Randomized Controlled Trial of a Group Cognitive Behavior Therapy HIV Prevention Intervention for Immigrant Latino Gay, Bisexual, and Other Men who Have Sex with Men

Latino gay, bisexual, and other men who have sex with men (LGBMSM) are disproportionally affected by HIV in the U.S. We tested a culturally tailored community-based group HIV prevention intervention ("Siempre Seguiré") for immigrant LGBMSM that uses cognitive behavior therapy to address coping with intersectional stigma and medical mistrust. A total of 289 immigrant LGBMSM were randomized (144 control, 145 intervention) and completed surveys at baseline and 4-, 8-, and 12-months (79% retained). Intention-to-treat repeated-measures regressions indicated significant intervention effects on higher HIV testing and reduced internalized Latino and sexual minority stigma, anticipated HIV stigma, stigmatizing PrEP beliefs, and medical mistrust. Intervention cost-effectiveness was $876 per 10% increase in HIV testing per participant, which improved to $600 excluding fidelity and recruitment costs (which would likely be minimal for implementation). To expedite efforts to end the HIV epidemic, research is needed to determine strategies to implement, disseminate, and sustain Siempre Seguiré.