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"And Then Break the Cliché": Understanding and Addressing HIV Vulnerability Through Development of an HIV Prevention Telenovela with Men Who Have Sex with Men and Transwomen in Lima, Peru.
Arch Sex Behav. 2018 10; 47(7):1995-2005.AS

Abstract

HIV and other sexually transmitted infections (STIs) continue to affect men who have sex with men (MSM) and transgender women (TW) in Peru at disproportionately high rates. The ineffectiveness of traditional prevention strategies may be due to the disconnect between health promotion messages and community-level understandings of sexual cultures. We conducted 15 workshops with MSM and TW to develop a community-based sexual health intervention. Intervention development consisted of focus groups and scenic improvisation to identify sexual scripts for an HIV prevention telenovela, or Spanish soap opera. Workshops were stratified by self-reported socioeconomic status, sexual orientation, and gender identity: (1) low-income MSM (n = 9); (2) middle/high-income MSM (n = 6); and (3) TW (n = 8). Employing a conceptual model based on sexual scripts and critical consciousness theories, this paper reports on three themes identified during the telenovela-development process as participants sought to "rescript" social and sexual stereotypes associated with HIV-related vulnerability: (1) management of MSM and TW social identities at the intersection of socioeconomic status, sexuality, and gender performance; (2) social constructions of gender and/or sexual role and perceived and actual HIV/STI risk(s) within sexual partnership interactions; and (3) idealized and actual sexual scripts in the negotiation of safer sex practices between MSM/TW and their partners. These findings are key to reframing existing prevention strategies that fail to effectively engage poorly defined "high-risk populations." Leveraging community-based expertise, the results provide an alternative to the static transfer of information through expert-patient interactions in didactic sessions commonly used in HIV prevention interventions among MSM and TW.

Authors+Show Affiliations

School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, 118C Milam Hall, Corvallis, OR, 97331, USA. jonathan.garcia@oregonstate.edu.Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.Asociacion Civil Via Libre, Lima, Peru.Department of Medicine/Division of Infectious Diseases, UCLA Geffen School of Medicine, Los Angeles, CA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29464455

Citation

Garcia, Jonathan, et al. ""And Then Break the Cliché": Understanding and Addressing HIV Vulnerability Through Development of an HIV Prevention Telenovela With Men Who Have Sex With Men and Transwomen in Lima, Peru." Archives of Sexual Behavior, vol. 47, no. 7, 2018, pp. 1995-2005.
Garcia J, Perez-Brumer AG, Cabello R, et al. "And Then Break the Cliché": Understanding and Addressing HIV Vulnerability Through Development of an HIV Prevention Telenovela with Men Who Have Sex with Men and Transwomen in Lima, Peru. Arch Sex Behav. 2018;47(7):1995-2005.
Garcia, J., Perez-Brumer, A. G., Cabello, R., & Clark, J. L. (2018). "And Then Break the Cliché": Understanding and Addressing HIV Vulnerability Through Development of an HIV Prevention Telenovela with Men Who Have Sex with Men and Transwomen in Lima, Peru. Archives of Sexual Behavior, 47(7), 1995-2005. https://doi.org/10.1007/s10508-017-1119-x
Garcia J, et al. "And Then Break the Cliché": Understanding and Addressing HIV Vulnerability Through Development of an HIV Prevention Telenovela With Men Who Have Sex With Men and Transwomen in Lima, Peru. Arch Sex Behav. 2018;47(7):1995-2005. PubMed PMID: 29464455.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - "And Then Break the Cliché": Understanding and Addressing HIV Vulnerability Through Development of an HIV Prevention Telenovela with Men Who Have Sex with Men and Transwomen in Lima, Peru. AU - Garcia,Jonathan, AU - Perez-Brumer,Amaya G, AU - Cabello,Robinson, AU - Clark,Jesse L, Y1 - 2018/02/20/ PY - 2017/07/24/received PY - 2017/11/14/accepted PY - 2017/11/07/revised PY - 2018/2/22/pubmed PY - 2019/9/17/medline PY - 2018/2/22/entrez KW - Critical consciousness KW - HIV prevention KW - Men who have sex with men KW - Sexual scripts KW - Transgender women SP - 1995 EP - 2005 JF - Archives of sexual behavior JO - Arch Sex Behav VL - 47 IS - 7 N2 - HIV and other sexually transmitted infections (STIs) continue to affect men who have sex with men (MSM) and transgender women (TW) in Peru at disproportionately high rates. The ineffectiveness of traditional prevention strategies may be due to the disconnect between health promotion messages and community-level understandings of sexual cultures. We conducted 15 workshops with MSM and TW to develop a community-based sexual health intervention. Intervention development consisted of focus groups and scenic improvisation to identify sexual scripts for an HIV prevention telenovela, or Spanish soap opera. Workshops were stratified by self-reported socioeconomic status, sexual orientation, and gender identity: (1) low-income MSM (n = 9); (2) middle/high-income MSM (n = 6); and (3) TW (n = 8). Employing a conceptual model based on sexual scripts and critical consciousness theories, this paper reports on three themes identified during the telenovela-development process as participants sought to "rescript" social and sexual stereotypes associated with HIV-related vulnerability: (1) management of MSM and TW social identities at the intersection of socioeconomic status, sexuality, and gender performance; (2) social constructions of gender and/or sexual role and perceived and actual HIV/STI risk(s) within sexual partnership interactions; and (3) idealized and actual sexual scripts in the negotiation of safer sex practices between MSM/TW and their partners. These findings are key to reframing existing prevention strategies that fail to effectively engage poorly defined "high-risk populations." Leveraging community-based expertise, the results provide an alternative to the static transfer of information through expert-patient interactions in didactic sessions commonly used in HIV prevention interventions among MSM and TW. SN - 1573-2800 UR - https://www.unboundmedicine.com/medline/citation/29464455/"And_Then_Break_the_Cliché":_Understanding_and_Addressing_HIV_Vulnerability_Through_Development_of_an_HIV_Prevention_Telenovela_with_Men_Who_Have_Sex_with_Men_and_Transwomen_in_Lima_Peru_ L2 - https://doi.org/10.1007/s10508-017-1119-x DB - PRIME DP - Unbound Medicine ER -