Digital storytelling (DST) engages participants in a group-based process to create and share narrative accounts of life events. We present key evaluation findings of a 2-year, mixed-methods study that focused on effects of participating in the DST process on young Puerto Rican Latina's self-esteem, social support, empowerment, and sexual attitudes and behaviors. Quantitative results did not show significant changes in the expected outcomes. However, in our qualitative findings we identified several ways in which the DST made positive, health-bearing effects. We argue for the importance of "measuring down" to reflect the locally grounded, felt experiences of participants who engage in the process, as current quantitative scales do not "measure up" to accurately capture these effects. We end by suggesting the need to develop mixed-methods, culturally relevant, and sensitive evaluation tools that prioritize process effects as they inform intervention and health promotion.

PurposeRecent studies in Puerto Rico have reported an increasing incidence of anal cancer in Puerto Rican men. The objective of this study was to determine the prevalence, genotype distribution and risk factors associated with anal HPV infection among men attending an STI clinic in Puerto Rico.MethodsWe conducted a cross-sectional study among 205 men 18 years and older. A comprehensive survey was administered that included a demographic and a behavioral assessment. Separate logistic regression models were performed to determine factors associated with any, high-risk (HR), and multiple anal HPV infection.ResultsThe mean age of the study sample was 38.0±13.5 years. The most common HR types were 58, 51 and 31. Overall, HR anal HPV infection was found in 53.5% of the participants. Multiple HPV types in the anal canal were found in 47.6% of the sample. A third (29.8%) of participants reported being men who had sex with men (MSM). MSM had a significantly higher prevalence of any, HR and multiple HPV infection (p-value<0.05). Separate multivariate logistic regression analyses showed that being MSM was associated with any (OR = 4.5; [95%CI: 1.9–10.7]), HR (OR = 3.4; [95%CI: 1.1–10.3) and multiple anal HPV infection (OR = 3.6; [95%CI: 1.5–9.1). HIV was marginally associated with multiple anal HPV infection in multivariate analysis (OR = 3.3; 95%CI = 1.0–11.0).ConclusionsAnal HPV is common among sexually active men attending this STI clinic, with higher likelihood of anal HPV infection among MSM.

Background Recent studies in Puerto Rico (PR) have reported an increasing incidence of anal cancer in Puerto Rican men. The objective of this study was to determine the prevalence, genotype distribution and risk factors associated with anal HPV infection among heterosexual men and men who have sex with men (MSM) attending an STI clinic in PR. Methods: We conducted a cross-sectional study of men 18 years and older. A comprehensive survey was administered that included a demographic and behavioural assessment. Logistic regression was performed to determine factors associated with any, high-risk (HR), low-risk (LR) and multiple anal HPV infection. Results: The mean age of the study sample was 38.0 ± 13.5 and 37.7 ± 13.0 years for MSM and heterosexual men, respectively. A third (29.8%) of the study sample reported being MSM. Significant differences were observed in the prevalence of any anal HPV infection for MSM (84.5%) as compared with heterosexual men (45.7%; P < 0.001). Although MSM showed a higher prevalence of both HR and LR HPV types, no significant differences were observed in the bivariate analysis. Overall, HR anal HPV infection was found in 58.5% of the participants. The most common HR types were 53, 58, 68, 51 and 31. Multiple HPV types in the anal canal were found in 50.0% of the sample. Multivariate logistic regression analysis showed that being a MSM was associated with any anal HPV infection (OR = 6.2; 95% CI 1.5, 25.7). Conclusions: Anal HPV is common among sexually active men attending this STI clinic, with a higher likelihood of any anal HPV infection among MSM.

Digital storytelling workshops are increasingly being used to capture lived experiences and develop/disseminate health promotion messages for vulnerable and marginalized populations. Thirty female Latina teens of varied sexual/parity status produced digital stories of significant life experiences in a group context and then viewed and evaluated them using the Narrative Quality Assessment Tool. This tool was used to examine participants' experience of emotional engagement and identification with each story as well as a single-item indicator of desire to "do something in my community" related to the story. Emotional engagement was moderately strong; identification scores were neutral relative to the stories. Emotional engagement was strongly, significantly related to "desire to act in my community," while identification was not related. Emotional engagement should be considered an important factor to incorporate in the production of digital stories for purposes of developing interest in social action beyond the digital storytelling workshop.