Strategies for HIV risk reduction among African American female middle school students:

A grant proposal

Vanessa Gonzales

California State University, Long Beach

May 2013

 

• African American females in the United States are disproportionately impacted by the Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) at alarming rates (Centers for Disease Control and Prevention, 2011a).

• In 2009, 39% of all new HIV infections were comprised of youth (ages 13-24 years), African Americans accounted for 65% of these new HIV infections (CDC, 2011c)

• One in every 32 African American women will contract HIV in her lifetime (CDC, 2011b)  

• The goal of the proposed program is to create and implement an effective HIV prevention intervention tailored for African American adolescent females in order to prevent increased risk for acquiring HIV by the time they reach adulthood.

Introduction

The CDC (2011a) lists contributing factors to the prevalence of HIV among the African American community to socioeconomic issues related to poverty (e.g., limited access to health care, housing, and HIV prevention education).  

Social Work Relevance According to the National Association of Social

Workers’ Code of Ethics (2008),  social workers should promote social justice. The disparity between the prevalence of HIV among the African American community and all other racial and ethnic groups is a social justice issue.  

African American girls will benefit from culturally appropriate risk reduction interventions.

• Social-network-based HIV risk reduction and social support interventions are needed for African American females (n=513) at risk of acquiring HIV and other STIs (Neblettt, Davey-Rothwell, Chander, & Latkin, 2011).

• Successful education for African American girls should be both gender and culturally specific, and should include modules on HIV transmission, condom usage, healthy relationships, and effective communication skills (DiClemente et al., 2004).

Cross-Cultural Relevance

• I n 2008 African Americans accounted for 25% of newly diagnosed HIV cases in Los Angeles County; yet, African Americans make up less than 10% of the entire county population (LACDPH, 2011).  

• Between the grades of 5 and 8, there is a significant increase in sexual activity among middle school students (De Rosa, et al., 2010).

MethodsThis intervention will target African American female

adolescents attending public middle schools in South Los Angeles, California.

An examination of sources including internet searches, resource directories, and grant-funding databases was utilized to identify potential funding sources at the federal, state, local and private levels. Further grant research entailed a visit to the Long Beach Nonprofit Library (http://www.lbnp.org/librarygrant-search).

MethodsBristol-Myers Squibb was selected as the funding source for their

commitment to improving health outcomes for racial and ethnic minorities, women, and the urban poor, as well as their history of funding community grants which support partnerships with non-profit agencies that work to eliminate health disparities (www.bms.com/pages/default.aspx ).  Information from the Los Angeles Office of AIDS Programs and Policy, the County of Los Angeles Department of Public health, the Centers for Disease Control and Prevention, and the U.S. Department of Health and Human Services was utilized to provide evidence of the impact of HIV and AIDS on the female African American community. In addition an extensive literature review of scholarly articles was conducted to further emphasize the need for new and innovative HIV prevention interventions.

The overall proposed program budget is $186,990.• Personnel costs $110,500• Operational costs $32,100• In-direct costs $24,390• In-kind donations$20,000

Grant ProposalThe proposed program will incorporate two different CDC DEBIs,

Focus on Youth and the Real AIDS Prevention Program, in order to work towards the eradication of HIV/AIDS by increasing risk awareness, harm reduction, and willingness to screen for the disease among African American female adolescents in South Los Angeles.

Over an 8-week period at a prearranged public middle school, and in a group of no more than ten, the pilot program participants will join in games, role plays, group discussions, and community projects which emphasize HIV and AIDS facts, assertive communication and refusal skills related to sexual behaviors.

Program participants, who volunteer for more in-depth training, will then be educated on implementing the intervention and delivering it to new participants. These individuals, now peer educators, will return for an additional 16-hour training which will include a module on hands-on community outreach. Subsequent tiers of participants will be drawn using snowball sampling, as peer educators will deliver the intervention in their own communities.

Program Objectives1. To hire necessary staff to implement the pilot program (i.e., MSW program

manager, two skilled program facilitators). 2. To partner with a South Los Angeles public high school where program

facilitators will present to various health classes in order to promote the program and begin the recruiting process.

3. To provide participants with HIV/AIDS education, and decision making and harm reduction skills in order to minimize their risk of acquiring HIV.

4. To train African American adolescent females as peer health educators who will in turn recruit and train new program participants from their own communities.

5. To increase community awareness regarding risk of HIV and the importance of screening for the disease.

Program Evaluation• The success of the proposed program will be measured utilizing both a pre-test/post-test

and a satisfaction survey.

Grant Proposal

• It was important for the grant writer to collaborate with community members in order to gain first-hand suggestions regarding the needs of the specific community the proposed program intends to target.

• African American adolescent females have largely been left out of HIV prevention discussions. Thus, there is currently a need for innovative HIV prevention interventions which take into consideration the unique needs of this population.

• There is the possibility for school social workers to link schools to not-for-profit agencies, such as Women Alive Coalition, Inc., which will be able to provide more in-depth education and training regarding safer sex practices, decision making, and risk awareness.

Lessons Learned/Implications for Social Work

ReferencesBristol-Myers Squibb. (2013). Retrieved from http://www.bms.com/pages/default.aspx

Centers for Disease Control and Prevention. (2011a). Fact sheet: HIV among African Americans. Retrieved from http://www.cdc.gov /hiv/topics/aa/PDF/aa.pdf

 Centers for Disease Control and Prevention. (2011b). Fact sheet: HIV among women. Retrieved from http://www.

cdc .gov/hiv/topics/women/pdf/women.pdf Centers for Disease Control and Prevention. (2011c). Fact sheet: HIV among youth. Retrieved from http://www. cdc.gov/hiv/youth/pdf/youth.pdf

County of Los Angeles Office of Public Health. (2011). 2011 Annual HIV Surveillance Report. Los Angeles, CA: LACDPH.

De Rosa, C.J., Ethier, K.A., Kim, D.H., Cumberland, W.G., Afifi, A.A., . . . Kerndt, P.R., (2010). Sexual intercourse and oral sex among public middle school students: Prevalence and correlates. Perspectives on Sexual and Reproductive Health, 42(3), 197-205.

DiClemente, R. J., Wingood, G. M., Harrington, K. F., Lang, D. L., Davies, S. L., Hook, E. W., . . . . Robillard, A. (2004). Efficacy of an HIV prevention intervention for African American adolescent girls: A

randomized controlled trial. Journal of the American Medical Association, 292(2), 171–1 79.

National Association of Social Workers. (2008). Code of Ethics of the National Association of Social Workers. Washington, DC: Author

Neblette, R.C., Davey-Rothwell, M., Chander, G., & Latkin, C.A. (2011). Social network characteristics and HIV sexual risk behavior among urban African American women. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 88(1), 54-65.