“La Familia” HIV prevention program: A focus on disclosure and family acceptance for Latino immigrant MSM to the USA

Abstract

Objective. The objective of this study was to pilot test and evaluate a HIV prevention program that used a Freirean approach to engage Latino immigrant MSM (men who have sex with men) on issues of sexual orientation, family acceptance, stigma as well as HIV prevention and sexual risk behaviors. Materials and methods. Participants were evaluated using a survey before and after participation in the program and compared to a control group. Focus groups where participants discussed their experiences in the program as well as perceptions of the program were held and analyzed. Results. Survey results indicate that after their participation in the program, participants increased their safer sex behaviors, comfort disclosing their sexual orientation and support from friends. Conclusions. HIV prevention needs to incorporate cultural, social and structural factors.Key words: latinos; immigrants; HIV; prevention; family; disclosure; stigma; homophobia ResumenObjetivo. El objetivo de este estudio fue probar de manera piloto y evaluar un programa de prevención de VIH que usó una aproximación Freiriana que motivaba a los HSH (hombres que tienen sexo con hombres) en temas de orientación sexual, aceptación familiar, estigma, prácticas sexuales de riesgo y prevención de VIH. Material y métodos. Los participantes contestaron un cuestionario antes y después de participar en el programa mismo que se comparó con un grupo piloto. También se llevaron a cabo grupos focales donde los participantes discutieron sus experiencias y percepciones sobre el programa. Resultados. El análisis de los resultados señala que después de su participación en el programa, los HSH reportaron más prácticas sexuales seguras, más comodidad en revelar su orientación sexual y apoyo de amistades. Conclusiones. La prevención del VIH debe tomar en cuenta factores culturales, sociales y estructurales.

A Systematic Review of Behavioral Interventions to Reduce Condomless Sex and Increase HIV Testing for Latino MSM

“…Three interventions were evaluated using controlled trials, two of which utilized randomized allocation [3, 47] and one that utilized non-randomized allocation [26]. Three were evaluated using pretest-posttest designs [48–50], and four community-level interventions utilized a similar pretest-posttest design but with discrete samples collected at each time point [46, 51–53].…”

“…Of these, number of group sessions ranged from one to twelve. Sessions covered topics such as empowerment [47], oppression as it relates to both ethnic and sexual identity [26, 47, 49], sexual identity disclosure [26, 50], social connectedness to other Latino MSM [50], and communication with sexual partners [3, 26, 49]. Session activities included informational presentations, group discussions, and role-playing exercises.…”

“…Methodological quality of intervention studies varied. Based on the Quality Assessment Tool for Quantitative Studies, one intervention received a strong methodological quality rating [3], six moderate ratings [47–52], and three weak ratings [26, 46, 53]. All 10 interventions utilized convenience-sampling techniques by recruiting participants from locations frequented by the target population, such as bars, clubs, restaurants, gay pride parades, and organizations.…”

“…Most interventions had a theoretical basis and two were adaptations of interventions that had been designed for other target populations [3, 53]. Among group-session based interventions, dosage ranged from one [3] to twelve sessions [26]. However, session attendance seemed to vary widely among studies that reported it, with 16.7% attending all eight Latinos Empowering Ourselves sessions [47] and 100% attending all five SOMOS sessions [50].…”

“…Latino MSM are particularly silent about their sexuality within their families, in an effort to preserve harmony and maintain acceptance [22], and they are vulnerable to familial rejection after disclosing their sexual orientation [23]. Relatedly, there is a phenomenon called sexual migration in which Latino MSM must relocate, sometimes leaving their home country, in an effort to escape homophobia and the stigma of family and friends [24–26]. Consequently, immigration experiences may shape the context of HIV risk for Latino MSM who migrate to the U.S. [25].…”