HIV and Hispanic Men: Impact of Drugs and Culture

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DESCRIPTION (provided by applicant): Hispanic men who have sex with men (HMSM) are at increased risk of HIV infection. Interventions for reducing HIV risk among HMSM are urgently needed. Because studies have primarily focused on gay-identified White men, data to guide intervention development and strategies for identifying and accessing HMSM who use drugs and have risky sex are limited. In this application, we propose to compare the effectiveness and estimate the economic cost of two message delivery modalities (the internet versus face-to- face) for recruiting drug-using HMSM into prevention studies. Embedded within this comparison, we will collect quantitative and qualitative data on the cultural, psychosocial and contextual factors associated with drug use and risky sex in this population. We will use these findings to develop a model and outline the key components of a culturally appropriate, HMSM-specific, HIV prevention intervention. To achieve the study goals, we will craft an appealing recruitment message designed to persuade HMSM, 18 years of age or older, who live in South Florida to come to one of our two community assessment sites. Eligible men who present at these sites and agree to participate will complete an anonymous, audio-computer assisted self-interview (ACASI) to assess their drug use and sexual behaviors, as well as cultural, psychosocial and contextual factors associated with these behaviors. In-depth qualitative interviews with a subset of men will be conducted to assist with recruitment message development, questionnaire construction, and intervention model development. During Phase I, we will refine our assessment measures and create the persuasive, culturally appropriate recruitment message. In Phase 2, we will implement the study and gather the quantitative and qualitative data to guide intervention development. To minimize the potential for cross-contamination, the two recruitment approaches (internet and face-to-face) will be implemented sequentially. In Phase 3, we will assess which approach is more successful in recruiting HMSM and estimate the cost of each strategy. We will examine the psychosocial, cultural, and contextual factors associated with drug use and risky sex and use this data to develop a model and identify the key conceptual components of an HIV prevention intervention for HMSM.