Sisters Informing Sisters about Topics on AIDS and Prevention (SISTA-P): Adaptation of the SISTA intervention to include PrEP information and skills building for Black women who are risk for HIV

姐妹们向姐妹们通报艾滋病和预防主题 (SISTA-P)：调整 SISTA 干预措施，纳入针对有艾滋病毒风险的黑人妇女的 PrEP 信息和技能建设

• 批准号: 10471242
• 负责人: SHAWNIKA J HULL
• 金额: $ 17.41万
• 依托单位: RUTGERS, THE STATE UNIV OF N.J.
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10471242
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adult; Advocacy; Age; Alcohols; Assertiveness; Behavior Therapy; Behavioral; Caring; Cognitive; Cognitive Therapy; Collaborations; Communication; Communities; Competence; Consult; Consultations; Development; Disadvantaged; Drug Interactions; Drug usage; Education; Empirical Research; Evidence based intervention; Feedback; Focus Groups; Future; Gender; HIV; HIV diagnosis; HIV risk; Health Personnel; Health Services; Healthcare; Impairment; Incidence; Individual; Intervention; Interview; Knowledge; Literature; Marijuana; Mediation; Mentors; Outcome; Pain; Patients; Persons; Pharmaceutical Preparations; Phase; Population; Prevention; Process; Provider; Psychosocial Factor; Recommendation; Reporting; Research; Resistance; Risk; Risk Factors; Safe Sex; Sampling; Scientist; Self Efficacy; Self-control as a personality trait; Sexism; Shapes; Sister; Social Processes; Social Work; Surveys; Testing; Training; Voice; Washington; Woman; Women' s Group; Work; acceptability and feasibility; barrier to care; base; binge drinking; black women; cohort; condoms; contextual factors; effective intervention; experience; follow-up; improved; intersectionality; male; men; men who have sex with men; outreach; phase 3 study; pill; pilot test; pre-exposure prophylaxis; preventive intervention; provider-level barriers; racism; recruit; skills; skills training; social; social cognitive theory; social stigma; social structure; sociodemographics; substance use; surveillance study; theories; therapy design; therapy development; uptake; virtual; willingness; women of color

Abstract Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention medication, but Black women (BW), the group of women at highest HIV risk in the U.S., show disparately low rates of PrEP uptake. Many eligible BW are unaware of PrEP. Further, mounting evidence suggests that for many BW, PrEP use will require successful navigation of partner, provider and substance-use related barriers. Yet, behavioral interventions to increase BW’s PrEP use are virtually nonexistent. There is a dire need for evidence-based interventions (EBI) that address social-structural and contextual factors that impede BW’s PrEP uptake. As a communication scientist, I harness the power of communication to impact psychosocial factors in HIV prevention. My training and experience are heavily concentrated on individual level theory and effects. But, communication is a potentially powerful vehicle for addressing social-structural and contextual factors that impact HIV prevention. My training plan centers on gaining competence in 1) social-structural theoretical frameworks (Primary Mentor: Dr. Lisa Bowleg; 2) HIV prevention in drug using populations (Mentor: Dr. Irene Kuo); 3) culturally-tailored behavioral intervention development and testing (Mentor: Dr. Gina Wingood). Guided by Theory of Gender and Power, Intersectionality Frameworks and Social Cognitive Theory, the proposed research seeks to: 1) understand the social-structural and contextual barriers to BW’s PrEP uptake; and 2) design an intervention that leverages BW’s agency to overcome these barriers. I propose to adapt Sisters Informing Sisters about Topics on AIDS (SISTA), a widely implemented gender- and culture specific HIV prevention EBI. SISTA is a 5-session cognitive-behavioral intervention to increase condom use through gender and ethnic pride, HIV education, condom negotiation and assertiveness skills training, sexual self-control, and condom use efficacy in the context of partner resistance. I propose a 3-phase study to understand social-structural and contextual barriers to BW’s PrEP uptake (Aim 1), adapt SISTA to address overcoming these barriers (Aim 2), and determine the acceptability and feasibility of the adapted intervention, SISTA-P (Aim 3). Phase I comprises in-depth interviews with adult (ages 18+) BW who are at risk for HIV (N = 30) to understand how partners, HCP, and SU facilitate and hinder PrEP uptake. In Phase 2, I plan to adapt SISTA, in consultation with an expert panel, to address efficacy and skills for overcoming these barriers (SISTA-P). In Phase 3, I will pilot test SISTA-P to establish feasibility and acceptability among adult BW who are at risk for HIV, with 3 cycles of theater testing (N = 15/cycle). All phases will be conducted in Washington, DC in collaboration with The Women’s Collective, a community-based organization that provides health and social services for women of color who are living with or at risk for HIV. TWC has extensive experience with outreach, care navigation, recruitment, and EBIs, including SISTA. A significant contribution of the proposed research is that it centers BW’s voices and attends to bolstering their agency to overcome barriers to HIV prevention that they experience.

摘要