Wednesday, April 2, 2025
4/2/2025
Adaptation of the Reflexiones Electronic Screening and Brief Intervention for U.S. MSM Seeking HIV Testing. - The overall goal of this administrative supplement is to adapt Reflexiones, our electronic screening and brief intervention (e-SBI) program to reduce substance use and sexual risk behavior among men who have sex with men (MSM) in Argentina, for MSM in the U.S. MSM are disproportionally affected by HIV and substance abuse in the U.S., Europe, and Latin America. However, as in the general population, identifying and engaging MSM with problematic substance use (PSU) into treatment is a significant challenge, which results in the great majority of MSM with PSU never receiving treatment. The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends Screening (S), Brief Intervention (BI), and Referral to Treatment (RT; SBIRT) as an early intervention for non-treatment-seeking individuals with risky alcohol and drug use, as well as the timely referral to more intensive substance abuse treatment for those with substance use disorders. To address this need, we developed Reflexiones, an e-SBI aimed at reducing substance use and HIV sexual risk behavior among MSM seeking HIV testing at Nexo Asociacion Civil, our community partners in Buenos Aires, Argentina. Our formative work and pilot (N=46) of Reflexiones has been highly encouraging. On an acceptability assessment based on the Theoretical Framework of Acceptability 100% of participants agreed the intervention was acceptable (23% “agreed” and 77% “totally agreed”) and, in qualitative interviews, participants noted how the intervention helped them reflect on their substance use and sexual risk behavior, topics they did not discuss with others. All participants felt the intervention was non-judgmental and respectful of individuals who use substances, which they felt was critical given the “taboo” behaviors discussed. While Reflexiones was designed for MSM in Buenos Aires, the need for interventions to reduce PSU and sexual risk behavior among MSM in the U.S. is equally great. As such, the overall goal of this administrative supplement is to adapt and pilot Reflexiones for MSM in U.S. who are seeking HIV testing at CAN Community Health, our community collaborators in Florida, a state with seven EHE high-risk counties. While Reflexiones benefits from having been designed for MSM, it must undergo a formal adaptation process to address issues that have not been relevant in Argentina (e.g., racial and ethnic representation and language) and its acceptability assessed among the demographically diverse MSM that typically seek HIV testing in community testing sites in the U.S. To this end, we have partnered with CAN Community Health to assess its acceptability among intended users and its feasibility during HIV testing visits. The Specific Aims of this administrative supplement are to 1) Adapt Reflexiones to MSM in the U.S. (renamed as Reflections); 2) Conduct a pilot study (N=40) to assess the feasibility and acceptability of Reflections among a diverse sample of MSM coming to a community agency in the U.S. for HIV testing; and 3) Identify barriers and facilitators to implementing Reflections at CAN.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).