Stigma-Reduction Intervention for HIV Prevention

Overseen By Rodman Turpin, PhD

Age: 18+

Sex: Male

Trial Phase: Academic

Sponsor: George Mason University

Must be taking: PrEP

Disqualifiers: HIV positive, refusal of HIV testing

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

120 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of the proposed research is to design a peer-based community intervention focused on addressing internalized homophobia, internalized racism, HIV stigma, and peer BSMM support to increase PrEP initiation among BSMM in Prince George's County, MD. Participants will attend intervention events focused on stigma reduction and building community among Black queer men. Researchers will compare intervention and control group participants to see if there in a difference in PrEP initiation and adherence.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment MPowerment Stigma-reduction Intervention for HIV prevention?

Research shows that the MPowerment intervention, which is similar to the MPowerment Stigma-reduction Intervention, has been effective in reducing risky sexual behavior and increasing HIV testing among young men who have sex with men. This suggests that the stigma-reduction component could also help in HIV prevention by addressing social factors that contribute to HIV risk. ^{1 2 3 4 5}

How does this stigma-reduction treatment for HIV prevention differ from other treatments?

This treatment is unique because it addresses multiple levels of stigma (personal, social, and community) that men who have sex with men face, rather than focusing on just one type of stigma. It uses a combination of education, peer support, and community leader involvement to reduce stigma and increase HIV testing. ^{3 6 7 8 9}

Research Team

Rodman Turpin, PhD

Principal Investigator

George Mason University

Eligibility Criteria

This trial is for HIV-negative, Black sexual minority men who are 18 or older. Participants must live in Prince George's County, Maryland, or have had a sexual partner there within the past year. Those who are HIV positive or refuse HIV testing cannot join.

Inclusion Criteria

You do not have HIV.

I am male.

I am 18 years old or older.

Exclusion Criteria

HIV Positive

Refusal of HIV testing

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants engage in peer-based community intervention events focused on reducing internalized homophobia, racism, and HIV stigma, and increasing social support to boost PrEP initiation.

4-8 weeks

Multiple community events (in-person)

Follow-up

Participants are monitored for PrEP initiation and adherence, with blood spot tests conducted to assess adherence.

6 months

1 visit (mail-in blood spot test)

Treatment Details

Interventions

• MPowerment Stigma-reduction Intervention

Trial Overview The study tests a peer-based community intervention aimed at reducing stigma and increasing support among Black queer men to encourage PrEP use for preventing HIV. It will compare those receiving the intervention with a control group to assess differences in starting and sticking with PrEP.

Participant Groups

Group I: Intervention Experimental Treatment 1 Intervention

This is the arm engaging in the stigma-reduction and support-increasing activities.

Group II: Comparison Active Control 1 Intervention

This is the arm not engaging in the stigma-reduction and support-increasing activities.

Who Is Running the Clinical Trial?

George Mason University

Lead Sponsor

Trials

60

Recruited

50,200+

Findings from Research

The Mpowerment-based community intervention significantly improved psychosocial factors such as social diffusion of safer sex messages and comfort with being gay among young black MSM over 4 years, indicating its effectiveness in reducing HIV risk behaviors.

While the intervention showed positive effects on social diffusion and depressive symptoms, it also highlighted challenges, as participants reported less favorable attitudes towards condom use and difficulties in sexual situations, suggesting a need for a more comprehensive approach to address broader health issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of a Community-Level HIV Prevention Intervention on Psychosocial Determinants of HIV Risk Behaviors among Young Black Men Who Have Sex with Men (YBMSM). Eke, AN., Johnson, WD., O'Leary, A., et al.[2022]

The Mpowerment (MP) intervention significantly increased HIV testing and self-efficacy for safer sex among 298 young men who have sex with men (MSM) of color over a 3-year period, indicating its effectiveness in promoting safer sexual behaviors.

Participants reported higher self-acceptance as MSM and improved perceptions of positive social norms regarding safer sex after the intervention, although the reduction in condomless anal/vaginal sex was only noted at the first follow-up.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An Evaluation of Mpowerment on Individual-Level HIV Risk Behavior, Testing, and Psychosocial Factors Among Young MSM of Color: The Monitoring and Evaluation of MP (MEM) Project. Shelley, G., Williams, W., Uhl, G., et al.[2022]

The study aims to develop a multi-level intervention to reduce intersectional stigma faced by men who have sex with men (MSM) in Ghana, which is crucial for improving HIV testing rates among this population.

By conducting a cluster randomized controlled trial with 216 MSM participants, the research will assess the effectiveness of combined stigma-reduction strategies at different levels (health care facility, peer group, and individual) in increasing HIV testing uptake over 3 and 6 months.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multi-level intersectional stigma reduction intervention to increase HIV testing among men who have sex with men in Ghana: Protocol for a cluster randomized controlled trial. Nelson, LE., Nyblade, L., Torpey, K., et al.[2022]

Stigma surrounding HIV significantly affects both individuals living with HIV and those who could benefit from prevention services, and it is crucial to analyze how stigma is perpetuated within healthcare service delivery systems.

The commentary emphasizes the need for new strategies to reduce stigma in HIV service implementation, advocating for stigma reduction to be a core outcome in research and evaluation to improve health equity for affected populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Recognizing and disrupting stigma in implementation of HIV prevention and care: a call to research and action. Golub, SA., Fikslin, RA.[2022]

The HIV Stigma Scale was revised and shortened from 40 to 32 items based on a study of 157 individuals living with HIV/AIDS, maintaining four key factors that measure different aspects of stigma.

The revised scale demonstrated high internal consistency (Cronbach's alphas between .90 and .97), confirming its reliability and validity for assessing stigma perceptions among people living with HIV/AIDS.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Measurement of stigma in people with HIV: a reexamination of the HIV Stigma Scale. Bunn, JY., Solomon, SE., Miller, C., et al.[2022]

The community intervention in South Africa effectively reduced HIV stigma among people living with HIV (PLWH) and those close to them, enhancing relationships and increasing willingness to disclose HIV status.

Participants reported improved knowledge about stigma and coping strategies, empowering them to lead stigma reduction efforts in their communities, indicating a positive impact on community awareness and support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A comprehensive HIV stigma-reduction and wellness-enhancement community intervention: a case study. French, H., Greeff, M., Watson, MJ., et al.[2015]

The systematic review identified 11 effective interventions that reduce HIV stigma among men who have sex with men (MSM), highlighting the importance of addressing both internalized and anticipated stigma through various strategies.

Interventions were categorized into three mechanisms: intrapersonal strategies (like education), interpersonal strategies (such as peer support), and structural strategies (community sensitization), all of which work together to promote self-acceptance and social empowerment, ultimately improving HIV prevention and care engagement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A realist systematic review of stigma reduction interventions for HIV prevention and care continuum outcomes among men who have sex with men. Dunbar, W., Labat, A., Raccurt, C., et al.[2021]

Reducing stigma and discrimination related to HIV and AIDS is essential for achieving an AIDS-free generation, as highlighted by recent political initiatives from UNAIDS, UN, and PEPFAR.

To effectively incorporate stigma reduction into national AIDS plans, the research community must standardize intervention assessments, clearly connect activities to specific stigma domains, and link these reductions to improved HIV prevention and treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Editorial: Global action to reduce HIV stigma and discrimination. Grossman, CI., Stangl, AL.[2022]

A new HIV Stigma Scale was developed and validated using responses from 318 individuals with HIV, demonstrating strong reliability and validity in measuring perceived stigma.

The scale identified four key factors related to stigma: personalized stigma, disclosure concerns, negative self-image, and public attitudes, which are important for understanding the psychosocial impact of living with HIV.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Measuring stigma in people with HIV: psychometric assessment of the HIV stigma scale. Berger, BE., Ferrans, CE., Lashley, FR.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Effect of a Community-Level HIV Prevention Intervention on Psychosocial Determinants of HIV Risk Behaviors among Young Black Men Who Have Sex with Men (YBMSM). [2022]

2. United States pubmed.ncbi.nlm.nih.gov

An Evaluation of Mpowerment on Individual-Level HIV Risk Behavior, Testing, and Psychosocial Factors Among Young MSM of Color: The Monitoring and Evaluation of MP (MEM) Project. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Multi-level intersectional stigma reduction intervention to increase HIV testing among men who have sex with men in Ghana: Protocol for a cluster randomized controlled trial. [2022]

4. Switzerland pubmed.ncbi.nlm.nih.gov

Recognizing and disrupting stigma in implementation of HIV prevention and care: a call to research and action. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Measurement of stigma in people with HIV: a reexamination of the HIV Stigma Scale. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

A comprehensive HIV stigma-reduction and wellness-enhancement community intervention: a case study. [2015]

7. England pubmed.ncbi.nlm.nih.gov

A realist systematic review of stigma reduction interventions for HIV prevention and care continuum outcomes among men who have sex with men. [2021]

8. Switzerland pubmed.ncbi.nlm.nih.gov

Editorial: Global action to reduce HIV stigma and discrimination. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Measuring stigma in people with HIV: psychometric assessment of the HIV stigma scale. [2022]