P AGE Facilitator’s Guide i IMPORTANT INFORMATION FOR USERS This HIV/STD prevention intervention is intended for use with persons who are at high risk for acquiring or transmitting HIV or sexually transmitted diseases (STDs), or both, and who are voluntarily participating in the intervention. The materials in this intervention package are not intended for general audiences. The intervention package includes an implementation manual, training and technical assistance material, and other items used in intervention delivery. The package also includes the following: (1) the Centers for Disease Control and Prevention (CDC) fact sheet on male latex condoms, (2) the CDC Statement on Study Results of Products Containing Nonoxynol-9, (3) the Morbidity and Mortality Weekly Report (MMWR) article “Nonoxynol-9, Spermicide Contraception Use—United States, 1999,” (4) the ABC’s of Smart Behavior, and (5) CDC guidelines on the content of HIV educational materials prepared or purchased by CDC grantees (Content of AIDS-Related Written Materials, Pictorials, Audiovisuals, Questionnaires, Survey Instruments, and Educational Sessions in CDC Assistance Programs). Before you conduct this intervention in your community, all materials must be approved by your community HIV review panel for acceptability in your project area. Once approved, the intervention package materials are to be used by trained facilitators who will implement the intervention. ACKNOWLEDGMENTS The Many Men, Many Voices (3MV) Facilitator’s Guide was developed with funding from CDC. Dr. Hank Tomlinson of the Capacity Building Branch (CBB), Division of HIV/AIDS Prevention (DHAP), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), led the conceptualization, development, and distribution of this manual. Dr. David Whittier of the CBB also participated in its development. Significant contributions were made by Patricia Coury-Doniger of the Center for Health & Behavioral Training (CHBT); Gary English; and the staff at ICF Macro, an ICF International Company. We thank Alvin Dawson and Ezekiel Goodwin for providing essential feedback and piloting the intervention materials. We also thank all of the men who participated in the pilot intervention. Finally, we wish to acknowledge the ICF Macro staff members who developed and produced this manual with the support of Dr. David Cotton, ICF Macro’s HIV project director. 3MV DECEMBER 2010 P AGE Facilitator’s Guide ii PROJECT STAFF CDC Technical Monitors Hank Tomlinson, PhD David Whittier, PhD Center for Health & Behavioral Training (CHBT), University of Rochester Patricia Coury-Doniger, FNPC Independent Consultant Gary English, HIV Prevention Consultant ICF Macro Warren Passin, MSW, MPH Tai Edward Few, MDiv Seseni Nu, MPH, MA Sonya L. Shropshire, MS, MEd Ronique Raynor, BS Graphic Design and Desktop Publishing ICF Macro Publications Department For More Information, Please Contact: Hank Tomlinson, PhD Behavioral Scientist Science Application Team Capacity Building Branch Division of HIV/AIDS Prevention National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Centers for Disease Control and Prevention 1600 Clifton Road, MS E40 Atlanta, GA 30333 E-mail: [email protected] 3MV DECEMBER 2010 P AGE Facilitator’s Guide iii TABLE OF CONTENTS Preparing to Conduct 3MV Sessions .................................................................. 1 FACILITATOR ROLES AND RESPONSIBILITIES .................................................................. 1 Training and Practice Sessions ...................................................................................... 2 Qualities of Effective 3MV Facilitators .......................................................................... 3 GENERAL FACILITATION TIPS ....................................................................................... 6 Preparing for Each Session ............................................................................................ 6 Using the 3MV Facilitator’s Guide ................................................................................. 7 Understanding the Purpose of 3MV (Making the Connections) ................................... 7 Managing Group Dynamics .......................................................................................... 15 Setting and Enforcing Ground Rules ........................................................................... 15 Dealing With Challenging Participants ....................................................................... 15 Managing Time ............................................................................................................. 18 Managing Role-Plays ................................................................................................... 19 Getting Participants to Attend the Sessions .............................................................. 20 Evaluating the Sessions and Debriefing ..................................................................... 20 Session 1: Black Men Who Have Sex With Men (MSM) and Dual Identity ..... 23 PURPOSE ................................................................................................................ 23 SESSION OBJECTIVES ............................................................................................... 23 FACILITATOR TIPS .................................................................................................... 23 Session 1: Black Men Who Have Sex With Men (MSM) and Dual Identity ............... 27 Materials Checklist ...................................................................................................... 27 Exercise 1.1 Welcome and Introductions ................................................................... 29 Exercise 1.2 “Why We Do the Things We Do” Factors That Influence Behavior Change .......................................................................................................................... 33 Exercise 1.3 Dual Identity ............................................................................................ 37 Exercise 1.4 Making the Connection .......................................................................... 41 Exercise 1.5 Session Summary ................................................................................... 45 TABLE OF CONTENTS 3MV DECEMBER 2010 P AGE Facilitator’s Guide iv Session 2: STD/HIV Prevention for Black MSM—The Roles and Risks for Tops and Bottoms .............................................................................................. 47 PURPOSE ................................................................................................................ 47 SESSION OBJECTIVES ............................................................................................... 47 FACILITATOR TIPS .................................................................................................... 48 Session 2: STD/HIV Prevention for Black MSM—The Roles and Risks for Tops and Bottoms ........................................................................................................................ 51 Materials Checklist ...................................................................................................... 51 Exercise 2.1 Session Preview ...................................................................................... 53 Exercise 2.2 Tops and Bottoms: Roles and Risks ...................................................... 55 Exercise 2.3 What Do You Know About STDs and HIV for Black Gay Men? .............. 59 Exercise 2.4 How Do You Get an STD or HIV? ............................................................. 73 Exercise 2.5 Sex in the City: An Inside View............................................................... 77 Exercise 2.6 Transmission Puzzle ............................................................................... 89 Exercise 2.7 Session Summary ................................................................................. 101 Session 3: STD/HIV Risk Assessment and Prevention Options ................... 103 PURPOSE .............................................................................................................. 103 SESSION OBJECTIVES ............................................................................................. 103 FACILITATOR TIPS .................................................................................................. 103 Session 3: STD/HIV Risk Assessment and Prevention Options ............................... 107 Materials Checklist .................................................................................................... 107 Exercise 3.1 Session Preview .................................................................................... 109 Exercise 3.2 Creating a Menu of Options for STD/HIV Prevention ......................... 111 Exercise 3.3 Take Your Own Inventory ...................................................................... 115 Exercise 3.4 My Personal HIV/STD Risk Behaviors ................................................. 119 Exercise 3.5 Session Summary ................................................................................. 123 TABLE OF CONTENTS 3MV DECEMBER 2010 P AGE Facilitator’s Guide v Session 4: Intentions to Act and Capacity for Change ................................. 125 PURPOSE .............................................................................................................. 125 SESSION OBJECTIVES ............................................................................................