Many Men, Many Voices

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Many Men, Many Voices
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Many Men, Many Voices

• Target Population
• MSM
• gay/bisexual
• some non-gay identified
• Black
• African American, African, Caribbean, and Black
  Hispanic
• Can be adapted for other populations

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Many Men, Many Voices

• Adapted through a partnership between
• CHBT - Center for Health Behavioral Training,
  University of Rochester, NY a Part II STD/HIV
  Prevention Training Center (PTC)
• POCC - People of Color in Crisis, Brooklyn, NY
• MOCHA - Men of Color Health Awareness Project,
  Rochester, NY

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Many Men, Many Voices

• Behavioral Self-Management and Assertion Skills
  intervention by Jeffrey Kelly, PhD adapted for
  Black MSM
• Cognitive-behavioral, skills building prevention
  intervention
• Conducted in 7 group sessions of 6-12
  participants.
• Integrates STD and HIV prevention

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Core Elements

• Educate clients about HIV and STD risk and
  sensitize to personal risk
• Develop risk reduction strategies
• Train in behavioral skills
• Train in sexual assertiveness
• Provide social support and relapse prevention
• Based on CDCs Procedural Guidance found at
  www.effectiveinterventions.org

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Key Characteristics

• Foster positive identity development for gay men
  of color by
• exploring the dual identity culture
• addressing social and cultural norms within
  racial/ethnic communities
• exploring positive and negative peer influences,
  setting self-standards and clarifying values
• Based on CDCs Procedural Guidance found at
  www.effectiveinterventions.org

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Key Characteristics

• Discuss sexual roles and risks
• addressing knowledge
• exploring beliefs about the risks
• Address perceived personal risk and
  susceptibility for HIV/STD and perceived benefits
  and outcomes of remaining HIV-negative.

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Key Characteristics

• Increase skills and self-efficacy for protective
  behaviors and intentions to engage in those
  behaviors.
• Explore sexual relationship dynamics
• Address the importance of peer support and social
  influence on maintaining healthy behaviors

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Many Men, Many Voices

• Seven Intervention Sessions

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Intervention Sessions

• Sessions are experiential (not lecture or
  teaching).
• Each exercise or activity builds on the previous
  ones. Ex. Session 5. consists of the following
  exercises
• 1 The man of my dreams
• 2 Whos got the power?
• 3 Why we choose the ones we choose -
• are you a Top or a Bottom?
  

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Session 1Dual Identity

• Identify factors that influence behavior change
• Discuss norms in the Black and gay communities
• Explore the concept of dual identity being a
  Black gay man
• Identify factors influencing Black MSM including
  internalizing racism and homophobia
• Identify risk behaviors and STD/HIV infections of
  Black MSM

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Session 2STD / HIV Prevention for Black MSM

• Discuss the roles and risks of tops and
  bottoms
• Provide an overview of HIV/AIDS and STDs for
  Black MSM
• Identify risks associated with different types of
  sex
• Make a connection between STDs and HIV
• Explain the transmission puzzle and how to reduce
  risk of contracting/transmitting STDs including
  HIV

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Session 3STD/HIV Risk Assessment Prevention
Options

• STD/HIV prevention options based on transmission
  puzzle
• Ranking of sexual risk behavior
• Inventory of personal STD/HIV risk behaviors
• (what would you do with whom)
• Clients personal risk behaviors
• (sexual, substance use and health care
  seeking)

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Session 4 Intentions to Act and Capacity to
Change

• Provide an overview of how behavior change occurs
• Review menu of options for STD/HIV prevention
• Work through ambivalence by identifying each
  clients personal ambivalence and barriers
• Explore pros/cons of current behavior and making
  a change
• Acquire skills - Safer sex , Substance use,
  Health care seeking

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Session 5Relationship Issues Partner
Selection, Communication, Negotiation of Roles
for Black MSM

• Discuss attitudes towards gender roles in Black
  communities, differences in perceived power
• Help participants to recognize the relationship
  between sex position (top or bottom) and power
  and decision-making within ones sexual
  relationship(s)
• Define stereotyping and sexism as it relates to
  Black MSM

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Session 5 Relationship Issues Partner
Selection, Communication, Negotiation of Roles
for Black MSM

• Discuss relationship dynamics Tops and Bottoms
  assigned relationship role may not
  fitconsequences for individual
• Identify different types of power within sexual
  relationship(s)
• Make a connection between relationship roles and
  safer sex negotiation.

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Session 6 Social support problem solving to
maintain change

• Review the chosen individual and relationship
  risk reduction options
• Practice skills and problem solving with specific
  scenarios
• Identify ways to avoid cues
• Anticipate problems that may occur and use group
  problem-solving

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Session 6 Continued.

• Provide problem solving strategies
• Reinforce change efforts
• Identify supports for change
• Offer rewards and substitutes

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Session 7 Where Do We Go From Here

• Linkage to other services offered by agency
• Community resources for substance use,mental
  health, other services - Survival Handbook
• Involvement in community building for Black gay
  men

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Getting Started

• Implementation needs and resources

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Internal Agency Capacity-Staff

• Staffing at a level to sustain implementation on
  the schedule of deliverables
• Supervision, planning, recruitment, facilitation,
  and monitoring/reporting responsibilities
• Staff training needs
• Overview of HIV and STDs
• Bridging theory and practice
• Group facilitation skills
• Many Men, Many Voices training Level I and Level
  II

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Other Agency Capacity

• Manual and related materials
• Space (confidential, safe)
• Commitment to implement entire intervention
  program
• Sufficient funds- quality quantity of delivery
• Implementation plan, including recruitment,
  referral, monitoring/evaluation, and QA
  procedures
• Technical assistance

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Technical Assistance to Support
Implementation Training, including relevant
supportive trainings (skill sets
needed). www.effectiveinterventions.org and
www.stdhivpreventiontraining.org
Published resources (manual). Intervention
Kit Web resources. CDC technical
assistance system.
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Agency Planning Tool(www.effectiveinterventions.o
rg)

• Should be completed by funded agency in
  collaboration with CDC project officer.
• Running record of funded agencys progress in
  implementing the intervention

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Many Men Many Voices

• www.effectiveinterventions.org
• Training is available in each of the four
  geographic quadrants of the United States,
  offered by the 4 CDC Part II STD/HIV Prevention
  Training Centers (PTCs). www.stdhivpreventiontrai
  ning.org
• Rochester, NY
• Denver, CO
• Berkeley, CA
• Dallas, Texas

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Many Men Many Voices

• Intervention Kit
• Agencies will be sent 1 - 2 intervention kits
  after staff have completed the Level 1 and Level
  2 series.
• Kits include the intervention curriculum and
  materials as well as planning tools and marketing
  and recruiting materials.

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• THANK YOU