In a recent paper published in PLOS ONE, associate professor of social work Dr. Omar Martinez and other researchers from the School of Social Work in Temple’s College of Public Health examine how to best develop HIV prevention interventions for Latino male couples. Here Dr. Martinez discusses the intervention his team developed, called Conectando Latinos en Pareja, and explains their broader study that provided the basis for several recently published papers.
What’s the ultimate goal of this study?
We are looking at strategies to better engage Latino men who have sex with men (MSM) in HIV testing and prevention. The CDC’s data shows that this is a priority: there is a new emergence of HIV infection among this population, and one in four Latino MSM will be diagnosed with HIV in their lifetime if the current rates persist. But when we talk about HIV testing, there are several barriers to care that impact Latino MSM more than other populations. Documentation of immigration status was a significant barrier — if someone does not have their papers together, they might hesitate to go to a clinic. Language is another barrier. And we found that young Latino MSM were less likely to get tested for HIV than their older counterparts. Looking at all these pieces, we need to develop effective interventions that address these barriers creatively — for example, by using social media campaigns and mobile apps that promote HIV testing and care.
Your study found that high-risk alcohol consumption is particularly prevalent among Latino MSM, and that this alcohol use can in turn increase the risk of contracting HIV. Why?
In our study we evaluated how life experiences impact high-risk alcohol consumption among Latino MSM. We looked at four key conditions that work together synergistically: depression, childhood sexual abuse, discrimination, and intimate partner violence. We found a high prevalence of these conditions affecting Latino MSM, and that participants who reported three or four of these conditions were also more likely to engage in high-risk alcohol consumption. This finding suggests that healthcare providers and social workers who address an individual’s alcohol use should also screen for these conditions, and link that person to appropriate care.
So this high-risk drinking increases risky sexual behavior, which in turn leads to increased risk of contracting HIV?
Exactly. The sad part is that we do not have any prevention and treatment interventions that are culturally and linguistically appropriate for Latino MSM.
How did you adapt to the Conectando Latinos en Pareja intervention to better suit this population?
We needed to make sure that the content resonated with the experiences of Latino gay couples. We talked with healthcare providers and community organizations that serve this population, and interviewed couples to learn about their experiences. Then we adapted Connect ‘N Unite, an intervention for blacks in same-sex relationships, by changing the activities and materials to make them responsive to the needs of Latino MSM. The intervention that we developed can be adapted to each couple’s unique circumstances, reflecting their own concerns and issues.
The intervention strategy you and your team developed focuses on romantic couples. Why is that more effective than focusing on individuals?
Couples are key to promoting HIV prevention. With couples, there are dynamics: discussing condom use, for instance, or agreements about whether the relationship is open or closed. These are behaviors that are related to risky sexual behaviors and HIV risk. An intervention that promotes communication and sexual health can address these issues. For example, maybe the couple doesn’t talk about the fact that they’re engaging in risky sexual behaviors outside the relationship. Having a healthcare provider facilitate that discussion can be helpful. The idea is that the couple will start communicating about the outside relationship, come to an agreement, and reduce their risky practices.
Besides making the intervention culturally relevant and encouraging behavioral changes, what else have you found that makes HIV prevention intervention more effective?
HIV prevention researchers have a hard task to do, and that is where innovation comes along. As researchers we need to find better strategies to engage community-based organizations, and to make sure they are involved in every phase of the research process. Here in Philadelphia we are working with GALAEI, an organization serving Latino MSM and Latina transgender women. Together with GALAEI, we have applied for a grant reduce HIV transmission among Latino male couples. We have to make sure that we hear the voices of the community — this is a fundamental solution for improving the interventions that we create.