An HIV risk-reduction intervention for African American MSMW: The inclusion of culture

Issues: African Americans continue to be the most at risk for HIV/AIDS. Attention to beliefs and values that may contradict or reinforce prevention efforts is lacking in existing tested interventions. Theory-based HIV interventions that target populations by race/ethnicity, gender, and sexual identification while incorporating culture are needed.

Description: Men of African American Legacy Empowering Self (MAALES), an HIV risk-reduction intervention for African American men who have sex with men and women (MSMW), models the inclusion of culture as a mediator for sexual and drug risk outcomes. Developed by researchers and community stakeholders, MAALES utilizes cultural process and content to address pertinent protective and contributing factors of HIV risk. Cultural process is the manner in which facilitating elements of change are presented, such as using ethnically matching facilitators, videos with African Americans, or Ghanian Adinkra symbolism to illustrate and reinforce health messages. MAALES also addresses the tendency toward present-time orientation by engaging participants in recognizing how individual and collective histories affect current and future sexual decision-making. Cultural content involves the presentation of contextualized and culturally congruent information and skill building necessary for behavioral change, such as condom use self-efficacy among African American MSMW.

Lessons Learned: Participant evaluations from initial intervention groups indicate that MAALES' attention to African American history, values, and norms, and sexual decision-making and identification have been well received.

Recommendation: MAALES, based on the Empowerment Theory, Theory of Planned Behavior and Reasoned Action, and Critical Thinking and Cultural Affirmation, demonstrates how culture can be incorporated into HIV interventions.