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.

Public Health Relevance

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.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
1R01MH098675-01
Application #
8403864
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Grossman, Cynthia I
Project Start
2012-09-26
Project End
2017-08-31
Budget Start
2012-09-26
Budget End
2013-08-31
Support Year
1
Fiscal Year
2012
Total Cost
$442,493
Indirect Cost
$76,585
Name
University of Washington
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195
Molina, Yamile; Scheel, John R; Endeshaw, Meheret et al. (2018) Enacted HIV-related stigma and breast-health beliefs and practices among African American women living with HIV: The mediating roles of internalized HIV-related stigma and depressive symptoms. Stigma Health 3:377-384
Andu, Eaden; Wagenaar, Brad H; Kemp, Chris G et al. (2018) Risk and protective factors of posttraumatic stress disorder among African American women living with HIV. AIDS Care 30:1393-1399
Rao, Deepa; Kemp, Christopher G; Huh, David et al. (2018) Stigma Reduction Among African American Women With HIV: UNITY Health Study. J Acquir Immune Defic Syndr 78:269-275
Rao, Deepa; Molina, Yamile; Lambert, Nina et al. (2016) Assessing Stigma among African Americans Living with HIV. Stigma Health 1:146-155