An application of the ADAPT-ITT model to an evidence-based behavioral HIV prevention intervention for men who have sex with men in Ghana

G. M. Abubakari, DeAnne Turner, LaRon E Nelson, Apondi J Odhiambo, F. Boakye, A. Manu, K. Torpey, L. Wilton
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引用次数: 7

Abstract

Despite constituting only about 1% of Ghana’s population, men who have sex with men (MSM) carry a disproportionate burden of HIV infections, constituting 18% of the population of people living with HIV in the country. Scholars have associated the disproportionate infection rates of HIV among MSM with existing structural factors (such as criminalization and stigma against MSM), and individual-level factors (such as sex without a condom, and transactional sex). Nonetheless, limited scholars consider intervention as an approach to reducing HIV and STI risk among MSM in the country. As such, in collaboration with community partners, we engaged MSM through the use of the ADAPT-ITT model to adapt the Many Men Many Voices (3MV) to address the needs of MSM. We addressed HIV/STD risk factors and ways to reduce HIV/STD infections. In this paper, we describe the use of the ADAPT-ITT model in the adoption and adaptation of the 3MV with MSM in Ghana. Whereas the 3MV was a good fit for our target population, we made modifications to fit the Ghanaian cultural setting by examining HIV and STD risk in the context of bisexuality, emphasizing on secrecy in location choice, and incorporating historical colonial setting in contextualizing sexuality and stigma in the Ghanaian sociocultural context. Our implementation process shows the efficacy of collaboration with community partners to implement culturally relevant interventions in HIV and STD prevention efforts in highly stigmatized environments.
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ADAPT-ITT模型在加纳男男性行为艾滋病预防干预中的应用
尽管仅占加纳人口的1%左右,但男男性行为者(MSM)承担着不成比例的艾滋病毒感染负担,占该国艾滋病毒感染者人口的18%。学者们将男男性接触者中不成比例的艾滋病毒感染率与现有的结构性因素(如对男男性接触者的刑事定罪和污名化)和个人层面的因素(如不戴避孕套的性行为和交易性行为)联系起来。尽管如此,有限的学者认为干预是减少该国男同性恋者中艾滋病毒和性传播感染风险的一种方法。因此,我们与社区伙伴合作,通过使用adapt - itt模式,让男同性恋者参与进来,调整“多男多声”(3MV),以满足男同性恋者的需求。我们讨论了艾滋病毒/性病的危险因素和减少艾滋病毒/性病感染的方法。在本文中,我们描述了在加纳采用和适应3MV与MSM的过程中使用ADAPT-ITT模型。虽然3MV很适合我们的目标人群,但我们做了一些修改,以适应加纳的文化背景,通过在双性恋的背景下检查艾滋病毒和性病的风险,强调地点选择的保密性,并在加纳社会文化背景下将历史殖民背景与性和耻辱结合起来。我们的实施过程表明,在高度污名化的环境中,与社区伙伴合作,在艾滋病毒和性病预防工作中实施与文化相关的干预措施是有效的。
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