health (NIH)
Type
Research Project (R01)
Project #
5R01MH087339-05
Application #
8627206
Study Section
Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
Program Officer
Pequegnat, Willo
Project Start
Project End
Budget Start
Budget End
Support Year
5
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Wake Forest University Health Sciences
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
City
Winston-Salem
State
NC
Country
United States
Zip Code
27157
Rhodes, Scott D; Wong, Frank Y (2016) HIV Prevention Among Diverse Young MSM: Research Needs, Priorities, and Opportunities. AIDS Educ Prev 28:191-201
Sun, Christina J; Reboussin, Beth; Mann, Lilli et al. (2016) The HIV Risk Profiles of Latino Sexual Minorities and Transgender Persons Who Use Websites or Apps Designed for Social and Sexual Networking. Health Educ Behav 43:86-93
Alonzo, Jorge; Mann, Lilli; Simán, Florence et al. (2016) [Perspectives to improve the sexual health of sexual and gender identity minorities in Guatemala]. EHQUIDAD 5:51-70
Rhodes, Scott D; Leichliter, Jami S; Sun, Christina J et al. (2016) The HoMBReS and HoMBReS Por un Cambio Interventions to Reduce HIV Disparities Among Immigrant Hispanic/Latino Men. MMWR Suppl 65:51-6
Sun, Christina J; Ma, Alice; Tanner, Amanda E et al. (2016) Depressive Symptoms among Latino Sexual Minority Men and Latina Transgender Women in a New Settlement State: The Role of Perceived Discrimination. Depress Res Treat 2016:4972854
Rhodes, Scott D; McCoy, Thomas P (2015) Condom use among immigrant Latino sexual minorities: multilevel analysis after respondent-driven sampling. AIDS Educ Prev 27:27-43
Sun, Christina J; Mann, Lilli; Eng, Eugenia et al. (2015) Once a Navegante, Always a Navegante: Latino Men Sustain Their Roles as Lay Health Advisors to Promote General and Sexual Health to Their Social Network. AIDS Educ Prev 27:465-73
Wagoner, Kimberly G; Downs, Mario; Alonzo, Jorge et al. (2015) Latino men's qualitative perspectives on a lay health advisor intervention to promote their sexual health. Health Soc Care Community 23:304-12
Rhodes, Scott D; Alonzo, Jorge; Mann, Lilli et al. (2015) Using Photovoice, Latina Transgender Women Identify Priorities in a New Immigrant-Destination State. Int J Transgend 16:80-96
Sun, Christina J; García, Manuel; Mann, Lilli et al. (2015) Latino sexual and gender identity minorities promoting sexual health within their social networks: process evaluation findings from a lay health advisor intervention. Health Promot Pract 16:329-37

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