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In the decades since the first AIDS cases were reported in New York, San Francisco, and Los Angeles in 1981, the epicenter of the nation’s HIV epidemic has shifted from urban centers along the coasts to the Southern United States. According to Centers for Disease Control and Prevention (CDC), “the South now experiences the greatest burden of HIV infection, illness and deaths of any U.S. region, and lags far behind in providing quality HIV prevention and care to its residents” (CDC, 2016). Many people living in the Southern U.S. face a multitude of serious societal and systemic challenges that converge to delay both biomedical and structural interventions, often until it is too late. The burden of poverty, the cloud of stigma and prejudice, low health literacy and lack of insurance and access to care are among the critical challenges that face people living with or at risk for HIV in the region. Addressing the HIV/AIDS crisis is not limited to issues of healthcare access and delivery, but also involves navigating cultural norms and daily barriers to seeking and remaining in care.
There is a pronounced need to design, implement, and evaluate interventions to reduce HIV-related stigma for people living with HIV (PLHIV). This need is greatest in the Deep South, a subset of nine (9) states that is a significant driver of the HIV epidemic in the United States. PLHIV in the Deep South experience considerable HIV-related stigma. This stigma, particularly when internalized, is associated with negative health outcomes, including poorer medication adherence and missed medical appointments. Consequently, fewer Southerners living with HIV receive timely medical care and treatment, fewer have their virus suppressed, and a disproportionate number are missing out on the opportunity to preserve their health and avoid transmitting the virus to their partners. Mortality in the South remains alarmingly high as a result, with death rates in some southern states reaching nearly three times higher than the national average.
The Southern AIDS Coalition is seeking to partner with four (4) community-based organizations to implement and evaluate the following HIV-related stigma reduction interventions:
- LEAD (Leadership, Education, and Advocacy Development) Academy: LEAD Academy is a retreat-style health promotion intervention (spanning 2 nights and 2.5 days) designed to combat HIV-related stigma by training PLHIV to be leaders, educators, and advocates in their communities. The curriculum was created by and for people living with HIV in the South, and all content is delivered in-person and on-site by PLHIV in conjunction with subject matter experts and local partners. Upon completion of the LEAD Academy, participants graduate as “Southern LEADers” with advanced knowledge of HIV, real-world experience with advocacy, and the skills to serve as leaders and trusted sources of information within their communities. LEAD Academy is most appropriate for PLHIV who already understand the basic facts of HIV transmission and advocacy and who are ready to serve as leaders within their communities.
- Younity Workshop: Younity Workshop is a two-session group-level intervention that teaches PLHIV techniques and skills to reduce internalized HIV-related stigma. The intervention is based on the HIV Stigma Toolkit developed by the International Center for Research on Women, and the materials were originally adapted for use among women in the United States by researchers at the University of Washington. We have further adapted the intervention for use among men as well as men in the U.S. South. Younity Workshop is most appropriate for PLHIV who are newly diagnosed or who are struggling to accept their HIV diagnosis.
Mandatory Orientation Meeting: If selected, partner organizations will be required to send two (2) representatives to an orientation meeting in Birmingham, Alabama, tentatively scheduled for April 10-12, 2019. All expenses related to attendance at the orientation meeting will be covered by the Southern AIDS Coalition.
Compensation: The Southern AIDS Coalition will cover all reasonable expenses related to implementation of the interventions, including lodging (for LEAD Academy), meals, printing, and incentives (estimated at $125 per participant for LEAD Academy and $75 per participant for Younity Workshop). In addition, partner organizations will receive an award compensated in the amount of $10,000.
- Geographic Location: Partner organizations must be located in and doing work in one of nine Deep South states: Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, or Texas. Having experience with working in both urban and rural regions within your state.
- Non-Profit Status: Partner organizations must be non-profit and tax-exempt as set forth in section 501(c)(3) of the Internal Revenue Code. Applicants without federal non-profit status must have a fiscal sponsor that is a 501(c)(3).
- Capacity to Recruit Participants: Partner organizations must have the capacity to recruit at least 46 people living with HIV (of different ages and gender orientation) to participate in the interventions: sixteen (16) for LEAD Academy and thirty (30) for Younity Workshop. The majority of participants should be people of color, but other people living with HIV are permitted to participate. Please note: participants cannot participate in both interventions. The majority of participants should be people of color, but other people living with HIV are permitted to participate.
- Willingness to Assign Point Person: Partner organizations must designate one (1) staff person to serve as the official point person for this partnership. The staff person is expected to assist with all logistics, lead recruitment efforts, and actively participate in regular phone calls with SAC and other partners.
- March 6, 2019 (11:59pm): Application Due Date
- March 15, 2019: Notification of Selected Partners
- April 10-12, 2019: Orientation meeting in Birmingham, Alabama
- May & June: Implementation of LEAD Academy
- July - October: Implementation of Younity Workshop
- December & January: Reunion dinner (and final data point)
Evaluation: This is a research project. Ultimately, our goal is to identify scalable and fundable interventions that are affective at reducing HIV-related stigma and capable of being replicated elsewhere in the South. As such, we are deeply committed to the evaluation of LEAD Academy and Younity Workshop. If selected, partner organizations will be required to work collaboratively with our research team at the Duke University Center for Health Policy and Inequalities Research (CHPIR).
Please retun to the Home Page to apply for this funding opportunity.