Development of an internet-based intervention using motivational interviewing culturally tailored for young Hispanic MSM
R.J. Jacobs1, M.I. Fernandez2, G.S. Bowen2
1Nova Southeastern University, Preventive Medicine & Psychiatry and Behavioral Medicine, Ft. Lauderdale, United States, 2Nova Southeastern University, Preventive Medicine & Public Health, Ft. Lauderdale, United States
Background: Despite continued high HIV-risk among young Hispanic men who have sex with men (YHMSM), culturally tailored, theoretically-based interventions have yet to be developed and tested.
Methods: As a first step toward intervention development, we collected quantitative and qualitative data on socio-cultural and psychological factors associated with risky sex among 105 YHMSM aged 18-29 years (M=24 years; SD=3.2) recruited from community venues in South Florida. Quantitative data were collected through Audio Computer Assisted Self Interviews (ACASI) offered in English and Spanish. We used the quantitative data to create a sampling frame stratified by age and sexual risk. From this sampling frame, we selected a purposive sample with replacement of 10 YHMSM to participate in the qualitative in-depth audio-taped interviews.
Results: Participants reported high rates of unprotected anal sex (70%) and multiple sex partners (66%) in the past 6 months (mean number of partners=7; median=3). Correlation analyses showed more experience of racism was associated with unprotected sex, r =.232, p< .05. Multivariate analysis showed that more orientation to American culture as well as higher levels of Hispanic cultural orientation and lower adult identity formation were associated with more sex partners (p< .01). Participants had high levels of agreement regarding the markers of adulthood; the most endorsed factors were using protection when having sex, having decided on personal beliefs and values, and accepting responsibility for the consequences of actions. Internalizing culturally-driven stereotypes regarding being a gay man, dearth of emotional connections in the gay community, and the need for support to make safer choices emerged as core drivers of HIV risk in the qualitative data.
Conclusions: Findings were used to guide development of Motiv8.2.change, a theoretically grounded Internet-based intervention for YHMSM using motivational interviewing that targets core determinants of HIV risk, builds on protective cultural influences, and addresses developmental issues in YHMSM.
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