Overlapping syndemics: Integrating HIV prevention into a trauma-responsive psychosocial intervention for black women with experiences of intimate partner violence and depression
Arianne Morrison, Florence Momplaisir, Caroline O’Brien, Annet Davis, John B. JemmottObjective
We conducted a contextual inquiry to assess the acceptability of adapting an efficacious psychosocial intervention for Black women experiencing intimate partner violence (IPV) and depressive symptoms to incorporate PrEP education, skill building, and linkage to care.
Method
The Grady Nia Project is a psychoeducational group intervention shown to reduce depressive symptoms among Black women who have experienced IPV and suicide. To inform adaptation of the Nia Project in a new context, we recruited staff and residents from four residential substance use treatment facilities in Philadelphia for semi-structured interviews and a focus group. Interviews used the Consolidated Framework for Implementation Research (CFIR) and syndemic theory to understand (1) barriers and facilitators of delivery of the adapted intervention and (2) baseline knowledge, awareness, attitudes, and acceptability of PrEP within the organization and among the population they serve.
Results
Despite very low PrEP knowledge or awareness, participants expressed high PrEP acceptability and interest. All residents and staff thought the proposed intervention would provide relevant information related to HIV prevention and PrEP, not readily available through current programming. However, structural conditions shaped both enthusiasm for and feasibility of implementing the proposed intervention within the residential setting and staff and resident buy-in was contingent not only on intervention content, but on the organization’s capacity to support implementation.
Conclusions
Advancing equitable HIV prevention for Black women requires system-level integration of PrEP within intimate partner violence settings, alongside investment in organizational readiness, workforce capacity, and structural infrastructure to support sustainable PrEP delivery.