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D. Rao, M. Desmond, M. P. Andrasik, T. Rasberry, N. Lambert, S. E. Cohn, J. M. Simoni

Feasibility, Acceptability, and Initial Efficacy of the ‘Unity Workshop’: An Internalized Stigma Reduction Intervention for African-American Women Living with HIV. D. Rao, M. Desmond, M. P. Andrasik, T. Rasberry, N. Lambert, S. E. Cohn, J. M. Simoni. Conceptual Model. Culture

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D. Rao, M. Desmond, M. P. Andrasik, T. Rasberry, N. Lambert, S. E. Cohn, J. M. Simoni

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  1. Feasibility, Acceptability, and Initial Efficacy of the ‘Unity Workshop’: An Internalized Stigma Reduction Intervention for African-American Women Living with HIV D. Rao, M. Desmond, M. P. Andrasik, T. Rasberry, N. Lambert, S. E. Cohn, J. M. Simoni

  2. Conceptual Model Culture (Social norms, shared beliefs about body, health & illness, power structures) Culture (Social norms, power structures, shared beliefs about body, health & illness,) Public Stigma Institutionalized Stigma Public Stigma Institutionalized Stigma Public Level Individual Level Race Race Internalized Stigma Poor Treatment Utilization Poor Health Outcomes Poor Treatment Utilization Gender Gender Health Condition(s) (Other Statuses) 1Rao et al., 2007 2Rao et al., 2011

  3. Reducing HIV/AIDS Stigma • Societal level1 • Removal of institutional stigmas • Microfinance programs (economic empowerment) • Community organizing • Individual level2,3 • Education/Information • Coping Skills Acquisition • Contact with Affected Persons (e.g. Social Support) 1Link & Phelan, 2001; 2 Brown, Trujillo, Macintyre, 2001; 3Corrigan, 2011

  4. ICRW HIV Stigma Toolkit • HIV Stigma Toolkit developed by International Center for Research on Women (ICRW)1 • Developed in Zambia, facilitators trained globally • We chose from 40+ exercises based on focus groups feedback • We developed ‘trigger videos’ from Toolkit scenarios/focus group content in order to • model proactive behaviors • trigger discussion 1Kidd, Clay, Chiiya, 2007

  5. The Unity Workshop • Piloted as 8-hour workshop across 2 afternoons • Peer facilitated • Group setting • Participants • 24 African American women living with HIV • Living with HIV from 3 months to 25 years

  6. Content Examples • “Group Expectations” (e.g. Mutual Respect, No right or wrong answers) • Personal Experiences of Stigma • Coping with Stigma (sharing methods) • Role play – navigating stigmatizing situations

  7. Web of String represented “Peace,” “Unity,” “Togetherness”

  8. Methods • Pre-test post-test design • Paired t-tests • Primary outcome: Stigma Scale for Chronic Illness (SSCI), 14 item scale adapted for African-Americans living with HIV1 1Rao, Choi, et al., 2009; Rao, Molina, et al., under review

  9. Results • Day 1 to 2: t=2.05 (df=20), p=0.054 • Day 1 to Day 8: t=1.95 (df=18), p=0.067

  10. Limitations/Future Directions • No control group • Trends/non-significance likely related to small sample size • Booster session potentially helpful • Next step: randomized clinical trial

  11. Thank You! • Our Participants • Tom Furtwangler (Video Producer), James and Margaret Longley (Camera and Sound), Yamile Molina (Scripting) • NIH K23 MH 084551 Questions? deeparao@uw.edu

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