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"It Had a Lot of Cultural Stuff in It": HIV-Serodiscordant African American Couples' Experiences of a Culturally Congruent Sexual Health Intervention.

Mthembu J, Hamilton AB, Milburn NG, Sinclair D, Mkabile S, Mashego M, Manengela T, Wyatt GE. "It Had a Lot of Cultural Stuff in It": HIV-Serodiscordant African American Couples' Experiences of a Culturally Congruent Sexual Health Intervention. Ethnicity & disease. 2020 Apr 23; 30(2):269-276.

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Objective: The increased life expectancy of people living with HIV has brought about an increase in serodiscordant couples, in which there is risk of HIV transmission. Therefore, interventions that promote sexual health and reduce risk are critical to develop for these couples. Given the disproportionate burden of HIV among populations of color, it is also critical that these interventions are culturally congruent. The EBAN intervention for African American serodiscordant couples recognizes the centrality of culture in shaping sexual behaviors and helps couples develop intimacy and positive prevention behaviors. The analytic objective of our study was to examine the knowledge and awareness gained by participants in the intervention. Participants: Participants (n = 17) who completed at least half of the eight intervention sessions. Methods: Brief post-implementation semi-structured interviews were conducted between January 1, 2016 and December 31, 2016. Team-based, targeted content analysis focused on knowledge and awareness gains. Results: Participants described learning about sexual health, expanded sexual options, and sexual communication. The "EBAN café," a component that gives couples a menu of options for safer sex behaviors, was particularly popular. Participants also noted the value of learning how to communicate with one another about their sexual health-related concerns and preferences. They appreciated the "cultural stuff" that was infused throughout the sessions, including the emphasis on learning from one another as couples. Conclusions: Couples at risk for HIV transmission benefit from strengthening skills and knowledge related to healthy sexuality. A behavioral intervention that aligns with cultural values and imparts culturally congruent sexual health information appeals to couples who seek ways to enhance their intimacy and sexual options while also reducing risk.

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