Latino gay men face multiple barriers to human immunodeficiency virus (HIV) prevention, in particular a lack of intervention programs that integrate prevention messages with cultural norms and address issues of social marginalization from multiple communities (gay community and Latino community), homophobia and racism. In order to address these specific issues, a multilayered HIV intervention was designed to incorporate and integrate psychosocial and community factors through multiple session groups, social marketing and community presentations. Participants learned strategies for effective community leadership and were encouraged to provide HIV education and address internalized homophobia in their communities. There were a total of 113 Latino gay male participants. Pretests and post-tests at 90-day follow-up were administered to measure knowledge, attitudes and behaviors related to HIV infection, self-efficacy, internalized homophobia and connectedness (i.e. gay community affiliation and social provisions); a risk index was calculated to measure level of behavioral risk for HIV infection. Participants demonstrated lower risk indices and a decrease in partners at 3 and 6 months after the intervention. There was also an increase in reported social support resources, along with an increase in group identification. Connectedness was a strong predictor of the number of sexual partners at the 90-day follow-up. This homegrown program represents a culturally responsive, highly needed and relevant intervention that should be subjected to further rigorous testing.

Campaigns should address the local epidemic and target audience with culturally appropriate messages.

These findings highlight the importance of ongoing support for sexual risk reduction among women with HIV-infection and for strategies that reduce the strength of relationships between ART beliefs and sexual risk behavior.

The CHANGE approach to capacity-building assistance (CBA), developed over 4 years by the Latino Commission on AIDS Manos Unidas' Program to assist Latino-serving community-based HIV prevention programs in eight northern U.S. states, Puerto Rico, and the U.S. Virgin Islands, is a system for providing community-based organizations (CBOs) with not only the skills to implement interventions from the Centers for Disease Control and Prevention's Diffusion of Effective Behavioral Interventions (DEBI) project, but also the capacity to reorient to the disruptive innovation of the DEBIs. The CHANGE (customized, holistic, analytical, network-building, grassroots, evaluatory) approach entails an integrated CBA-model emphasizing community and programmatic diagnosis and reflection and the enhancement of staff skills through tailored curricula in six areas: community-assessment, target-refinement, recruitment and retention, basic skills, program implementation, and evaluation. The CHANGE model encourages active CBO participation in the learning process rooted in the experiences of the organization as a member of its community.

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