Community involvement has played a central role in the fight against HIV/AIDS since the beginning of the epidemic. Volunteers and activists led the first educational, prevention, and care activities and created community-based organizations in the most affected populations. They created a culture of safe sex in their communities. Furthermore, in the process of mobilizing, volunteers and activists transformed themselves. They became educated about the risks and prevention measures for HIV/AIDS; developed a sense of community and a positive self-identity in spite of the stigma associated with being gay and bisexual men in the times of HIV/AIDS; and mobilized their social networks and social support to cope with their individual and community stressors.
Thus, individuals’ community involvement may have critical public health implications. First, through their involvement in HIV/AIDS-related organizations and efforts, individuals develop and maintain a positive sense of themselves and become educated and conscious of HIV/AIDS risks and preventive behaviors. Second, via this involvement individuals affect change in their communities; and interventions are likely to be culturally appropriate and sustainable. Yet, research and prevention programs have overlooked community involvement as a mechanism to reduce HIV/AIDS sexual risk behavior among minority gay and bisexual men.
For the purposes of this study, we defined community involvement as a construct indicating individuals’ unpaid work on behalf of others or a collective good and in the context of a formal or semi-formal organization and social networks, that is, outside the home and the family. We refined and tested cultural and sexual identity-based theoretical models of the association between community involvement and HIV/AIDS sexual risk behavior using qualitative and quantitative methods.
Specifically this research aimed to:
1. Examine the protective effects of community involvement in HIV/AIDS for Latino gay and bisexual men’s sexual risk behavior. We tested the moderating effects of community involvement on the association between three socio-structural risk factors (i.e., poverty, racism, and homophobia) and sexual risk behavior.
2. Refine and test a model of the mediating factors of the association between community involvement and HIV/AIDS sexual risk behavior among Latino gay and bisexual men. The model identified and defined the mechanisms (i.e., peer norms, self-efficacy, positive self-identity, and alienation) by which community involvement affects HIV/AIDS sexual risk behavior.
3. Examine the socio-cultural barriers to and facilitators of Latino gay and bisexual men’s community involvement in HIV/AIDS (i.e., motives for participation, poverty, acculturation, stigma, and perceived opportunities).
The research aimed to offer three major contributions. It constituted the first empirical effort to study HIV/AIDS protective factors among Latino gay and bisexual men. In addition, it advanced the understanding of community involvement in HIV/AIDS, its operationalization and association with HIV/AIDS sexual risk behavior. To our knowledge, no previous research had empirically studied community involvement in HIV/AIDS and its effects on sexual risk behavior, especially among Latinos. Finally, this research provided the basis for future interventions at both community and individual levels.
This research was conducted in three phases. The first phase involved the refining of constructs. Using life history methods we defined the concept of community involvement in HIV/AIDS. We described the concept and its dimensions, and refined our theoretical models. In the second phase, we developed and tested measures in culturally relevant ways for Latino gay and bisexual men, and tested a survey instrument. The third phase of this research was the testing of the protective effects of community involvement (Aim 1), the model of the mediating factors (Aim 2), and the barriers/facilitators for community involvement (Aim 3) in a cross-sectional survey of Latino gay and bisexual men in Chicago (University of Illinois) and San Francisco (CCI/SF State).