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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 CDC’s 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 CDC’s 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 Who’s got the power?

– #3 Why we choose the ones we choose -

are you a Top or a Bottom?

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Session 1:Dual 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 2:STD / 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 3:STD/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 5:Relationship 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 one’s 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 fit—consequences 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.org)

Should be completed by funded agency in collaboration with CDC project officer.

Running record of funded agency’s progress in implementing the intervention

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Many Men Many VoicesMany 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

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Many Men Many VoicesMany 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