This application describes a five-year research program to test a theoretical model of disclosure tailored for use with Latino gay and bisexual men. The model specifies sociocultural, psychosocial, and HIV-related factors that impede and facilitate disclosure of seropositive status to the social network, as well as mental health, adherence to care, and sexual consequences of that disclosure. The social network is defined as family, friends, and main sex partner. This study consists of three phases. Phase I consists of a pilot study and measure development. In Phase II, hypotheses based on the theoretical model will be tested in a cross-sectional study of 300 HIV-positive Latino gay and bisexual men. Psychological well-being, protected sex, and adherence to treatment will be the outcomes. In Phase III, the results of the cross-sectional study will be used both to refine the model and to inform the development of an intervention, the goals of which are to improve the mental and physical health and to increase safer-sex practices of men who are HIV-positive. This intervention will be pilot tested with 80 HIV-positive Latino gay men. The investigators expect the intervention to provide additional information about causal relationships within the theoretical model, as well to provide guidelines for Latino-centered interventions.
The aim of the cross-sectional study is to refine their theoretical model of disclosure among HIV-positive Latino gay and bisexual men by testing the following hypotheses: A) Sociocultural factors will influence psychosocial factors, which along with HIV-related factors, will influence degree of disclosure of seropositive status to the social network. B) Disclosure of sero-positive status to the social network will promote psychological well-being, which in turn will decrease sexual risk, and will promote adherence to care.
The aim of the intervention study is to use the findings of the cross-sectional study to develop and pilot test an intervention for use with HIV-positive Latino gay and bisexual men building on the aspects of the theoretical model. Results from the cross-sectional study will inform the structure and content of the intervention. The investigators will test whether the disclosure intervention promotes psychological well-being, reduces sexual risk behaviors, and promotes adherence to HIVIAIDS care.
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