HiFi Lab develops and tests culturally-responsible intervention strategies that can be integrated and targeted to address determinants of HIV infection among African and African diaspora communities. Our research projects employ a range of research traditions, designs and methods including randomized controlled trials, structural equation modeling, ethnography and systematic reviews.
Although African, Caribbean and Black (ACB) patients make up only 4.7% of Ontario’s population, they represent 30% of Canada’s population living with HIV, and 25% of all new HIV cases in Canada. Rates of new HIV infections can be brought down with HIV Pre-Exposure Prophylaxis (PrEP), a medication that has proven extremely effective in preventing HIV infections when it is taken correctly. Unfortunately, PrEP uptake remains insufficient, especially amongst at-risk individuals. Moreover, most research concerning PrEP tends to focus on improving adherence to PrEP and little is known about the decision conflicts experienced by Black patients, and the decision support needs when asked to adopt PrEP for HIV prevention. The main aim of this study was to
The study was conducted in two phases. In Phase I, we conducted an in-depth interview for 29 ACB participants who were at different stages of decision regarding adoption of PrEP to understand their decision support needs. Results obtained was used to adapt the Ottawa Decision Support Framework for the design of a web-based decision support intervention.
In Phase II of the study, we conducted a randomized-controlled trial to test the efficacy of the decision support tool on decision conflict and adherence to PrEP. We recruited 37 participants and randomized them into the intervention arm and the control arm. All participants were evaluated for decision conflict, decision readiness and adherence to PrEP at baseline and post intervention day 14, 30 and 60.
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