Ending the HIV and Stigma Syndemic: Re-framing Health Education Content for Southern Black Churches

项目总结 为了响应RFA-PS-21-001少数民族艾滋病毒研究倡议(MARI)，该项目的目标是 应用是使用基于社区的参与性研究和干预地图来 解决结束艾滋病毒流行的优先事项：为美国制定的计划。我们将使用3年期 利用艾滋病毒监测数据和光声讲述污名内在化的时期 由公共卫生署经历，以告知、实施和评估受圣经启发、以教会为基础的 为孟菲斯以黑人为主的宗教会众量身定做的干预 大都市区，已被确定为深海司法管辖区的高负担 南。在第一阶段，我们将分析社区监测数据，以确定保护因素和 可能促进和阻碍艾滋病毒预防工作的行为风险。这些 随后的数据将为试点干预提供信息。在第二阶段，我们将随机分配N=10 教会对艾滋病的教育+干预和额外的N=10个教会的标准 艾滋病教育干预(控制)武器。在这些教堂中，我们将随机选择n=10 每个教会的会众(总数n=200名会众)，并进行一项调查，评估各种 健康促进行为、感知的艾滋病毒风险、PrEP知识、艾滋病毒检测历史，以及 与艾滋病毒有关的态度/信念(即，污名)。独一无二的文化和文脉景观 孟菲斯城市/农村大都市区融合了历史信仰和观点， 间接归因于艾滋病毒相关的耻辱。拟议的研究将利用一个 建立了由LGBTQ+守门人、信仰领袖和学术研究人员组成的艾滋病毒联盟 解开一些可能导致HIV种族的已知和未知决定因素 南方腹地的不平等现象。最终，我们预计这项研究将为后续的 更大规模的疗效试验。公共卫生的意义包括使艾滋病毒预防和治疗正常化 测试行为，促进减少耻辱，并获得基于信仰的伙伴关系，这 与孟菲斯EHE计划中详细说明的当前优先事项相吻合，这两个计划都涉及“诊断”和 “款待”支柱。

PROJECT SUMMARY In response to RFA-PS-21-001 Minority HIV Research Initiative (MARI), the goal of this application is to use community-based participatory research and intervention mapping to address priorities of Ending the HIV Epidemic (EHE): A Plan for America. We will use the 3-year period to leverage HIV surveillance data and photovoice narratives of internalizations of stigma experienced by PLWH to inform, implement, and evaluate a biblically-inspired, church-based intervention tailored for predominantly Black religious congregations located in the Memphis metropolitan area, which has been identified as a high burden EHE jurisdiction in the Deep South. In Phase 1, we will analyze community surveillance data to identify protective factors and behavioral risks which may facilitate and impede HIV prevention efforts, respectively. These data subsequently will inform the pilot intervention. In Phase 2, we will randomly assign N=10 churches to the HIV education + intervention and an additional N=10 churches to the standard HIV education intervention (control) arms. Within these churches, we will randomly select n=10 congregants per church (Total n=200 congregants) and administer a survey assessing a variety of health promoting behaviors, perceived HIV risk, knowledge of PrEP, HIV testing history, and HIV-related attitudes/beliefs (i.e., stigma). The unique cultural and contextual landscape of the Memphis urban/rural metropolitan area blends historical beliefs and perspectives that have indirectly attributed to HIV-related stigma. The proposed research will utilize the expertise of an established HIV coalition of LGBTQ+ gatekeepers, faith leaders, and academic researchers to disentangle some of the known and unknown determinants that may contribute to HIV racial inequities in the Deep South. Ultimately, we anticipate this research will inform a subsequent larger efficacy trial. The public health significance includes normalizing HIV prevention and testing behaviors, promoting stigma reduction, and garnering faith-based partnerships, which dovetail current priorities detailed in the Memphis EHE plan addressing both ‘diagnose’ and ‘treat’ pillars.