Computer-Based HIV Prevention Package for Drug Using African American Women

Period of Performance: 09/01/2015 - 05/31/2016

$674K

Phase 2 SBIR

Recipient Firm

ISA Associates, Inc.
Alexandria, VA 22314
Principal Investigator

Abstract

DESCRIPTION (provided by applicant): HIV/AIDS has been especially devastating to African American women. The reason for this health disparity can largely be understood within the context of the unique prevention challenges faced by African American women. Specifically, 80% of new infections among women are the result of heterosexual contact, with the primary male partner the chief source of infection.3 In African American women, heterosexual transmission plays an even larger role. Sexually transmitted infections (STIs) also disproportionately affect African American women. The risk of becoming infected with HIV is increased two to five times when infected with an STI. Finally, the impact of HIV on African American women is further augmented among those who use drugs. While this combination of factors accounts for some of the prevention challenges faced by African American women, it does not account for the primary challenge. Beyond abstinence, the most effective way to prevent HIV infection is correct and consistent use of the male latex condom. For men, increasing condom use is a behavior. For women, it is a goal. Therefore, HIV behavioral interventions for women require a special focus on women's lack of power in relationships and their asymmetrical subordination of personal protective behavior in deference to relationship maintenance. This is especially true for African American women. While the challenges are clear, the solutions are not. Of the 84 HIV behavioral interventions identified by the Centers for Disease (CDC) control as effective, only two were developed for drug-using African American women. Neither has an intervention package and neither is being actively disseminated by CDC. To address this substantial need, we intend to computer-enable Female and Culturally Specific Negotiation Intervention (FCSNI), one of the effective interventions identified by the CDC. FCSNI was specifically developed for drug-using African American women who have sex with men. Based on formative research with service providers, we intend to call the computer-enabled version of FCSNI, Safe Sistah. While the scalability of computer-based programs allows for efficient dissemination, clinics still face significant implementation barriers when tryng to deliver empirically-validated interventions. As such, we will develop a second module called Safe Sistah in your Clinic. This module will provide clinics with strategies to help them adopt and integrate Safe Sistah into their clinical offerings. The results of Phase I strongly support the feasibility and potential effectiveness of the programs - far exceeding the three usability benchmarks established in the Phase I proposal. In Phase II we will complete development of the Safe Sistah and Safe Sistah in your Clinic modules. We will test the effectiveness of Safe Sistah in a randomized controlled trial with 120 drug-using African American women. Participants will be randomly assigned to receive either the Safe Sistah program or to an attention control condition. Before, and at two points after random assignment, participants'sexual and drug use behaviors will be assessed.