Document text
Principal Investigator: Brenice Duroseau
Organization: JOHNS HOPKINS UNIVERSITY
Fiscal Year: 2024
Award: $45,399
Funding agency: National Institute of Mental Health
PROJECT SUMMARY
Cisgender Black women in the United States (US) shoulder a significant burden of HIV and sexually transmitted
infections (STIs), with persistent disparities driven by stigma, implicit bias, and structural barriers. The
disproportionate impact of HIV/STIs among Black women in the US underscores a stark race disparity that
requires urgent action to address social and structural determinants of health (SSDHs). Maryland, a priority state
for the Ending the HIV Epidemic (EHE) initiative, has struggled to mitigate these disparities despite significant
prevention efforts. HIV prevention efforts in the United States have often been siloed and focused on individual
behavior modification, leaving significant gaps in addressing the complex interplay between individual, structural,
and social determinants of health that contribute to the disproportionate burden of HIV and STIs among Black
women. This R36 dissertation proposal seeks to bridge this gap by conducting a convergent mixed-methods
study to gain a comprehensive understanding of how existing SRH services can be adapted or expanded to
better address the prevention needs of Black women at risk for HIV in Maryland. By examining the current
availability, accessibility, and acceptability of SRH services for this population, this study aims to identify gaps in
service provision and explore the personal experiences and perspectives of Black women who have accessed
or attempted to access SRH services. The findings from this research will inform the development of evidence-
based recommendations for adapting or expanding existing SRH services to integrate HIV testing and prevention
strategies into broader SRH services, for an improved prevention approach that appeals to vulnerable
populations and accounts for social, structural, interpersonal, and individual factors. This study aligns with EHE
efforts and the National Institute of Mental Health (NIMH) Division of AIDS Research (DAR) priorities, as it aims
to inform the development targeted interventions for Black women at risk for HIV in Maryland. By employing a
scientifically rigorous, theory-based approach, the findings will contribute to the development of interventions
that contribute to both proximal and long-term distal outcomes for HIV prevention.
Terms: <AIDS><AIDS Virus><AIDS prevention><AIDS test><AIDS/HIV test><Accounting><Acquired Immune Deficiency><Acquired Immune Deficiency Syndrome><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome><Acquired Immunodeficiency Syndrome Virus><Address><American><Approaches to prevention><Baltimore><Behavior Conditioning Therapy><Behavior Modification><Behavior Therapy><Behavior Treatment><Behavioral Conditioning Therapy><Behavioral Modification><Behavioral Therapy><Behavioral Treatment><Biological><Black><Black race><Cause of Death><Chlamydia><Cities><Clinical><Cognitive Discrimination><Complex><Conditioning Therapy><Continuity of Care><Continuity of Patient Care><Continuum of Care><County><Data Collection><Decision Making><Decrease disparity><Dedications><Development><Discrimination><Disparities><Disparity><Distal><Eligibility><Eligibility Determination><Ensure><Epidemic><Evaluation><Evidence based practice guidelines><Exhibits><Face><Female><Female Groups><Gonococcal Infection><Gonorrhea><Groups at risk><HIV><HIV Infections><HIV Prevention><HIV diagnosis><HIV disparities><HIV inequalities><HIV inequities><HIV related disparities><HIV related inequities><HIV risk><HIV test><HIV-1 test><HIV-2 test><HIV/AIDS disparities><HIV/AIDS inequities><HIV/AIDS prevention><HIV/AIDS related disparities><HTLV-III Infections><HTLV-III-LAV Infections><Haitian><Health Care Utilization><Health Promotion><High Risk Woman><Human Immunodeficiency Viruses><Human T-Lymphotropic Virus Type III Infections><Human immunodeficiency virus test><Incidence><Individual><Intervention><Intervention Strategies><Interview><Investigators><LAV-HTLV-III><Lower disparity><Lymphadenopathy-Associated Virus><Maryland><Methods><Miyagawanella><Modeling><NIMH><National Institute of Mental Health><Outcome><Participant><People at risk><Persons at risk><Population><Populations at Risk><PrEP><Preventative intervention><Preventative measure><Preventative strategy><Prevention><Prevention approach><Prevention strategy><Preventive measure><Preventive strategy><Proliferating><Protocol Screening><Public Health><Racial Group><Reproductive Health Services><Research><Research Personnel><Research Priority><Researchers><Salutogenesis><Service provision><Services><Sexism><Sexual Health><Sexually Transmitted Diseases><Sexually Transmitted Disorder><Sexually Transmitted Infection><Shoulder><Structure><Survey Instrument><Surveys><Syphilis><Testing><United States><Venereal Diseases><Venereal Disorders><Venereal Infections><Viral Diseases><Virus Diseases><Virus-HIV><Vulnerable Populations><Woman><Women's Group><access to health care><access to healthcare><accessibility of health care><accessibility to health care><accessibility to healthcare><at-risk females><at-risk women><bedsonia><behavior intervention><behavioral intervention><biologic><black female><black women><cis-gender><cisgender><design><designing><develop therapy><developmental><disparities in race><disparity due to race><disparity in health><disparity reduction><evidence based guidelines><evidence based recommendations><experience><faces><facial><females at high risk><great pox><health care access><health care availability><health care service><health care service access><health care service availability><health care service use><health care service utilization><health disparity><healthcare access><healthcare accessibility><healthcare availability><healthcare service><healthcare service access><healthcare service availability><healthcare service use><healthcare service utilization><healthcare utilization><high risk females><high risk group><high risk individual><high risk people><high risk population><implicit bias><improved><inequality due to race><inequity due to race><insight><intervention development><intervention for prevention><interventional strategy><life-time risk><lifetime risk><marginalization><mitigate disparity><neglect><novel><pre-exposure prophylaxis><prevention intervention><preventional intervention strategy><preventive intervention><promoting health><race based disparity><race based inequality><race based inequity><race disparity><race related disparity><race related inequality><race related inequity><racial disparity><racial inequality><racial inequity><racial population><racial subgroup><racially unequal><racism><reduce disparity><reduction in disparity><reproductive health intervention><risk perception><sexual and reproductive health><sexually acquired infection><social><social determinants><social health determinants><social stigma><sociodeterminant><statistics><stigma><structural determinants><structural factors><structural health determinants><theories><therapy development><treatment development><trend><uptake><viral infection><virtual><virus infection><virus-induced disease><vulnerable group><vulnerable individual><vulnerable people><women at high risk>