Adapting an Evidence-based Intervention for Stigma-related Stress, Mental Health, and HIV Risk for MSM of Color in Small Urban Areas
Condition: HIV in MSM
Study type: Interventional

Summary: 
      The purpose of this study is adapt an evidence-based intervention for stigma-related stress,
      mental health, and HIV risk for bay, bisexual, and other men who have sex with men (MSM) of
      color in small urban areas.
    

Detailed description: 
      This study has two specific aims. Aim 1 will focus on the modification of an existing
      intervention manual (created by the study PI) using feedback from previous qualitative
      interviews with MSM in New Haven and Hartford, CT. Also incorporated will be recent
      qualitative research on MSM of color's resilience. Specifically, the ways in which racial
      minority stigma impacts the mental health of MSM in small urban areas and adaptive coping
      skills that MSM can use in the face of these health threats.

      Aim 2, will consist of the deliver of the adapted intervention to approximately 30 young MSM
      (15 HIV-negative and 15 HIV-positive) to gather data on the feasibility and acceptability of
      the newly adapted program. The evaluation of the new program will be conducted using pre-post
      comparisons of quantitative assessments and from qualitative interviews hoped to provide
      information regarding intervention feasibility, acceptability, and any needed refinement.

      This project integrates expertise in culturally-sensitive evidence-based interventions for
      MSM's HIV risk into a community-based HIV prevention and care context at the Fair Haven
      Community Health Center, where the intervention will be delivered to the existing patient
      population.

      As of April, 2019, the study protocol was updated and approved by the Yale IRB such that the
      two intervention cohorts did not differ by HIV serostatus. This decision was made: (1)
      because of the greater number of HIV-negative men, compared to HIV-positive men, who
      expressed interest in the study and (2) because participants could decide whether or not to
      disclose their serostatus in the group, as they do in other real-life interactions with other
      MSM, as reviewed during the consent process. Thus, there was no group assignment based on HIV
      serostatus.
    

Intervention name(s): ESTEEM conneCT
Intervention type(s): Behavioral
Intervention description(s): The intervention adapts the ESTEEM (Pachankis et al, 2015) intervention to address the multiple-stigma stressors faced by MSM of color, including sexual orientation and racial stigma in a manualized, CBT-based intervention. Approximately thirty participants (divided between two cohorts) will complete ten group sessions will take place at regular times once per week over the course of three months. The groups will be "closed," in that no new members will be allowed to join after the first week in order to promote open self-disclosure and trust among group members.
Intervention model: Single Group Assignment
Intervention model description: Adaptation of the Effective Skills to Empower Effect Men (ESTEEM; Pachankis, 2014; Pachankis et al, 2015) intervention that addresses young gay and bisexual men's occurring maladaptive behavioral patterns, including HIV-transmission risk behavior and mental health concerns, to address multiple stigma-related stressors for young gay and bisexual men of color in a group therapy format. All participants were part of the same intervention (no randomization) to assess the feasibility and acceptability of this adapted intervention (protocol update 4.24.2019; please see attached protocol). Two cohorts were formed to retain ideal group size for group therapy (10-15 participants per group).
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: HIV; MSM