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.

抽象的 暴露前预防 (PrEP) 是一种高效的艾滋病毒预防药物，但黑人女性 (BW) 美国 HIV 风险最高的女性群体的 PrEP 吸收率明显较低。许多符合条件的 BW 不了解 PrEP。此外，越来越多的证据表明，对于许多 BW 来说，PrEP 的使用需要成功 导航合作伙伴、提供者和药物使用相关的障碍。然而，行为干预可以增加 BW 的 PrEP 使用几乎不存在。迫切需要基于证据的干预措施（EBI） 解决阻碍 BW 采用 PrEP 的社会结构和背景因素。作为一名传播学家， 我利用沟通的力量来影响艾滋病毒预防中的社会心理因素。我的训练和 经验主要集中在个人层面的理论和效果上。但是，沟通是一种潜在的 解决影响艾滋病毒预防的社会结构和环境因素的强大工具。我的训练 计划的重点是获得 1) 社会结构理论框架的能力（主要导师：丽莎博士 罗圈腿； 2) 吸毒人群的艾滋病毒预防（导师：郭艾琳博士）； 3）适应文化的行为 干预开发和测试（导师：Gina Wingood 博士）。以性别与权力理论为指导， 交叉性框架和社会认知理论，拟议的研究旨在：1）了解 BW 采用 PrEP 的社会结构和背景障碍； 2）设计一种干预措施，利用 BW 的代理机构就是为了克服这些障碍。我建议改编《姐妹们向姐妹们通报有关艾滋病的话题》 (SISTA)，广泛实施的针对性别和文化的艾滋病毒预防 EBI。 SISTA 是一个为期 5 次的会议 认知行为干预，通过性别和民族自豪感、艾滋病毒教育、 安全套协商和自信技能培训、性自我控制以及安全套使用功效 合作伙伴抵制的背景。我建议进行三阶段研究，以了解社会结构和背景障碍 适应 BW 的 PrEP 吸收情况（目标 1），调整 SISTA 以克服这些障碍（目标 2），并确定 调整后的干预措施 SISTA-P（目标 3）的可接受性和可行性。第一阶段包括深入 采访有 HIV 风险的成人（18 岁以上）BW (N = 30)，以了解伴侣、HCP 和 SU 的情况 促进和阻碍 PrEP 的吸收。在第二阶段，我计划与专家小组协商，调整 SISTA，以 解决克服这些障碍的功效和技能（SISTA-P）。在第 3 阶段，我将试点测试 SISTA-P 通过 3 个周期的剧院测试，确定有 HIV 风险的成人 BW 的可行性和可接受性 （N = 15/周期）。所有阶段都将与 The Women’s Collective 合作在华盛顿特区进行， 一个以社区为基础的组织，为居住的有色人种女性提供健康和社会服务 患有艾滋病毒或有感染艾滋病毒的风险。 TWC 在外展、护理导航、招聘和 EBI 方面拥有丰富的经验， 包括西斯塔。拟议研究的一个重要贡献是它以 BW 的声音为中心并参与 加强他们的机构，克服他们遇到的艾滋病毒预防障碍。