# Presentation: 066581

## Finding The Invisible

**A Best Practices Model for HIV/AIDS-STD Prevention & Services                  for AAMSMs through Community Collaboration**
**March 08, 2004**
**Orin G. Johnson, Training & Technical Assistance Manager – CHAG**
**for the 2004 National STD Conference, Philadelphia, PA.**

**Man**

## Workshop Rationale

- Why is there a _need_ for a Best Practices  Model for AAMSMs?
- In the last decade of HIV prevention it has been explained that the population of **African-American MSMs have been and remain one of the hardest hit groups** in America’s HIV/AIDS [and STD] epidemics.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

**Notes:**
Preparing for Questions:
 To keep questions manageable during the facilitation process set up a board, poster, or piece of newsprint for questions and call it the “Parking Lot” 
Explain that this area is where audience questions are placed on post-it notes when questions arise that either have not been addressed yet or that were not gotten to because of time. 

Taking Attendance:
Make sure that you have training participants sign an attendance roster of some sort as you begin the training.

Explaining Breaks:
Remind participants that “training breaks” occur at a designated period and that prompt return is required to finish all of the training content as planned. However individuals are free to take personal breaks as need so long as they do not interfere with the flow of the training.

Explaining Goals & Learning Objectives:
 After all of the maintenance issues for the training are resolved, be sure to explain the overall goal of the module. 

Explaining the Training Purpose:
The overall purpose of this 5 part module on Understanding Community Mobilization is to give its participants a distinct set of knowledge & skills that will help them engage and involve targeted community members in the fight against the spread of HIV and STDs within familiar surroundings in ways that work best for the individuals they serve and represent.
You may at this point decide to explain the long term purpose of this training in terms of the project or program under which it is funded depending on the policy and procedure at the community based organization in which you work (consult with your supervisor before disclosing your program information to insure accuracy- you never know who is listening):
Project/Program name and goal
Project objectives
Training activity (of which this is apart)
And the short & long terms outcomes that will be accomplished.

## Workshop Rationale

- Why is there a _need_ for a Best Practices  Model for AAMSMs?
- While several attempts have been made to access this population for prevention & services **current methods** that only imitate processes successful in the white gay population **do not prove effective or appropriate with African-American Men who have Sex with Men.**

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

**Notes:**
Preparing for Questions:
 To keep questions manageable during the facilitation process set up a board, poster, or piece of newsprint for questions and call it the “Parking Lot” 
Explain that this area is where audience questions are placed on post-it notes when questions arise that either have not been addressed yet or that were not gotten to because of time. 

Taking Attendance:
Make sure that you have training participants sign an attendance roster of some sort as you begin the training.

Explaining Breaks:
Remind participants that “training breaks” occur at a designated period and that prompt return is required to finish all of the training content as planned. However individuals are free to take personal breaks as need so long as they do not interfere with the flow of the training.

Explaining Goals & Learning Objectives:
 After all of the maintenance issues for the training are resolved, be sure to explain the overall goal of the module. 

Explaining the Training Purpose:
The overall purpose of this 5 part module on Understanding Community Mobilization is to give its participants a distinct set of knowledge & skills that will help them engage and involve targeted community members in the fight against the spread of HIV and STDs within familiar surroundings in ways that work best for the individuals they serve and represent.
You may at this point decide to explain the long term purpose of this training in terms of the project or program under which it is funded depending on the policy and procedure at the community based organization in which you work (consult with your supervisor before disclosing your program information to insure accuracy- you never know who is listening):
Project/Program name and goal
Project objectives
Training activity (of which this is apart)
And the short & long terms outcomes that will be accomplished.

## Workshop Rationale

- Why is there a _need_ for a Best Practices  Model for AAMSMs?
- This model attempts **to bridge that gap** in prevention & services but **in a manner** that is **culturally specific and inclusive of multiple agencies** **expertise** in a way that preserves the unique spirit of the population for which it is designed.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

**Notes:**
Preparing for Questions:
 To keep questions manageable during the facilitation process set up a board, poster, or piece of newsprint for questions and call it the “Parking Lot” 
Explain that this area is where audience questions are placed on post-it notes when questions arise that either have not been addressed yet or that were not gotten to because of time. 

Taking Attendance:
Make sure that you have training participants sign an attendance roster of some sort as you begin the training.

Explaining Breaks:
Remind participants that “training breaks” occur at a designated period and that prompt return is required to finish all of the training content as planned. However individuals are free to take personal breaks as need so long as they do not interfere with the flow of the training.

Explaining Goals & Learning Objectives:
 After all of the maintenance issues for the training are resolved, be sure to explain the overall goal of the module. 

Explaining the Training Purpose:
The overall purpose of this 5 part module on Understanding Community Mobilization is to give its participants a distinct set of knowledge & skills that will help them engage and involve targeted community members in the fight against the spread of HIV and STDs within familiar surroundings in ways that work best for the individuals they serve and represent.
You may at this point decide to explain the long term purpose of this training in terms of the project or program under which it is funded depending on the policy and procedure at the community based organization in which you work (consult with your supervisor before disclosing your program information to insure accuracy- you never know who is listening):
Project/Program name and goal
Project objectives
Training activity (of which this is apart)
And the short & long terms outcomes that will be accomplished.

## Workshop Goal

- SO, The overall goal of this workshop is to give its participants a distinct set of **knowledge & skills** that will help them **to engage** **and** more effectively **involve targeted community members** in the fight against the spread of HIV/AIDS and STDs within familiar surroundings in ways that work best for the individuals they serve and represent.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

**Notes:**
Preparing for Questions:
 To keep questions manageable during the facilitation process set up a board, poster, or piece of newsprint for questions and call it the “Parking Lot” 
Explain that this area is where audience questions are placed on post-it notes when questions arise that either have not been addressed yet or that were not gotten to because of time. 

Taking Attendance:
Make sure that you have training participants sign an attendance roster of some sort as you begin the training.

Explaining Breaks:
Remind participants that “training breaks” occur at a designated period and that prompt return is required to finish all of the training content as planned. However individuals are free to take personal breaks as need so long as they do not interfere with the flow of the training.

Explaining Goals & Learning Objectives:
 After all of the maintenance issues for the training are resolved, be sure to explain the overall goal of the module. 

Explaining the Training Purpose:
The overall purpose of this 5 part module on Understanding Community Mobilization is to give its participants a distinct set of knowledge & skills that will help them engage and involve targeted community members in the fight against the spread of HIV and STDs within familiar surroundings in ways that work best for the individuals they serve and represent.
You may at this point decide to explain the long term purpose of this training in terms of the project or program under which it is funded depending on the policy and procedure at the community based organization in which you work (consult with your supervisor before disclosing your program information to insure accuracy- you never know who is listening):
Project/Program name and goal
Project objectives
Training activity (of which this is apart)
And the short & long terms outcomes that will be accomplished.

## Workshop Goal

- Specifically the workshop sets out to:
**Highlight** the state of HIV/AIDS and STD acquisition for African-Americans and the AAMSM populations.
**Explain** the collaborative process **and illustrate** a model in which such practice can bridge the services among multiple organizations to meet the needs of the African-American MSMs.
**Advocate** the use of a best practices model of HIV/AIDS prevention & services that is culturally specific for African-American men who have sex with men (AAMSM).

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

**Notes:**
Preparing for Questions:
 To keep questions manageable during the facilitation process set up a board, poster, or piece of newsprint for questions and call it the “Parking Lot” 
Explain that this area is where audience questions are placed on post-it notes when questions arise that either have not been addressed yet or that were not gotten to because of time. 

Taking Attendance:
Make sure that you have training participants sign an attendance roster of some sort as you begin the training.

Explaining Breaks:
Remind participants that “training breaks” occur at a designated period and that prompt return is required to finish all of the training content as planned. However individuals are free to take personal breaks as need so long as they do not interfere with the flow of the training.

Explaining Goals & Learning Objectives:
 After all of the maintenance issues for the training are resolved, be sure to explain the overall goal of the module. 

Explaining the Training Purpose:
The overall purpose of this 5 part module on Understanding Community Mobilization is to give its participants a distinct set of knowledge & skills that will help them engage and involve targeted community members in the fight against the spread of HIV and STDs within familiar surroundings in ways that work best for the individuals they serve and represent.
You may at this point decide to explain the long term purpose of this training in terms of the project or program under which it is funded depending on the policy and procedure at the community based organization in which you work (consult with your supervisor before disclosing your program information to insure accuracy- you never know who is listening):
Project/Program name and goal
Project objectives
Training activity (of which this is apart)
And the short & long terms outcomes that will be accomplished.

## Workshop Design

- Further, this workshop is specifically** **designed for** ****individuals, groups and/or organizations** with a commitment to the needs of:
*African American men,*
*from the ages of either 13-24 or 25 and older, *
*who have sex with men,*
*referred to by the CDC as (MSM, AA/MSM or AA/YMSM),**** ****though the community uses other terms*
- And put together in a manner that will reflect & validate the lived experiences of those within the populations targeted for services in response to CDC’s HIV Prevention Strategic Plan through 2005** **(page 23).

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

**Notes:**
Curriculum Design:
 It is also very important to describe how and for whom the curriculum is designed as outlined on this slide. 

Target Audience:
This module was designed for individuals, groups and/or organizations with a commitment to the needs of ...
African American men,
from the ages of either 13-24 or 25 and older. 
who have sex with men,
referred to by the CDC as (AA/YMSM) or (AA/MSM), however the community uses other terms

Cultural Competency:
The module was put together in a manner that will reflect & validate the lived experiences of those within the populations targeted for services.
It uses examples that include members of the targeted populations
Slides and graphics are designed to have a positive and empowering visual impact on the members of the target audience.
The sessions are designed to be taught in a manner consistent with the communication styles of the target audiences – using more egalitarian participant centered, didactic discussions and less authoritarian and pedantic facilitator centered methodologies.

Preliminary Assessment:
At this point explain that a preliminary assessment will be administered to address the change in learning from the beginning of the training to its conclusion. Reiterate that there is no need for alarm and that the test scores are not counted toward their success or failure during the training – but as an initial starting point (i.e. What do You know already)
Administer the instrument (10 -15 minutes) be strict on the time there will be those that feel the need to mull over the instrument – longer than necessary. 
 Tell them to make sure that they go through the entire instrument first and then answer the questions. This procedure gives them a chance to see what is expected of them by the end of the training and an opportunity for them to determine what they need to learn the most about and what they already know.
 It is very important to make sure that the participants understand that the learning assessment tool will not be the same test – though it will cover the same content.

## Learning Objectives

- By the end of this workshop you will be able to ...
**Explain** the impact of HIV/AIDS and STD in the world, on African-Americans & AAMSMs
**Describe** the multiple factors that have acted as barriers to the acquisition of prevention & services for AAMSMs as well as the multiple identities, and issues that exist for AAMSM in the larger African-American community.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## Learning Objectives

- By the end of this workshop you will be able to ...
**Distinguish** among the levels of collaboration that exist and the level of collaboration operating within your organization, AND...
**Identify** the current services that could effectively support the African-American MSM population for prevention and/or services in a culturally competent manner.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## Learning Objectives

- By the end of this workshop you will be able to ...
**Create** an action plan toward preparing your organization, to contribute to a prevention intervention or service related model in your own community through the use of one or more of a variety of evidence-based behavioral interventions.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## Workshop Overview

- To meet the above goals & objectives this workshop will cover the following **topics**:
- Overview of the Epidemic
- The Impact of Race, Gender Roles, Identity & Sexual Orientation on AAMSMs
- New Directions for HIV/AIDS-STD Prevention & Services for AAMSMs
- A Best Practices Model for HIV/AIDS-STD Prevention & Services for AAMSMs

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## Overview of the Epidemic

**FACT:**** Several people **_***worldwide***_** are living with HIV/AIDS at the end of 2003.**

**North America**
**790,000 – 1.2 million**

**Caribbean**
**350,000 - 590,000**

**Latin America**
**1.3 - 1.9 million**

**Western Europe**
**520,000 – 680,000**

**North Africa**
**    ****& Middle East**
**470,000 - 730,000**

**Eastern Europe ****& Central Asia**
**1.2 – 1.8 million**

**South &          South-East Asia**
**4.6 – 8.2 million**

**East Asia & Pacific**
**700,000 - 1.3 million**

**Sub-Saharan Africa**
**25 - 28.2 million**

**Australia **
**& New Zealand**
**12,000 - 18,000**

**Total: 34 - 46 million**

- * UNAIDS/WHO, AIDS Epidemic Update, December 2003

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## Overview of the Epidemic

**Factors In the US**

**Sexual Trends**
- Younger Ages for 1st Sexual experience & Experimentation
- More Sexual Partners in Lifetime
- Increased use of Drugs & Alcohol prior to Sex

**Prevailing Attitudes**
- Belief in HIV Immunity
- Sexual Complacency
- Persistent Social Myths
- Relational Trust Issues
- Low Self Esteem

- Overview of the Epidemic

**HIV+ Developments**
- Success of HIV Treatment
- More Acceptance HIV+
- Economic benefits associated with HIV+
- Glamorization of HIV

**Resulting Behaviors**
- Increased ***Sexual Practice***
- Increased ***# of Sex Partners***
- Increased ***Unsafe Sex***
- Increased ***Spread of STDs***
- Increased*** Spread of HIV***

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## Overview of the Epidemic

- 	What groups have CDC Reports named as the _***most***_ ***at risk populations*?***...
- Incarcerated Individuals
- Injection Drug Users
- Teens (esp. Homeless)
- Women & Families
***Persons of Color**** (***African-Americans***, Latinos, etc.)
***MSMs* ******(men who have sex with men)***

***** All at-risk populations are of equal importance though we focus on only 1 of these groups today.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

**Notes:**
Have the participants place their ideas on newsprint before reveling the answers

## Overview of the Epidemic

- Feelings of Hopelessness
- Fear of Testing
- Fear of Status Disclosure
- Transportation to Services
***Cultural Relevance of Services****
***Multiple Stigmas****

- What ***Barriers**** do groups face in terms of access to HIV/AIDS-STD Prevention & Services?...

***** Individuals apart of any at risk group may be dealing with more than one barrier simultaneously.

- HIV/AIDS  & STD
- Prevention
- & Services

- Barriers _*BLOCK!*_

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## Overview of the Epidemic

- Poverty
- Partners @ Risk
- Substance Abuse
- Other Health Disparities
***Denial***

- What ***Barriers**** do African-Americans face in relation to HIV/AIDS-STD Prevention & Services?...

***** Individuals apart of any at risk group may be dealing with more than one barrier simultaneously.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## Overview of the Epidemic

**FACT:** African-Americans are disproportionately affected by HIV/AIDS in the United States:
- According to the 2000 Census, African Americans make up **12.3%** **of the population** of the United States. However, they have accounted for **39%** **of the estimated HIV/AIDS cases diagnosed** since the beginning of the epidemic up to the year 2000.
- By the end of December 2002, more than **185,000 **African Americans **had died with AIDS**.
- African Americans also accounted for over **50%** **of the new HIV diagnoses** reported in the US in 2002.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## Overview of the Epidemic

**FACT:** African-Americans are disproportionately affected by HIV/AIDS in the United States:
- The leading cause of HIV infection among African-American women is ***heterosexual contact***, followed by ***injection drug use***.
**62%** of children born to HIV-infected mothers were African American.
- The leading cause of HIV infection among African-American men is ***sexual contact with other men***, followed by ***injection drug use*** and ***heterosexual contact***.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## The Impact of Race, Gender Roles, Identity & Sexual Orientation on AAMSMs

**Race:** The influence of race in America has resulted in the following...
- A widely felt/known history of race & racism
- The importance of religion as a support mechanism for African-Americans
- Inconsistent gender bias against the African-American males by all of society
- Hyper masculinity as a coping mechanism
- Fuel added to the cycle of oppression using African-Americans against others & themselves.

- Adapted from:  Race & Ethnicity a collection, of over forty literary collections on the                                      _[EServer](http://eserver.org/)_, consisting of reference material, essays, and other works addressing          issues of race and ethnicity in the United States at _[http://eserver.org/race/](http://eserver.org/race/)_

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

**Notes:**
Gender: somebody’s sex: the sex of a person or organism, or of a whole category of people or organisms in terms of reproductive capabilities. 
Asexual: in terms of gender is a state in which a person or organism is lacking any sexual characteristics or organs – very rare or can reproduce on its own (plantlife).
Female: a person or organism capable of childbearing; relating to, belonging to, or characteristic of the sex that produces eggs or young.
Male: a person or organism capable of producing sperm; relating or belonging to the sex that produces sperm to fertilize eggs.
Intersex: are those persons that are born with characteristics of both sexes anatomically. 

Adapted from: Encarta® World English Dictionary [North American Edition]                                                                             © & (P) 2002 Microsoft Corporation. All rights reserved. 

## The Impact of Race, Gender Roles, Identity & Sexual Orientation on AAMSMs

**Gender-Role:**  **behaviors deliberate or unconscious that **convey a sense of gender to others** as male or female;**
- also referred to as _**Sex Role**_ or **behaviors** **typical** of a particular sex**;**
- a set of **behaviors** **expected**** **of a particular sex that include but are not limited to:
*Dress*
*Speech*
*Occupation*
*Sexual desire etc.*

**Adapted from: Encarta® World English Dictionary [North American Edition] © & (P) 2002 Microsoft Corporation. All rights reserved.**

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

**Notes:**
Gender-Role:  behavior conveying gender to others; a set of behaviors, whether deliberate or unconscious that indicates to others whether one’s gender identity is male or female; also referred to as sex role or  behavior typical of a sex: a set of behaviors characteristic of or expected of members of one sex or the other that include but are not limited to:
Dress
Speech
Occupation
Sexual desire etc.
Adapted from: Encarta® World English Dictionary [North American Edition]                                                                             © & (P) 2002 Microsoft Corporation. All rights reserved.

## The Impact of Race, Gender Roles, Identity & Sexual Orientation on AAMSMs

**Gender Identity**: a* *firm belief in ones own gender**;** **the possession by a person of a conviction of belonging to a particular sex, regardless of whether this corresponds to his or her anatomical sex**– not to be confused with sexual orientation.
**What are types of Gender Identity?**
***Traditional (male/female)***
***Cross-dresser***
***Transvestite****
***Transgender****
***Transsexual****

- Source: "Transvestism," “Intersexual” Microsoft® Encarta® Online Encyclopedia 2002_[http://encarta.msn.com](http://encarta.msn.com/)_  © 1997-2002 Microsoft Corporation. All Rights Reserved.
- Source: “Myths about Transsexualism” _[http://www.genderweb.org/~julie/general/tsinf2.html](http://www.genderweb.org/~julie/general/tsinf2.html)_
- Source “Extending Transsexual Diagnosis” O’Keefe, Tracie _[http://](http://easyweb.easynet.co.uk/~katfox/extend.htm)__[easyweb.easynet.co.uk/~katfox/extend.htm](http://easyweb.easynet.co.uk/~katfox/extend.htm)_
- Source: “About Our Transgendered Children” PFLAG Virtual Library _[http://www.critpath.org/pflag-talk/library.html](http://www.critpath.org/pflag-talk/library.html)_

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## The Impact of Race, Gender Roles, Identity & Sexual Orientation on AAMSMs

**Sexual Orientation**:  **refers to a person's *****combined*** erotic, romantic, & affectionate attraction to:
- neither sex – **Nonsexual**,
- either sex – **Bisexual**,
- another sex – **Heterosexual**, or
- the same sex – **Homosexual***
- Note:** *****A persons sexual orientation ****is not always linked**** directly to his or her gender, gender role or gender identity.***

*Source:* "Heterosexuality," “Homosexuality” “Bisexuality” “Asexuality” Microsoft®  Encarta® Online Encyclopedia 2002 _[http://](http://encarta.msn.com/)__[encarta.msn.com](http://encarta.msn.com/)_                                                                                                                                 © 1997-2002 Microsoft Corporation. All Rights Reserved.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## The Impact of Race, Gender Roles, Identity & Sexual Orientation on AAMSMs

**Exclusively Heterosexual**, little to no homosexual activity.
**Mostly heterosexual**, only incidental homosexual activity.
**Frequently heterosexual**, but more than incidental homosexual activity.
**Equally heterosexual and homosexual** activity or what is often called Bisexual.
**Frequently homosexual**, but more than incidental heterosexual activity.
**Mostly homosexual**, but only incidental heterosexual activity.
**Exclusively Homosexual**, little to no heterosexual activity.

**Sexual Expression:**** **Most research suggests that sexual orientation is expressed in society on a continuum.

*Source:* “Master’s & Johnson's research,“
- Microsoft®  Encarta® Online Encyclopedia 2002 _[http://](http://encarta.msn.com/)__[encarta.msn.com](http://encarta.msn.com/)_                                                                                                                                 © 1997-2002 Microsoft Corporation. All Rights Reserved.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

**Notes:**
Give some Specific Researchers Find an Article

## The Impact of Race, Gender Roles, Identity & Sexual Orientation on AAMSMs

- A ladder of acceptance for today’s AAMSM in his/her communities...
***Validation**** *
***Tolerance***** *
- Sexism (gender, hetero)
- Internalized Phobia (self)
- Phobia (gender, homo, race)
- Acts of Violence

**Adapted from: Encarta® World English Dictionary [North American Edition] © & (P) 2002 Microsoft Corporation. All rights reserved.**

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

**Notes:**
A Ladder of Acceptance - Sexual Orientation:
Validation: authentication, proof, endorsement, corroboration, justification, substantiation, confirmation of human rights; support of different views as well as the authorization, endorsement, ratification, certification, legalization of different lifestyles etc.
Tolerance: The concession that different views exist; the concession of the differing views of other people, for example, in religious or political matters, and some fairness toward the people who hold these different views; the act of putting up with something or somebody irritating or otherwise unpleasant.
Homophobia: The fear and hatred of gay men, lesbians, the transgendered, transsexuals and transvestites; a fear of being perceived as a gay or lesbian; a fear of one’s attraction to those of the same sex and ultimately the systematic exclusion of people through negative behavior based on their sexual orientation.
Internalized Homophobia: same as above but the fear and possible negative behaviors is directed at self vs. others.
Heterosexism: the assumption that all people are or should be heterosexual; a view that heterosexuality is the “norm” for all social/sexual relationships and the systematically institutionalized through legal and social discrimination. 
Adapted from: Encarta® World English Dictionary [North American Edition] © & (P) 2002 Microsoft Corporation. All rights reserved.

## The Impact of Race, Gender Roles, Identity & Sexual Orientation on AAMSMs

***“******AAMSMs are dealing with multiple conflicting issues in their daily lives that often have negative effects on their sexual behavior.***

- Sexual Ambivalence
- Religious Affiliations
- Family Relationships
- Intimate Relationships
- Homophobia (internal & external)
- Lack of community (AA or MSM)
- Cultural & Racial Identities
***Sexual Identity****

- What are some of the ***Issues**** with which AAMSM struggle?

- The negative outcomes of these issues can often lead to unprotected sex

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## The Impact of Race, Gender Roles, Identity & Sexual Orientation on AAMSMs

***“******AAMSMs collectively take varied stances upon how & why they Identify sexually based on the outcome of the issues in their daily lives.***

- Homosexual/Gay/Queer
- Bisexual (truth or cover)
- Same Gender Loving
- On the Down Low
- Homo Thugs
- Banjee Boy / B-Boy
- Heterosexual / Straight

- What are some ways in which AAMSM ***sexually*** ***Identify****?

- For various political, social, and personal reasons AAMSM adopt one or more of these labels to enhance their own quality of life.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## AAMSM Programs should make room for clients that are also HIV-positive or IDU to reduce risky sexual and drug use practices; increase access to and use of HIV primary health care; and increase access and adherence to HIV treatments. 
AAMSM Programs should provide for openly gay and bisexual men & those that may not disclose sexual orientation to reduce their sexual risk-taking behaviors in the context of their heritage.
AAMSM Programs should also provide for incarcerated, sex workers or raped/molestation victims that identify as heterosexual but describe past MSM behavior and focus upon their HIV education and sexual risk-taking behaviors

- AAMSM Programs** should provide for openly gay and bisexual men & those that may not disclose sexual orientation** to reduce their sexual risk-taking behaviors in the context of their heritage.
- AAMSM Programs** should also provide for incarcerated, sex workers or raped/molestation victims that identify as heterosexual but describe past MSM behavior**** **and focus upon their HIV education and sexual risk-taking behaviors

***“******New Strategies must focus upon the known barriers to primary HIV prevention for AAMSM communities”***

- New **Directions** for HIV/AIDS-STDPrevention & Services for AAMSMs

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## AAMSM Programs should use multi-component, multi-agency efforts to address more needs of AAMSM communities. 
AAMSM Programs should include Web Based opportunities for those wish to connect privately with others to discuss issues that may impact their lives at any time.
AAMSM Programs should Include some form of Advocacy to mobilize clients and get them involved in the discussion of how providers, researchers, and policy-makers adopt prevention/care efforts that do not stigmatize the AAMSM community. 

- AAMSM Programs** should include Web Based opportunities for those wish to connect privately** with others to discuss issues that may impact their lives at any time.
- AAMSM Programs** should Include some form of Advocacy** to mobilize clients and get them involved in the discussion of how providers, researchers, and policy-makers adopt prevention/care efforts that do not stigmatize the AAMSM community.

***“******New Strategies ***_***MUST***_*** engage creative collaborations among individuals, organizations & Government in order to service AAMSMs appropriately.”***

- New Directions for HIV/AIDS-STDPrevention & Services for AAMSMs

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## New Directions for HIV/AIDS-STDPrevention & Services for AAMSMs

**The Key Is Collaboration – What Is It?**
*Community-based collaboration* ***refers to the process*** by which citizens, agencies, organizations, and businesses make formal, sustained commitments for ***working together to accomplish a shared vision*** (Chandler Center for Community Leadership, n.d.). More simply, collaboration involves two or more agencies sharing information and resources to achieve common goals (Iowa State University Extension, 1992). The two key components of these definitions are **sharing both information** and **resources** as well as having a **shared vision**.

- Adapted from - Parent News: Community Spotlight. Building Community Collaborations to Support Young Children Downloaded from - _[http://npin.org/pnews/1997/pnew497/pnew497c.html July 23](http://npin.org/pnews/1997/pnew497/pnew497c.html%20July%2023)__, 2003_

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## New Directions for HIV/AIDS-STDPrevention & Services for AAMSMs

**Why Should Organizations Collaborate?**
**	**There have been nine trends identified in society that support the growth of community-based collaborations as follows:
*Shift to Community*
*Redefining Private and Public Roles*
*Policy Development*
*New Issues*
*Citizen Participation*
*Quality of Life/Wellness*
*Fragmentation of Services*
*Focus on Root Causes*
*Shared Decisions...*

- Adapted from - Parent News: Community Spotlight. Building Community Collaborations to Support Youth Downloaded from - _[http://npin.org/pnews/1997/pnew497/pnew497c.html July 23](http://npin.org/pnews/1997/pnew497/pnew497c.html%20July%2023)__, 2003_

***& Dwindling ******Funds****** Available for        ******HIV/AIDS-STD****** Prevention and Services Efforts***

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## New Directions for HIV/AIDS-STDPrevention & Services for AAMSMs

**Levels of Collaboration: A Continuum**
**Cooperation:** Individuals or organizations ***associating*** as they accomplish ***similar but*** ***separate & distinct goals***.
**Coordination:** Individuals or organizations ***working simultaneously*** but under ***separate direction******,*** using ***separate resources*** to accomplish ***common goals***.
**Partnership:** Individuals or organizations ***working together in a side-by-side*** but under ***separate direction*** using*** ******separate resources*** with a ***shared ******sense*** of ***vision, purpose*** and ***commitment*** to accomplish ***common goals***.
**Collaboration:**** **The process of individuals or organizations working together, side-by side with ***shared resources*** and ***leadership*** ***responsibilities*** to jointly plan, implement and evaluate efforts to achieve ***shared goals***.

- * Adapted from: PARTNERS Collaboration Manual Section 1: Defining Collaboration                                                Downloaded from - _[http://www.azpartners.org/sectionOne01.asp](http://www.azpartners.org/sectionOne01.asp)_ July 23, 2003.
- Nissen, L., (2001) Community Collaboration:  An Overview of the Literature and Web-Based Resources.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## New Directions for HIV/AIDS-STDPrevention & Services for AAMSMs

**The Advantages:**
- Effective Program Delivery
- Improved professional development
- Improved Communication & Program Evaluation
- Decreased program/services duplication
- Improved Public Image
- Improved Needs Assessment
- Increased Information & Resources

**The Challenges:**
- Turf Protection and Mistrust
- Decision-Making Processes
- Limited Resources
- Attrition (i.e. Dropping Out)
- Reduced Participation.
- Broad Representation.
- Communication: Groups should maintain open and frequent communication so that all individuals and organizations feel included.
- Solid Leadership: Groups that engage a facilitator or maintain strong leadership can succeed.

- Adapted from: PARTNERS Collaboration Manual Section 2: Advantages and Disadvantages of Collaboration downloaded from _[http://www.azpartners.org/sectionTwo02.asp July 18](http://www.azpartners.org/sectionTwo02.asp%20July%2018)__, 2003._

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## A Best Practices Model for HIV/AIDS-STD Prevention & Services for AAMSMs

- This Best Practices Model is named The Adinkra Project because...
- As **Adinkra Symbolism** is a visual representation of social thought relating to the history, philosophy and religious beliefs of the **Asante peoples of Ghana** and **Cote' d'Ivoire"** (Ivory Coast) so...
- This project embodies the social thought that community based organizations, through collaboration must deal with the *history, philosophy and religious beliefs associated with HIV/AIDS in African-American MSM communities* in order to fight the epidemic in this population successfully.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## A Best Practices Model for HIV/AIDS-STD Prevention & Services for AAMSMs

- The Adinkra Project has a dual purpose to:
- Encourage the ***formation of formal, healthy relationships***, coordinated efforts, cooperative agreements, partnerships & collaborations ***among local organizations*** in the fight against HIV/AIDS-STDs.
- Establish ***a distinct network*** of community based organizations ***that will provide the necessary services and resources for African-American MSMs*** that will effectively*** ***prevent the*** ***_***acquisition***_*** or ***_***transmission***_*** of HIV/AIDS and STDs***.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## A Best Practices Model for HIV/AIDS-STD Prevention & Services for AAMSMs

- The Adinkra Projects target population is the **organizations** in communities **with limited capacities** to serve the AAMSM population.
*African-American MSM* Is defined, for the purposes of this project, as the population of ***African-American ***_***M***_***en who have ***_***S***_***ex with ***_***M***_***en*** and so includes those African American men that fall in to one or more of the following 4 categories:
***Homosexual Men*** (those in sexual contact with men openly & exclusively)
***Bisexual Men*** (those in sexual contact with men and women)
***Heterosexual Men*** that under particular circumstance have had or currently engage in some sexual contact with men ( sex workers, those previously incarcerated or rape/molestation victims) and
***Unidentified Men*** (those that for political, social or personal reasons simply do not identify sexual orientation though they may have sexual contact with men).

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## A Best Practices Model for HIV/AIDS-STD Prevention & Services for AAMSMs

- The concept of the Adinkra Project is in four parts...
***Part 1:*** of this initiative is achieved through a _***collaborative***_*** organizational structure*** ***in which local organizations form a network*** ***of resources*** through informal coordination planned cooperative agreements, and/or organizational partnerships that results in the connection of AAMSM clients with specific services available as needed from the member organizations that have a demonstrated commitment to the fight against HIV/AIDS.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## A Best Practices Model for HIV/AIDS-STD Prevention & Services for AAMSMs

- The concept of the Adinkra Project is in four parts...
***Part 2:*** of this initiative is achieved by ***planning a*** ***multilevel intervention*** ***committed to African American themes & perspectives*** that will provide AAMSM communities with service at these levels:
- outreach, (environmental, promotional, etc.)
- individual level, (HIV CTR, case management, etc.)
- group level (educational sessions, discussion groups),
- community level interventions (forums, town hall meetings),
- community building (social activities, support groups), &
- community awareness (informal & formal marketing campaigns)

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## A Best Practices Model for HIV/AIDS-STD Prevention & Services for AAMSMs

- The concept of the Adinkra Project is in four parts...
***Part 3:*** of this initiative is achieved with the ***delivery of high quality services*** through either the enhancement of preexisting resources or development of new resources at member organizations to insure that services are...
- focused on HIV prevention & services for HIV + & -  persons,
- based on sound academic research,
- carefully documented and archived,
- culturally _relevant_, _appropriate_ and _significant_ to the diverse population of African-American MSMs using them and
- reflective of the target population’s experiences.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## A Best Practices Model for HIV/AIDS-STD Prevention & Services for AAMSMs

- The concept of the Adinkra Project is in four parts...
***Part 4:*** of this initiative is achieved through the ***maintenance of all network resources*** by an elected leadership body (The Adinkra Planning Council) composed of member organization representatives (2 per agency) that will:
- Review the services available in each organization,
- Discuss client feedback and experiences with services
- Receive technical assistance from one another or other entities
- Stay abreast of the latest trends in reference to HIV prevention, funding, etc.
- Voice concerns and ideas for the Adinkra Project
- Share goals and accomplishments of services delivered
- Gain organizational support from the network

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## A Best Practices Model for HIV/AIDS-STD Prevention & Services for AAMSMs

- The model **needs** 6 to 9 organizations to work.

**The **Adinkra** Planning Council**

- 1

- Outreach Interventions

- 2

- Individual  Interventions

- 3

- Group Interventions

- 4

- Community Interventions

- 8

- Evaluation & Assessment

- 7

- Planning Council

- 5

- Community Building Activities

- 6

- Community Awareness &  Social Marketing

- 9

- Technical Assistance

- The tasks for organizations 7-9 can be allocated to one or more of  the other six depending on present agency capacity.

- The Planning Council is the body of organizational representatives that meets regularly to determine the future of the Project

- Organizations participating in the Adinkra Project are selected based on desire, expertise & experience working with AAMSM populations.

- The tasks for member organizations 1-6 can be allocated to the agency with the best present capacity for the intervention.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## A Best Practices Model for HIV/AIDS-STD Prevention & Services for AAMSMs

- In order for this model to work the Adinkra Planning Council will need the following training initially and regularly...
- Organizational Collaboration & Cultural Competency
- Community Planning, Mobilization & Leadership Development
- Behavior Change Theory & Effective Interventions
- Information Dissemination & Social Marketing
- Regular Updates on...
- Human Sexuality - Behavior & Trends
- HIV/AIDS, STDs & other communicable diseases
- Substance Use/Abuse & Mental Health

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## A Best Practices Model for HIV/AIDS-STD Prevention & Services for AAMSMs

- The Adinkra Project has the following possible benefits...
**Benefit 1:** This intervention affords participating organizations the opportunity to ***learn through practice how to collaborate at multiple levels with other organizations*** by allowing them to...
- Create, maintain or revive old organizational relationships
- Determine informal cooperative agreements
- Establish informal coordinated engagements/activities
- Articulate formal written partnerships for funding
- Contemplate formal collaborative organizational mergers

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## A Best Practices Model for HIV/AIDS-STD Prevention & Services for AAMSMs

- The Adinkra Project has the following possible benefits...
**Benefit 2:** This intervention affords participating organizations the opportunity to ***improve their grant application & usage practices*** by allowing them to...
- focus their organizational efforts more clearly,
- define potential service contracts for funding more specifically,
- allocate organizational resources more efficiently,
- diffuse inter-organizational competition for clients, and
- demonstrate improved service delivery for the target population.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## A Best Practices Model for HIV/AIDS-STD Prevention & Services for AAMSMs

- The Adinkra Project has the following possible benefits...
**Benefit 3:** This intervention affords participating organizations the opportunity ***to expand their capacity for HIV services*** as members of the planning council through ...
- organizational development,
- technical assistance & training,
- shared resources & information,
- collective evaluation & assessment processes,
- improved organizational relationships
- preparation for future collaboration in other areas.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## A Best Practices Model for HIV/AIDS-STD Prevention & Services for AAMSMs

- The Adinkra Project has the following possible benefits...
**Benefit 4:** This intervention affords participating organizations ***the capacity to better recognize and address the needs of the target population*** through ...
- Increased cultural competence in terms of service delivery & program goals
- Improved group discussions that focus upon self esteem, male relationships & communication, and African-American sexual & general health
- Increased client participation due to Interventions that develop a strong positive sense of identity for participants as, African-American, as male and/or as MSM.
- a more exhaustive prevention experience for African-American MSMs than could be accomplished by organizations individually
- Organizational access to a population that may have been overlooked or underserved.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004

## Resources

- The following are the specific sources used for this presentation that include related facts sheets, briefs, and commentaries...
- Chandler Center for Community Leadership. (n.d.). Community -based collaboration: Community wellness multiplied. URL http://www.cyfernet.org/nnco/wellness.html
- Centers for Disease Control “Sexually Transmitted Diseases Treatment Guidelines 2002”
- Nissen, L., (2001) Community Collaboration:  An Overview of the Literature and Web-Based Resources.
- Parent News: Community Spotlight. Building Community Collaborations to Support Young Children Downloaded from - _[http://npin.org/pnews/1997/pnew497/pnew497c.html](http://npin.org/pnews/1997/pnew497/pnew497c.html)_ July 23, 2003.
- PARTNERS Collaboration Manual Section 1: Defining Collaboration                                                Downloaded from - _[http://www.azpartners.org/sectionOne01.asp](http://www.azpartners.org/sectionOne01.asp)_ July 23, 2003.
- PARTNERS Collaboration Manual Section 2: Advantages and Disadvantages of Collaboration downloaded from _[http://www.azpartners.org/sectionTwo02.asp July 18](http://www.azpartners.org/sectionTwo02.asp%20July%2018)_, 2003.

- Finding The Invisible Man: A Best Practices Model for HIV/AIDS-STD Prevention & Services                                                        for AAMSMs through Community Collaboration - 2004 National STD Conference, Philadelphia, PA

- 3/08/2004