K01DA059328

HIV Risk, Prep Disparities, and Stigma Among Women Who Use Drugs (WWUD) in the U.S. South, with Attention to Race and Sexual Orientation: A Mixed-Method Intersectionality Study - Project Summary/Abstract

HIV infection among cisgender women who use drugs (WWUD) in the US South is a critical public health issue. WWUD with diverse marginalized identities (e.g., black heterosexual, white sexual minority) experience intersectional stigma uniquely, which can result in HIV risk/protective behavior (e.g., condomless sex, social support) and impact access to HIV prevention healthcare resources (Prep). WWUD are Prep indicated, but their Prep continuum outcomes (i.e. awareness, acceptability, uptake) remain low.

WWUD have complex proximal (e.g., syringe sharing) and distal (e.g., intersectional stigma experiences in healthcare settings) HIV risk/resilience experiences that require further examination to develop effective interventions. Intersectionality theory, undergirding this proposal, acknowledges interlocking power dynamics (e.g., racism) playing out in social processes (e.g., intersectional stigma) to impact health outcomes and disparities.

The proposed mixed-method research aims to study HIV risk/resilience, healthcare barriers/facilitators, and Prep continuum disparities among WWUD in the US South, employing an intersectional strengths-based analytical lens to inform multi-level stigma-reduction, HIV prevention, and Prep promotion initiatives.

To do so, I will first describe HIV risk and Prep continuum disparities by identifying WWUD subgroups based on intersectional identity (i.e., race x sexual orientation) and contextual factors (e.g., sex exchange) using intersectional quantitative approaches gained from training (e.g., latent class analyses) with Southern National HIV Behavioral Surveillance data (Aim 1).

Next, I will explore multi-level barriers/facilitators (e.g., intersectional stigma) in HIV prevention-related healthcare, HIV risk, and Prep continuum via qualitative healthcare go-along interviews with a purposively selected sample of Prep indicated WWUD in New Orleans, LA (Aim 2).

Subsequently, I will explore institutional practices related to WWUD identified barriers/facilitators to HIV prevention-related healthcare seeking, HIV risk, and Prep continuum utilizing institutional ethnography (Aim 3).

This proposed research will facilitate application of training objectives towards my long-term career goal of becoming an independent NIH-funded HIV prevention and health equity investigator. My career development plan, including an expert team of mentors, (Drs. Latkin, Bowleg, Theall, German, Baral), centers the following training objectives:

1) Develop comprehensive expertise in intersectionality theory application, associated mixed-methods study design approaches, and advanced ethnographic methodology (e.g., go-along interviews);
2) Develop advanced statistical theory and methods to conduct quantitative intersectionality analyses (e.g., latent class analysis);
3) Gain expertise in multi-level intersectional stigma theory and ethnographic methods (e.g., institutional ethnographies); and
4) Develop skills needed for a successful academic career in intersectional mixed-method HIV prevention research with vulnerabilized populations (e.g., research bioethics, multi-stakeholder dissemination, grant writing; and interdisciplinary networking).

Louisiana State University Health Sciences Center New Orleans

TO SUPPORT BASIC AND CLINICAL NEUROSCIENCE, BIOMEDICAL, BEHAVIORAL AND SOCIAL SCIENCE, EPIDEMIOLOGIC, HEALTH SERVICES AND HEALTH DISPARITY RESEARCH. TO DEVELOP NEW KNOWLEDGE AND APPROACHES RELATED TO THE PREVENTION, DIAGNOSIS, TREATMENT, ETIOLOGY, AND CONSEQUENCES OF DRUG ABUSE AND ADDICTION, INCLUDING HIV/AIDS. TO SUPPORT RESEARCH TRAINING AND RESEARCH SCIENTIST DEVELOPMENT. TO SUPPORT DISSEMINATION OF RESEARCH FINDINGS. SMALL BUSINESS INNOVATION RESEARCH (SBIR) LEGISLATION IS INTENDED TO EXPAND AND IMPROVE THE SBIR PROGRAMS TO EMPHASIZE AND INCREASE PRIVATE SECTOR COMMERCIALIZATION OF TECHNOLOGY DEVELOPED THROUGH FEDERAL SBIR RESEARCH AND DEVELOPMENT, INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN THE SBIR PROGRAM. THE LEGISLATION INTENDS THAT THE SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.279 - Drug Abuse and Addiction Research Programs

National Institute on Drug Abuse (NIDA) [HHS - NIH]

New Orleans, Louisiana 701127021 United States

Single Zip Code

Mentored Research Scientist Development Award (Parent K01 - Independent Clinical Trial Not Allowed) (PA-20-190)

Amendment Since initial award the total obligations have increased 213% from $186,192 to $583,523.