256678 Lessons Learned: Overcoming Challenges to Developing HIV Interventions for Black MSMW with Child Sexual Abuse Histories

Tuesday, October 30, 2012 : 2:45 PM - 3:00 PM

Kimberly Kisler, MPH, CHES , Community Health Sciences, University of California, Los Angeles, Los Angeles, CA
John K. Williams, MD , Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
Issues: Trauma, especially in the form of childhood sexual abuse (CSA), has been associated with psychological distress and HIV risk behaviors among men who have sex with men (MSM). However, HIV interventions rarely address issues of trauma among MSM, let alone among Black men who have sex with men and women (MSMW) despites its potential contribution to the HIV epidemic. Description: We developed the Enhanced Sexual Health Intervention for Men, a six-session, culturally congruent intervention aimed at reducing CSA-driven symptoms of depression and posttraumatic stress disorder, as well as HIV risk behaviors and tested it against an attention matched health promotion control. The sample consisted of 88 participants who were non-gay identifying behaviorally bisexual HIV-positive Black men with histories of CSA. Lessons: Recruitment and retention of participants who were not open about their sexuality and who may be stigmatized by their HIV status and sexual abuse histories were significant barriers. Maintaining collaborations with fiscally challenged community based organizations who often served as the first point of contact for this population, was also difficult. Finally, despite randomization, some psychological factors were more prevalent within the control condition, impacting ability to analyze intervention effectiveness. Recommendations: Interventions that focus on multiple outcomes, especially prior trauma histories, are needed. This is especially true among highly affected and stigmatized populations, such as HIV-positive Black MSMW with CSA histories. Further, stratifying participants by trauma history and psychological symptoms prior to randomization is an important consideration as demographics alone may not reflect the heterogeneity among individuals.

Learning Areas:
Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs

Learning Objectives:
1) To describe an intervention that addresses childhood sexual abuse and HIV prevention among non-gay identifying HIV-positive Black MSMW. 2) To identify the challenges associated with conducting an intervention aimed at reducing multiple outcomes among a highly vulnerable population.

Keywords: African American, HIV Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am a doctoral student and was the project director for the risk reduction intervention for nongay-identifying HIV-positive African American men who have sex with men and women that is described in this abstract submission.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4317.0: HIV in MSM/MSMW