This trauma-informed, culturally sensitive HIV intervention will focus on the diverse subset of the men who have sex with men (MSM) community who have experienced at least one adverse childhood experience (ACE). Current data suggests exposure to ACEs increases a person’s risk to contracting HIV; as such, our program will be based in resilience. Through education, peer mentoring, motivational interviewing, and therapy sessions, we will guide our participants toward safer sex practices. These activities also aim to build their capacity throughout the intervention by improving their knowledge, skills, and behaviors relating to HIV prevention. Our intervention team will adopt a multi-leveled social ecological approach that considers the importance of relationships and community when improving an individual’s health. Access to free year of PrEP will be guaranteed for those interested, and linkage to free HIV testing and care services will be provided free of charge to our participants.
Public Health Framework
Our intervention will employ a public health framework by operating within each level of prevention while addressing how trauma impacts HIV prevention and education. Since our participants are all considered “high-risk” for HIV since there are members of the MSM community, free HIV testing will be included as part of our intervention, so that participants may know their current status. This aligns most closely with the secondary prevention level.
The intervention will also consider the primary level of prevention by educating participants on safe sex practices and taking universal precautions against HIV transmission by using condoms or taking PrEP.
Finally, if any of our participants are found to be HIV+ following our screening, we would utilize the third level of prevention by connecting them to Ryan White for subsidized anti-retroviral treatment and resource navigation.
Our program will be informed by the public health paradigm that health includes patient well-being and goes beyond being free of a condition or disease. Our intervention will address how past traumas can affect sexual behaviors and emotional health, while offering both resources and emotional support from our two full-time certified mental health providers (Philanthropy Network Greater Philadelphia, 2016).
Levels of Social Ecological Model
The Social Ecological Model put out by the CDC will serve as this intervention’s framework (CDC 2019). Motivational interviewing and the project’s HIV prevention curriculum will bolster the knowledge and skills necessary for behavior change at the individual level. Given the nature of HIV as a sexually transmitted infection, our project will also closely consider the relationship level of the model. We will address positive behavioral change at this level through educating our participants on how to talk to their sexual partners about knowing their status and adopting safer sex practices. These behaviors will be practiced during our HIV prevention curriculum in pairs of participants, with their trained peer leader processing and providing feedback. Our program will also include a community linkage and referral portion completed during one-on-one counseling sessions. Whether through Ryan White or another HIV community resource, participants will learn how to navigate their community to find these essential resources. Utilizing this multi-level approach will hopefully result in superior project outcomes, as consistent with the CDC’s research on their Social Ecological Model (Centers for Disease Control and Prevention, 2019).
Trauma-Informed Principles
Since our project is rooted in being trauma-informed, SAMHSA’s six principles will serve as a guideline for project planning and execution (SAMHSA 2014). Firstly, the principle of physical and emotional safety will be embedded into each activity of our intervention. We will ensure that peer leader volunteers understand the importance of safety, and each space in which the educational portion is presented will be safe. Our intervention will also follow a “challenge by choice” approach, in which participants never need to feel the need to share their experiences if they feel uncomfortable doing so.
The principle of peer support, additionally, is laced throughout our project activities. Our recruitment of community liaisons as intervention staff, as well as volunteer peer leaders, will ensure our participants know their experiences are shared by those with whom they are confiding.
Since all of our participants have experienced some version of trauma in their past, it is imperative our intervention takes an individualized, empowering approach to advising behavior changes. The principle of empowerment, voice, and choice will be ensured by the use of motivational interviewing as a tactic to spark behavior change. This approach places the focus on the participant, and the peer leader serves as a facilitator to lead them towards adopting a safer sex practice that best suits the participant’s needs.
Finally, our program will address the complicated cultural and political history of HIV by partnering with long-standing and trusted HIV resources, such as Ryan White. Furthermore, our peer leader volunteers will be given training in cultural sensitivity with a focus on intersectionality in HIV. Through this, they will be equipped with the knowledge to better understand how a person’s cultural or religious identity can impact how they view HIV.
Comments (0)