Abstract
BackgroundDisparities in the prevalence of HIV persist in the southern United States, and young African American women have a disproportionate burden of HIV as compared with young women of other racial/ethnic backgrounds. As a result, engaging young African American women in the HIV care continuum through HIV testing is imperative. This study is designed to reach this key population at risk for HIV. The study seeks to test the efficacy of two formats of a gender-focused, evidence-based, HIV-risk reduction intervention—the Young Women’s CoOp (YWC)—relative to HIV counseling and testing (HCT) among young African American women between the ages of 18 and 25 who use substances and have not recently been tested for HIV.MethodsUsing a seek-and-test framework, this three-arm cross-over randomized trial is being conducted in three county health departments in North Carolina. Each county is assigned to one of three study arms in each cycle: in-person (face-to-face) YWC, mobile Health (mHealth) YWC, or HCT. At study enrollment, participants complete a risk behavior survey via audio computer-assisted self-interview, and drug, alcohol, and pregnancy screening tests, and are then referred to HIV, gonorrhea, and chlamydia testing through their respective health departments. Participants in either of the YWC arms are asked to return approximately 1 week later to either begin the first of two in-person individual intervention sessions or to pick up the mHealth intervention preloaded on a tablet after a brief introduction to using the app. Participants in all arms are asked to return for a 6-month follow-up and 12-month follow-up, and repeat the survey and biological testing from baseline.DiscussionThe findings from this study will demonstrate which delivery format (mHealth or face-to-face) is efficacious in reducing substance use and sexual risk behaviors. If found to be efficacious, the intervention has potential for wider dissemination and reach.Trial registrationClinicalTrials.gov: NCT02965014. Registered November 16, 2016.
Highlights
Disparities in the prevalence of Human immunodeficiency virus (HIV) persist in the southern United States, and young African American women have a disproportionate burden of HIV as compared with young women of other racial/ethnic backgrounds
African Americans account for 12% of the U.S population, they are disproportionately affected by HIV [1]
Given the significant role of Alcohol or other drugs (AOD) use and violence in influencing sexual behavior, creating an mobile Health (mHealth) intervention that is woman-focused and addresses the intersections of AOD use, sexual risk, and violence may be essential to alleviating the disparities that persist with HIV
Summary
Aims and objectives This study seeks to determine the efficacy of a behavioral health intervention, the YWC delivered in two formats, relative to standard HIV counseling and testing (HCT) in reducing risk behaviors such as condomless sex and substance use. Eligibility criteria To be eligible for this trial, individuals must meet the following criteria: (1) be age 18–25; (2) self-identify as Black and/or African American; (3) self-identify as female; (4) have had penetrative sex with a male partner without using a condom within the past 3 months; (5) have used AOD in a greater quantity or for a longer period than they originally intended within the past 30 days; (6) have not tested for HIV within the past 3 months; (7) currently reside in Durham, Wake, or Guilford County for at least the past 6 months; (8) have no intent to move from the area within the year; (9) have not participated in the previous YWC/Teen CoOp randomized controlled trial or the formative phase of this study; (10) be willing to test for HIV, chlamydia, and gonorrhea through their respective county health departments and sign a release; and (11) be willing to provide locator information for future contact.
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