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Frye V, Paige MQ, Gordon S, Matthews D, Musgrave G, Greene E, Kornegay M, Farhat D, Smith PH, Usher D, Phelan JC, Koblin BA, Taylor-Akutagawa V. Impact of a Community-level Intervention on HIV Stigma, Homophobia and HIV Testing in New York City: Results from Project CHHANGE. Stigma Health 2019; 4:72-81. [PMID: 35317216 PMCID: PMC8936543 DOI: 10.1037/sah0000109] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
BACKGROUND HIV stigma and homophobia are barriers to access to HIV prevention and treatment services. Project CHHANGE, Challenge HIV Stigma and Homophobia and Gain Empowerment, was a multicomponent intervention designed to reduce community-level HIV stigma and homophobia via workshops, space-based events and bus shelter ads delivered to community-based organizations and neighborhood residents in a high HIV prevalence, primarily African-American, Black and/or Afro-Caribbean, neighborhood in New York City (NYC). METHODS Serial cross-sectional, street intercept surveys among residents of the invention neighborhood and matched control neighborhood were conducted before and after the intervention. Propensity score matching and generalized estimating equation regression models assessed the impact of CHHANGE on HIV stigma and homophobia. HIV testing service utilization data were assessed and multivariable models of self-reported HIV testing among post-intervention street survey respondents were built. RESULTS We did not find a significant treatment effect on HIV stigma and homophobia among residents of the intervention neighborhood as compared with control community residents. However, HIV testing increased by 350% at the testing site in the intervention community after the intervention implementation. Further, lower HIV stigma, attending an HIV stigma workshop and having friends or family living with HIV were independently associated with past six-month HIV testing among post-intervention respondents in both neighborhoods. CONCLUSIONS CHHANGE was feasible and acceptable to community residents. Evaluating community-level interventions is challenging. Our triangulated approach yielded somewhat conflicting results, which may be due to design limitations. Further research is needed to understand whether and how CHHANGE affected HIV testing.
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Affiliation(s)
- Victoria Frye
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, USA
- Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Mark Q. Paige
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, USA
| | - Steven Gordon
- Gay Men of African Descent (GMAD), Brooklyn, NY, USA
| | - David Matthews
- Brooklyn Men Konnect/Bridging Access to Care (BMK), Brooklyn, NY, USA
| | | | - Emily Greene
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, USA
- Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | | | - Davida Farhat
- Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Philip H. Smith
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, USA
| | - DaShawn Usher
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Jo C. Phelan
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Beryl A. Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
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Frye V, Paige MQ, Gordon S, Matthews D, Musgrave G, Kornegay M, Greene E, Phelan JC, Koblin BA, Taylor-Akutagawa V. Developing a community-level anti-HIV/AIDS stigma and homophobia intervention in new York city: The project CHHANGE model. Eval Program Plann 2017; 63:45-53. [PMID: 28371668 DOI: 10.1016/j.evalprogplan.2017.03.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 03/03/2017] [Accepted: 03/08/2017] [Indexed: 06/07/2023]
Abstract
HIV/AIDS stigma and homophobia are associated with significant negative health and social outcomes among people living with HIV/AIDS (PLWHA) and those at risk of infection. Interventions to decrease HIV stigma have focused on providing information and education, changing attitudes and values, and increasing contact with people living with HIV/AIDS (PLWHA), activities that act to reduce stereotyped beliefs and prejudice, as well as acts of discrimination. Most anti-homophobia interventions have focused on bullying reduction and have been implemented at the secondary and post-secondary education levels. Few interventions address HIV stigma and homophobia and operate at the community level. Project CHHANGE, Challenge HIV Stigma and Homophobia and Gain Empowerment, was a community-level, multi-component anti-HIV/AIDS stigma and homophobia intervention designed to reduce HIV stigma and homophobia thus increasing access to HIV prevention and treatment access. The theory-based intervention included three primary components: workshops and trainings with local residents, businesses and community-based organizations (CBO); space-based events at a CBO-partner drop-in storefront and "pop-up" street-based events and outreach; and a bus shelter ad campaign. This paper describes the intervention design process, resultant intervention and the study team's experiences working with the community. We conclude that CHHANGE was feasible and acceptable to the community. Promoting the labeling of gay and/or HIV-related "space" as a non-stigmatized, community resource, as well as providing opportunities for residents to have contact with targeted groups and to understand how HIV stigma and homophobia relate to HIV/AIDS prevalence in their neighborhood may be crucial components of successful anti-stigma and discrimination programming.
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Affiliation(s)
- Victoria Frye
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, United States; Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States; Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States.
| | - Mark Q Paige
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, United States
| | - Steven Gordon
- Gay Men of African Descent (GMAD), Brooklyn, NY, United States
| | - David Matthews
- Brooklyn Men Konnect/Bridging Access to Care (BMK), Brooklyn, NY, United States
| | | | | | - Emily Greene
- Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States
| | - Jo C Phelan
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Beryl A Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States
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