256825 Guatemalan gay men and MSM identify what is needed to promote sexual health and prevent HIV: An ecological framework

Tuesday, October 30, 2012

Scott Rhodes, PhD, MPH, CHES , Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
Jorge Alonzo, JD , 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
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 MSM range from 11-18%.

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

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 identified 13 intervention approaches to target intra- and interpersonal factors identified as contributing to sexual risk, including programming based community-identified assets; filling knowledge gaps; and offering safe spaces for facilitated supportive MSM group dialogue around masculinity/machismo; sexual scripts; family, religious, and societal expectations; intimacy; and intragroup discrimination.

We also identified 5 intervention approaches to target community, institutional, and public policy factors, including the development of safe housing, vocational training, and educational opportunities. Finally, we identified 4 approaches to target all factors, including the incorporation of Mayan values.

Conclusions: Guatemalan MSM remain a neglected population in need of culturally congruent programming. We identified intervention approaches and characteristics that may be useful to guide intervention development to reduce sexual risk and promote sexual health, using an ecological perspective.

Learning Areas:
Assessment of individual and community needs for health education
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning
Social and behavioral sciences

Learning Objectives:
By the conclusion of the presentation, the participant will be able to: 1) Describe potentially effective intervention approaches and characteristics to promote sexual health and reduce risk among a sample of Guatemalan gay men and MSM; and 2) Apply preliminary findings to future sexual health and intervention research among Guatemalan MSM.

Keywords: Gay Men, Health Promotion

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a PhD in Health Behavior/Health Education and an MPH in Health Administration. I am a Fellow in the American Academy of Health Behavior. As PI, I have >10 years of federally funded research in partnership with immigrant Latino communities in the US. I also have >110 peer-reviewed scientific papers and book chapters.
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.