CTN 333: Sexual Health and HIV/AIDS: Longitudinal Women’s Needs Assessment (SHAWNA)

About The Study

CTN 333 brings together an established interdisciplinary team, including social scientists, epidemiologists, clinical researchers, and community members to examine how violence and stigma impact treatment and care for women living with HIV. Leveraging a Phase I cohort study of 350 cis and trans women living with HIV in Metro Vancouver, CTN 333 will expand this cohort to include 500 women living with HIV. The ultimate aim of the study is to inform HIV care programs and interventions designed with and for women living with HIV.

Background

In British Columbia, substantial gender gaps exist in HIV care, with only 57 per cent of women living with HIV achieving optimal ART adherence, compared with 77 per cent of men, and 50 per cent of women achieving viral load suppression, compared with 59 per cent of men. This could partly be due to women living with HIV experiencing high levels of violence and stigma throughout their lifetimes, which has been linked to reduced access to HIV and broader health care. Globally, there have been calls to incorporate trauma- and violence-informed care principles into HIV care to address these barriers, but limited research exists to understand how this can be done and how to tailor these programs to meet the needs women living with HIV.

Study Approach

Women will be invited to participate in CTN 333 through a variety of community recruitment strategies including peer-led outreach, social media, posters, and referrals through service providers. Study participants are welcome to join and leave the study at any time.

Participants will be invited to baseline and subsequent semi-annual follow-up visits where they will complete an interview questionnaire and be offered HIV monitoring and STI testing. The interview questionnaire will ask about background, housing, income, access to health and social programs, past and current violence and stigma experiences, sexual health and relationships, and current and past sex work and drug use experiences. The interview questionnaire will also ask about overall health and wellness, including physical, mental, sexual, and reproductive health, and experiences accessing health care. Each visit will last around one to two hours.

Participants are welcome to refuse to answer any questions they are not comfortable with, and if they want to speak with an interviewer or seek counseling services after being interviewed, they may ask the interviewer for assistance. In addition, the interviewer will ask if participants need help if they think they are having any difficulties.

At their baseline interview, participants will be offered $55 compensation for their participation in the first part of the interview questionnaire and a further $25 if they choose to participate in the second part and undergo HIV monitoring and STI testing. At each subsequent semi-annual visit, participants will be offered $40 for the first part of the interview questionnaire and $25 for the second part. Data collected from the questionnaires will help investigators understand the impact that violence and stigma have on HIV and broader health care, and support the development of trauma- and violence-informed HIV care programs that are focused on the needs of women in British Columbia.

Study Resources

• SHAWNA Newsletter: Summer 2023
• Infographic: Addressing lack of access to primary care among women living with HIV
• Infographic: Addressing barriers to stable housing among women living with HIV