Award Recipients

This project aims to adapt and pilot test a peer mentor program for postpartum women living with HIV (WLHIV) which integrates clinical and community resources. By combining clinical and community expertise, this project will integrate a community-based peer mentor program for postpartum WLHIV into a clinical setting and pilot test it among postpartum WLHIV who attend infant visits. For this proposal, Dr. Adeline Koay at HIV Prevention and Treatment Services (HPTS) at Children’s National Hospital in Washington, DC and Ms. Martha Cameron with International Community of Women Living with HIV (ICWNA) have partnered to develop a comprehensive wellness package for postpartum WLHIV that integrates clinical and community partnerships and expand the community support network. The UK-based program (Mentor Mothers) trains WLHIV who have been through pregnancy to be peer mentors to WLHIV of childbearing age who are considering getting pregnant, are pregnant or are postpartum. Through focus group discussions, this project will engage clinical staff at HPTS, postpartum WLHIV and peer mentors to delineate the process of adapting the “Mentor Mothers” program into a US-based clinical setting (Aim 1).
ICWNA will conduct “Mentor Mothers” training of candidate peer mentors, all of whom are WLHIV who are experienced community health workers. This type of peer mentorship helps the pregnant or postpartum WLHIV better navigate the challenges of the healthcare system and increase their ability to self-advocate. The adapted peer mentor program will be pilot tested among postpartum WLHIV (n=20) who attend infant visits at HPTS (Aim 2). Its impact on postpartum depression will be assessed by comparing postpartum depression scores between participants who enroll in the peer mentor program and controls who have not enrolled in the peer mentor program. Acceptability of the peer mentor program will be determined through stakeholder surveys and focus group discussions.

In the United States (U.S.), it is estimated that 1 in 48 Black women as compared to 1 in 880 White women will acquire HIV in their lifetime. Viral suppression resulting from optimal adherence to antiretroviral therapy (ART) is associated with improved quality of life and reduces the risk of opportunistic infections as well as the risk of transmitting HIV to others. Due to social-structural and psychosocial factors, Black women living with HIV (BWLWH) have lower viral suppression rates, are less likely to be engaged in HIV care and to adhere to ART long enough to achieve sustained lower or undetectable viral loads. Internalized HIV stigma is a significant psychosocial barrier to optimal ART adherence. Due to factors like racism, societal stigma, and discriminatory interactions within healthcare and community settings, BWLWH experience greater internalized HIV stigma. One promising strategy for addressing psychosocial barriers to ART adherence is religion and spirituality. It is well documented that Black women in the U.S. have higher levels of religious and spiritual engagement. However, findings for the positive role of religion in BWLWH’s lives are mixed and suggest that spirituality may be more salient for addressing psychosocial factors that challenge their ART adherence. Given the paucity of available interventions targeted to improving ART adherence and clinical outcomes among BWLWH, we propose to develop a culturally congruent spirituality informed online intervention to improve ART adherence among BWLWH in Washington, D.C. Motivated by models of spirituality and health and conceptualizations of HIV-related stigma, the proposed study will use a  mixedmethods (quantitative surveys and in-depth interviews with BWLWH) approach to investigate associations between internalized HIV stigma, spirituality, and ART adherence among BWLWH. Next, using findings from the first phase of the study, along with the study team’s expertise and knowledge of other interventions to improve ART adherence, we will systematically develop and assess components of a spirituality enhanced online intervention to improve ART adherence among BWLWH in D.C. Optimal ART adherence is a core component of the U.S. Ending the HIV Epidemic (EHE) initiative and represents a critical step in the HIV care continuum. Interventions designed to provide strategies to improve stigma management and ART adherence, while also targeting the cultural and spiritual needs of BWLWH are a promising next step in achieving EHE goals.