Presentation on theme: "Ensuring Community Participation in Developing An HIV Prevention Intervention for Psychiatric Settings: A US-Brazil Collaboration M.L. Wainberg 1, V. Terto."— Presentation transcript:
Ensuring Community Participation in Developing An HIV Prevention Intervention for Psychiatric Settings: A US-Brazil Collaboration M.L. Wainberg 1, V. Terto 2, C. Passarelli 2, P. Mattos 3, F. Cournos 1, K.M. McKinnon 1, R. Remien 1, R. Parker 4, E. Susser 4, P. Collins 4, L. Otto-Salaj 5, S. Oliveira-Broxado 3, C. Mann-Gruber 3, D. Feijo 3, C. Silva 1, A. Gonzalez 4 1 New York State Psychiatric Institute/Columbia University; 2 AIDS Brazilian Interdisciplinary Association-ABIA, Rio de Janeiro, Brazil; 3 Instituto de Psiquiatria/Universidade Federal do Rio de Janeiro, Brazil; 4 Columbia University, New York, United States; 5 Medical College of Wisconsin, Milwaukee, United States. Associação Brasileira Interdisciplinar de AIDS Rio de Janeiro/RJ – Brazil Issues Our National Institute of Mental Health-funded project, Brazilian HIV Prevention Intervention for the Severely Mentally Ill (NIMH- 1R01 MH ), may be used as a model that ensures true partnership between countries and between community and academia. Several HIV prevention interventions for the Severely Mentally Ill (SMI) have been developed in the US. In adapting these interventions to develop a Brazilian intervention, we planned a strategy whereby both countries and the community participated in the project. Description People with SMI have been found to be at extremely elevated risk for HIV- 4% to 23% seroprevalence-in the U.S. To address the special needs of this population, several HIV prevention interventions have been tested and found to be efficacious for the SMI. Despite a well documented AIDS crisis in Brazil and the Brazilian government's commitment to HIV prevention for the whole society, Brazilian SMI are not regularly offered HIV prevention interventions. Tailoring efficacious prevention interventions to the SMI of Brazil is likely to facilitate integration into the mental health care system of HIV prevention programming. Besides adapting and piloting a provider- delivered HIV prevention intervention for men and women with SMI in Brazil, it is important to: impart skills to local providers to deliver the intervention; to help their SMI clients reduce their HIV risk behaviors; to establish an infrastructure for further research development; and to guarantee community participation throughout the study. In our model, New York State Psychiatric Institute Columbia University, Instituto de Psiquiatria Universidade Federal do Rio de Janeiro Rio de Janeiro/RJ, Brazil Community participation is ensured through: a)Co-ownership of the study with ABIA (AIDS Brazilian Interdisciplinary Association), a CBO in Rio de Janeiro, and IPUB (Instituto de Psiquiatria/ Universidade Federal do Rio de Janeiro), a psychiatric center; b)Quarterly meetings with a Community Advisory Board, which includes providers, patients (psychiatric, HIV +), and community leaders; c)Ethnographic evaluation of the local setting, including observations, focus groups and key informant interviews; d)Recruitment of 25 Brazilian providers who will be charged with adapting/ developing the Brazilian intervention; and e)Capacity building of all staff involved. Lessons Learned This study is a result of a US-Brazil collaboration, including a US and a Brazil Academic Institution and a Brazil CBO. Community participation will be obtained throughout the study. Results of the partnership and intervention pilot will be disseminated in a 2-day conference in Brazil. Recommendations This project may serve as a model of Community Participation for International HIV prevention research adaptation and capacity building for enhancing needed HIV prevention interventions and further local research world wide.