The US Centers for Disease Control and Prevention presented alarming statistics demonstrating that for nearly a decade, HIV and AIDS had been the leading cause of death for African American women between the ages of 25 and 34. This trend has continued. A growing body of research has shown that the stigma internalized by people living with HIV (PLWH) undermines adherence to lifesaving antiretroviral medications, particularly for African Americans. Given the clear link between stigma and treatment utilization, it is clear that to improve engagement to care, we must provide proven, effective interventions to reduce HIV-related stigma. To begin to respond to this need, our research group has taken a well-utilized intervention, the International Center for Research on Women's HIV Stigma Toolkit, and converted it into a literacy-sensitive, multimedia, internalized stigma reduction intervention that can be implemented through an eight-hour workshop. Our approach makes use of Corrigan's best practices for 'Strategic Stigma Change,'and emphasizes making contact with PLWH through peer facilitation and active participation. In particular, we adapted the intervention for African American women living with HIV. A feasibility pilot test of the interventin (named the "Unity Workshop" based on participant feedback) in Seattle, Washington, produced encouraging results. As the next step, we propose to conduct a randomized clinical trial to establish effectiveness and to better understand barriers to, and facilitators of, stigma reduction Our study team is comprised of experts in stigma reduction, adherence, engagement in care, peer-led behavioral interventions, and intervention research. They are based at the University of Washington, University of Alabama, and Northwestern University (Chicago), institutions with extensive resources for HIV-related research. We expect that the Unity Workshop will demonstrate effectiveness in reducing internalized stigma through an easily-disseminated method, and that it will have a positive impact on adherence and engagement in care for African American women living with HIV.
The stigma reduction intervention, if proven effective, has the potential to improve health outcomes for African American women living with HIV by increasing their treatment utilization.