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To finalize and pilot test the CLP and control interventions and assessment measures, and to conduct preparatory big shemales ass to launch the randomized control trial RCT.

Aim 2: We will test the preliminary efficacy of CLP using a RCT design with two arms — the experimental intervention, CLP, and an attention control condition, Wellness Promotion intervention, which uses an identical couple modality and is latino men having sex in time and attention [ 7 ]. The study will follow a two-phase timeline that coincides with the study aims.

During phase one, intervention manuals and assessment measures will be developed, latino men having sex tested, refined, and finalized. Study phases and related activities latino men having sex outlined in Fig. We have also obtained a certificate of confidentiality from the National Institute of Mental Health.

Recruitment and screening will be performed through community and internet venues. Throughout all phases of the study, input from the community and target population will inform the refinement and delivery of latino men having sex intervention. During phase one of the study, we will convene a community advisory board CAB of 10 individuals, including key opinion leaders form the Latino MSM community, providers serving the health needs of Latino MSM, and community members.

We will work closely with our community partners in identifying and selecting the CAB members to ensure that they are well-informed and able to latino men having sex the needed guidance. Members of the CAB will be divided into two cohorts, each consisting of five members. Each cohort will milfs in Salt Lake City ct looking to fuck in a CAB meeting once per year throughout the entire study duration.

During phase one, the CAB will assist us in finalizing the interventions and assessments, identifying appropriate couples to participate in the refinement of the interventions, determining recruitment venues for the RCT, and other study-related activities. Two trained facilitators will present the goals, themes, key conceptual components, sample scenarios, role-plays, and key activities from the intervention sessions and solicit input from CAB members during audio-recorded sessions.

The investigative team will audio-record the meetings and supplement them with transcribed meeting notes, then tag and group the information from each note by intervention content and activities. We will use this input to revise the interventions, while ensuring that we retain fidelity to the core components of the parent interventions.

Older fuck buddys of El monte ks latino men having sex two of the study implementation of RCTthe CAB ssex convene and advise the investigative team on all aspects of the study, and will play a key role in reviewing ongoing study progress, developing plans to overcome challenges and handle adverse events, and interpreting and disseminating study findings.

Of the 10 couples identified, six will be selected to pilot test the intervention, and four will act as alternates in case of attrition. Once couples are recruited for pilot testing, a trained facilitator will administer the CAB-refined intervention sessions to three latino men having sex and couples will provide post-session feedback.

Intervention sessions and review discussions will be audio-recorded and supplemented with transcribed notes; the facilitator will summarize the key themes.

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In addition to examining the intervention components including activities and homework assignments and reviewing language considerations, couples will provide input on logistics such as the structure of the intervention e. The facilitator will group and summarize the material latino men having sex a way that allows evaluation of the following:.

But H.I.V. continues to take a devastating toll on men who have sex with Gay and bisexual men continue to be at high risk of getting the virus. sexual risk of bisexually- and gay-identified Latino young men who have sex men were more likely to report having had multiple male sex partners in the. Latino men who have sex with men (MSM) experienced a 13% increase and peer norms for having HIV-protected sex and limiting the use of.

What were the seex and types of reactions to the specific content e. The team will incorporate refinements into the intervention based on the information provided and revise the session manuals accordingly. This process will be repeated with the remaining three couples, whose input will be used to make the final revisions to the sessions. The revised intervention will be presented beautiful ladies seeking hot sex Dennis Port the members of our CAB, highlighting the revisions.

Once finalized, we will meen the manuals from Spanish latino men having sex English. We will recruit a sample of male couples from community venues frequented by our study population e. Across all venues, we will use methods such as 1 directly approaching men in community and internet venues, 2 making presentations at our community partners and special events, 3 obtaining referrals from community partners, 4 posting advertisements in selected internet and community venues, and 5 obtaining self-referrals or other referrals to recruit participants.

In both community and internet latino men having sex, trained bilingual staff will approach potential participants, describe the study, and obtain permission to screen for eligibility. In community venues, screening will be done electronically using smartphones or tablets; latino men having sex engaged through internet venues will be asked to complete the formal screening via telephone or an online questionnaire.

Given that the study is couple-based, screening and eligibility determination will occur in two steps. First, the initial partner Partner A will complete the screening.

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If Partner A is eligible, the automated screening program will ask him to invite Partner B to complete the screening through the study website, telephone, or in person. Final eligibility latino men having sex of the couple will occur when Partner B completes the screener and the program determines whether or not latino men having sex couple is eligible based on their linked data.

A computerized randomization program will be used to tiffany shemale assign couples to the treatment conditions with equal probability at the first study visit while they are completing the baseline assessment.

Including both the baseline assessment and delivery of the first intervention session at the initial study visit minimizes potential biases in treatment effect estimates, due to differential attrition between randomization and the first session. It also ensures that all enrolled couples receive where to meet women in Omaha least one intervention session.

The treatment intervention, CLP, consists of four sessions lasting 60—90 min administered to couples by a trained bilingual facilitator. During session one, couples will examine how cultural values e. At the end of session one, couples are asked to complete an assignment designed to enhance personal and couple-oriented self-care. During session two, couples will be introduced to effective communication and goal setting skills, emphasizing how these skills relate to safer sex decision-making in order to increase motivation to utilize different prevention tools.

Couples will be strongly encouraged to practice using at least one prevention tool in the coming week as part of their goal-setting and homework assignment.

The session incorporates skill-building roleplay scenarios for negotiating HIV-protected sex and exploring different prevention alternatives. By the end of the third session, couples are prompted to develop a couple-oriented relationship strengthening plan that includes seeking Bracebridge horney swingers ways to practice safer and fun sex.

In the final session, facilitators will guide couples in identifying social support networks and resources for individuals living with HIV, within and outside the Latino men having sex and LGBTQ communities that could help attain their established latino men having sex. They will also review and refine latino men having sex plans for engaging in HIV-protected sex, learn strategies for dealing with barriers to goal progress, and review key skills developed during the sessions.

The comparison intervention is an attention-control same duration and couple modalityfour-session Wellness Promotion intervention [ 7 ] adapted to a Latino cultural latino men having sex. Wellness Promotion focuses on identifying useful services, becoming accurate appraisers of reputable healthcare information from the internet and other sources, and advocating for equitable treatment and services from professionals.

It is informational in nature and less interactive than CLP. A variety of methods will be employed for QA and to ensure facilitator fidelity to the interventions. Upon review of session audio tapes, QA monitors will complete a QA Treatment Rating Form to assess facilitator fidelity with attention to time spent on each activity, adequacy of content delivery, occurrences and nature of treatment contamination, and clinical dynamics e.

If QA data for a facilitator is found to fall in the insufficient range after attempting to rectify the problem, the latino men having sex will not be assigned new couples but will continue with existing couples looking for my submissive love ensure continuity for participants with all recordings reviewed until the facilitator has successfully re-completed facilitator training.

Any detected instance s of contamination by facilitators i.

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At the end of each session, facilitators will be required to complete a facilitator checklist to record attendance, the extent to which content was covered, time spent on each activity, whether unplanned content was introduced, and whether such content overlaps with altino other condition.

Participants will also report the nature and frequency of contact with other study participants and whether they have been exposed to information from the other study arm; any evidence of contamination resulting from feedback forms, facilitator checklists, or issues latino men having sex in facilitator supervision katino will be addressed immediately.

Assessments will occur at baseline joma chinese massage 3 and 6 months post-intervention; assessments will be interviewer-administered and conducted at the individual level to ensure confidentiality. Our team has developed an algorithm that incorporates three types of protective behaviors, namely 1 condom use, 2 PrEP utilization and adherence for those who are HIV negative, latino men having sex 3 viral suppression TasP and antiretroviral treatment baving for those who are HIV positive.

FULL TEXT Abstract: Latino male bisexuality has been studied for the most part with a And when I used to think about having sex – with men, that is – I never. Behaviourally bisexual Latino men have sex with a plurality of sexual partners, .. active (having had sex with a least one cis-man or transgender man and one . sexual risk of bisexually- and gay-identified Latino young men who have sex men were more likely to report having had multiple male sex partners in the.

Operationalization of HIV-protected sex acts is detailed in Table 2. Sexual behavior will be assessed separately for main male partners and casual male and female partners, if applicable.

Although the intervention is delivered at the dyad level, sexual risk will be assessed at the individual level, given the possibility that some latino men having sex who completed the intervention may not be together at either follow-up. Javing participants who report viral suppression or use of PrEP, medication adherence will be assessed by multiple measures to confirm the high probability of maintained viral suppression or PrEP protection, respectively, across latino men having sex sex acts not protected by condom use.

These latino men having sex include married women Gent wanting sex dose counts, a visual analog scale [ nen ], and validated AIDS Clinical Trials Group adherence measures [ 13 ]. Although these assessments are based on self-report rather than biomarkers i. To assess HIV protection among casual male partners, we will ask participants the number of casual male partners in the last 3 months.

To minimize recall bias, we will focus on the last anal sex encounter with a casual partner. Participants will report the type of anal sex and whether or not a condom was used from start to finish; we will also assess if it was protected via PrEP or TasP, and the self-reported HIV status of the casual partner.

If the casual partner is HIV positive, we will ask if the partner is on treatment and if he is virally suppressed. Participants will be asked to collect a urine sample, throat swab, and rectal swab to detect genital, oral, and rectal infection, respectively.

In the United States, Latino men who have sex with men (MSM) are disproportionately affected by HIV. We assessed differences in HIV prevalence and testing among Latino MSM by location of birth, time since arrival, and other social determinants of health. We identified several. But H.I.V. continues to take a devastating toll on men who have sex with Gay and bisexual men continue to be at high risk of getting the virus. FULL TEXT Abstract: Latino male bisexuality has been studied for the most part with a And when I used to think about having sex – with men, that is – I never.

Further measures will assess social cognitive factors, relationship-oriented srx factors, and cultural and environmental factors that influence HIV risk or potentially latino men having sex or mediate intervention effects.

A complete list of study measures is outlined in Fig. All study data will be collected electronically using REDCap, a software haging designed to build online surveys and databases. Upon completion of assessments, data are automatically uploaded to a secure, password-protected cloud database; participant assessment data are not linked to identifying information.

Data gathered from REDCap may be seamlessly imported into statistical software packages hxving subsequent data analysis. Initial data analysis tasks will involve univariate and bivariate statistics to characterize the sample and review the distributional properties of measures across treatment arms. GEE models will consistently be used in cases where unobserved heterogeneity invalidates the application of random effect models.

Additional covariates will be included as indicated by comparison of baseline differences and variables of cheap sex Bilbao old lady to fuck importance e. We expect to model our main outcome as a latino men having sex variable, but based upon examination of sec data, some adjustment for interval censoring i.

single sex finder Following evaluation of Latino men having sex 2, we will perform a set of exploratory analyses to develop dyadic models for sero-discordant couples in which partners are not exchangeable in terms of risk [ 15 ]. We will also explore factors associated with the magnitude of treatment effects i.

Effect modification will be evaluated directly through random effects models or as multiplicative composites in GEE models. Hypothesis testing will implement an intention-to-treat approach. Missing data introduce uncertainty about unobserved values and their potential influence on parameter estimates and study conclusions [ 1617 ]. Application of recent developments in non-ignorable data i. Sensitivity analyses will determine the latino men having sex to which conclusions depend on the assumptions about unobserved values [ 20 ].

Identification of latino men having sex data patterns will ensure that relevant covariates are included implicitly i. Based on our previous research with Latino MSM, we do not expect attrition or missing data to be a significant issue; however, we are dark and Jacksonville Florida slender still seeking prepared in the event that it occurs.

Autocorrelation was estimated to be 0. Power analyses also utilized an effect size involving a 12 percentage point increase in HIV-protected acts i. We hope that findings from this study will help reduce the impact of HIV on Latino male couples. We latino men having sex dissemination as an naughty married women in Jasper, multi-directional process. Not only must these efforts be guided by science, but latino men having sex approaches must be tailored to the intended audiences.

Our anticipated audiences include 1 scientists, 2 prevention practitioners, 3 policy-makers, and 4 the community at-large. For the scientific community, we will use traditional dissemination vehicles, including manuscripts and presentations at international and national meetings. Insights gathered from the first two CAB meetings have already served as the basis for an oral presentation at the American Public Health Association conference, focusing on the development of effective health communication strategies for recruiting and engaging Latino MSM.

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We plan oatino assist our local health department in planning initiatives and will explore other vehicles with our community partners to maximize utilization of our findings by local HIV prevention practitioners. Finally, we will present our findings to community-based organizations and their clients at seminars and workshops, and latino men having sex work collaboratively to explore the relevance of the findings to their unique circumstances and settings.

The evidence indicating that HIV transmission often occurs within primary relationships [ 56 latino men having sex suggests that focusing HIV risk reduction efforts on male couples may present latino men having sex critical — albeit often overlooked — opportunity to reduce the my last Newport news for an older woman of HIV among MSM.

Moreover, the need for HIV prevention interventions to be culturally tailored and otherwise context sensitive is highlighted by a growing body of evidence supporting greater efficacy among such interventions [ 14 ]. The present study and related intervention make several advances in this area of HIV mdn, and build upon previous work in several innovative ways.

Second, we are intervening at the level of the couple, where a high proportion of HIV transmission occurs.

Intervening at this level offers a number of advantages over individual level interventions, and provides the opportunity to influence safer sex practices among two individuals simultaneously, to strengthen couple dynamics and relationship communication skills, in turn enhancing safer sex decision-making and negotiation skills, and to engage individuals who may not otherwise latino men having sex targeted for individual-level prevention efforts, despite latino men having sex for HIV infection.

These benefits have the potential to low self esteem girl and enhance the broader public health impact of the intervention. The resulting intervention, CLP, can thus advance more quickly through the testing process and be ready for widespread community implementation more rapidly.

Despite its unique advantages, there are several limitations. We will recruit a convenience sample, which limits generalizability. We acknowledge that the sample may not reflect the general population of Latino MSM. The budgetary constraints and the length of the project period of the MARI initiative limit our ability to include a month follow-up. Thus, while we may detect change at 3 or 6 months post intervention, we will not be able to determine if the effects are sustained over time.

Our sample size, although adequate latino men having sex test for intervention effects, is not powered for efficacy. Thus, we cannot test the effects of moderators or mediators; moderation and mediation analysis are exploratory. Our primary outcome is limited to sexual activity with main partners. While appropriate for testing a couple-based intervention, we recognize that the HIV nyc escort ads and protection with outside partners should also be considered.

We will be conducting these as secondary analysis. The present study not only advances HIV prevention research, but more importantly, if CLP results in significant behavior change, it holds promise in helping to reduce the HIV epidemic among Latino male latino men having sex. Centers for Disease Control and Prevention.

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Responses to a 1 month self-report on adherence to antiretroviral therapy are consistent with electronic data and virological treatment outcome. Chesney MA, et al. Homosexually and nonhomosexually identified men who have sex with men: J Sex Res. Arch Sex Behav. Sexual latino men having sex, condom use, disclosure of sexuality, and stability havung sexual orientation in fun free chat sites men.

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Bloomington, Ind: Indiana University Press; Behavior patterns and sexual identity of bisexual males. Rust PCRed. Bisexuality in the United States: A Social Science Reader. New York, NY: Columbia University Press; Toward an understanding of behaviorally bisexual men: Can J Hum Sex. Dual Latino men having sex Understanding Bisexuality. Oxford University Press; Hutchins LKaahumanu L, eds.

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Chicago, Ill: University of Chicago Press; The Social Organization of Sexuality: Sexual Practices in the United States. Sandfort TGM. Homosexual and bisexual behaviour in European havimg. UCL Press; Sexual risk behavior, viral load and perceptions of HIV latino men having sex among homosexually active Latino men: An exploratory study.

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Pacific Grove, Calif: Duxbury; Parker R. Masculinity, femininity and homosexuality: J Homosex. Bodies, Pleasures and Passions: Havihg Culture in Contemporary Brazil. Boston, Mass: Beacon; Carrier J.

De Los Otros: Intimacy and Homosexuality Among Mexican Men. Lancaster R. Life Is Hard: Machismo, Danger, and the Intimacy of Power in Nicaragua. Berkeley and Los Angeles, Calif: University of California Press; Schifter J. Public Latino men having sex in a Latin Society. Binghamtom, NY: Aggleton P, ed. Bristol, Penn: Taylor and Francis; De Moya and Haing, A. Taylor and Francis. Beyond MSM.

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Sexual desire among bisexually active Latino men in New York Lahino. Bisexual practices: J Bisex. Carrillo, H. The Night Is Young: Looking for a tall, dark, macho man: Cult Health Sex. HIV sexual risk reduction interventions with heterosexual men: AIDS Behav. At latino men having sex or not? Susceptibility of women using family planning services in an AIDS epicenter. Fuller N.