Speaker
Description
Authors: Emily Dauria, Jerry Jiang, Katerina Christopoulos, Logan Lehman, Marina Tolou-Shams, Martha Shumway, Salam Ayana
Background: Women impacted by the criminal legal system (WI-CLS) in the US encounter intersecting stigmas because of their multiply marginalized identities, have elevated vulnerability to and incidence of HIV, and experience persistent inequities in uptake of HIV prevention strategies (e.g., PrEP). We developed and tested a peer-led navigation intervention for WI-CLS at risk of HIV acquisition to reduce intersectional stigma and improve linkage to HIV-prevention services.
Methods: Informed by the Intersectionality Enhanced Consolidated Framework for Implementation Research, we collected qualitative data from WI-CLS (N=9) and system partners (N=14) to elicit feedback on a peer-led navigation program developed using existing PrEP navigation models, and the “Understanding and Challenging HIV Stigma Toolkit”. Using these data, we adapted navigation content and structure to reflect the lived experience and healthcare challenges of WI-CLS. The newly developed “kINSHIP” intervention was tested in an open trial with WI-CLS (N=5). Interviews were conducted with intervention participants, the navigator, and systems partners to further adapt and refine the intervention in preparation for pilot randomized controlled trial testing. Data were analyzed using inductive thematic analysis.
Results: Participants recommended that navigator training topics address boundary setting and secondary trauma. The reaction to stigma and health related navigation activities was overwhelmingly positive. Other participant suggestions included that intervention content was framed using a resilience-approach, and that sessions were brief (< 45 minutes), flexibly ordered, and allowed for virtual engagement. The resulting intervention protocol consists of five sessions focused on relationship building, HIV and PrEP education and appointment scheduling, goal setting, and addressing needs. Open trial results indicated acceptance of session structure and content, high navigator satisfaction, and proposed contact at additional CLS intercepts.
Discussion: The kINSHIP intervention is an acceptable approach to improve HIV-prevention service access for WI-CLS by addressing intersectional stigma. We are currently testing kINSHIP to explore feasibility (R34DA050480).
| Conflict of interest | None |
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