Bright Spot: Voices/Voces

Photo by Charles Deluvio on Unsplash

This bright spot was originally published in the 100 Million Healthier Lives Change Library and is brought to you through partnership with 100 Million Healthier Lives and the Institute for Healthcare Improvement.


Detailed Description

VOICES/VOCES is a group-level, single-session, video-based intervention designed to increase condom use among heterosexual African American and Latino men and women who visit STD clinics. Information on HIV/STD risk behavior and condom use is delivered by viewing a culturally-specific video.

Expected Outcomes

The objectives of VOICES/VOCES are to:

  • Increase knowledge about HIV/STD transmission
  • Develop realistic personal risk assessments Increase intention to use condoms
  • Increase skills for effective condom negotiation Increase consistent condom use
  • Reduce STD infections

Key Lessons Learned

The following core elements are essential and cannot be ignored, added to, or changed:

  • Show-culture specific videos portraying condom negotiation
  • Convene small-group skill-building sessions to work on overcoming barriers to condom use
  • Educate clients about different types of condoms and their features
  • Distribute samples of condoms identified by clients as best meeting their needs

Cost Details

As of July 2014, the cost of this intervention is as follows:

  • Costs for personnel Costs for condoms (CBOs should budget for a diverse supply)
  • Costs for equipment (TV and DVD player)
  • $130 for VOICES/VOCES Intervention Kit
  • Cost for supplemental DVDs

For the latest cost details, please contact the VOICES/VOCES program directly.

Key Steps for Implementation


  • Review intervention kit materials, behavior change logic model, and curriculum to understand the theory and science behind the intervention
  • Assess available resources and cost of implementation
  • Develop program budget Identify appropriate setting, place, and equipment Assess agency and staff capacity to conduct VOICES/VOCES
  • Create administrative and staff buy-in
  • Identify methods to recruit population at risk for HIV/STDs
  • Hire staff that are culturally appropriate skilled small group facilitators; send to VOICES/VOCES training (if targeting MSM population)
  • Inform local/state health officials about VOICES/VOCES to gain support
  • Gather baseline data/information about the target population
  • Plan and implement procedures to integrate VOICES/VOCES into flow of agency services and program
  • Develop and implement marketing and recruitment plan
  • Complete the Implementation Planning Worksheet
  • Develop program monitoring and evaluation plan to improve program and for quality assurance
  • Design evaluation tools, conduct data collection, data analyses, interpretation, and reporting


  • Plan VOICES/VOCES program schedule, logistics (time, days, space)
  • Implement marketing and recruitment plan Select appropriate videos for target populations
  • Conduct VOICES/VOCES sessions with fidelity: Health educators convene groups of 4-8 clients for a single, 45-minute session
  • Whenever possible, groups are uniform in gender and ethnicity so clients can customize culturally appropriate prevention strategies
  • The actors in the videos present information on HIV/STD risk behavior and model condom use and negotiation
  • In the following small-group discussion, condom negotiation is role-played, practiced, and discussed
  • A poster is then used to show features of various condom brands in English and Spanish
  • At the end of the session, clients are given samples of the types of condoms they have identified as best meeting their needs
  • Request technical assistance before, during, and after conducting sessions
  • Assess need for adapting based on data about target populations HIV/STD risk behaviors, risk factors, and cultural characteristics
  • If necessary, adapt intervention to target population; revise logic model and request technical assistance; if necessary obtain CDC project officer approval
  • Obtain and utilize consumer community stakeholder input on VOICES/VOCES
  • Implement Program Monitoring and Evaluation Plan, refine tools if needed

Policies, Laws and Regulations

CBOs must know their state laws regarding disclosure of HIV status to sex and needle-sharing partners; CBOs are also obligated to inform clients of the organization's responsibilities if a client receives a positive HIV test result and the organization's potential duty to warn. CBOs also must inform clients about state laws regarding the reporting of domestic violence, child abuse, sexual abuse of minors, and elder abuse.

Special Infrastructure

VOICES/VOCES can use existing clinic and CBO space. The main requirement is a private, quiet room for having confidential discussions and watching videos. Possible sites include STD clinics, family planning clinics, community health centers, CBOs, drug treatment centers, and prisons and jails.

  • Preview Guide of materials for agency administrators Bilingual (English/Spanish) planning and implementation manual Bilingual (English/Spanish) condom poster
  • Five videos to target both African American and Latino participants
  • Do It Right is aimed at African American, heterosexual men and women
  • It's About You is a telenovela (soap opera) - style video aimed at English-speaking or bilingual, heterosexual Latino men and women
  • Se Trata De Ti is a telenovela-style video aimed at Spanish-speaking, heterosexual Latino men and women
  • Porque Si targets Latino men and women
  • Safe in the City consists of three soap-opera style vignettes and two animated clips. The characters in this video are more ethnically diverse (African American and Latino) Penile model and sample condoms (CBOs should budget for at least 3 condoms per person in the intervention) Television and DVD player


If using VOICES/VOCES for MSM populations: It is strongly recommended that 2-3 staff members per organization attend a VOICES/VOCES training. Training is also recommended for program coordinators, group facilitators, program managers, and executive director's of the organization. Staff that will facilitate the sessions are required to attend training.

Types of Staff

1-2 facilitators to recruit clients, show the video, and run the small-group skill-building sessions Program coordinator/manager Public Health Educators

Outcome Measures

Changes in attitudes in intentions to obtain condoms and regularly use condoms. Changes intentions to change risk behaviors. Changes in knowledge and attitudes about condom features, types, use, and strategies for obtaining them. Improved perception and skills in negotiating condom use. Increased HIV/STD transmission knowledge. Decrease in STD prevalence rates among intervention participants. Increase in HIV/STD testing rates among intervention participants

Process Measures

  • Number of samples of condoms identified by participants as best meeting their needs distributed, Length of sessions
  • Demographic data from individual/families (e.g., geographic location, gender, race/ethnicity, sexual orientation, educational level). Behavioral risk data from individual/families (e.g., information on behavioral intentions, information on sexual risk behaviors, STD prevalence data). Challenges/issues and best practices identified by facilitators, program supervisors, and intervention observers
  • Number of small group sessions conducted during 3-month period. Proposed number of small group sessions noted in the implementation plan or described in work plan objectives

Program Theory Documents

Logic Model and Summary Implementation Plan


Webpage for VOICES/VOCES
VOICES/VOCES: Video Opportunities for Innovative Condom Education
Resource - Website/webpage
Brought to you by CDC

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