1. Sannisha K. Dale, PhD, EdM1,2 and Steven Safren, PhD3
Open Pilot Trial of Striving Towards Empowerment and Medication Adherence (STEP-AD): A Tailored Intervention for Black Women with HIV
Sannisha K. Dale, PhD, EdM1,2 and Steven Safren, PhD3
1Massachusetts General Hospital, 2Harvard Medical School, 3University of Miami
INTRODUCTION
MEASURES
RESULTS (CONT’D)
Baseline, 3- and 6- month follow-up visits.
Adherence: Wisepill.
Viral load: Medical records review if available.
Trauma: Davidson Trauma Scale (Davidson et al., 1997) was used to capture trauma symptoms.
Figure 1: ART Adherence Overtime for Open Pilot Trial
In the U.S. Black women living with HIV (BWLWH) face numerous psychosocial factors (e.g. trauma, racism, HIV-related discrimination and gender role expectations) that are associated with low medication adherence and negative HIV health outcomes.1-4
This study presents an open pilot trial of an intervention to improve medication adherence among BWLWH.
PARTICIPANTS
Five Black women living with HIV were enrolled.
Table I. Sociodemograohics & Clinical Characteristics
Maya: 37 y.o., non- U.S. born, unemployed, stable housing
Bell: 41 y.o., U.S. born, unemployed, SSDI, stable housing
Audre: 59 y.o., U.S. born, volunteered part-time, SSDI, stable housing
Assata: 50 y.o., U.S. born, worked part-time, SSDI, unstable housing
Toni: 51 y.o., U.S. born, unemployed, SSDI, unstable housing
METHODS
RESULTS
Figure 2: Trauma Symptoms Overtime for Open Pilot Trial
Striving Towards EmPowerment and Medication Adherence (STEP-AD) is a 10-session intervention developed with the input of Black women living with HIV in the Boston area and community stakeholders.
STEP-AD is aimed at improving medication adherence by combining
cognitive behavioral strategies for trauma
strategies for coping with racism and HIV-related discrimination, and gender role expectations
problem solving techniques for medication adherence and other resilient coping strategies
Table II. Viral load status
Baseline
3 month
6 month
Maya
1100(detectable)
Not available
1000 (detectable)
Bell
20 (detectable)
44 (detectable)
Audre
Reluctant to start ART,
295 (detectable)
Not on ART,
473 (detectable)
Start ART,
0 (undetectable)
Assata
524 (detectable)
Toni
32 (detectable)
66 (detectable)
DISCUSSION
Findings support the preliminary feasibility/acceptability of the STEP-AD. 
Areas for refinement and issues/barriers (e.g. new trauma, housing, major life stressors) in the lives of the women were also noted.
A pilot randomized control trial comparing STEP-AD to a control condition is ongoing to evaluate the preliminary efficacy of STEP-AD. 
REFERENCES
Brody, L.R., Stokes, L.R., Dale, S.K., Kelso, G.A., Cruise, R.C., Weber, K.M., Cohen, M.H. (2014). Gender Roles and Mental Health in Women With and at Risk for HIV. Psychology of Women Quarterly, 38(3), doi: /
Katz, I. T., Ryu, A. E., Onuegbu, A. G., Psaros, C., Weiser, S. D., Bangsberg, D. R., & Tsai, A. C. (2013). Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis. J Int AIDS Soc, 16(3 Suppl 2), doi: /IAS
Kelso G, Cohen M, Weber K, Dale SK, Cruise RC, Brody L. Critical consciousness, racial and gender discrimination, and HIV disease markers in African-American women with HIV. AIDS Behav Jul; 18 (7): PubMed PMID:
Machtinger, E. L., Wilson, T. C., Haberer, J. E., & Weiss, D. S. (2012). Psychological trauma and PTSD in HIV-positive women: a meta-analysis. AIDS Behav, 16(8), doi: /s
For further information, contact: Sannisha K. Dale, PhD, EdM, Massachusetts General Hospital, One Bowdoin Square, Suite 701, Boston, MA ,
This research was supported by 1K23MH (PI Dr. Sannisha Dale)
and K24MH (PI Dr. Steve Safren).