Photo Credit: Aaron Amat

Peer-led interventions for improving HIV prevention among Latino MSM exist, but research is needed before they can be fully implemented and used effectively.

Although there are a variety of peer-led interventions to help Latinx MSM adhere to HIV care and prevention, many programs are still in their infancy and need more research to maximize their potential, according to findings published in Current HIV/AIDS Reports.

Research has shown that the Ending the HIV Epidemic plan cannot succeed without addressing ethnic and racial disparities in access to prophylaxis and care, Jahn Jaramillo, MPH, PhD candidate, and colleagues noted. Latinx MSM experience a disproportionate HIV burden and are underserved by current prevention and care outreach measures.

“While there is limited research on culturally appropriate peer-driven interventions for LMSM, a growing body of literature have identified peer-led interventions in systematic reviews assessing HIV testing, treatment, and PrEP outcomes among LMSM,” Jaramillo and colleagues wrote. “Specifically in the case of PrEP, LMSM’s timely and consistent access is hindered by financial, logistical, social, and provider-related barriers, which limit the potential of PrEP to reduce HIV transmission among LMSM.”

Jaramillo and colleagues conducted a scoping review of the available literature regarding peer-led strategies for delivering HIV care and prevention to Latinx MSM. The goal of the study was to characterize and quantify peer-led adjunctive HIV prevention or care interventions for Latinx MSM.

Reviewing Peer-Led Interventions in Latinx MSM

The researchers reviewed 23 articles covering 17 different adjunctive interventions. Nine studies had populations composed only of Latinx MSM. Most (83%; n = 19) were conducted in the US.

While noting that language barriers are among the factors impacting access to HIV interventions, the reviewers found that seven studies (30%) conducted their major activities entirely in Spanish, three studies (13%) conducted their major activities in both Spanish and English, and four (17%) conducted their major activities entirely in English.

More than half of the interventions (57%) were directed at individuals, 30% were in group settings, 4% were for couples, and 4% were public campaigns.

The most common outcome was HIV testing uptake (74%), whereas 22% had PrEP uptake as an outcome, 4% had PEP uptake as an outcome, and 39% had treatment linkage as an outcome, according to the researchers.

Jaramillo and colleagues noted that the programs described in these studies were in various stages of development. When information on implementing the interventions was available, the reviewers classified them on a translational phase scale ranging from “formative” to “implementation,” with the final phase being “broad scale up.” They found that 22% were in the formative stage, 26% were in the pilot stage, 22% were in the efficacy stage, and 22% were in the effectiveness stage.

Tailoring Outreach to Latinx MSM

The researchers also investigated how these interventions were adapted for the population they served. They described interventions as using two different kinds of cultural tailoring: surface-level and deep-level.

Surface Adaptions

• Translating messages into Spanish
• Incorporating race-related stress and resiliency components
• Hiring bilingual peers, which tailored the intervention without changing its content

Deep Adaptions

• Modifying the content of the intervention
• Changing strategies
• Changing delivery methods to meet cultural norms and valueshom

Only 17% of the included studies made deep cultural adaptations to the peer-led adjunctive interventions. Surface-level adaptations were uncommon, with only 22% of studies using surface cultural tailoring.

The researchers acknowledged that the study’s design—a scoping review—limited it because it did not review effect size or quality. However, its strengths included using multiple databases with no language or geographic limits, including interventions at different stages, and identifying areas for future research in this population.

“These insights offer valuable guidance for future research and the development of interventions that are responsive to the diverse needs of Latino MSM, ultimately contributing to improved health outcomes and health equity,” Jaramillo and colleagues wrote.