# Adaptation and evaluation of an intersectional stigma reduction intervention to increase HIV care engagement among women who use drugs

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2024 · $185,273

## Abstract

PROJECT SUMMARY
The goal of this R01 proposal is to adapt and pilot an intervention to reduce individual-level intersectional
HIV/AIDS and drug use stigma and increase retention in HIV care among women living with HIV and who use
drugs (HIV+ WWUD) in Ukraine. The scientific evidence is consistent across populations and settings that
stigma is associated with poor health outcomes. HIV stigma is associated with poor HIV medication
adherence; worse health outcomes, lower health care utilization, and low self-reported health status, low HIV
medication adherence, and diminished mental health. Drug use stigma is associated with poorer access to
health care, suboptimal engagement in HIV care, increased injection risk behaviors, and decreased use of
harm reduction and medical services. HIV+ WWUD experience worse health outcomes than other women
living with HIV. Intersectional stigma refers to the recognition that people may belong to multiple stigmatized
groups and that focusing on a single dimension of disadvantage (e.g., only HIV or only drug use) obscures how
these multiple identities interact and are compounded to produce specific health outcomes or statuses. Despite
the known impact of intersectional stigma on HIV care outcomes and advancements in HIV stigma reduction
strategies, few interventions have been developed, implemented, and tested to specifically address
intersectional HIV and drug use stigma among women to improve HIV care outcomes. We will adapt a small
group, multi-session intervention to train participants in cognitive and behavioral skills to improve adaptive
coping and reduce internalized and anticipated HIV and drug use stigma, develop communication skills to
respond to enacted stigma and enlist social support, and address structural barriers to ART The Specific Aims
of this study are: 1) To adapt the Workshop intervention for HIV+ WWUD using the ADAPT-ITT model; 2) To
assess the preliminary efficacy of the adapted intervention on primary clinical outcomes of HIV care
engagement and ART adherence and secondary outcome of drug treatment engagement; and 3) To assess
acceptability, feasibility, cost, and implementation-related processes and outcomes of the intervention. We will
enroll n=100 HIV+ WWUD who will be randomized to the intervention or control arm. To assess HIV outcomes,
participants will complete baseline and 3- and 6-month post intervention assessments to measure HIV care
engagement outcomes and changes in stigma mechanisms. We will also obtain medical records to validate
HIV care engagement and ART medication adherence. The proposed intervention is novel in that it addresses
intersectional stigma and seeks to intervene on specific stigma mechanisms that lead to worse HIV and other
health outcomes for HIV+ WWUD. This pilot study will increase understanding of the intervention and
contextual factors that will facilitate a larger RCT to determine the effectiveness of the intervention for HIV+
WWUD.

## Key facts

- **NIH application ID:** 11002878
- **Project number:** 1R01TW012908-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Tetiana Kiriazova
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $185,273
- **Award type:** 1
- **Project period:** 2024-08-09 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11002878

## Citation

> US National Institutes of Health, RePORTER application 11002878, Adaptation and evaluation of an intersectional stigma reduction intervention to increase HIV care engagement among women who use drugs (1R01TW012908-01). Retrieved via AI Analytics 2026-06-13 from https://api.ai-analytics.org/grant/nih/11002878. Licensed CC0.

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