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Dr. Kamila Alexander

Title: Pilot trial of an intervention to increase HIV engagement and reduce Intimate Partner Violence among Black women living with HIV Lead Investigator: Dr. Kamila Alexander

Black women living with HIV (LWH) continue to experience disparities in exposure to intimate partner violence (IPV) and sub-optimal HIV care engagement. Black women LWH are twice as likely to experience IPV than non-HIV infected Black women. IPV experiences among Black women LWH are associated with decreased access to social support resources and impaired mental and physical health. Cognitive behavioral approaches (CBA) are efficacious to reducing stigma, improving IPV safety strategies, and increasing HIV care engagement, yet interventions designed for Black women LWH and experiencing IPV are lacking.  Furthermore, few CBA interventions leverage the existing resilience of Black women LWH using a sources of strength framework.  The overarching aim of this research is to conduct: a) component testing of an intervention among Black women with lived experiences of HIV and IPV; and b) a pilot study to evaluate acceptability, feasibility and preliminary efficacy of a 7-session small group-based CBA intervention to reduce HIV and IPV stigma and subsequently increase IPV safety strategies and HIV care engagement. The intervention is delivered by a trained community health worker and will enroll and randomize 80 IPV-exposed Black women LWH into the experimental CBA or control condition.

Title: Place-based Determinants of Violence & HIV Risk Experiences among Black Young Women in Baltimore Lead Investigator: Dr. Kamila Alexander

Intimate partner violence (IPV) disparities disproportionately affect Black adolescent and young adult (AYA) women ages 16-24 years living in areas with endemic HIV. In fact, homicide by an intimate partner is a leading cause of death and as many as 70% of women reporting lifetime IPV indicate their experiences occur before the age of 25.  In this research, we use an activity space approach to examine physical, sexual, or psychological IPV among Black AYA women living in the Baltimore Metropolitan area.  We define activity spaces as those places and spaces in which one engages in routine activities. These daily routines and paths constitute predictable and regular socio-behavioral patterns and are shaped by Black AYA women’s social networks; influencing access to resources and reflecting specific social norms that elevate risk or promote protection from IPV. Violence victimization is associated with several socio-spatial factors however, IPV among Black AYA women is often invisible, occurring in private, semi-private, or public spaces within the context of intimate relationships. Thus, there is an urgent need to develop effective and sustainable interventions that address place-based determinants of IPV to improve health outcomes for Black AYA women. The scientific premise of this research is that IPV and HIV risks and protective factors may shift as people move about their daily lives and might vary depending on a AYA woman’s individual characteristics.  

Title: Evaluating the influence of risk perception and cultural worldviews on HPV vaccination intention among Haitian immigrant women living with HIV Lead Investigator: Dominique Guillaume Faculty Mentor: Dr. Kamila Alexander

Haitian immigrant women in the United States experience some of the highest cervical cancer and HIV incidence rates nationwide. Despite their high objective risk of cervical cancer, Haitian immigrant women living with HIV are less likely to undergo HPV vaccination. Risk perceptions have been identified as a critical component of health behaviors; and studies have reported that women living with HIV have low perceived risk towards cervical cancer. Low levels of risk perception may negatively influence decisions to engage in health promotion behaviors such as HPV vaccination. This exploratory mixed-methods study guided by the PEN-3 Model and the Theory of Planned Behavior evaluates how HIV status, cultural worldviews, and affective measures of risk perception influence HPV vaccination intention among Haitian immigrant women living with HIV and Haitian immigrant women without HIV.

Hypothesis: Affective measures of HPV and cervical cancer risk perception will be more predictive of HPV vaccination intention than individual-level factors.