Adapting and Pilot Testing a Relationship Strengthening Intervention to Prevent HIV Acquisition and Transmission among Hispanic Men in South Florida - Hispanic gay and bisexual men experience significant HIV disparities alongside mutually reinforcing health concerns, including intimate partner violence (IPV), depression, and alcohol/stimulant use. Strengthening Hispanic gay and bisexual men’s interpersonal skills (e.g., communication, decision-making) in their intimate relationships could address these co-occurring health concerns because they often unfold in the context of romantic relationships (e.g., HIV transmission often occurs in main partnerships, IPV is highly prevalent, alcohol/stimulant use with sex is linked to HIV acquisition/transmission, strong relationships can be protective against depression). Yet, this population faces challenges to navigating these relationships due to multiple stressors and a lack of relationship role models which heightens HIV risk. Grounded in prior empirical research and our Community Advisory Board’s stated priorities, our team used a community-guided process to adapt an evidence-based intervention to address interpersonal communication and decision-making skills to fit the needs of this population and prevent HIV acquisition and transmission. In our initial feasibility study, this adapted intervention was considered acceptable, appropriate, and feasible to deliver by recipients (N=16) and facilitators. We propose a solution-focused R34 to reduce HIV acquisition and transmission among Hispanic gay and bisexual men via the following Specific Aims. Aim 1: Complete adaptation and tailor the HIV prevention intervention for Hispanic gay and bisexual men. Our feasibility study of the initial adaptation identified areas of refinement to maximize acceptability, appropriateness, and feasibility (e.g., visual depictions, addition of specific topics). We will complete these refinements with our Community Advisory Board. Aim 2: Evaluate the acceptability, appropriateness, and feasibility of the intervention and its preliminary impacts on HIV risk and co-occurring health outcomes. We will recruit and randomize 70 Hispanic gay and bisexual men in South Florida 1:1 to the adapted intervention or an attention matched control. The primary goal of Aim 2 is to evaluate the acceptability, appropriateness, and feasibility of the adapted intervention, quantitatively and qualitatively. We will also explore preliminary effects on our primary outcome of sexual risk for HIV, as well as secondary outcomes quantitatively and qualitatively. Aim 3: Identify potential implementation determinants and strategies for community implementation. We will demonstrate the intervention to future implementers (i.e., frontline providers, high-level leaders) from organizations in South Florida. We will assess potential barriers and facilitators to future adoption and implementation of the intervention, and corresponding implementation strategies that could surmount barriers. Completing this R34 will provide data on the intervention’s acceptability, appropriateness, and feasibility, and preliminary data on the degree to which the intervention prevents sexual behaviors that can lead to HIV disparities. This will inform refinements for a future fully powered hybrid effectiveness-implementation trial of the intervention, with a goal to reduce HIV disparities among Hispanic gay and bisexual men, aligned with community priorities and the NIH Unified Strategy.
