Development and preliminary findings of an intervention for stigma management targeted to Hispanic/Latino HIV+ MSM: The Contacto intervention

Background: Despite the substantial and growing prevalence of HIV among men who have sex with men (MSM) in Puerto Rico (PR), there is relatively limited targeted HIV-related programming for MSM in PR, including HIV+MSM.  The objective of this study was to develop a culturally congruent intervention for Spanish-speaking HIV+MSM to increase stigma management and reduce HIV transmission and reinfection. Methods: Mixed methods, including in-depth interviews and quantitative data assessments to inform the intervention development were used. Using ADAPT-ITT as a framework, we translated findings from these methods into an intervention to increase stigma management among HIV+MSM.  Systematic medical chart abstraction was used to document the needs and priorities of HIV+MSM in PR. Results: Contacto, a six-week, three-encounter intervention with a health educator using motivational interviewing techniques was created.  The goal of the intervention is to support participants’ management of the negative impact of stigma related to HIV-status, sexual orientation, and the interconnection between them. Initial participants (N=35) expressed the need to explore and make changes related to HIV-status and sexual orientation disclosure, mental health services seeking, and cigarette-smoking cessation. Discussion: Stigma is a barrier for disclosure of HIV-status and sexual orientation, as well as for seeking mental health services and reducing risk behaviors among HIV+MSM. Contacto is designed to increase the intention of successful management of these issues. The intervention helps participants identify challenges and plan for changes needed to overcome the negative impact of stigma when using healthcare services. Future research will rigorously evaluate the effectiveness of the intervention.