Table 3.

Intervention content areas adapted from existing interventions or added to address local needs in Brazil

Core component (5)	Risk-reduction messages from US interventions (38)	Specific content adapted for Brazil	Specific content added for Brazil
Risk information	HIV basic information Sexual transmission Other sources of transmission Condom facts SMI vulnerability to HIV/AIDS HIV treatment and adherence Re-infection STIs IDU, needle-cleaning methods	Myths/misconceptions and facts about HIV/AIDS – address beliefs and religiosity Brazil-Rio-SMI vulnerability Needle availability	Sex and healthier/safer sexuality
Enhance awareness of attitudes, intentions, and readiness for change	Personalizing risk Relative risk of behaviors Building motivation Empowerment Commitment Masculinity Homosexuality Peer advocacy and education/training Ethics of transmitting HIV	HIV testing	Social responsibility—protecting self and the community Self-expression and sexual freedom
Acquire and rehearse sexual risk-reduction behavioral skills (e.g., condom use, sexual assertiveness, and negotiation of safer sex practices)	Condom use Pros and cons of condom use Barriers to condom use Condom-use demonstration and practice Dental dam-use demonstration and practice Female condom-use demonstration and practice Self-efficacy using condoms Lubricant information and demonstration	Sex exchange Focus exercises to address Make condom use sexy using local content	Communication exercises using local model (Theater of the Oppressed)
	Sexual assertiveness Empowerment Applying safer sex skills Negotiation of safer sex practices Negotiating condom use Modeling communication	Intimate relationships Address mental illness stigma Address gender issues Refusal to have sex and sexual violence
Problem-solve how to handle factors that precipitate high-risk sex (including those in which alcohol and other drug use plays a role)	Strategies to avoid risky situations Reframing unsafe sex experiences into safer experiences Consolidating problem solving Consolidating condom skills Triggers to unsafe sex Identifying individual risk scenarios for managing risky behaviors Alcohol and drugs	Stigma added to triggers	Communication with health care providers about the impact of psychiatric medications on sexual health and risk behaviors
Reinforce behavior changes made between intervention sessions and post-intervention	Relapse prevention Goal maintenance	Homework to address peers and sexual partners	Homework to address family and relatives Song with lyrics about safer sex, social responsibility and maintenance of a healthier/safer sexuality