Generating CHARISMA: Development of an intervention to help women build agency and safety in their relationships while using prep for HIV prevention

Ellen K. Wilson; Elizabeth Trask Montgomery; Laura Danielle Wagner; Miriam Aviva Hartmann; Sarah Tyler Roberts; Miriam Aviva Hartmann; Michele Lanham; Thesla Palanee-Phillips; Florence Mathebula; Elizabeth Tolley; Dean Peacock; Laura Pascoe; Seth Zissette; Sarah Tyler Roberts; Danielle Wagner; Ellen K. Wilson; Asha Ayub; Rose Wilcher; Elizabeth Trask Montgomery

Generating CHARISMA

Development of an intervention to help women build agency and safety in their relationships while using prep for HIV prevention

Hartmann, M., Lanham, M., Palanee-Phillips, T., Mathebula, F., Tolley, E. E., Peacock, D., Pascoe, L., Zissette, S., Roberts, S. T., Wagner, D., Wilson, E., Ayub, A., Wilcher, R., Montgomery, E. T., & CHARISMA Team (2019). Generating CHARISMA: Development of an intervention to help women build agency and safety in their relationships while using prep for HIV prevention. AIDS Education and Prevention, 31(5), 433-451. https://doi.org/10.1521/aeap.2019.31.5.433

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Abstract

This article describes the development of the Community Health clinic model for Agency in Relationships and Safer Microbicide Adherence intervention (CHARISMA), an intervention designed to address the ways in which gender norms and power differentials within relationships affect women's ability to safely and consistently use HIV pre-exposure prophylaxis (PrEP). CHARISMA development involved three main activities: (1) a literature review to identify appropriate evidence-based relationship dynamic scales and interventions; (2) the analysis of primary and secondary data collected from completed PrEP studies, surveys and cognitive interviews with PrEP-experienced and naïve women, and in-depth interviews with former vaginal ring trial participants and male partners; and (3) the conduct of workshops to test and refine key intervention activities prior to pilot testing. These steps are described along with the final clinic and community-based intervention, which was tested for feasibility, acceptability, and preliminary effectiveness in Johannesburg, South Africa.