La Nueva Generación, a collaborative effort between the César E. Chávez Institute and San Francisco’s Mission Neighborhood Health Center (MNHC) was designed to test the effectiveness of an HIV prevention program that targets low-SES, Spanish-speaking, Latino, immigrant men who have sex with men (MSM) in the San Francisco Bay Area, a population with high and well-documented vulnerability to HIV infection.
The program evaluated, Hermanos de Luna y Sol (HLS), has been in existence for over 14 years. HLS was initially funded and developed as a component of a larger CDC grant to MNHC, and it is currently funded by the San Francisco Department of Health (SFDH). Guided by Diaz’ research on sociocultural and contextual factors that predict high-risk behavior in this population, the HLS program intervenes in a culturally appropriate manner to reduce the incidence of unprotected anal intercourse through the following four specific aims:
- Provide experiences of social support, social belonging, and enhanced self-esteem in the context of a Latino gay identity and community;
- Promote critical awareness of social and cultural forces (e.g., homophobia, racism, poverty and forced migration) that impact and shape participants’ social and sexual lives;
- Increase participants’ sexual self-knowledge, with particular emphasis on sexual contexts and situations of personal vulnerability that limit participants’ ability to practice safer sex; and,
- Facilitate community involvement and activism to support a sense of increased personal agency and self-efficacy (instead of fatalism and victimization) in response to oppressive social forces in participants’ lives.
Program participants receive HIV prevention services in three major modalities:
- An initial group intervention for new participants, implementing a pre-determined HIV prevention curriculum that promotes a sense of social belonging and critical thinking about the social factors and contextual barriers that compete with safer sex intentions;
- A weekly discussion/support group for graduates of the initial group intervention, aimed at providing ongoing social support and open reflective communication to sustain behavior change over time; and
- Individual risk reduction counseling to address individual prevention needs of those participants whose marked vulnerability to HIV risk -- due perhaps to mental health or substance abuse problems -- merits individual attention.
In addition, the program supports ongoing community involvement through drop-in sessions, bimonthly social “Encuentros” and facilitates members’ participation in social events and activities that promote the rights of Latino immigrants and LGBT individuals.