Development of an HIV Status-Neutral Video Intervention to Reduce Stigma and Promote U=U and PrEP Among Sexual and Gender Minority DC Community Members

September 21, 2022
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Sarah Calabrese, PhD (GW) has received an NIH CFAR Administrative Supplement entitled, “Development of an HIV Status-Neutral Video Intervention to Reduce Stigma and Promote U=U and PrEP Among Sexual and Gender Minority DC Community Members.”

Ending HIV in Washington, DC, requires people of both serostatuses to be aware of, access, and adhere to the highly effective biomedical treatment and prevention options that exist, including antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP). The DC Ends HIV plan recognizes these needs and stigma as a key barrier to addressing them. An HIV status-neutral educational intervention promoting both Undetectable=Untransmittable (U=U) and pre-exposure prophylaxis (PrEP) and simultaneously engaging people of both serostatuses could maximize reach and impact while mitigating stigma.

Guided by an implementation research logic model and the information-motivation-behavioral skills theory of behavior change, we propose a collaboration between academic researchers at George Washington University and implementing and community partners in a DC community healthcare setting (Whitman-Walker [WW]) to develop and evaluate English and Spanish versions of a 5-minute, HIV status-neutral web-based educational video intervention to reduce stigma and promote ART and PrEP, and to develop a plan for implementation at WW. We will engage WW health administrators and clinicians in key informant interviews (n = 6) and sexual and gender minority patients in focus groups (6 groups, total n = 24-48) to elicit initial video input and develop a plan for future video implementation at WW. The video will be further refined through an iterative, human-centered design process whereby the focus group patients provide feedback at four stages of video development. Subsequently, we will evaluate the acceptability and perceived impact of English and Spanish versions of the video using an online survey with 120-240 WW sexual and gender minority patients, ensuring representation from gender minority, Spanish-speaking, and Black patients. The study will yield a status-neutral video intervention, intervention acceptability data, and a tailored implementation plan. Study results will also provide pilot data for an NIH R34 grant application to conduct an implementation study building on this work. Ultimately, development of an HIV status-neutral web-based educational video about U=U and PrEP will provide a brief, inexpensive, easily scalable intervention to advance the priorities of the DC Ends HIV plan and the broader Ending the HIV Epidemic in the US initiative.