Development and Use of Vignettes in HIV Prevention Research with Young Latino Sexual Minority Men (YLSMM)

Background and Purpose:

Vignettes are short stories about a hypothetical person or situation, commonly used within research on sensitive topics such as HIV prevention. In social and behavioral research, vignettes can be used to gather qualitative data that captures the lived experiences and perspectives of the affected populations. Unlike traditional research approaches that often exclude the nuanced realities and diverse perspectives of participants, vignettes allow researchers to delve deeper into the lived experiences and contextual influences shaping behaviors. This study presents the development and use of vignettes in stigma reduction and HIV prevention research with young Latino sexual minority men (YLSMM). Our aim was to enhance our understanding of stigma experiences among YLSMM and inform tailored interventions.

Methods:

Our team conducted eight focus group discussions (n=26) and in-depth interviews (n=15) to better understand the experiences of intersectional stigma and resilience strategies among YLSMM aged 15–24 years. Data collection was conducted in English and Spanish. Thematic analysis of data was guided by the Health Stigma and Discrimination Framework. After thematically analyzing the transcripts, preliminary storylines were collaboratively developed by researchers and community partners. Storylines were vetted by community members, including YLSMM and members of the project’s youth advisory board. In addition to weekly meetings, a two-day workshop, co-facilitated by a member of the research team and a community partner, was conducted to develop and finalize the vignettes. The vignettes are available in English and Spanish.

Results

Four vignettes, or short stories about hypothetical young Latino men, were created. Each vignette offers a structured narrative encompassing different types of stigmas (internalized, enacted, anticipated, and perceived) associated with multiple stigmatized identities (race/ethnicity, sexual orientation, and perceived immigration status) and health conditions (HIV, mental health, substance use, and violence). The vignettes also illustrated stigmatizing practices perpetuated by family members, providers, and peers, occurring in multiple settings (schools, health clinics, workplaces, and media), stigma effects on mental health, and coping strategies. Positive (adaptive) and negative (maladaptive) coping mechanisms were included as the characters’ response to stigmatizing events. The hypothetical characters reflected the diversity of the Latine community through variation in nativity and immigration status, migration recency, language fluency and comfort, family support, and other sociodemographic characteristics that influence access to resources.

Conclusion and Implications

Drawing on principles of cultural humility and community engagement, the bilingual vignettes emerged from the collaborative efforts between university researchers and members of the Latine and LGBTQ+ communities in North Carolina. The vignettes offer a person-centered approach in exploring stigma and HIV and eliciting in-depth narratives. These hypothetical scenarios relevant to their lived experiences may create a safe space for YLSMM to reflect on their experiences, beliefs, and decision-making processes. The development of vignettes underscores the importance of employing culturally and linguistically appropriate methods in research. By amplifying the voices and experiences of YLSMM, this research approach can inform the development of culturally responsive and effective HIV prevention strategies that address the unique needs of young Latino sexual minority men.