Integration of Social, Cultural, and Biomedical Strategies into an Existing Couple-Based Behavioral HIV/STI Prevention Intervention: Voices of Latino Male Couples.
Integration of Social, Cultural, and Biomedical Strategies into an Existing Couple-Based Behavioral HIV/STI Prevention Intervention: Voices of Latino Male Couples.
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DOI：
10.1371/journal.pone.0152361
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Rhodes SD
中科院分区：
文献类型：
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作者：
Martinez O;Wu E;Levine EC;Muñoz-Laboy M;Fernandez MI;Bass SB;Moya EM;Frasca T;Chavez-Baray S;Icard LD;Ovejero H;Carballo-Diéguez A;Rhodes SD
成功的艾滋病毒预防和治疗需要采取循证方法，将联合收割机生物医学战略与在社会和文化上适合被优先考虑的人口或社区的行为干预措施结合起来。虽然一直在推动一种综合方法，但如何最好地将不同的战略纳入现有的艾滋病毒行为预防干预措施仍不清楚。需要制定有效的综合办法，这对男男性行为者特别重要，因为他们感染艾滋病毒的风险特别高。我们与拉丁美洲男性夫妇和供应商合作，为拉丁美洲男性夫妇调整连接'n Unite，这是一项针对黑人男性夫妇的循证干预措施。我们进行了一系列的三个焦点小组，每个小组有两个队列的夫妇，和一个焦点小组与供应商。一个有目的的分层样本20对夫妇（N = 40，分为两个队列）和10个供应商提供的见解，如何适应和整合社会，文化和生物医学的方法在夫妇为基础的艾滋病毒/艾滋病行为干预。大多数（N = 37）的夫妇参与者没有以下新的生物医学策略的先验知识：非职业暴露后预防（nPEP）;暴露前预防（PrEP）;和艾滋病毒自我检测试剂盒。在向他们介绍了这些生物医学干预措施之后，所有与会者都表示需要通过了解和认识这些干预措施来获得信息和增强能力。特别是，参与者建议我们在干预过程中或结束时提供PrEP和艾滋病毒自我检测试剂盒。提供者建议需要解决行为、社会和结构问题，如语言障碍;促进以客户为中心的方法，以增加获得、适应和遵守生物医学战略的机会。证实了夫妇参与者的建议，提供者同意，生物医学战略应提供后，提供有关这些工具的信息。关于文化敏感和应对办法，与会者认为，与艾滋病毒和性身份有关的耻辱和歧视是护理的障碍，语言障碍和证件状况是护理的进一步障碍，以夫妇为基础的办法是促进健康的理想办法，需要将家庭问题纳入干预措施。我们成功地为拉丁美洲男性夫妇采用了基于证据的艾滋病毒预防行为干预。适应性干预，称为Conectando Latinos en Pareja，整合了社会，文化，行为和生物医学战略，以解决拉丁美洲男男性行为者中的艾滋病毒流行病。该研究强调了在这一人群中实施艾滋病毒预防综合方法的可行性。
Successful HIV prevention and treatment requires evidence-based approaches that combine biomedical strategies with behavioral interventions that are socially and culturally appropriate for the population or community being prioritized. Although there has been a push for a combination approach, how best to integrate different strategies into existing behavioral HIV prevention interventions remains unclear. The need to develop effective combination approaches is of particular importance for men who have sex with men (MSM), who face a disproportionately high risk of HIV acquisition. We collaborated with Latino male couples and providers to adapt Connect ‘n Unite, an evidence-based intervention for Black male couples, for Latino male couples. We conducted a series of three focus groups, each with two cohorts of couples, and one focus group with providers. A purposive stratified sample of 20 couples (N = 40, divided into two cohorts) and 10 providers provided insights into how to adapt and integrate social, cultural, and biomedical approaches in a couples-based HIV/AIDS behavioral intervention. The majority (N = 37) of the couple participants had no prior knowledge of the following new biomedical strategies: non-occupational post-exposure prophylaxis (nPEP); pre-exposure prophylaxis (PrEP); and HIV self-testing kits. After they were introduced to these biomedical interventions, all participants expressed a need for information and empowerment through knowledge and awareness of these interventions. In particular, participants suggested that we provide PrEP and HIV self-testing kits by the middle or end of the intervention. Providers suggested a need to address behavioral, social and structural issues, such as language barriers; and the promotion of client-centered approaches to increase access to, adaptation of, and adherence to biomedical strategies. Corroborating what couple participants suggested, providers agreed that biomedical strategies should be offered after providing information about these tools. Regarding culturally sensitive and responsive approaches, participants identified stigma and discrimination associated with HIV and sexual identity as barriers to care, language barriers and documentation status as further barriers to care, the couple-based approach as ideal to health promotion, and the need to include family topics in the intervention. We successfully adapted an evidence-based behavioral HIV prevention intervention for Latino male couples. The adapted intervention, called Conectando Latinos en Pareja, integrates social, cultural, behavioral and biomedical strategies to address the HIV epidemic among Latino MSM. The study highlights the promise regarding the feasibility of implementing a combination approach to HIV prevention in this population.