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: 10082077
• 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/10082077
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adult; Advocacy; Age; Alcohol or Other Drugs use; Alcohols; Assertiveness; Behavior Therapy; Behavioral; Caring; Cognitive; Cognitive Therapy; Collaborations; Color; 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; Pharmaceutical Preparations; Phase; Population; Prevention; Preventive Intervention; Process; Provider; Psychosocial Factor; Recommendation; Reporting; Research; Resistance; Risk; Risk Factors; Safe Sex; Sampling; Scientist; Self Efficacy; Self-control as a personality trait; Sex Bias; Shapes; Sister; Social Processes; Social Work; Structure; Surveys; Testing; Training; Voice; Washington; Woman; Women' s Group; Work; barrier to care; base; binge drinking; cohort; condoms; contextual factors; effective intervention; experience; follow-up; improved; intersectionality; male; men; men who have sex with men; outreach; phase 3 study; pill; pre-exposure prophylaxis; provider-level barriers; racism; recruit; skills; skills training; social; social cognitive theory; social stigma; social structure; sociodemographics; surveillance study; theories; therapy design; therapy development; uptake; virtual; willingness

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HIV预防药物，但黑人妇女（BW）， 在美国，艾滋病毒最高风险的妇女组显示出摄取的预期率较低。许多合格的BW 不知道准备。此外，越来越多的证据表明，对于许多BW，PrEP使用将需要成功 合作伙伴，提供商和与物质使用相关的障碍的导航。但是，行为干预措施增加 BW的准备使用实际上是不存在的。迫切需要基于证据的干预措施（EBI） 解决阻碍BW的预期吸收的社会结构和上下文因素。作为传播科学家， 我利用沟通能力影响预防艾滋病毒的社会心理因素。我的训练和 经验主要集中在个人级别的理论和效果上。但是，沟通是一种潜在的 解决影响预防艾滋病毒的社会结构和背景因素的强大工具。我的训练 计划以1）社会结构理论框架（主要导师：Lisa博士 Bowleg; 2）使用人群中的药物预防艾滋病毒（导师：艾琳·库博士）； 3）经过文化范围的行为 干预开发和测试（导师：Gina Wingood博士）。在性别和权力理论的指导下， 交叉性框架和社会认知理论，拟议的研究试图：1）了解 BW的预期吸收的社会结构和上下文障碍； 2）设计一种利用的干预措施 BW的代理商克服这些障碍。我建议调整姐妹，向姐妹们介绍有关艾滋病的主题 （SISTA），一种广泛实施的性别和文化的预防EBI。 Sista是5条 认知行为干预以通过性别和种族自豪，艾滋病毒教育来增加避孕套的使用， 避孕套谈判和自信技能培训，性自我控制以及避孕套在 伴侣抵抗的背景。我提出了一项三相研究，以了解社会结构和上下文障碍 为了获得BW的预付款（AIM 1），请适应Sista解决这些障碍（AIM 2），并确定 改编干预措施的可接受性和可行性，SISTA-P（AIM 3）。第一阶段是深入的 接受艾滋病毒风险（n = 30）的成人（18岁以上）的访谈，以了解伴侣，HCP和SU如何 促进并阻碍吸收。在第2阶段，我计划在与专家小组协商时调整Sista，以 解决克服这些障碍（SISTA-P）的效力和技能。在第3阶段，我将试点测试SISTA-P 在有3个剧院测试周期的成年BW中，建立可行性和可接受性 （n = 15/循环）。所有阶段将在华盛顿特区与妇女集体合作， 一个基于社区的组织，为生活的有色妇女提供健康和社会服务 患有或有艾滋病毒的风险。 TWC在外展，护理导航，招聘和EBIS方面拥有丰富的经验， 包括Sista。拟议的研究的一个重大贡献是，它以BW的声音为中心 加强他们的代理商来克服他们所经历的预防艾滋病毒的障碍。