Many Men, Many Voices

Many Men, Many Voices n Target Population –MSM gay/bisexual some non-gay identified –Black African American, African, Caribbean, and Black Hispanic n Can be adapted for other populations

Many Men, Many Voices n Adapted through a partnership between: –CHBT - Center for Health & Behavioral Training, University of Rochester, NY a Part II STD/HIV Prevention Training Center (PTC) –POCC - People of Color in Crisis, Brooklyn, NY –MOCHA - Men of Color Health Awareness Project, Rochester, NY

Many Men, Many Voices n Behavioral Self-Management and Assertion Skills intervention by Jeffrey Kelly, PhD adapted for Black MSM n Cognitive-behavioral, skills building prevention intervention Conducted in 7 group sessions of 6-12 participants. –Integrates STD and HIV prevention

Core Elements n Educate clients about HIV and STD risk and sensitize to personal risk n Develop risk reduction strategies n Train in behavioral skills n Train in sexual assertiveness n Provide social support and relapse prevention Based on CDC’s Procedural Guidance found at

Key Characteristics n Foster positive identity development for gay men of color by – exploring the dual identity culture –addressing social and cultural norms within racial/ethnic communities –exploring positive and negative peer influences, setting self-standards and clarifying values Based on CDC’s Procedural Guidance found at

Key Characteristics n Discuss sexual roles and risks – addressing knowledge – exploring beliefs about the risks n Address perceived personal risk and susceptibility for HIV/STD and perceived benefits and outcomes of remaining HIV- negative.

Key Characteristics n Increase skills and self-efficacy for protective behaviors and intentions to engage in those behaviors. n Explore sexual relationship dynamics n Address the importance of peer support and social influence on maintaining healthy behaviors

Many Men, Many Voices Seven Intervention Sessions

Intervention Sessions n Sessions are experiential (not lecture or teaching). n Each exercise or activity builds on the previous ones. Ex. Session 5. consists of the following exercises: –#1 The man of my dreams –#2 Who’s got the power? –#3 Why we choose the ones we choose - are you a Top or a Bottom?

Session 1: Dual Identity n Identify factors that influence behavior change n Discuss norms in the Black and gay communities n Explore the concept of dual identity; being a Black gay man n Identify factors influencing Black MSM including internalizing racism and homophobia n Identify risk behaviors and STD/HIV infections of Black MSM

Session 2: STD / HIV Prevention for Black MSM n Discuss the roles and risks of “tops” and “bottoms” n Provide an overview of HIV/AIDS and STDs for Black MSM n Identify risks associated with different types of sex n Make a connection between STDs and HIV n Explain the transmission puzzle and how to reduce risk of contracting/transmitting STDs including HIV

Session 3: STD/HIV Risk Assessment & Prevention Options n STD/HIV prevention options based on transmission puzzle n Ranking of sexual risk behavior n Inventory of personal STD/HIV risk behaviors (what would you do with whom) n Clients personal risk behaviors (sexual, substance use and health care seeking)

Session 4: Intentions to Act and Capacity to Change n Provide an overview of how behavior change occurs n Review menu of options for STD/HIV prevention n Work through ambivalence by identifying each clients personal ambivalence and barriers n Explore pros/cons of current behavior and making a change n Acquire skills - Safer sex, Substance use, Health care seeking

Session 5: Relationship Issues: Partner Selection, Communication, Negotiation of Roles for Black MSM n Discuss attitudes towards gender roles in Black communities, differences in perceived power n Help participants to recognize the relationship between sex position (top or bottom) and power and decision-making within one’s sexual relationship(s) n Define stereotyping and sexism as it relates to Black MSM

Session 5: Relationship Issues: Partner Selection, Communication, Negotiation of Roles for Black MSM n Discuss relationship dynamics: Tops and Bottoms assigned relationship role may not fit—consequences for individual n Identify different types of power within sexual relationship(s) n Make a connection between relationship roles and safer sex negotiation.

Session 6: Social support & problem solving to maintain change n Review the chosen individual and relationship risk reduction options n Practice skills and problem solving with specific scenarios n Identify ways to avoid cues n Anticipate problems that may occur and use group problem-solving

Session 6: Continued…. n Provide problem solving strategies n Reinforce change efforts n Identify supports for change n Offer rewards and substitutes

Session 7: Where Do We Go From Here n Linkage to other services offered by agency n Community resources for substance use,mental health, other services - Survival Handbook n Involvement in community building for Black gay men

Getting Started Implementation needs and resources

Internal Agency Capacity- Staff n Staffing at a level to sustain implementation on the schedule of deliverables n Supervision, planning, recruitment, facilitation, and monitoring/reporting responsibilities n Staff training needs –Overview of HIV and STDs –Bridging theory and practice –Group facilitation skills –Many Men, Many Voices training: Level I and Level II

Other Agency Capacity n Manual and related materials n Space (confidential, safe) n Commitment to implement entire intervention program n Sufficient funds- quality & quantity of delivery n Implementation plan, including recruitment, referral, monitoring/evaluation, and QA procedures n Technical assistance

Technical Assistance to Support Implementation Training, including relevant supportive trainings (skill sets needed). and ■ Published resources (manual). Intervention Kit ■ Web resources. ■ CDC technical assistance system.

Agency Planning Tool ( n Should be completed by funded agency in collaboration with CDC project officer. n Running record of funded agency’s progress in implementing the intervention

Many Men Many Voices Training is available in each of the four geographic quadrants of the United States, offered by the 4 CDC Part II STD/HIV Prevention Training Centers (PTCs). –Rochester, NY –Denver, CO –Berkeley, CA –Dallas, Texas

Many Men Many Voices Intervention Kit n Agencies will be sent intervention kits after staff have completed the Level 1 and Level 2 series. n Kits include the intervention curriculum and materials as well as planning tools and marketing and recruiting materials.

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