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A Group-level Intervention to Reduce HIV/STI Risk for Women Who Have Sex With Women in Calgary and Toronto

Not Applicable
Completed
Conditions
Safer Sex
Interventions
Behavioral: Adapted Many Men, Many Voices (3MV) group level intervention
Behavioral: A group-based HIV/STI prevention intervention for women who have sex with women
Registration Number
NCT02067845
Lead Sponsor
University of Toronto
Brief Summary

The limited research that exists suggests that lesbian, bisexual and queer (LBQ) women are at similar risk for sexually transmitted infections (STI) as heterosexual women. This is a particularly important area to address, as literature highlights the convergence of sexual stigma and gender-based sexual violence as elevating LBQ women's risk for HIV and STI infection. However, recent Statistics Canada data indicated that: lesbians reported significantly lower rates of Pap testing than heterosexual or bisexual women; lesbians and bisexual women had higher odds of not having a regular doctor than heterosexual women; and bisexual women had higher reported unmet health care needs than lesbian and heterosexual women. These differences highlight the importance of implementing and evaluating interventions to address STI risk among LBQ women; however, no published study exists of this nature. A STI prevention intervention will be implemented with groups of LBQ women and WSW in Toronto and Calgary. The study has 5 distinct components: 1) key informant interviews to inform the development of the intervention training manual and survey questionnaire, 2) pre-test; 3) intervention (6 group sessions during a weekend retreat); 4) post-test directly following intervention, and 5) follow-up post-tests at 6 and 12 weeks. The study hypothesis is that, compared to pre-intervention, participants who receive the group-based intervention will report an increase in sexually transmitted infections (STI) knowledge post-intervention. The secondary hypotheses are that, compared with pre-intervention, participants will demonstrate higher mean scores of (a) safer sex self-efficacy; (b) STI testing; (c) safer sex practices; (d) resilient coping, (e) self-esteem, (f) social provisions, (g) community connectedness and (h) access to health care. We anticipated that compared to pre-intervention, participants post-intervention would report lower mean scores of (a) depression and (b) internalized stigma.

Detailed Description

This is a single-centre pragmatic N-of-1 pilot study. The target population is LBQ women in Calgary and Toronto, Canada. The authors aim to recruit 40 participants using purposive peer-driven recruitment methods. LBQ women from agencies that serve LBQ women will deliver the intervention. A survey will be conducted at pre and post-intervention to evaluate the impact of the intervention. Paired-sample t-tests will be used to assess pre- and post- intervention differences in sexual risk behaviour outcomes (safer sex practices, safer sex self-efficacy), protective factors (resilient coping, HIV/STI knowledge and testing) and social-structural determinants (social support, access to health care, internalized sexual stigma) directly following the intervention and 3 months post-intervention. Logistic and linear generalized estimating equation (GEE) regression models will be used to assess intervention effects for the follow-up period of 3 months to control for repeated within-subject measurements.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
44
Inclusion Criteria
  • Self-identified lesbian, bisexual, queer, or women who have sex with women
  • Over 18 years old who
  • Are capable of providing informed consent
  • Are interested in attending a weekend retreat with 6 group sessions and 3 month follow up
  • Live in the greater Calgary and Toronto area.
Read More
Exclusion Criteria
  • Below 18 years old
  • Does not identify as lesbian, bisexual or queer or a WSW
  • Insufficient interest/attention to attend the group sessions.
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Pre-post test designAdapted Many Men, Many Voices (3MV) group level intervention-
Pre-post test designA group-based HIV/STI prevention intervention for women who have sex with women-
Primary Outcome Measures
NameTimeMethod
STI knowledge3 months

Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ)

Secondary Outcome Measures
NameTimeMethod
Access to care3 months

Participants will responded to questions asking if they had ever received (i) an HIV test and (ii) an STI test (not including HIV). Participants also responded to questions asking if they had ever experienced the following barriers to accessing health care: (i) cost travel, (ii) cost medications and (iii) belief that their HCP was not comfortable with their sexual orientation. Follow up surveys will ask if participants had received an HIV or STI test in the past 4 weeks.

Safer sex self-efficacy3 months

A modified Condom Use Self Efficacy Scale, for enhanced appropriateness for LBQ women

STI and HIV incidence3 months

Self-reported HIV/STI testing history and incidence (lifetime and in past 3 months)

Resilient coping3 months

Brief Resilient Coping Scale

Self-Esteem3 months

Rosenberg Self Esteem Scale

Safer sex practices3 months

Safer Sexual Practices among Lesbian Women' Scale

Social Provisions3 months

Social Provisions Scale

Sexual stigma3 months

Homophobia Scale

Internalized sexual stigma3 months

Revised Internalized Homophobia Scale (IHP-R)

Depression3 months

Patient Health Questionnaire 2

Trial Locations

Locations (2)

Faculty of Social Work, University of Calgary

🇨🇦

Calgary, Alberta, Canada

University of Toronto, Factor-Inwentash Faculty of Social Work

🇨🇦

Toronto, Ontario, Canada

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