Eliminating Disparities in Espaņa: Applying the ADAPT-ITT Model for the Adaptation of an Evidence-Based US HIV Intervention for Adolescents in Madrid

Issues: In an era where migration into Madrid is prevalent, new HIV/AIDS infections among Latin American immigrants are increasing at alarming rates. Vulnerability to acquiring HIV/AIDS is attributed to poverty, cultural barriers, and decreased access to healthcare. While efforts have been made to eliminate disparities among adult immigrants, adolescents have yet to be adequately addressed. We describe the ADPAT-ITT Model to facilitate adaptation of an HIV intervention defined as evidence-based by the CDC.

Description: Applying the ADAPT-ITT Model, US and Spain researchers: Assessed adolescents HIV risk via focus groups and literature reviews, Decided to adapt the SIHLE Intervention, Administered theatre tests with Spanish adolescents, Produced 1st draft of adaptation, Topic experts were identified, Integrated feedback from focus groups, topic experts and literature reviews, Trained staff to implement adapted intervention, and Testing of the efficacy of the adapted SIHLE in a randomized trial is currently underway.

Lessons Learned: Expertise of local researchers, adolescents and community is essential to ensure understanding of the local environment. Moreover, flexibility is required by the researchers to adapt the intervention.

Recommendations: Madrid must formulate policies and create programs needed to make immigration a healthy and socially productive process. This would not only enhance the health of recent immigrants but also reduce the economic burden associated with treating sexually transmitted infections, including HIV, on Madrid government. Guidelines for the structured process of adapting evidence-based interventions must be disseminated globally. Applying ADAPT-ITT to adapt interventions enhances fidelity to the original research and cultural congruence to the new population.