Primary Submission Category: Health behaviors
Digital Intervention Development to Increase HIV/STI Home Testing, Linkage to Care, and Linkage to PrEP among Black Women in Texas
Authors: Liesl Nydegger Camila Gaudin Gonzalez Mandy Hill J Mark Eddy
Presenting Author: Liesl Nydegger*
Black women in Southern states are disproportionately impacted by HIV; Black women account for 67% of new HIV cases among women in the US and over half of new HIV diagnoses occur in Southern states. Travis County, Texas—which includes Austin and has a population of over 1.2 million—is one of 48 US counties identified by US DHHS as an HIV hotspot (i.e., high HIV diagnoses). There are dramatic racial disparities in these diagnoses: Black women make up 8.2% of women in Travis County yet account for 51% of women living with HIV. Among all women in Travis County, over 20% who are HIV-positive learned about their diagnosis one year after transmission as a result of failure to seek or access HIV/STI testing. We conducted formative research to finalize a digital intervention that combines the situated, information-motivation-behavioral skills (sIMB) model, mental contrasting, and implementation intentions to increase home testing, and linkage to care and pre-exposure prophylaxis (PrEP) for Black women at high risk for HIV. To date, we conducted 5 virtual focus groups with N = 15 participants. Data collection is still underway. Preliminary results indicated low perceived HIV risk, and barriers to home testing, linkage to care, and linkage to PrEP. Examples of barriers included conducting the HIV/STI home test incorrectly, finding time to take the test, anxiety regarding receiving results, cost of treatment and transportation, lack of information about PrEP, and overall distrust due to past mistreatment of marginalized communities. Participant suggestions for overcoming barriers include having tutorials for conducting the home test, reminder emails and texts, telemedicine, and having empathetic providers deliver important results. Guided by sIMB, mental contrasting, and implementation intentions, results will inform the finalization of a digital intervention. Next steps include pilot testing the intervention to assess accessibility and feasibility, and then evaluate efficacy.