Reducing HIV Stigma for African American Women

African American women account for 66% of HIV infections in women in the U.S., AIDS is a
leading cause of death for African American women, and African Americans have the lowest
medication adherence rates compared to other groups in the U.S. One of the reasons for low
medication adherence among African Americans is fear of stigma. HIV stigma has been linked
to depression, psychological distress, poor quality of life, poor medication adherence and
service utilization contributing to morbidity and mortality. Research has found that stigma
is a moderator to poor adherence via depressive symptoms.

The current study is a randomized control trial with a time and attention control group to
test the effectiveness of a stigma reduction intervention adapted for use with African
American women. A total of 224 African American women will be recruited to participate in
the study. Half of the women will be from Chicago, Illinois (112) and the other half will be
from Birmingham, Alabama (112). A workshop will be held once a study site has recruited 28
women, half of the women will be in the intervention group (14) and the other half will be
in the control group (14). Each study site will have 4 cohorts of 28 women.

The main aims of the current study are:

1. to determine the long-term effectiveness of the intervention to reduce stigma for
African American women living with HIV in Chicago Illinois and Birmingham, Alabama

2. to examine whether stigma reduction due to the intervention is associated with improved
physical health biomarkers (CD4+ T cell count, viral load), mediated by reduced
psychological symptoms (depressive symptoms), improved engagement to care, and improved
medication adherence

3. to explore whether stigma reduction due to the intervention is moderated by location
(Chicago vs. Birmingham), transmission risk factor, time since diagnosis, and perceived
social support

We expect that the multimedia workshop intervention will demonstrate effectiveness in
reducing internalized stigma through an easily-disseminated method, and that it will have a
positive impact on medication adherence and engagement in care for African American women
living with HIV.