RESUMEN
Although HIV pre-exposure prophylaxis (PrEP) is effective for women, studies show limited uptake among women to date. Barriers to women's PrEP uptake include their limited knowledge about PrEP and low perceived HIV risk. To address these barriers, we developed and pretested a printed palm card containing HIV prevention/PrEP information that addressed HIV prevention motivation with self-assessment questions about HIV risk. We conducted expert interviews (N = 8), focus groups with health, education, and social service providers (N = 13), and interviews with community women (N = 30) in New York City to assess attention to and acceptability of the card, comprehension of the information, and potential impact on prevention motivation. The card format and content were found to be acceptable and potentially motivational for preventive behaviors, as well as particularly relevant for women. Results of testing for language use, comprehension, and attention guided the final version of the card content.
Asunto(s)
Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Tamizaje Masivo/métodos , Aceptación de la Atención de Salud , Profilaxis Pre-Exposición , Adulto , Femenino , Grupos Focales , Humanos , Motivación , Ciudad de Nueva York , Aceptación de la Atención de Salud/estadística & datos numéricosRESUMEN
This study explored the knowledge, attitudes, and perceived facilitators and barriers to adoption of HIV pre-exposure prophylaxis (PrEP) among black women and Latinas in the Bronx, NY. Data were collected in focus group discussions (FGDs) held separately with staff (n = 21) and black and Latina female clients aged 18 to 50 (n = 23) of four organizations providing health and social services. Participants were also asked to give feedback about four action messages regarding PrEP for a social marketing campaign. Transcripts were analyzed by two researchers using grounded theory. We found that the majority of clients (74%) and staff (57%) had not heard about PrEP before participating in the FGDs. Following brief educational messaging about PrEP, participants identified potential facilitators and barriers to PrEP uptake among women, and expressed enthusiasm for more widespread efforts to raise awareness about PrEP as an HIV prevention option. Participants preferred an action message that was brief, referred to PrEP as a pill, and did not mention condoms or STD testing. These findings demonstrate the need to raise awareness about PrEP among women and build the capacity of women-serving organizations to educate, screen, and refer or provide PrEP services.
Asunto(s)
Negro o Afroamericano/psicología , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud , Hispánicos o Latinos/psicología , Profilaxis Pre-Exposición , Adolescente , Adulto , Negro o Afroamericano/estadística & datos numéricos , Femenino , Grupos Focales , Infecciones por VIH/epidemiología , Comunicación en Salud/métodos , Personal de Salud/psicología , Accesibilidad a los Servicios de Salud , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Prioridad del Paciente/etnología , Profilaxis Pre-Exposición/estadística & datos numéricos , Investigación Cualitativa , Población Urbana/estadística & datos numéricos , Adulto JovenRESUMEN
Healing Our Women (HOW) is a group-level HIV risk-reduction intervention developed to address the role of prior sexual victimization in HIV risk and protective behaviors among HIV-positive women of color. This article describes the process of adapting HOW for transgender women of color in New York City in accordance with CDC guidance for the adaptation of efficacious interventions. Twenty-one transgender women were enrolled in a study to evaluate the acceptability and fidelity of the adapted intervention, and to assess HIV knowledge, depressive symptoms, coping, condom use self-efficacy, and condom use via pre- and post-intervention surveys. We found the adapted program to be feasible to implement and acceptable to participants. We also found significant decreases in depressive symptoms and increases in positive coping from pre- to post-intervention, although replication with a larger sample and a control group comparison is needed to determine efficacy with this population.
Asunto(s)
Adaptación Psicológica , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Aceptación de la Atención de Salud/etnología , Personas Transgénero/educación , Adulto , Negro o Afroamericano/psicología , Población Negra/psicología , Condones/estadística & datos numéricos , Depresión/psicología , Femenino , Infecciones por VIH/etnología , Infecciones por VIH/psicología , Infecciones por VIH/transmisión , Hispánicos o Latinos/psicología , Humanos , Persona de Mediana Edad , Ciudad de Nueva York , Proyectos Piloto , Conducta de Reducción del Riesgo , Asunción de Riesgos , Sexo Seguro , Autoeficacia , Conducta Sexual/etnología , Personas Transgénero/psicologíaRESUMEN
This study compared rates of intimate partner violence reports on a new, empirically-developed screening tool completed by 385 women in 2007 to those from an older tool completed by 420 women in 2006. Data were obtained from randomly selected medical charts across three health center locations, which were part of the same reproductive health care organization. Chi-square analyses were conducted to test associations between demographic characteristics and partner violence reports. Multiple regression analyses were used to compare odds ratios of disclosure by type of screening tool, adjusting for associated demographic factors associated with partner violence reports. Women completing the old and new tools were similar across all demographic characteristics. After adjusting for age and center location, women completing the new screening form were more than 2.5 times as likely to report any partner violence. When analyzed by mutually exclusive violence history categories, women completing the new screening form were over 2.5 times as likely to report past or current violence and over 4 times as likely to report experiencing both past and current violence. Findings suggest that implementing empirically developed brief screening tools for partner violence in reproductive health settings may elicit more disclosures from patients than more traditional tools.