African American women represent 2 out of every 3 cases of HIV among women of all racial and ethnic groups in the United States. While safer sex interventions have been largely utilized to target individual-level sexual risk behavior in reducing new HIV transmissions, these interventions are limited in scope and effectiveness. African American young adults have the highest rates of new and undiagnosed HIV infection in the United States. Undiagnosed HIV infections are a serious impediment to HIV prevention goals, as over half of new HIV infections among young adults result from individuals uninformed of their positive HIV status unknowingly passing on the virus. Receiving an HIV test is the only way to be knowledgeable of one's HIV status. HIV-positive individuals who know their status are less likely to pass on the virus through unprotected sex, and are more likely to be less infectious after being linked to care. Thus, increased HIV testing as a HIV prevention strategy is needed to reduce rates of new transmissions. Despite the benefits of HIV testing, limited research has examined mechanisms to increase HIV testing among African American women. Additionally, few studies have examined barriers and facilitators related to HIV testing.
The specific aims of this proposal are to: 1) identify barriers and facilitators related to HIV testing among young African American women and 2) develop and test evidence-based health messages to increase HIV testing among this population. Study methods: Study 1 is a cross-sectional study which will identify barriers and facilitators related to HIV testing and test intentions among 100 African American young adult women (aged 18-24) through use of online questionnaires. Study 2 is an online randomized control trial that will utilize results from Study 1 to develop HIV testing messages, and to examine whether the developed messages increase rates of HIV testing behavior and HIV test intentions. This study will also examine message acceptability and feasibility. The long term objectives of the proposed research are to: 1) reduce rates of HIV transmission that happen inadvertently by making more HIV positive young adults aware of their status, 2) reduce likelihood of transmission by linking HIV positive individuals to healthcare which can thereby reduce their viral load and make them less infectious, and 3) promote HIV testing as a HIV reduction strategy among young adults and African Americans, as this strategy has been largely disregarded in favor of safer sex behavioral interventions. These messages can be utilized by clinicians and healthcare providers, HIV prevention groups/organizations, and within HIV prevention interventions to increase rates of testing. Results from this study will be disseminated scientifically through manuscript submissions and research conferences, in addition to being distributed to local HIV prevention serving organizations. Training Plan. This proposal will be guided by Dr. Faye Belgrave (sponsor), Dr. Dace Svikis (co-sponsor), and Dr. Isaac Lipkus (health message development consultant). The applicant's training plan includes frequent meetings with her sponsors and consultant, ethnics/research training, relevant coursework and workshops, clinical methods and quantitative statistical trainings, writing development, and scientific dissemination.

Public Health Relevance

HIV is a significant public health concern among African American young women in the United States, as they represent 2 out of 3 women diagnosed with HIV and over 50% of young adults who have HIV are living with an undiagnosed infection. The proposed studies will develop and test messages aimed at increasing HIV testing rates among young African American women. Results from the proposed research will inform the content, structure, and delivery of evidence-based health messages that can reduce rates of inadvertent HIV transmission, by increasing the number of individuals who know their HIV status from receiving testing.

Agency
National Institute of Health (NIH)
Institute
National Institute on Minority Health and Health Disparities (NIMHD)
Type
Predoctoral Individual National Research Service Award (F31)
Project #
5F31MD011278-02
Application #
9551354
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Rajapakse, Nishadi
Project Start
2017-08-21
Project End
2019-08-20
Budget Start
2018-08-21
Budget End
2019-08-20
Support Year
2
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Virginia Commonwealth University
Department
Type
Schools of Arts and Sciences
DUNS #
105300446
City
Richmond
State
VA
Country
United States
Zip Code
23298
Moore, Melanie Paige; Belgrave, Faye (2018) Gender Differences in Predictors of HIV Testing Among African American Young Adults. J Racial Ethn Health Disparities :