"And Then Break the Cliché": Understanding and Addressing HIV Vulnerability Through Development of an HIV Prevention Telenovela with Men Who Have Sex with Men and Transwomen in Lima, Peru.
"And Then Break the Cliché": Understanding and Addressing HIV Vulnerability Through Development of an HIV Prevention Telenovela with Men Who Have Sex with Men and Transwomen in Lima, Peru.
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DOI：
10.1007/s10508-017-1119-x
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发表时间：
2018-10
影响因子：
3.8
通讯作者：
Clark JL
中科院分区：
文献类型：
--
作者：
Garcia J;Perez-Brumer AG;Cabello R;Clark JL
在秘鲁，艾滋病毒和其他性传播感染继续以不成比例的高比率影响男男性行为者和变性妇女。传统预防战略的无效可能是由于健康促进信息与社区一级对性文化的理解脱节。我们与男男性接触者和台湾妇女举办了15个工作坊，以发展以社区为基础的性健康干预。干预发展包括焦点小组和现场即兴表演，以确定艾滋病毒预防电视剧或西班牙肥皂剧的性脚本。研讨会按自我报告的社会经济地位、性取向和性别认同进行分层：（1）低收入MSM（n = 9）;（2）中高收入MSM（n = 6）;（3）TW（n = 8）。采用基于性脚本和批判意识理论的概念模型，本文报告了在肥皂剧开发过程中确定的三个主题，参与者试图“重新编写”与艾滋病毒相关的脆弱性相关的社会和性别刻板印象：（1）在社会经济地位，性行为和性别表现的交叉点上管理MSM和TW的社会身份;（2）在性伙伴关系互动中对性别和/或性角色的社会建构以及对艾滋病毒/性传播感染风险的感知和实际风险;（3）MSM/TW与其伙伴之间就安全性行为进行谈判时的理想化和实际性脚本。这些发现是重新制定现有预防战略的关键，这些战略未能有效地吸引定义不清的“高风险人群”。利用社区为基础的专业知识，结果提供了一种替代静态的信息传递，通过专家-病人的互动，在教学会议中常用的艾滋病毒预防干预措施之间的男男性行为者和TW。
HIV and other sexually transmitted infections (STIs) continue to affect men who have sex with men (MSM) and transgender women (TW) in Peru at disproportionately high rates. The ineffectiveness of traditional prevention strategies may be due to the disconnect between health promotion messages and community-level understandings of sexual cultures. We conducted 15 workshops with MSM and TW to develop a community-based sexual health intervention. Intervention development consisted of focus groups and scenic improvisation to identify sexual scripts for an HIV prevention telenovela, or Spanish soap opera. Workshops were stratified by self-reported socioeconomic status, sexual orientation, and gender identity: (1) low-income MSM (n = 9); (2) middle/high-income MSM (n = 6); and (3) TW (n = 8). Employing a conceptual model based on sexual scripts and critical consciousness theories, this paper reports on three themes identified during the telenovela-development process as participants sought to “rescript” social and sexual stereotypes associated with HIV-related vulnerability: (1) management of MSM and TW social identities at the intersection of socioeconomic status, sexuality, and gender performance; (2) social constructions of gender and/or sexual role and perceived and actual HIV/STI risk(s) within sexual partnership interactions; and (3) idealized and actual sexual scripts in the negotiation of safer sex practices between MSM/TW and their partners. These findings are key to reframing existing prevention strategies that fail to effectively engage poorly defined “high-risk populations.” Leveraging community-based expertise, the results provide an alternative to the static transfer of information through expert–patient interactions in didactic sessions commonly used in HIV prevention interventions among MSM and TW.
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影响因子：
3.7
作者：
Blas MM;Alva IE;Carcamo CP;Cabello R;Goodreau SM;Kimball AM;Kurth AE
通讯作者：
Kurth AE
影响因子：
3.3
作者：
Garcia J;Parker RG;Parker C;Wilson PA;Philbin M;Hirsch JS
通讯作者：
Hirsch JS
影响因子：
5.4
作者：
Campbell, C;MacPhail, C
通讯作者：
MacPhail, C
影响因子：
3.8
作者：
Garcia J;Muñoz-Laboy M;Parker R;Wilson PA
通讯作者：
Wilson PA
影响因子：
3.3
作者：
Maiorana A;Kegeles S;Salazar X;Konda K;Silva-Santisteban A;Cáceres C
通讯作者：
Cáceres C