Adapting and Evaluating an Evidence-based Intervention for HIV+ Men Who Have Sex with Men (MSM) : A Case Study in NYC

Issues: Since the advent of CDC's evidence-based interventions, there have been concerns that these models do not address complex HIV needs of some minority populations. A community-based organization in NYC has formally adapted and evaluated the Healthy Relationships program for African American HIV-positive men who have sex with men (MSM).

Description: The purpose of this formative and outcome evaluation is to understand how and what type of adaptations can be made, without “re-inventing” the original model, as well as measure the efficacy of the adapted model. Healthy Relationships is a five-session group-level intervention, whose main goal is to promote skills that enable HIV-positive participants to make informed decisions about risk-taking behaviors and disclosure of sero-status.

Lessons Learned: Based on formative evaluation findings, African American MSM are often marginalized and difficult to reach due to socially imposed barriers stemming from race, sero-status, sexual orientation, and religion. Though this process, we were able to effectively address multicultural issues to promote healthier behaviors. Formative activities also highlighted various risk factors, service gaps, and recommendations to recruit and retain clients within the program. Preliminary outcome findings show an increase in sexual self-efficacy from baseline to post (3.85 vs. 4.30, n=46)

Recommendations: Adaptation is a complex process that requires persistent collaboration with stakeholders and an extended time period in order to adapt, implement, and evaluate the intervention. We recommend phased funding to allow organizations to fully assess the target population and gauge agency capacity before determining which program to adapt for a particular population.