Using CBPR to Engage Hazardous Drinking Women in the HIV Prevention and Care Continuum

  • STATUS
    Recruiting
  • days left to enroll
    37
  • participants needed
    30
  • sponsor
    Johns Hopkins University
Updated on 7 October 2021
HIV Vaccine

Summary

Unhealthy alcohol use among women with and at risk for HIV can interrupt critical steps in the HIV prevention and care continuum, is associated with HIV transmission risk behaviors, and contributes to health disparities. Thus it is critical to accurately identify alcohol use and implement alcohol interventions among women with and at risk for HIV to optimize health outcomes. The proposed pilot study will examine the implementation and effects of a computer delivered brief alcohol intervention with peer navigation/Community Health Worker compared to usual care on alcohol use, linkage to health services, and uptake of HIV prevention practices.

Description

Women account for 1 in 4 people living with HIV (PLWH) in the United States, and while African American (AA) women comprise only 14% of the US female population, African American women account for greater than 60% of women living with HIV (WLWH). Unhealthy alcohol use interrupts critical steps in the HIV prevention and care continuum (HPACC) and thus contributes to significant health disparities among at-risk and WLWH. The investigators have developed theory-based, in-person and computer-delivered brief interventions (CBI) for at risk and WLWH with alcohol use, demonstrating drinking reduction. However behavioral and structural barriers to optimal uptake of alcohol interventions and engagement in the HPACC remain, including mental health comorbidity and low knowledge, access, and use of HIV prevention practices such as HIV pre-exposure prophylaxis (PrEP). The goals of this proposal are two-fold: 1) to build on the investigators' current community partnerships to determine how to optimally implement evidence based alcohol treatment for at risk and WLWH in Baltimore, and 2) to determine whether the addition of information, motivational and peer navigator/Community Health Worker support related to comorbid mental health, and HIV prevention practices can enhance CBI and improve alcohol and HPACC outcomes among at risk and WLWH. To achieve these goals the investigators will use a Community Based Participatory Research (CBPR) approach, engaging patient and community stakeholders during all aspects of study development, and community pilot testing. In collaboration with the investigators' Community Advisory Board (CAB), the investigators will: 1) adapt the investigators' current CBI to address gaps in the HIV prevention and care continuum (CBI-CC). The investigators will conduct focus groups with both at risk and WLWH to tailor intervention manuals. 2) The investigators will conduct a pilot study of CBI-CC and peer navigation among 30 at-risk or WLWH with unhealthy alcohol use. The investigators hypothesize that the CBI-CC will result in reduction in drinking and heavy drinking days, increase linkage to substance use, and mental health services and HIV pre exposure prophylaxis (PrEP), and increase use of HIV prevention practices including condoms and PrEP. Through this U34 planning grant the investigators will partner with key stakeholders in the community to build capacity to deliver effective, evidence-based interventions at the nexus of alcohol and HIV for at risk and WLWH with alcohol misuse, and improve engagement in the HIV prevention and care continuum.

Details
Condition HIV, psychiatric disorder, HIV/AIDS, psychiatric illness, psychiatric disease, hiv disease, HIV positive, psychiatric diseases, Alcohol; Harmful Use, mental disorders, psychological disorder, Psychological Disorders, HIV infection, mental disease, Mental illness, HIV (Pediatric), HIV Infections, psychiatric disorders, hiv vaccines, AIDS Vaccines, mental disorder, human immunodeficiency virus, HIV Vaccine
Treatment CBI-CC with peer navigation
Clinical Study IdentifierNCT04090723
SponsorJohns Hopkins University
Last Modified on7 October 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

At risk and Women with HIV 18 years
Alcohol misuse, defined as >7 standard drinks per week or > 3 drinks per occasion in the last three months or AUDIT-C 3
Able to understand English
Able to read at a 5th grade level
Additional inclusion criteria for at risk women
sex under the influence of alcohol or
exchanging sex for money or other resources or
unprotected vaginal or anal sex or illicit drug use in the last 12 months

Exclusion Criteria

Pregnant (will be referred immediately to alcohol, mental health, substance use treatment as needed)
Non-English speaking
Unable to receive text messages
Actively psychotic, or otherwise not able to participate in the computer delivered brief intervention
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