1. Engagement of Latino/Hispanic MSM in HIV prevention
Natividad Hernandez, BSPH, Jason D. Coleman, PhD, MSPH, Sofia Jawed-Wessel, PhD, MPH
School of Health, Physical Education, and Recreation, University of Nebraska at Omaha, Omaha, NE
Demographics
Introduction
Nationally, men who have sex with men (MSM) continue to be significantly affected by HIV compared to other populations. Surveillance data indicates that in Nebraska, between and 2015, over 55% of new HIV cases were MSM.1 More specifically, the majority of new HIV cases in the state of Nebraska are reported in Douglas County.2 The rate of Hispanic Latino males living with an HIV diagnosis is 2.3 times of white males.3 Similarly, the rate of Hispanic/Latina women living with HIV diagnosis is 3.4 times that white females.3 It is important to identify culturally appropriate messages and methods of communication to prevent the transmission of HIV.
Objective
To reduce HIV transmission and improve the effectiveness of HIV prevention programs with the Latino/ Hispanic MSM community of Omaha through a needs assessment.
Research Questions
Where do MSM Hispanic/ Latino community members congregate or “hang out”?
What modes of communication are most efficient for reaching the priority population?
What type of messages are most appropriate to reach the priority population
What facilitators/barriers currently exist to engage the priority population in HIV prevention and testing?
Two focus groups were conducted in English and one was conducted in Spanish.
A total of 16 participants attended the focus groups.
Fifteen participants reported being Latino or Hispanic. Eleven participants were male, three were female, and two were transgender (male to female). Eleven participants reported their sexual orientation as gay, three as lesbian, and two as transgender.
A Better Boink table at Cinco de Mayo
Display case placed in various locations around Omaha
Primary Findings
Question 1
Participants indicated no true place for social engagement in South Omaha for the MSM community.
Individuals go to locations not necessarily intended for the MSM community.
Question 2
Participants believed there were multiple channels through which to distribute information.
Newspaper, social media, phone applications were highly mentioned.
Question 3
Messages should emphasize overall health, not focus on the disease.
Messages should clear up misconceptions about HIV.
Information should be in Spanish and simply worded for the community to understand.
Question 4
Undocumented status as barrier to seeking prevention and services.
Lack of services and information in Spanish.
Fear of stigma related to HIV, rejection, and discrimination were barriers to testing.
Individuals are hesitant to seek information, people do not want to be associated with HIV.
Conclusion and Moving Forward
In conclusion, through the needs assessment the four research questions were addressed in detail. Modes of communication and appropriate messages were identified. Current barriers and facilitators to prevention and HIV testing were determined.
Moving forward our presence in the community must be consistent. Important to participate in community events such as Cinco de Mayo.
Important to combine HIV prevention with other health services to help normalize and reduce stigma toward testing for HIV.
Methods
Community-Based Participatory Approach was used. This method focuses on trust development, mutual learning, and power dynamics.
The timeline of the project included four phase
Phase 1 involved identifying community navigators. Based on interest and availability, four individuals were selected as community navigators. The community navigators were responsible for recruiting individuals for the focus groups and to provide advice for the project.
Phase 2 involved the creation of the focus group guide and the logistics of the focus groups were addressed. It was important to decide were to meet, as this topic may be sensitive to some individuals.
Phase 3 included the facilitation of focus groups. The staff and Community Navigators led the recruitment for focus groups.
Phase 4 involved data analysis. Each focus group was audio recorded and transcribed verbatim. Transcripts were loaded into QRS Nvivo and were coded. After coding, Community Navigators and research team reviewed the codes and transcripts to ensure accurate interpretation of data.
Common Themes
Acknowledgements
Funding was awarded by the Nebraska Department of Health and Human services to support staff time, community navigator stipends, and participant incentives. The Office of Research and Creative Activity provided a grant for a presentation at a research conference. A special thank you to Dr. Jason Coleman and Dr. Sofia Jawed-Wessel.
“There are some people that don’t know that HIV testing services exist.”
Lack of awareness about HIV/ AIDS
Silence that surround the epidemic in the community
Intersectionality of being Latino/Hispanic and gay
Equation of AIDS with Sexuality
Religion
“Sex & HIV are things that are very taboo to talk about..”
References
“People have a negative connotation and negative stereotypes with them [HIV and Sex].”
DHHS Internet Website - Public Health. Retrieved March 01, 2017, from
Health Rankings. Retrieved March 01, 2017, from
AIDSVu(2017, February 06). Nebraska. Retrieved March 01, 2017, from
“She thought I was possessed by an evil demon.”
“It’s the honor of having a macho, a man in the family.”
“Being gay was like equal to having AIDS.”