# Status-neutral community-based multilevel intervention to address intersectional stigma and discrimination, and increase HIV testing, PrEP, and ART uptake among YGBMSM in Ghanaian Slums

> **NIH NIH R01** · UNIVERSITY OF ROCHESTER · 2024 · $465,030

## Abstract

Project Summary
Young gay, bisexual, and other men who have sex with men (YGBMSM) make up 63% of the HIV prevalence
(18%) among GBMSM in Ghana. Our previous studies show that intersectional stigma and discrimination (ISD)
(around HIV, sex, and gender expression) and insufficient HIV knowledge impede HIV testing, PrEP, and ART
(HPART) adherence among GBMSM. Those in slums face additional stigma associated with their communities;
hence the social and economic barriers in slum communities can intertwine with ISD to exacerbate the risk of
HIV infections and discourage HPART adherence among YGBMSM as they internalized stigma and avoid HCF.
A status-neutral approach to HIV care can reduce ISD among YGBMSM and HCFs and improve HPART among
YGBMSM. Yet, current HIV interventions and programs in Ghana have focused on separate services and
predominantly address only testing. To this effect, we propose to adapt a multilevel intervention (LAFIYA,
meaning wellness) to address ISD and HPART using status neutrality among YGBMSM and HCF in Ghanaian
slums. LAFIYA showed early efficacy in increasing HIV testing/self-testing among HIV-negative or unknown-
status YGBMSM in Ghanaian slums. Adaptation to a status-neutral intervention will extend its utility for HIV
prevention and care by utilizing scientific advancements around intersectional stigma, HIVST, PrEP, and linkage
to care. LAFIYA also mainly focused on GBMSM and involved providers from two facilities who received ISD
reduction training. The proposed LAFIYA will include HCF-wide training, PrEP, and ART components. Guided
by the eight steps of the ADAPTT-IT model, we will implement the two aims. 1) Adapt a multilevel intervention
to address ISD and HPART using status neutrality among YGBMSM. We will conduct FGDs and in-depth
interviews (IDI) with YGBMSM (n=70), GBMSM providers (n=20), and NURSES/HCWs (n=80) to deepen
understanding of ISD, barriers, and facilitators of HPART adherence among YGBMSM. In a summative analysis,
we will integrate realities from providers and YGBMSM to optimize the intervention potential to address ISD and
increase HPART. 2) Test the preliminary efficacy of the intervention to address ISD and increase HPART
adherence using CRT Design. We will assign YGBMSM (n=240) friend groups to control or intervention groups
(n=120) and HCF(n=6) to control or intervention (n=3). The intervention arm will receive LAFIYA. We will collect
3, 6, and 9 months post-intervention data among YGBMSM (n=240) and HCWs(n=300). to measure HPART
adherence (primary outcomes), ISD reduction, HIV and status-neutral knowledge (secondary outcomes), and
acceptability, appropriateness, and feasibility of the intervention (implementation outcomes). We will conduct
additional focus groups and interviews post-intervention among implementers and participants (sample sizes
same as in AIM1) to evaluate their experiences with the intervention. The findings will inform intersectional stigma
reduction and HIV status-neutral impl...

## Key facts

- **NIH application ID:** 10932383
- **Project number:** 5R01NR021170-02
- **Recipient organization:** UNIVERSITY OF ROCHESTER
- **Principal Investigator:** Gamji Rabiu Abu-Ba'are
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $465,030
- **Award type:** 5
- **Project period:** 2023-09-20 → 2025-03-21

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10932383

## Citation

> US National Institutes of Health, RePORTER application 10932383, Status-neutral community-based multilevel intervention to address intersectional stigma and discrimination, and increase HIV testing, PrEP, and ART uptake among YGBMSM in Ghanaian Slums (5R01NR021170-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10932383. Licensed CC0.

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