An intervention to Cope with HIV and Trauma for Monolingual Latinos

Andres Sciolla, University of California, San Diego
Social and Behavioral Sciences
Thematic Priority Area: HIV-Related Disparities in Highly Impacted, Under-researched Populations
Innovative, Developmental, Exploratory Award (IDEA)

We propose to develop a linguistically and culturally appropriate intervention for HIV-positive monolingual Spanish-speaking (MSS) Latino men who have sex with men (MSM) and have histories of childhood sexual abuse (CSA) to help them reduce HIV sexual risk behaviors as well as symptoms of depression and posttraumatic stress disorder (PTSD). Currently there are few HIV risk reduction interventions that have been developed specifically for MSS Latino MSM, and none that targets members of that group who also have histories of CSA. During the first phase of the study (Formative Phase), we will propose an intervention and adapt it with the input of members from the target population as well as from service providers who work with Latino MSM. Besides a modified and translated intervention manual, the input from the focus group will help find a suitable name for the intervention –temporarily called the Sexual Health Intervention for Men – Spanish (SS-HIM). The proposed intervention will be based on previous research that has developed interventions that are delivered in small groups for HIV-positive African American and Latina females with histories of CSA, as well as HIV-positive African American and English-speaking Latino men with histories of CSA. The SS-HIM will be tested (Intervention Phase) in a sample of 100 HIV-positive MSS Latino MSM with histories of CSA, who will be randomly assigned to SS-HIM or to a health promotion control group. In addition to a reduction of unprotected anal sex and symptoms of depression and PTSD, we expect to find changes in metabolism and hormones that may be associated with the behavioral changes resulting from SS-HIM. We propose to measure at baseline and at 3 month follow-up a group of biological markers that reflect the cumulative impact of stress on the body. Some of these biomarkers are part of routine medical checkups (heart rate, blood pressure, body mass index) while others require 12-hour overnight urine samples (cortisol and norepinephrine). Changes in these biomarkers will help advance the science of HIV risk reduction interventions by providing an objective marker of effectiveness. The study of biomarkers of cumulative stress will also help us understand the many ways in which CSA may affect adults both physically and mentally, especially when these adults have a chronic illness such as HIV.