Reducing HIV Stigma to Improve Health Outcomes for African-American Women

描述（由申请人提供）：美国疾病控制和预防中心提供了令人震惊的统计数据，表明近十年来，艾滋病毒和艾滋病一直是25至34岁非裔美国妇女死亡的主要原因。这一趋势还在继续。越来越多的研究表明，艾滋病毒感染者（PLWH）内化的耻辱感削弱了对挽救生命的抗逆转录病毒药物的依从性，尤其是对非洲裔美国人而言。鉴于耻辱与治疗利用之间的明显联系，很明显，为了提高对护理的参与，我们必须提供经过验证的有效干预措施，以减少与艾滋病毒相关的耻辱。为了应对这一需求，我们的研究小组采用了一种有效的干预措施，国际妇女艾滋病污名研究中心工具包，并将其转化为一种对识字率敏感的，多媒体的，内化的污名减少干预措施，可以通过一个8小时的研讨会来实施。我们的方法利用了Corrigan的“战略性污名改变”的最佳实践，并强调通过同伴促进和积极参与与PLWH联系。特别是，我们对感染艾滋病毒的非裔美国妇女进行了干预。在华盛顿州西雅图进行的干预措施可行性试点测试（根据参与者的反馈命名为“团结研讨会”）产生了令人鼓舞的结果。下一步，我们建议进行一项随机临床试验，以确定有效性，并更好地了解减少耻辱感的障碍和促进因素。我们的研究团队由耻辱感减少、依从性、护理参与、同伴主导的行为干预和干预研究方面的专家组成。他们位于华盛顿大学、阿拉巴马大学和西北大学（芝加哥），这些机构拥有广泛的艾滋病相关研究资源。我们期望统一研讨会能够通过一种易于传播的方法有效地减少内化的耻辱感，并对非裔美国感染艾滋病毒妇女的护理依从性和参与度产生积极影响。

DESCRIPTION (provided by applicant): The US Centers for Disease Control and Prevention presented alarming statistics demonstrating that for nearly a decade, HIV and AIDS had been the leading cause of death for African American women between the ages of 25 and 34. This trend has continued. A growing body of research has shown that the stigma internalized by people living with HIV (PLWH) undermines adherence to lifesaving antiretroviral medications, particularly for African Americans. Given the clear link between stigma and treatment utilization, it is clear that to improve engagement to care, we must provide proven, effective interventions to reduce HIV-related stigma. To begin to respond to this need, our research group has taken a well-utilized intervention, the International Center for Research on Women's HIV Stigma Toolkit, and converted it into a literacy-sensitive, multimedia, internalized stigma reduction intervention that can be implemented through an eight-hour workshop. Our approach makes use of Corrigan's best practices for 'Strategic Stigma Change,' and emphasizes making contact with PLWH through peer facilitation and active participation. In particular, we adapted the intervention for African American women living with HIV. A feasibility pilot test of the interventin (named the "Unity Workshop" based on participant feedback) in Seattle, Washington, produced encouraging results. As the next step, we propose to conduct a randomized clinical trial to establish effectiveness and to better understand barriers to, and facilitators of, stigma reduction Our study team is comprised of experts in stigma reduction, adherence, engagement in care, peer-led behavioral interventions, and intervention research. They are based at the University of Washington, University of Alabama, and Northwestern University (Chicago), institutions with extensive resources for HIV-related research. We expect that the Unity Workshop will demonstrate effectiveness in reducing internalized stigma through an easily-disseminated method, and that it will have a positive impact on adherence and engagement in care for African American women living with HIV.