Effects of a Pilot Church-Based Intervention to Reduce HIV Stigma and Promote HIV Testing Among African Americans and Latinos

Derose, Kathryn Pitkin; Griffin, Beth Ann; Kanouse, David E.; Bogart, Laura M.; Williams, Malcolm; Haas, Ann C.; Flórez, Karen R.; Collins, Deborah Owens; Hawes-Dawson, Jennifer; Mata, Michael; Oden, Clyde W.; Stucky, Brian D.

doi:10.1007/s10461-015-1280-y

Cited by 69 publications

(50 citation statements)

References 59 publications

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“…Attendance. Five studies examined HIV/STI in association with service attendance [49,[65][66][67][68]. Two studies were mixed methods and three were quantitative.…”

Section: Plos Onementioning

confidence: 99%

Religion, faith, and spirituality influences on HIV prevention activities: A scoping review

et al. 2020

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Introduction Strategies to increase uptake of next-generation biomedical prevention technologies (e.g., long-acting injectable pre-exposure prophylaxis (PrEP)) can benefit from understanding associations between religion, faith, and spirituality (RFS) and current primary HIV prevention activities (e.g., condoms and oral PrEP) along with the mechanisms which underlie these associations. Methods We searched PubMed, Embase, Academic Search Premier, Web of Science, and Sociological Abstracts for empirical articles that investigated and quantified relationships between RFS and primary HIV prevention activities outlined by the United States (U.S.) Department of Health and Human Services: condom use, HIV and STI testing, number of sexual partners, injection drug use treatment, medical male circumcision, and PrEP. We included articles in English language published between 2000 and 2020. We coded and analyzed studies based on a conceptual model. We then developed summary tables to describe the relation between RFS variables and the HIV prevention activities and any underlying mechanisms. We used CiteNetExplorer to analyze citation patterns. Results We identified 2881 unique manuscripts and reviewed 29. The earliest eligible study was published in 2001, 41% were from Africa and 48% were from the U.S. RFS measures included attendance at religious services or interventions in religious settings; religious and/ or spirituality scales, and measures that represent the influence of religion on behaviors. Twelve studies included multiple RFS measures. Twenty-one studies examined RFS in association with condom use, ten with HIV testing, nine with number of sexual partners, and one with PrEP. Fourteen (48%) documented a positive or protective association between all

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“…Attendance. Five studies examined HIV/STI in association with service attendance [49,[65][66][67][68]. Two studies were mixed methods and three were quantitative.…”

Section: Plos Onementioning

confidence: 99%

Religion, faith, and spirituality influences on HIV prevention activities: A scoping review

et al. 2020

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“…These interventions are grounded in behavior change theory and focus on creating space for contact between those perpetrating stigma and the stigmatized (contact strategies) ( 24 – 28 ), fostering empathy ( 29 – 32 ) and building the knowledge and skills necessary to change stigmatizing behavior ( 27 , 33 – 38 ). This evidence, coupled with years of intervention efforts, has established basic principles for stigma-reduction programming, which can be designed to operate on what are often referred to as the immediately actionable drivers of stigma ( 11 , 19 , 21 , 23 , 35 – 40 ). Those basic principles focus on contact strategies ( 24 – 28 ), empathy creation ( 29 – 32 ) and building efficacy by increasing knowledge and skills ( 27 , 33 – 38 ) for reducing stigma by: (1) increasing awareness and understanding of the concrete forms stigma takes, as health workers (or people) are often unaware that they are stigmatizing; (2) addressing the specific fears surrounding HIV transmission that drive care or treatment avoidance behaviors; and (3) working on the negative attitudes that lead to blaming and shaming by health staff who judge people living with HIV to be engaging in socially “unacceptable” behaviors or belonging to groups that are considered “lesser or other” than mainstream society.…”

Section: Introductionmentioning

confidence: 99%

HIV Stigma Reduction for Health Facility Staff: Development of a Blended- Learning Intervention

Nyblade

Srinivasan²,

Mazur

et al. 2018

Front. Public Health

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Introduction: The effect of stigma on health and health inequity is increasingly recognized. While many medical conditions trigger stigmatization, the negative effects of HIV stigma are particularly well documented. HIV stigma undermines access, uptake, and adherence to both HIV prevention and treatment. People living with HIV face stigma in all aspects of their daily lives; however, stigma in the health system is particularly detrimental. A key component for health facility stigma-reduction interventions is participatory training of staff, often through several days of in-person training. Though this approach shows promise, it is time intensive and poses challenges for busy health facilities. In response, the DriSti study has developed a brief blended-learning approach to stigma reduction in Karnataka State, India. This paper describes the process and final content of the intervention development. The intervention is currently being tested. Final evaluation results will be published upon study completion.Methods: Grounded in behavior change strategies based on social cognitive theory principles that stress the importance of combining interpersonal interactions with specific strategies that promote behavior change, we used a three-phase approach to intervention development: (1) content planning—review of existing participatory stigma-reduction training activities; (2) story boarding—script development and tablet content production; and (3) pilot testing of tablet and in-person session materials.Results: The final intervention curriculum consists of three sessions. Two initial self-administered tablet sessions focus on stigma awareness, attitudes, fears of HIV transmission, and use of standard precautions. The third small group session covers the same material but includes skill building through role-play and testimony by a person living with HIV. A study team member administers the tablet sessions, explains the process, and is present throughout to answer questions.Conclusion: This paper describes the theoretical underpinning and process of developing the blended-learning curriculum content, and practical lessons learned.The approach covers three key drivers of HIV stigma—stigma awareness, fear of HIV transmission, and attitudes. Developing video content for the self-directed learning is complex, requires a diverse set of people and skills, and presents unexpected opportunities for stigma reduction. Co-facilitation of the in-person session by someone living with HIV is a critical component.

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“…Results from our pilot study found that, at the church level, the intervention reduced HIV stigma and HIV mistrust among the Latino churches and increased HIV testing across the African American and Latino churches. 24 Specifically, the Latino Catholic intervention church experienced a decrease between baseline and follow-up in both HIV stigma and HIV mistrust (effect size change=−0.16; 95% confidence interval [CI] −0.25 to −0.06 for HIV stigma; −0.15 for HIV mistrust; 95% CI −0.24 to −0.05). Similarly, the Latino Pentecostal intervention church experienced a significant decrease in both outcomes between baseline and follow-up (effect size change=−0.38 for HIV stigma; 95% CI −0.71 to −0.05; −0.56 for HIV mistrust; 95% CI −0.86 to −0.27).…”

Section: Introductionmentioning

confidence: 99%

Process Evaluation of a Peer-Driven, HIV Stigma Reduction and HIV Testing Intervention in Latino and African American Churches

et al. 2017

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Purpose: Faith-based organizations may be effective in addressing HIV-related disparities, but few interventions have been implemented across diverse churches. The Facilitating Awareness to Increase Testing for HIV (FAITH) intervention harnessed peer leadership to decrease HIV stigma and promote HIV testing in African American and Latino congregations. A pilot study found more consistent effects among Latino congregations. This process evaluation evaluates implementation of FAITH to better understand the pilot study's findings.Methods: Data sources included HIV education and peer leader workshop evaluation forms, participant views of the community's perspective of HIV, and peer leader follow-up interviews. Data were triangulated with systematic observation notes and analyzed using process-related themes of recruitment, reach, context, implementation, dose-delivered, and fidelity.Results: At the Latino churches (compared to the African American church), facilitators spent more time addressing community-based misconceptions about HIV. The peer leader model was well received, especially among Latino participants, and most said that after the workshop they felt comfortable speaking with others about HIV-related topics. Latino peer leaders reported speaking with up to 20 people within their social networks (particularly with family members); African Americans reported up to 4. Implementation challenges at the African American church may have contributed to the limited intervention effects. Nevertheless, we found the peer motivator model feasible and acceptable across diverse faith settings.Conclusion: Peer-based models within faith settings are promising for addressing HIV. However, differences among groups in HIV knowledge, social network characteristics and norms, and church preferences may influence overall effectiveness.

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Effects of a Pilot Church-Based Intervention to Reduce HIV Stigma and Promote HIV Testing Among African Americans and Latinos

Cited by 69 publications

References 59 publications

Religion, faith, and spirituality influences on HIV prevention activities: A scoping review

Religion, faith, and spirituality influences on HIV prevention activities: A scoping review

HIV Stigma Reduction for Health Facility Staff: Development of a Blended- Learning Intervention

Process Evaluation of a Peer-Driven, HIV Stigma Reduction and HIV Testing Intervention in Latino and African American Churches

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