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Take to the fields with HIV message for Latinos
How can Hispanic men be reached with an HIV prevention message? It's time to spread the word. While Hispanics/Latinos comprise 15% of the U.S. population, they accounted for 17% of all new HIV infections occurring in the United States in 2006.1
Researchers at Wake Forest University School of Medicine in Winston-Salem, NC, have partnered with Chatham Social Health Council in Siler City, NC, and AIDS Care Service in Winston-Salem to meet Hispanic/Latino men on their own turf: the soccer field. By training soccer team leaders to teach their own teammates about HIV and how to prevent it, researchers are helping to distribute information about HIV and sexually transmitted diseases (STDs).
How the project started
The project began in 2004 with initial funding from the Centers for Disease Control and Prevention (CDC), says Scott Rhodes, PhD, MPH, lead investigator for the project and an associate professor in the University's Department of Social Sciences and Health Policy. Researchers learned that Latino men lacked the knowledge and skills to protect themselves from HIV and STDs, so they worked with community members to develop a culturally relevant and gender-specific intervention, explains Rhodes, who also is affiliated with the Maya Angelou Center for Health Equity at Wake Forest.
The "HoMBReS: Hombres Manteniendo Bienestar y Relaciones Saludables" (MEN: Men Maintaining Wellness and Healthy Relationships) program has been designed to assist Latino men in learning the best way to protect themselves, developing the skills to protect themselves, and changing some of the factors that are associated with at-risk behavior, says Rhodes. For example, adhering to traditional masculine norms of what it means to be a man can contribute to not using condoms, Rhodes explains. Research findings indicate men who identify with machismo-like values strongly dislike condoms.2
Funded by a $2.4 million grant from the National Institutes of Health, the program is designed to provide health and disease prevention education to increase condom use and HIV testing in a peer-to-peer program. The five- year intervention study is based on social cognitive theory and the theory of empowerment education.
Identify the challenges
When it comes to reaching Hispanic/Latino men, several cultural, socioeconomic, and health-related factors factor into the equation.
One of the challenges faced by HoMBReS is that many Latinos in the area are undocumented, says Jaime Montano, project coordinator for HOMBRES at Chatham Social Health Council. Program workers have had to gain the trust of those in the community to help establish the program, he explains.
Establishing a rapport is important, because talking about sexual health matters does not come easily, says Montano. "I'm a Latino, myself — I come from Mexico City — and we are not that open to talk about it," he explains. "Sometimes, some of the questions we use are very intimate, so it's very hard for people to talk about it."
For the soccer program, 10 teams from Forsyth County and 10 teams from Chatham County are recruiting a peer leader, or trained lay health advisor, known as a "navegante." Navegantes are elected by teammates and are paid $50 per month for data collection. They keep simple logs of their work, says Rhodes. Navegantes are trained on how to avoid and prevent HIV and other STDs, as well as receive education on condom use skills. Navegantes learn how to reframe the negative aspects and bolster the positive points of what it means to be a man, as well as how to communicate effectively with teammates. The navegante then applies that training in interactions with his own teammates.
How will the program measure its effectiveness? Rhodes says various data collection steps have been devised. Researchers are collecting quantitative data from members of the soccer teams to measure and examine changes in the use of condoms and services for HIV testing, he notes; navegantes distribute condoms at no charge.
Scientists also are looking at potential factors that may be associated with risk such as knowledge about HIV transmission and prevention and local resources and eligibility, trust in condoms and condom use skills, adherence to traditional masculine norms, and sense of mastery over life's circumstances.
"We are training soccer team leaders as peer leaders to teach their own teammates about HIV and how to prevent it," Rhodes says. "We also are addressing norms and expectations about what it means to be a man. Men in general don't think about their own health, and we are training the peer leaders to talk to their teammates about how men can ask for help and seek care when needed, rather than waiting until it gets more serious."
The Health and Human Services National HIV Testing Mobilization Campaign has developed a free patient fact sheet in English and Spanish, "Hispanics and HIV/AIDS." To download the sheets, go to the web site, www.hhs.gov/aidsawarenessdays. Click on "National Latino HIV Awareness Day," then under "Resources," click on "Fact Sheets."