Ending the HIV and Stigma Syndemic: Re-framing Health Education Content for Southern Black Churches

项目摘要 为了响应RFA-PS-21-001少数民族艾滋病毒研究倡议（MARI），本项目的目标是： 应用是使用基于社区的参与性研究和干预绘图， 结束艾滋病毒流行（EHE）：美国计划。我们将使用3年 利用艾滋病毒监测数据和关于污名化内在化的照片之声叙述的时期 经验丰富的PLWH通知，实施和评估圣经启发，教会为基础的 为位于孟菲斯的主要黑人宗教集会量身定制的干预措施 大都市区，已被确定为一个高负担的EHE管辖区，在深 南在第一阶段，我们将分析社区监测数据，以确定保护因素， 可能促进和阻碍艾滋病毒预防工作的行为风险。这些 数据随后将通知试点干预。在第2阶段，我们将随机分配N=10 教会的艾滋病毒教育+干预和额外的N=10教堂的标准 艾滋病教育干预（控制）武器。在这些教会中，我们将随机选择n=10 每座教堂的教友人数（总计n=200名教友），并进行一项调查，评估各种 健康促进行为，感知艾滋病毒风险，PrEP知识，艾滋病毒检测史， 与艾滋病毒有关的态度/信念（即，耻辱）。独特的文化和背景景观的 孟菲斯城市/农村大都市区融合了历史信仰和观点 间接归因于艾滋病毒相关的耻辱。拟议的研究将利用一个 建立了由LGBTQ+看门人、信仰领袖和学术研究人员组成的艾滋病毒联盟， 解开一些已知和未知的决定因素，可能有助于艾滋病毒的种族 南方腹地的不平等。最终，我们预计这项研究将为随后的 更大的功效试验。公共卫生意义包括使艾滋病毒预防正常化， 测试行为，促进减少耻辱感，并建立基于信仰的伙伴关系， 衔接孟菲斯EHE计划中详细说明的当前优先事项， “治疗”支柱。

PROJECT SUMMARY In response to RFA-PS-21-001 Minority HIV Research Initiative (MARI), the goal of this application is to use community-based participatory research and intervention mapping to address priorities of Ending the HIV Epidemic (EHE): A Plan for America. We will use the 3-year period to leverage HIV surveillance data and photovoice narratives of internalizations of stigma experienced by PLWH to inform, implement, and evaluate a biblically-inspired, church-based intervention tailored for predominantly Black religious congregations located in the Memphis metropolitan area, which has been identified as a high burden EHE jurisdiction in the Deep South. In Phase 1, we will analyze community surveillance data to identify protective factors and behavioral risks which may facilitate and impede HIV prevention efforts, respectively. These data subsequently will inform the pilot intervention. In Phase 2, we will randomly assign N=10 churches to the HIV education + intervention and an additional N=10 churches to the standard HIV education intervention (control) arms. Within these churches, we will randomly select n=10 congregants per church (Total n=200 congregants) and administer a survey assessing a variety of health promoting behaviors, perceived HIV risk, knowledge of PrEP, HIV testing history, and HIV-related attitudes/beliefs (i.e., stigma). The unique cultural and contextual landscape of the Memphis urban/rural metropolitan area blends historical beliefs and perspectives that have indirectly attributed to HIV-related stigma. The proposed research will utilize the expertise of an established HIV coalition of LGBTQ+ gatekeepers, faith leaders, and academic researchers to disentangle some of the known and unknown determinants that may contribute to HIV racial inequities in the Deep South. Ultimately, we anticipate this research will inform a subsequent larger efficacy trial. The public health significance includes normalizing HIV prevention and testing behaviors, promoting stigma reduction, and garnering faith-based partnerships, which dovetail current priorities detailed in the Memphis EHE plan addressing both ‘diagnose’ and ‘treat’ pillars.