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HIV Prevention

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: 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: Ending the HIV Epidemic (EHE) – Prevention Services Lead Investigator: Dr. Jason E. Farley

Ending the HIV Epidemic (EHE) Prevention Services Program collaborates with surrounding community clinics, the needle exchange program, housing venues, and other community support partners to reduce the spread of HIV and increase access to PrEP as well as linking individuals who test positive for HIV treatment.

This program is a 5-year Ryan White Special Early Intervention Services funded project in collaboration with the Baltimore City Health Department HIV / STD Prevention Program to reduce the number of new HIV infections. Our community health workers provide HIV, HCV and STI testing (via community outreach or home-based options), linkage to HIV / STI prevention and treatment services including PrEP and PEP via standard of care in clinics, mobile sites, or telehealth visits.

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Title: AIDS Education and Training Center (AETC), Regional Partner for the MidAtlantic AETC Lead Investigator: Dr. Jason E. Farley

The JHU MidAtlantic AIDS Education and Training Center is a Regional Partner with the University of Pittsburgh. We provide education, training, capacity building, clinical consultation, preceptorships and technical assistance on HIV and other comorbidities to health providers of Federally Qualified Health Centers, primary care sites, community health centers, medication assisted treatment centers, behavioral health centers, rural health centers, and Historically Black Colleges and Universities in the state of Maryland.

The JHU AETC trains health professionals from various backgrounds and locations throughout the region. Training is tailored to meet the HIV prevention, care, and treatment challenges of specific geographic areas, clinics, and individual clinicians. The training center works diligently to prepare providers with skills and knowledge that is tailored to the populations they serve. This individualized focus is a key element of the AETC’s success.

Our training and education are based on the unique needs of trainees, and provides the foundation for workshops, seminars, symposia, mini-residencies, teleconferences, and other training sessions that prepare providers and clinicians to provide effective HIV prevention, care, and treatment.

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Title: TAKE CHARGE STUDY: Sexual Health Services Designed by You for You​ Lead Investigator: Brenice Duroseau Faculty Mentor: Dr. Jason E. Farley

Cisgender Black women face consistent disparities in Human Immunodeficiency Virus (HIV) and sexually transmitted infections (STIs) as a result of implicit bias, racism, sexism, and structural barriers. In the United States (U.S.), cisgender Black women accounted for 19% of new HIV infections in 2019, and 55% of new HIV infections among all women despite only being 13% of the U.S. female population. Those same barriers continue to perpetuate inequities in sexual health by limiting access to sexual services and uptake of highly effective HIV/STI prevention options. Improving the sexual health of Black women is a public health issue of high importance due to the potential negative impact STIs and HIV have on health systems and the social, sexual, and reproductive health of Black women. To address this public health need, this study aims to advance access of sexual health services to cisgender Black women for HIV and STI prevention using a framework that engages the participants in personal sexual health options delivered through telemedicine.

Hypothsis: This telemedicine intervention will improve HIV/STI risk perception, increase engagement with STI/HIV screening, and make sexual health and HIV prevention a shared value among cisgender Black women living in Maryland.