Using PrEP and Doing it for Ourselves (UPDOs Protective Styles), a Web-Based Salon Intervention to Improve Uptake of Pre-exposure Prophylaxis Among Black Women: Protocol for a Pilot Feasibility Study

BACKGROUND

Multilevel interventions are necessary to address the complex social contributors to health that limit pre-exposure prophylaxis use among Black women, including medical distrust, pre-exposure prophylaxis stigma, and access to equitable health care. Strategies to improve knowledge, awareness, and uptake of pre-exposure prophylaxis among Black women will be more successful if information-sharing and implementation take place within trusted environments. Providing women with information through trusted cultural and social channels can effectively support informed decision-making about pre-exposure prophylaxis for themselves and members of their social networks who are eligible for pre-exposure prophylaxis.

OBJECTIVE

The goal of this project is to improve knowledge, awareness, uptake, and trust of pre-exposure prophylaxis, as well as reduce pre-exposure prophylaxis stigma, among Black women living in the US South.

METHODS

This multilevel, mixed methods study uses a community-engagement approach to develop and pilot test a salon-based intervention. There are three components of this intervention: (1) stylist training, (2) women-focused entertainment videos and modules, and (3) engagement of a pre-exposure prophylaxis navigator. First, stylist training will be provided through two 2-hour training sessions delivered over 2 consecutive weeks. We will use a pre- and posttest design to examine knowledge and awareness improvement of pre-exposure prophylaxis among the stylists. Upon full completion of training, the stylists will receive a certificate of completion and "Ask Me about PrEP" signage for their beauty salons. Second, together with the community, we have codeveloped a 4-part entertainment series (The Wright Place) that uses culturally and socially relevant stories to highlight key messages about (1) HIV, (2) pre-exposure prophylaxis, and (3) Black women's social contributors to health. Quantitative and qualitative measures will be used in a pre- and posttest design to examine pre-exposure prophylaxis knowledge, awareness, risk, stigma, trust, intentions, and women's perceptions of the usability and acceptability of the overall intervention and its implementation strategies. A video blog will be provided after each video. Third, participants will have access through an email or text message link to a pre-exposure prophylaxis navigator, who will respond to them privately to answer questions or make referrals for pre-exposure prophylaxis as requested.

RESULTS

This project was funded in October 2020 by Gilead Sciences and was approved by the Duke University School of Nursing institutional review board in April 2021 (Pro00106307). Intervention components were developed in partnership with community partners in the first year. Data collection for phase 1 began in April 2022. Data collection for phase 2 began in May 2022. The study will be complete by October 2022.

CONCLUSIONS

Multilevel interventions that consider the assets of the community have promise for promoting health among Black women who have influence within their social networks. The findings of this study have the potential to be generalizable to other populations.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/34556.

[Mobilisation of reserve mannan in germinating date seeds]

Morphological and biochemical studies of the decomposition of endosperm tissue in germinating date seeds have shown that the mobilisation of reserve substances is effected with the help of exoenzymes. The depolymerisation of the mannan chain takes place in a "dissolution zone" surrounding the haustorium. This dissolution zone can be further divided into two sub-zones; a primary zone (consisting of several cell layers) where the secondary wall becomes swollen but does not lose its form, and a secondary zone (much smaller) where the mannan is broken down to mannose residues. The cellulose of the primary wall resists decomposition and remains as threadlike elements in the secondary zone.From the results of qualitative and quantitative sugar determinations it is evident that mannose is the endproduct of mannan decomposition. The mannose is then absorbed by the haustorium.From incubations in vitro of solutions of mannan A with haustoria a number of oligosaccharides were isolated. The substances found included fragments of pure mannan chains containing 1-5 mannose residues. In much smaller amounts oligosaccharides containing glucose and mannose residues were found. It is of interest to note that myoinositol was also detected.The failure to detect phosphorylase activity and the absence of phosphorylated intermediary products in the dissolution zone suggest that a hydrolytic process must be involved in the decomposition of the mannans.After absorption by the seedling, mannose is converted into sucrose, but the mechanism of this synthesis was not clearly determined. No sugar nucleotides were detected in the dissolution zone. In in vitro experiments with enzymes extracted from the haustorium (to observe possible sugar nucleotide formation) only UTP, and not GTP, was found to react with mannose.A possible reaction scheme for the conversion of mannan to sucrose is proposed, and form in which sugar is transported from the endosperm to the seedling is discussed.