Using Small Grants to SPARK! Substantial Reach to Reduce HIV-related Stigma.

Community-based organizations (CBOs) are well-positioned to address the negative effects of HIV stigma, which is prevalent in the U.S. South. This article describes a Gilead COMPASS-funded small grants and capacity-building program for CBOs to address stigma and describes the broad reach and positive outcomes associated with program implementation.

Adaptation and Preliminary Testing of an Intervention to Reduce Stigma among Individuals Living with HIV in the Deep South.

HIV-related stigma has been implicated as a contributor to the disproportionate impact of HIV in the US Deep South. However, effective interventions aimed at reducing HIV-related stigma are limited in the region. This study adapted and piloted an HIV-related stigma reduction intervention, the UNITY Workshop, for use among people living with HIV in the Deep South following a modified framework of the ADAPT-ITT model and the five principles of Corrigan's Model of Strategic Stigma Change. The adapted intervention, named the YOUNITY Workshop, was conducted in an experiential, group format and focused on enhancing stigma coping skills. Workshop satisfaction was high, and most participants reported acquiring new skills for coping with HIV-related stigma and HIV status disclosure. Participants also reported benefitting from the social support generated from the workshop and desired additional opportunities to connect with others in the future. This pilot study demonstrated the feasibility and positive preliminary outcomes of conducting a group-based HIV stigma reduction workshop in the Deep South. Future rigorous testing of the YOUNITY Workshop is planned to better examine health outcomes associated with participation.

HIV Stigma Reduction Through Peer-Led Advocacy Training.

HIV-related stigma is pervasive in the U.S. South and has potential negative effects on health outcomes and emotional well-being, and may act as a barrier to HIV-related advocacy among people living with HIV (PLWH). This article reports on the preliminary outcomes associated with participation in an HIV advocacy training for PLWH, LEAD, that included education and skills building for reducing HIV-related stigma. Fifty-seven PLWH at four sites in the U.S. South participated in the retreat-style training and completed a survey measuring stigma and comfort engaging in advocacy prior to and after the worshop. Participation was associated with statistically significant reduction in internalized HIV stigma and increase in comfort with participation in advocacy; however, participants reported a need for ongoing training and support to further increase comfort with advocacy participation. Although more research is needed on the LEAD Workshop, it shows promise as an option for reducing HIV-related stigma among PLWH.

Long-acting buprenorphine vs. naltrexone opioid treatments in CJS-involved adults (EXIT-CJS).

The EXIT-CJS (N = 1005) multisite open-label randomized controlled trial will compare retention and effectiveness of extended-release buprenorphine (XR-B) vs. extended-release naltrexone (XR-NTX) to treat opioid use disorder (OUD) among criminal justice system (CJS)-involved adults in six U.S. locales (New Jersey, New York City, Delaware, Oregon, Connecticut, and New Hampshire). With a pragmatic, noninferiority design, this study hypothesizes that XR-B (n = 335) will be noninferior to XR-NTX (n = 335) in retention-in-study-medication treatment (the primary outcome), self-reported opioid use, opioid-positive urine samples, opioid overdose events, and CJS recidivism. In addition, persons with OUD not eligible or interested in the RCT will be recruited into an enhanced treatment as usual arm (n = 335) to examine usual care outcomes in a quasi-experimental observational cohort.