Adapting an EBI for HIV Sexual Risk Prevention for Homeless Women

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DESCRIPTION (provided by applicant): Homeless women need highly accessible, community-based HIV sexual risk prevention services. Homeless women face greater risk of HIV/AIDS and substance use than low-income women who are housed. Evidence-based interventions (EBIs) can reduce HIV risk among highly vulnerable populations but dissemination is limited. EBIs may need to be adapted to suit homeless women's needs and their communities. The objective of this study is to produce an adapted EBI for HIV sexual risk prevention for homeless women that holds promise of translation into routine practice. The Specific Aims are as follows: Aim 1/Phase 1: Formative phase: (a) conduct focus groups (4 groups; 7-8 providers each) with shelter providers and semi-structured interviews with 4 HIV/AIDS service providers to assess the capacity and availability of resources for shelter providers to implement an EBI for HIV prevention; (b) systematically review EBIs and develop recommendations for adaptation; (c) conduct consensus group meetings with homeless women (2 groups; 14-16 women each) and shelter providers (2 groups, 14-16 providers each) to decide which EBI should be selected for adaptation and how it should be adapted; (d) consult with topical experts and prepare the adaptation of the selected EBI, and present and obtain feedback on the adapted EBI from homeless women and shelters providers through focus groups (4 groups, 7-8 women each; 4 groups, 7-8 providers each). Aim 2/Phase 2: Preliminary testing phase: (a) conduct pre-test of the adapted EBI with homeless women through focus groups (4 groups; 7-8 women each) and modify as necessary; (b) conduct pilot test of the adapted EBI with homeless women (10 groups; 7-8 women each); (c) finalize the adapted EBI with consultation from topical experts, and shelter and HIV/AIDS service providers; (d) plan for randomized controlled trial to test efficacy of adapted EBI for HIV prevention among homeless women. PUBLIC HEALTH RELEVANCE: Evidence-based interventions (EBIs) for preventing HIV/AIDS are critical, yet interventions tend not to be translated into routine practice in communities wher they are most needed due to poor fit with client needs and provider capacity. This study will advance public health through a collaboration with homeless women and providers in the Los Angeles downtown Skid Row and Westside to adapt an EBI for HIV sexual risk reduction for homeless women.