Although the overall rate of new HIV infections among women in the U.S. has declined, significant racial and ethnic disparities still exist. Alcohol abuse and sexual risk behaviors have been identified as the most important contributors to HIV transmission in South Florida. Intimate partner violence (IPV) has been associated with increased risk for HIV. Women in violent relationships have few feasible risk reduction options because traditional prevention methods, including female-controlled methods (e.g., the female condom), are largely dependent on a partner?s cooperation. There is a need to identify acceptable, feasible, and effective female-controlled HIV risk reduction methods for women in violent relationships as well as to address potential barriers to acceptability of these methods. One such strategy is oral pre-exposure prophylaxis (PrEP; tenofovir/emtricitabine). Since 2012, medication for PrEP has been FDA-approved in the U.S. with guidance for its use to all individuals at significant risk for HIV. However, the majority of women in the U.S. are not aware of oral PrEP as an HIV prevention strategy that applies to them. The study will focus on perceived barriers and facilitators to PrEP among Blacks and Latina women with a history of intimate partner violence who use alcohol and are at significant risk for HIV. The study will be conducted at three sites in Miami-Dade most representative of the target population of highly impacted women (AA and Latina). In Phase 1 (quantitative) we will enroll 60 women to complete the psychosocial measures. In Phase 2 (qualitative) a sample of 20 women (Black, n= 10; Latina, n = 10) with a history of intimate partner violence will participate in semi-structured in-depth interviews to explore perceived barriers to and facilitators of PrEP attitudes and beliefs and alcohol use and histories of sexual trauma. This mixed-methods approach will permit an in-depth understanding of the factors affecting attitudes and beliefs about PrEP. The results from this pilot will be used to inform a future intervention designed for women with a history of intimate partner violence. The purpose of this diversity supplement is to support a mentored research experience for Dr. Karina Villalba. The research will take place within the next two years of funding of the ongoing NIAAA-funded U34 AA026219- 01 developmental grant. The supplement outlines a research training plan to provide her with the tools to become an independent investigator in the areas of alcohol intervention and HIV infection. With the assistance of her mentors the training goals for the research include:1) develop an increased understanding of intimate partner violence and alcohol abuse in women at risk for HIV; 2) develop competence in methods for qualitative and quantitative data collection and analysis to independently apply them in the formative stages of the development of behavioral interventions; 3) gain skills related to professional and scientific development, including publication and presentations of study data, training in the ethical conduct of clinical research, research administration, and grant writing skills that will lead to the development of a K award application. .
The majority of women are not aware of oral PrEP as an HIV prevention strategy that applies to them. This study will determine perceived barriers and facilitators to attitudes and beliefs about PrEP among Blacks and Latina women with a history of intimate partner violence who use alcohol and are at significant risk for HIV.
