Epidemiological studies have attributed the source of many new HIV and STI infections among MSM to primary partners. Despite recent emphasis on couples-based interventions, efficacious interventions for Latino male couples have yet to be tested. The proposed study builds on the PI's post-doctoral research in which he adapted evidence based intervention for Black MSM couples, Connect `n Unite, for Latino male couples using methodologically rigorous adaptation procedures. The adapted intervention, Conectado Latinos en Parejas (CLP) extends expands the prevention alternatives offered in previous interventions by incorporating biomedical prevention methods such as pre-exposure prophylaxis (PrEP), promoting engagement in care, adherence to treatment regimens and viral suppression (TasP) and encouraging routine HIV testing if appropriate given the couple's serostatus. In the first year, when we will be obtaining CDC IRB and OMB approvals, we propose to extend the relevance of the adapted intervention to the broader population of Latino male couples by convening community advisory boards (CABs) of 4 Latino male couples in Miami, Los Angeles and San Francisco, 3 HIV epicenters with diverse populations of Latino MSM. We will present core intervention components, elicit CAB members' suggestions and make adjustments as needed. We will then conduct a randomized control trial (RCT) to examine whether participants assigned to CLP report an increase in the proportion of HIV protected anal sex acts (operationalized as using condoms, PrEP, TasP) compared to those assigned to a Wellness Promotion (WP) time matched attention control. We will recruit 150 Latino male couples from the Philadelphia MSA and randomly assign them to CLP or WP. Participants will complete ACASIs to assess behavioral and psychosocial factors and be tested for sexually transmitted infections (STI) at baseline, 3 and 6 month post intervention. We will test for HIV at baseline and 6 month post intervention. The proposed Principal Investigator is a promising Early Stage Investigator with significant experience working within community-based organization settings and an excellent publication record. He is supported by a strong team and mentored by a Latina researcher committed to his career development. The primary study activities will be conducted at a large Latino serving CBO in North Philadelphia. To our knowledge, this study will be the first to examine the impact of a couple-based intervention to increase HIV protected anal sex acts for Latino male couples capable of being scaled up and replicated in various communities to provide continuous support and protection for this heavily impacted group.
The proposed study is highly significant because it targets a disproportionately affected group, Latino MSM, and tests a culturally adapted, flexible intervention, Conectando Latinos en Parejas, developed specifically for Latino male couples. The project is innovative in that it includes Latino couples regardless of HIV status and expands prevention alternatives offered in other couples-based interventions by incorporating biomedical prevention methods such as pre-exposure prophylaxis (PrEP), promoting engagement in care, adherence to treatment regimens and viral suppression (TasP) and encouraging routine HIV testing if appropriate given the couple's serostatus. Our intervention targets multiple points in the HIV Care Continuum and is responsive to the National HIV/AIDS Strategy and the goals of the M.A.R.I. initiative.
