评估针对非洲移民妇女的循证艾滋病毒预防干预措施的文化适应性:探索性试点混合方法研究。
Evaluating the Cultural Adaptation of Evidence-Based HIV Prevention Interventions for African Immigrant Women: Exploratory Pilot Mixed-Methods Study.
作者信息
Malika Nipher, Bogart Laura M, Adamu Nabila, Maganga Gray, Jeon Elaine D, Fenta Esete Habtemariam, Diouf Khady, Ojikutu Bisola
机构信息
RAND Corporation, 1776 Main St, Santa Monica, CA, 90401, USA.
Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.
出版信息
J Immigr Minor Health. 2025 Aug 13. doi: 10.1007/s10903-025-01762-2.
African-born Black women living in the US experience markedly higher rates of HIV diagnosis than their US-born counterparts, with condom use and PrEP remaining underutilized despite their effectiveness. Existing HIV prevention interventions for African-born Black women are limited in scope; some lack cultural tailoring, linguistic appropriateness, and most not do include PrEP. Using the ADAPT-ITT model, we culturally adapted two evidence-based interventions for US Black women-Sister-to-Sister and Sisters Informing Sisters about Topics on AIDS (SISTA)-to increase condom use and PrEP uptake among African-born Black women through community stakeholder input. DADA, which was adapted from SISTA, consists of two 3-hour peer-led, group-level intervention and Dada kwa Dada (DKD), adapted from Sister-to-Sister, is a 1-hour individual-level intervention. To test feasibility and acceptability, 29 African-born women without HIV were recruited from social media groups and community partner listservs in Massachusetts and New York; 17 were randomized to DKD and 12 to DADA. Participants completed risk assessments at baseline and provided post-intervention feedback interviews and surveys. Both adapted interventions demonstrated high feasibility and acceptability, with participants expressing positive qualitative and quantitative feedback regarding their culturally appropriateness, and relevance. This study addresses critical gaps in tailored HIV prevention approaches for African-born Black women and paves the way for future trials to improve condom use and PrEP in this population. Next steps are to conduct a fully-powered comparative effectiveness trial to assess the relative impact of both interventions on increased condom use and uptake of PrEP.
生活在美国的非洲出生的黑人女性被诊断出感染艾滋病毒的比率明显高于美国出生的黑人女性,尽管使用避孕套和暴露前预防(PrEP)有效,但它们的使用率仍然很低。现有的针对非洲出生的黑人女性的艾滋病毒预防干预措施范围有限;一些缺乏文化针对性、语言适用性,而且大多数没有包括暴露前预防。我们使用ADAPT-ITT模型,对两项针对美国黑人女性的循证干预措施——“姐妹互助”和“姐妹告知艾滋病相关话题”(SISTA)进行文化调适,通过社区利益相关者的参与,提高非洲出生的黑人女性对避孕套的使用和暴露前预防的接受率。从SISTA改编而来的DADA包括两次由同伴主导、每次3小时的小组层面干预,而从“姐妹互助”改编而来的“达达关爱达达”(DKD)是一次1小时的个人层面干预。为了测试可行性和可接受性,我们从马萨诸塞州和纽约州的社交媒体群组和社区合作伙伴邮件列表中招募了29名未感染艾滋病毒的非洲出生女性;17人被随机分配到DKD组,12人被分配到DADA组。参与者在基线时完成了风险评估,并在干预后提供了反馈访谈和调查。两项改编后的干预措施都显示出了很高的可行性和可接受性,参与者对其文化适用性和相关性给出了积极的定性和定量反馈。这项研究填补了针对非洲出生的黑人女性量身定制的艾滋病毒预防方法方面的关键空白,并为未来提高该人群对避孕套的使用和暴露前预防接受率的试验铺平了道路。下一步是进行一项全面的比较效果试验,以评估这两种干预措施对增加避孕套使用和暴露前预防接受率的相对影响。