256761 Understanding the sexual health of gay men and MSM in Guatemala City: Formative research findings blending focus groups and individual in-depth interviews

Wednesday, October 31, 2012 : 12:45 PM - 1:00 PM

Jorge Alonzo, JD , Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
Scott Rhodes, PhD, MPH, CHES , Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
Cindy Wilks, BA , Consultant, ArteSanar, Inc, Durham, NC
Mario Downs , Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
Omar Martinez, JD, MPH , Center for Sexual Health Promotion, Indiana University-Bloomington, Bloomington, IN
Cynthia Miller , Division of Public Health Sciences/Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
Mario Andrade , CBPR partner, APAES Solidaridad, Guatemala, Guatemala
Guillermo Villatoro, MD , Unidad de Epidemiologia, Hospital Roosevelt, Guatemala City, Guatemala
Background: Guatemala has a concentrated and rapidly accelerating HIV epidemic. Prevalence estimates of HIV infection among men who have sex with men (MSM) range from 11-18%. Because of limited resources, Central America countries, including Guatemala, focus on medical care of persons living with HIV rather than prevention.

Methods: Our community-based participatory research (CBPR) partnership in NC designed and implemented this study in partnership with Guatemalan leaders to explore HIV risk among Guatemalan MSM. Focus groups and in-depth interviews were conducted with Guatemalan MSM, audio recorded, and transcribed verbatim. Partners used open coding and organized data into themes and domains.

Results: Participants included 87 focus group and 10 in-depth interview participants. Mean age of participants was 27 years old (range 18-60). All reported sex with men within the past 3 months; 74% self-identified as gay; 22%, as bisexual; and 4%, as heterosexual.

We organized qualitative themes into 5 ecological domains: (1) intrapersonal (e.g., misconceptions about HIV transmission/prevention, negative perceptions about condoms, low perceived susceptibility, internalized homo-negativity); (2) interpersonal (e.g., family rejection, need for love, arousal associated with non-condom use); (3) community (e.g., intra- and intergroup discrimination, lack of accessible low-cost condoms); (4) institutional (e.g., lack of MSM-affirming clinics/providers, rejection by church); and (5) public policy (e.g., anti-homosexual political rhetoric, lack of perceived confidentiality).

Conclusions: This study provides preliminary data describing the factors that contribute to HIV risk among Guatemalan MSM, a vulnerable and neglected population. These results also inform future studies to better understand and promote sexual health among Guatemalan MSM.

Learning Areas:
Assessment of individual and community needs for health education
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning
Public health or related research

Learning Objectives:
By the conclusion of the presentation, the participant will be able to: 1) Describe key factors affecting sexual health within a sample of gay men and MSM in Guatemala City; 2) Apply preliminary findings to future sexual health research with Guatemalan MSM; and 3) Analyze the advantages and disadvantages of using CBPR within the context of a bi-national research project.

Keywords: HIV/AIDS, International

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a project manager and have > 10 years experience in HIV prevention practice and research.
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.