The proposed research addresses a critical question for the future success of vaccine, microbicide, pre-exposure prophylaxis and other emerging HIV prevention technologies in the United States: How can we ensure that the community support and program capacity to evaluate and deliver new HIV prevention technologies are available where they are most needed? The research setting (Durham, NC) provides an ideal context to conduct research to address this question. The 5-year study will evaluate a systematic partnership-building approach for HIV prevention trial planning and implementation.
The research aims are three-fold.
AIM 1 is to implement and conduct a process evaluation of a systematic community-based participatory research model to build support for new HIV prevention technologies in the African American community. This is accomplished through use of a conceptual framework that (1) integrates research with policy, community, behavior, and programs;(2) builds on community-based participatory research principles;(3) uses ethnography to generate empirical evidence to inform research design and provide a bridge between local residents, the research team, and other stakeholder groups;and (4) draws on group theory to refine the structure of stakeholder involvement and foster inclusiveness, creativity and active problem-solving.
AIM 2 is to describe the communities and group affiliations that exist among young (ages 18-30) at-risk African Americans, and measure the relationship among experiences of discrimination, levels of trust, and support for new HIV prevention technologies in this population.
AIM 3 is to identify priorities for evaluating and implementing new HIV prevention technologies in the African American community. Research methods include participant observation, ethnographic mapping, focus groups, semi-structured interviews, and quantitative surveys. An HIV prevention technologies research literacy curriculum will be developed, implemented and evaluated;the evaluation will include an assessment of community attitudes toward research on specific HIV prevention technologies. Support for and feasibility of collaboration in conducting local research on new HIV prevention technologies will assessed with multiple stakeholder groups including researchers. Across all years a two-way process evaluation of the evolving community partnership will be undertaken. Sampling strategies include respondent-driven sampling for a community survey of young at-risk African Americans in Years 2 and 3;purposive sampling will be used for all other data collection activities. The results of all data collection activities will be presented to community partners and guidance solicited for next steps in evaluating and delivering new HIV prevention technologies.
African Americans experience significant health disparities and this is especially evident with regard to HIV/AIDS in the U.S. South. Improving the capacity for HIV prevention trials in partnership with African American communities will lay the groundwork for moving effective interventions into successful prevention programs.