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出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。这一趋势仍在继续。越来越多的研究表明，艾滋病毒感染者（PLWH）内在的耻辱感破坏了对挽救生命的抗逆转录病毒药物的坚持，特别是对非洲裔美国人。鉴于污名化与治疗利用之间的明确联系，显然，为了改善对护理的参与，我们必须提供经证明有效的干预措施，以减少与艾滋病毒有关的污名化。为了开始应对这一需求，我们的研究小组采取了一项得到充分利用的干预措施，即国际妇女艾滋病毒污名化研究中心工具包，并将其转化为一项扫盲敏感、多媒体、内化的减少污名化干预措施，可以通过一个8小时的讲习班实施。我们的方法利用了科里根的“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艾滋病毒携带者接触。特别是，我们调整了针对感染艾滋病毒的非裔美国妇女的干预措施。在华盛顿的西雅图进行的干预可行性试点测试（根据参与者反馈命名为“团结研讨会”）产生了令人鼓舞的结果。作为下一步，我们建议进行随机临床试验，以确定有效性，并更好地了解减少污名的障碍和促进因素。我们的研究团队由减少污名、坚持、参与护理、同行领导的行为干预和干预研究方面的专家组成。他们设在华盛顿大学、亚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毒相关研究资源。我们希望团结讲习班将通过一种易于传播的方法，在减少内化的耻辱方面发挥有效作用，并对坚持和参与照顾感染艾滋病毒的非裔美国妇女产生积极影响。

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.