Health Equity Considerations: HIV Intervention Adaptation for Black Women in Community Corrections
Karen A. Johnson, Timothy Hunt, Dawn Goddard‐Eckrich, Elwin Wu, Stanley Richards, Rick Tibbetts, Jessica Rowe, Quentin Maynard, Sharun Goodwin, Joana Okine, Milton L. Wainberg, Nabila El‐Bassel, Louisa Gilbert
Abstract
Objectives: This article describes the process used to adapt the only group-based, computer-assisted, HIV/sexually transmitted infections (STI) prevention intervention designed for drug-using Black women in community corrections using an integrated health equity ADAPT-ITT framework with a peer engagement lens. Methods: Key adaptation partners included cisgender, drug-using Black women in community corrections, and Black, female, community reentry providers slated to deliver the adapted intervention. Focus groups and a study pilot were held. Results: The resulting intervention, Empowering African-American Women on the Road to Health (E-WORTH), features HIV/STI-specific Afrocentric themes of risk and resiliency tailored for and by Black women in the criminal legal system. Evaluation of E-WORTH confirms its cultural resonance. Participants had a 54% lowered odds of testing positive for any STI and reported 38% fewer acts of condomless vaginal or anal intercourse at 12-month follow-up. Conclusions: Findings underscore the need to develop an adaptation model that is explicitly health equity in focus.