Abstract

Culturally and linguistically adapting a transdiagnostic LGBTQ-affirming cognitive behavioral skills intervention for Vietnamese gay and bisexual men at risk for HIV: Pre-adaptation interviews

Casey Xavier Hall, PhD, MPH¹, An Bao, MSc, MPH², Crim Sabuncu, MSW³, Minh Luu Nhat, MPH⁴, Liying Wang, MS⁵, Donn Colby, MD, MPH² and Frankie Wong, PhD⁶
(1)Florida State University, College of Nursing, Tallahassee, FL, (2)CARMAH, Ho Chi Minh, Viet Nam, (3)Florida State University, College of Social Work, Tallahassee, FL, (4)Emory University, Atlanta, GA, (5)University of Washington, Seattle, WA, (6)Florida State University, Tallahassee, FL

APHA 2023 Annual Meeting and Expo

Context: In Vietnam HIV population prevalence among men and women overall is <0.1%; however, among gay and bisexual men (GBM) HIV prevalence is roughly 13.3%. GBM in Vietnam face significant stigma, which is a known psychosocial factor impacting sexual behavior and increasing HIV transmission. While interventions such as Transdiagnostic LGBTQ-affirming Cognitive Behavioral Therapy (CBT) have been shown to reduce the impact of stigma on GBM, these interventions were developed in the context of the U.S. and require cultural adaptation to increase contextual appropriateness and maximize effectiveness. The present study used qualitative interviews to guide the cultural adaptations of an LGBTQ-affirmative CBT skills intervention in Vietnamese contexts.

Methods: 17 in-person interviews were conducted with GBM living in Ho Chi Minh City, Vietnam. Interviews were conducted in Vietnamese by native speakers, transcribed, and translated to English. A directed content analysis was conducted by a team of 4 analysts using the Stanford Lightening Review Method in which each transcript was summarized by two coders. The thematic summaries were synthesized after all discrepancies between coders were reconciled. Themes included sexual identity development, minority stress, coping, and intervention preferences.

Results: Participants described stigmatizing experiences, particularly among family members, with most affirming experiences occurring among casual or school friends. Experiences of stigma ranged from subtle micro-aggressions to physical violence. Reactions to stigma fell into 3 categories: emotional reactions, maladaptive behaviors, and—less frequent—healthy coping strategies.

Participants expressed a desire to learn emotional regulation skills, which aligns with existing LGBTQ-affirmative CBT skills content. They also suggested the inclusion of HIV prevention skills, rapport-building activities, and a majority of participants were in favor of the support-group format. The proposed adapted intervention will be discussed.

Conclusion and Discussion: LGBTQ-affirmative CBT skills appear to be desired among GBM in Vietnam to address the impact of identity-based stigma; however, content and delivery/format of the intervention should be adapted to fit their needs and maximize effectiveness. A randomized, controlled trial is planned to assess the impact of the adapted intervention on mental health and HIV risk.

Diversity and culture Planning of health education strategies, interventions, and programs Program planning Public health or related education Public health or related research Social and behavioral sciences