Abstract
In the United States, African Americans continue to bear a disproportionate amount of risk from HIV and illicit drug use, highlighting the importance of culturally responsive prevention programming. Manualized HIV and substance use prevention curricula that are conceptually African centered are few, and evaluative data of such programs are sparse. This research brief aims to describe a field evaluation of the “Color it Real” (CIR) program, a 6-session, 12-hr HIV and substance use prevention curriculum for African American males and females aged 18 to 24 years. Participants ( n = 225) were recruited using convenience sampling from two cities within a high-risk county in Indiana. Attitudes, knowledge, and confidence related to HIV and substance use were assessed before and after the intervention. Wilcoxon and McNemar tests were used to compare pretest and posttest scores, and binary logistic regression models were used to examine sociodemographic associations with outcomes. Among the analytic sample ( n = 195), the CIR program was associated with several improved attitudes and increased knowledge related to HIV and substance use, but not with increased confidence in sexual negotiation skills. These findings represent the first published data from CIR since the developers’ original study, and support continued use of the curriculum by our program. Given the positive findings (i.e., attitudes and knowledge) and community receptiveness to CIR, we believe that a randomized, controlled trial of the intervention that includes longitudinal behavioral measurement would be a meaningful addition to prevention research.
Highlights
In 2017, African Americans comprised 43% of new U.S HIV diagnoses (Centers for Disease Control and Prevention [CDC], 2018a) while only accounting for 12% of the total population
Substance use may introduce synergistic risk for HIV transmission and acquisition by altering judgment and sexual decision-making (Baliunas et al, 2010; Justice et al, 2010), and may reduce prevalence of HIV risk reduction behaviors, as reported in recent research suggesting that use of HIV self-tests prior to sexual activity may be reduced when one or more participants is under the influence of alcohol or drugs (Dolezal et al, 2020)
Lessons were delivered sequentially using a program manual developed by Wholistic Stress Control Institute (WSCI); lesson content has been summarized by Akintobi et al (2016) and included “(a) hip-hop and its influence on risky behavior, (b) relationships and decision-making, (c) learning the language of HIV, sexually transmitted infections (STIs), and substance abuse and cultural context, (d) HIV risk knowledge, (e) how to use condoms and HIV testing, and (f) recognizing and coping with feelings, and how to solve problems.”
Summary
In 2017, African Americans comprised 43% of new U.S HIV diagnoses (Centers for Disease Control and Prevention [CDC], 2018a) while only accounting for 12% of the total population. That same year, African Americans aged 12 years and older were more likely to have used an illicit drug in the past month than White non-Hispanics, Native Hawaiian/Pacific Islanders, Asians, and Hispanic/Latinos (CDC, 2018b). These data suggest that African Americans experience a disproportionate amount of risk from both HIV and substance use. Manualized prevention programs designed to influence behavior and behavioral precursors (e.g., social behaviors leading to HIV transmission; Cortopassi et al, 2019) can be effective risk reduction tools, especially when conducted among high-risk communities (CDC, 2006). Though HIV prevention programs have been developed to provide culturally tailored content for African Americans
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