This applied research project responds to a critical problem in health and development: how to effectively translate our research evidence to the communities with and for whom we work in order to stimulate successful, sustainable health promotion activities and social change. The tangible product of this research is a handbook for health and outreach workers from immigrant communities from the Horn of Africa living in Toronto. The handbook is a resource which will be used as a starting point for the generation of community-based health initiatives, in this case, HIV/AIDS prevention programs. The research applies a conceptual approach which emphasizes participatory action research theory and methodology, and equitable, transcontextual research partnerships. It uses a model which merges both scientific evidence and experiential (ethnographic) evidence of risk and vulnerability to create new understandings on which to base the development of health programs. Stories, grounded in ethnographic evidence, are at the heart of the research strategy. The handbook is an example of experimental ethnographic writing: dialogue is used to communicate research evidence, health, and skills information; and a number of personal narrative:s have been constructed as resources to help health workers generate dialogue on issues of risk and vulnerability, and begin a process of reflection and action. In a larger context, the lessons learned as this work is implemented and evaluated in the community will contribute to the knowledge of intervention science. The research also serves as an example of ethical anthropology and raises for discussion ethnography's future project at the tum of the century. With attention to how anthropologists represent their work, 'moral ethnography' can serve a larger human project, helping us better understand what it is to be human and stimulating moral conversations about how we want to live. / Thesis / Master of Arts (MA)

Thesis advisor: Kevin J. Mahoney / Recent empirical epidemiological and behavioral research has indicated that some secondary intervention preventions (e.g., condom use, HIV-disclosure, serosorting, etc.) might not be suitable for all HIV-infected gay and bisexual men, particularly for those who engage in multiple episodes of unprotected anal intercourse (UAI). The purpose of this dissertation was to answer the primary research question: What are the psychological, behavioral and contextual factors associated with HIV-infected men who have sex with men (MSM) who engage in risky sexual behavior? A qualitative descriptive approach was used to conduct a content analysis of 14 in-depth, semi-structured interviews and to provide a description of the lives of MSM who do not consistently use traditional secondary risk behavior strategies (e.g., safer-sex negotiation, condom use, etc.) to reduce HIV transmission among sexual partners, particularly those partners who are HIV-uninfected or whose HIV status is unknown. Risky sexual behavior was defined by HIV-infected MSM who had engaged in multiple episodes of UAI in the past three months. These interviews gathered preliminary data on the feasibility and acceptability of secondary HIV behavioral prevention strategies for MSM who engage in very risky sexual behavior. In addition, these data have identified descriptive themes that could be used to augment traditional secondary HIV invention preventions, creating new and specific risk-reduction strategies for this very high-risk group. / Thesis (PhD) — Boston College, 2011. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.