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- Title
The Influence of Housing Status and Food Insecurity on a Behavioral HIV/STI Prevention Intervention for Black Women under Community Supervision in New York City: A Moderation Analysis.
- Authors
Dsouza, Nishita; Gilbert, Louisa; Russo, Mary; Johnson, Karen; Chang, Mingway; Dasgupta, Anindita; Sabounchi, Nasim; Lounsbury, David; Wu, Elwin; El-Bassel, Nabila; Goddard-Eckrich, Dawn
- Abstract
Black women in community supervision programs (CSPs) are disproportionately affected by HIV and other sexually transmitted infections (STIs). A randomized controlled trial of a group intervention titled Empowering African-American Women on the Road to Health (E-WORTH) demonstrated effectiveness in reducing sexual risk behaviors and STI incidence among Black women in CSPs. This secondary analysis aimed to assess the moderating effects of housing status and food security on E-WORTH effectiveness in reducing sexual risk behaviors and cumulative incidence of STIs over a 12-month period which were found significant in the original trial among a sample of 351 Black women in CSPs in New York City who use drugs and/or engage in binge drinking who reported engaging in HIV risk behaviors or testing positive for HIV. We examined the moderating effects of housing stability, housing independence, and food insecurity on reducing cumulative STI incidence and number of unprotected sex acts using mixed-effects negative binomial regression and logistic regression models that controlled for age, high school education, employment status, and marital status. Findings indicate that the intervention effect was moderated by housing stability, but not housing independence or food security. Compared to the control group, E-WORTH participants who were housing insecure had 63% fewer acts of condomless sex. Our findings highlight the importance of interventions designed for women in CSPs that account for upstream determinants of health and include service linkages to basic needs provisions. Further research is needed to unpack the cumulative impacts of multiple experiences of poverty faced by this population.
- Subjects
NEW York (State); PREVENTION of sexually transmitted diseases; HIV prevention; RESEARCH funding; SECONDARY analysis; RISK-taking behavior; SOCIAL determinants of health; FOOD security; LOGISTIC regression analysis; PSYCHOLOGY of women; UNSAFE sex; PSYCHOLOGY of Black people; HEALTH behavior; HOUSING; FACTOR analysis; COMMUNITY-based social services
- Publication
AIDS & Behavior, 2024, Vol 28, Issue 9, p3161
- ISSN
1090-7165
- Publication type
Article
- DOI
10.1007/s10461-024-04403-1