To combat the spread of the HIV, the Centers for Disease Control (CDC) conducts ongoing reviews of the scientific literature to identify evidence-based HIV behavioral interventions (EBIs). Seventy-three EBIs have been identified. In conjunction with this, the CDC provides training and technical assistance to community based organizations and state and local health departments for a smaller subset (29) of these EBIs. This effort is known as the diffusion of effective behavioral interventions (DEBI) project. A consistent finding across EBIs is that interventions that are theoretically-based and tailored to the life- context of the individual are most effective. Of the 73 EBIs identified, only two address the most common ways that Black women become infected (i.e., heterosexual contact and drug use). Neither are part of the DEBI project and neither has an intervention package. And yet, 1 in 32 African American women will be diagnosed with HIV at some point in her lifetime. In comparison, 1 in 526 white women will become infected. Among drug using African American women the disproportionate impact of HIV is further enhanced. To address this need, we intend to develop a computer-based package for the EBI Female and Culturally Specific Negotiation Intervention (FCSNI). FCSNI was developed specifically for drug using African American women who have sex with men. There is also a substantial body of literature indicating that community-based organizations and health providers face significant barriers when trying to integrate EBIs into their clinical practice. To overcome these barriers, we intend to develop a second module designed specifically to help health providers integrate the computer-based FCSNI into their clinical practice. EBIs also have core elements that are key to intervention success and therefore should not be modified. Unfortunately, lack of fidelity to these core elements is common, leading to poorer outcomes. By adapting the core elements of FCSNI for a computer-based environment, it will be delivered with perfect fidelity across time and location. In this way, we hope to develop one of the first EBIs that is both scalable and widely utilized. Development of the Phase I prototype will be informed by the principal investigator from the original validation of FCSNI and formative research with treatment service providers. Following this, the prototype will undergo task-based usability testing with drug using African American women seeking services at a community-based health provider of HIV/STI services. Finally, treatment service providers will rate the functionality and content of module 2.
This project aims to develop a computer-based HIV prevention program for drug using African American women who have sex with men. For clinics, this will allow them to provide an empirically validated HIV prevention intervention to their cliens without creating additional demands on their already overburdened staff. For African American women, the skills contained in this program will help them reduce risk behaviors and, ultimately, prevent the spread of HIV.
