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Trabajando Juntos: Working for Health Disparity Reduction among Latinos

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The Southeastern Untied States has the fastest growing Latino population in the country and at the same time carries a disproportionate HIV/AIDS disease burden. Few efficacious HIV prevention interventions exist for Latinos, with none for recently arrived, monolingual (Spanish-speaking), less-acculturated Latino men who are settling in the Southeast. We propose a 2-year study (R21) to expand and test the efficacy of a culturally relevant intervention designed to reduce risk of HIV infection among immigrant Latino men. The intervention is based on the social cognitive theory and the theory of empowerment education. This study has used and will continue to use a community-based participatory research (CBPR) approach throughout all phases of the research process. A randomized controlled design is proposed to test the efficacy of the interventions. A total of 120 Latino men will be recruited in rural NC and informed consent obtained. All eligible and willing men will complete an initial baseline assessment designed to measure current sexual behavior, and cultural, social, and psychological influences on sexual behavior and healthcare utilization. Participants will then be randomized to an HIV prevention intervention or a cancer prevention education comparison intervention. All participants will complete identical assessments at immediate post intervention and 3-month follow-up. Participants in the HIV prevention interventions, relative to their peers in the comparison group, are anticipated to demonstrate (a) increased self-reported use of condoms during sexual intercourse; (b) increased self-reported utilization of HIV and sexually transmitted disease (STD) counseling, testing and treatment services; (c) greater knowledge of HIV risk behaviors and prevention strategies; (d) increased norm perception scores supporting risk-reduction strategies; (e) more positive attitudes toward condom use; (f) increased self-efficacy to use and assert the use of condoms; (g) increased sense of mastery scores; and (h) enhanced communication and sexual negotiation skills. This study will advance the field of HIV prevention research through the development of 3 important and much needed "products" that will fill existing gaps: (a) a culturally relevant Spanish-language intervention designed to reduce HIV/AIDS risk among recently arrived, less-acculturated Latino men that will be ready for further implementation and larger scale testing; (b) a deeper understanding of HIV risk among Latino men; and (c) insight into a research partnership process that includes lay community members, AIDS service organizations (ASOs), community-based organizations (CBOs), 3 universities, and a broad spectrum of other partners.

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