1. 5-16-051 Many Men, Many Voices

2. 5-16-05 2 Many Men, Many Voices n Target Population –MSM gay/bisexual some non-gay identified –Black African American, African, Caribbean, and Black Hispanic n Can be adapted for other populations

3. 5-16-05 3 Many Men, Many Voices n 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

4. 5-16-05 4 Many Men, Many Voices n Behavioral Self-Management and Assertion Skills intervention by Jeffrey Kelly, PhD adapted for Black MSM n Cognitive-behavioral, skills building prevention intervention Conducted in 7 group sessions of 6-12 participants. –Integrates STD and HIV prevention

5. 5-16-05 5 Core Elements n Educate clients about HIV and STD risk and sensitize to personal risk n Develop risk reduction strategies n Train in behavioral skills n Train in sexual assertiveness n Provide social support and relapse prevention Based on CDC’s Procedural Guidance found at www.effectiveinterventions.org

6. 5-16-05 6 Key Characteristics n 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 CDC’s Procedural Guidance found at www.effectiveinterventions.org

7. 5-16-05 7 Key Characteristics n Discuss sexual roles and risks – addressing knowledge – exploring beliefs about the risks n Address perceived personal risk and susceptibility for HIV/STD and perceived benefits and outcomes of remaining HIV- negative.

8. 5-16-05 8 Key Characteristics n Increase skills and self-efficacy for protective behaviors and intentions to engage in those behaviors. n Explore sexual relationship dynamics n Address the importance of peer support and social influence on maintaining healthy behaviors

9. 5-16-059 Many Men, Many Voices Seven Intervention Sessions

10. 5-16-05 10 Intervention Sessions n Sessions are experiential (not lecture or teaching). n Each exercise or activity builds on the previous ones. Ex. Session 5. consists of the following exercises: –#1 The man of my dreams –#2 Who’s got the power? –#3 Why we choose the ones we choose - are you a Top or a Bottom?

11. 5-16-05 11 Session 1: Dual Identity n Identify factors that influence behavior change n Discuss norms in the Black and gay communities n Explore the concept of dual identity; being a Black gay man n Identify factors influencing Black MSM including internalizing racism and homophobia n Identify risk behaviors and STD/HIV infections of Black MSM

12. 5-16-05 12 Session 2: STD / HIV Prevention for Black MSM n Discuss the roles and risks of “tops” and “bottoms” n Provide an overview of HIV/AIDS and STDs for Black MSM n Identify risks associated with different types of sex n Make a connection between STDs and HIV n Explain the transmission puzzle and how to reduce risk of contracting/transmitting STDs including HIV

13. 5-16-05 13 Session 3: STD/HIV Risk Assessment & Prevention Options n STD/HIV prevention options based on transmission puzzle n Ranking of sexual risk behavior n Inventory of personal STD/HIV risk behaviors (what would you do with whom) n Clients personal risk behaviors (sexual, substance use and health care seeking)

14. 5-16-05 14 Session 4: Intentions to Act and Capacity to Change n Provide an overview of how behavior change occurs n Review menu of options for STD/HIV prevention n Work through ambivalence by identifying each clients personal ambivalence and barriers n Explore pros/cons of current behavior and making a change n Acquire skills - Safer sex, Substance use, Health care seeking

15. 5-16-05 15 Session 5: Relationship Issues: Partner Selection, Communication, Negotiation of Roles for Black MSM n Discuss attitudes towards gender roles in Black communities, differences in perceived power n Help participants to recognize the relationship between sex position (top or bottom) and power and decision-making within one’s sexual relationship(s) n Define stereotyping and sexism as it relates to Black MSM

16. 5-16-05 16 Session 5: Relationship Issues: Partner Selection, Communication, Negotiation of Roles for Black MSM n Discuss relationship dynamics: Tops and Bottoms assigned relationship role may not fit—consequences for individual n Identify different types of power within sexual relationship(s) n Make a connection between relationship roles and safer sex negotiation.

17. 5-16-05 17 Session 6: Social support & problem solving to maintain change n Review the chosen individual and relationship risk reduction options n Practice skills and problem solving with specific scenarios n Identify ways to avoid cues n Anticipate problems that may occur and use group problem-solving

18. 5-16-05 18 Session 6: Continued…. n Provide problem solving strategies n Reinforce change efforts n Identify supports for change n Offer rewards and substitutes

19. 5-16-05 19 Session 7: Where Do We Go From Here n Linkage to other services offered by agency n Community resources for substance use,mental health, other services - Survival Handbook n Involvement in community building for Black gay men

20. 5-16-0520 Getting Started Implementation needs and resources

21. 5-16-05 21 Internal Agency Capacity- Staff n Staffing at a level to sustain implementation on the schedule of deliverables n Supervision, planning, recruitment, facilitation, and monitoring/reporting responsibilities n 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

22. 5-16-05 22 Other Agency Capacity n Manual and related materials n Space (confidential, safe) n Commitment to implement entire intervention program n Sufficient funds- quality & quantity of delivery n Implementation plan, including recruitment, referral, monitoring/evaluation, and QA procedures n Technical assistance

23. 5-16-05 23 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.

24. 5-16-05 24 Agency Planning Tool (www.effectiveinterventions.org) n Should be completed by funded agency in collaboration with CDC project officer. n Running record of funded agency’s progress in implementing the intervention

25. 5-16-05 25 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.stdhivpreventiontraining.org: –Rochester, NY –Denver, CO –Berkeley, CA –Dallas, Texas

26. 5-16-05 26 Many Men Many Voices Intervention Kit n Agencies will be sent 1 - 2 intervention kits after staff have completed the Level 1 and Level 2 series. n Kits include the intervention curriculum and materials as well as planning tools and marketing and recruiting materials.

27. 5-16-05 27 THANK YOU