# Exploring Syndemic Factors associated with HIV and STI Testing Preferences Among Students at an HBCU in Alabama

> **NIH NIH P30** · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2023 · $222,750

## Abstract

PROJECT SUMMARY
Black adolescents and young adults (AYAs) are disproportionately affected by the HIV epidemic. In Alabama
(AL), a state identified in the Ending the HIV Epidemic (EHE) initiative for America as a geographic hot spot, over
30% of new HIV infections occur in people aged 13 to 24 with over 80% of these infections occurring in Black
AYAs. In addition to high HIV incidence rates among this population, sexually transmitted infection (STI) rates
are also high in the South with Black AYAs disproportionately impacted. Given the largely asymptomatic nature
of both HIV and STIs, testing is necessary for diagnoses; however only 9% of adolescents have ever been tested
for HIV and yearly STI testing rates for this population are around 9%. Utilizing a syndemic theory approach
requires the consideration of other co-existing epidemics among this population, such as mental illness, drug
usage, and the social determinants of health (SDH) and how they may synergistically increase HIV and STI
acquisition risk. To improve HIV diagnosis in an EHE priority area we propose to evaluate various HIV and STI
testing modalities (i.e., facility based versus at home testing). We will assess the feasibility, acceptability, and
testing modality preferences for student populations at a Historically Black College and University (HBCU),
Stillman College, in Tuscaloosa, AL. The RE-AIM and CFIR implementation science frameworks will be utilized
in addition to a syndemics theory framework to better understand the role of syndemics in testing modality
preferences and follow through. In Aim 1, we will collect process data from Five Spot, the HIV and STI testing
provider and our community partner, to evaluate the uptake, distribution, and use of various STI and HIV testing
modalities. Five Spot will offer HIV and STI testing options to students attending Stillman while collecting data
on testing uptake and follow-up care (e.g., number of students tested, STI and HIV testing modality used, number
of students testing positive for any STI and/or HIV, testing and/or treatment/linkage to care or prevention). In
Aim 2, we will use a quantitative, online survey with 135 students attending Stillman College to assess
preferences for STI and HIV testing modalities (i.e., facility-based versus at home testing, secondary distribution
to partners), sexual risk behaviors, STI and HIV testing history, past medical history, implementation outcomes
informed by RE-AIM, and syndemic factors that may impact testing uptake and testing preferences, such as
mental illness, drug usage, and SDH. In Aim 3, we will conduct qualitative in-depth interviews with key
stakeholders and students attending Stillman College to explore barriers and facilitators to uptake and/or follow
through of HIV/STI testing and treatment and identify additional needed services. The stakeholder interviews will
focus on sustainability, opportunities for expansion, and unmet needs. We will solicit feedback from our
Communit...

## Key facts

- **NIH application ID:** 10814063
- **Project number:** 3P30AI027767-35S3
- **Recipient organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Principal Investigator:** Renee A. Heffron
- **Activity code:** P30 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $222,750
- **Award type:** 3
- **Project period:** 1997-03-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10814063

## Citation

> US National Institutes of Health, RePORTER application 10814063, Exploring Syndemic Factors associated with HIV and STI Testing Preferences Among Students at an HBCU in Alabama (3P30AI027767-35S3). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10814063. Licensed CC0.

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