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Employment as HIV Prevention: Adapting an Employment-focused Intervention to Achieve HIV-Related Health Equity among Latino SMM Born Outside the US
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DOI：10.1007/s13178-026-01379-6.png)
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Abstract
En 中文
In South Florida, a high-priority region within the federal Ending the HIV Epidemic initiative, a substantial proportion of new HIV diagnoses among Latino men who have sex with men (LSMM) occur in the context of employment-related barriers, language needs, and nativity-related challenges that undermine HIV prevention and care engagement. We applied the ADAPT-ITT framework to adapt Work2Prevent, an evidence-based “employment as HIV prevention” structural intervention, for Spanish-speaking LSMM born outside of the US. Focus groups with 12 LSMM and 13 topical experts were conducted, and rapid qualitative analysis identified six overarching themes and 15 subthemes to guide intervention adaptations. Participants viewed an adapted Work2Prevent as potentially valuable and unique for LSMM (Theme 1), though proposed modifications to enhance its acceptability and appropriateness, including: (2) centering immigrant and LGBTQ+ worker rights, (3) grounding the intervention in lived experience through language, design, and representation, (4) building foundational skills and flexible pathways to employment, and (5) supporting wellbeing, belonging, and connection. To improve feasibility, participants emphasized (6) developing strategic and flexible implementation models to enhance delivery and reach. The adapted intervention addresses this feedback for future piloting, and the lessons learned and articulated here can be applied to other employment interventions or programs for LSMM addressing this important structural driver of HIV disparities. Findings underscore the relevance of employment as a social determinant of health in shaping immigration-informed, status-neutral HIV prevention and care approaches for Latino sexual minority men, particularly when grounded in input from community partners.
Keywords:
Latino MSM
Status-neutral HIV interventions
ADAPT-ITT
Employment as HIV prevention
Immigration-related stress
Structural interventions
Work2Prevent
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