HIV Prevention and Sexual Health

RESEARCH

Women survivors of IPV are 4 times more likely to acquire HIV and sexually transmitted infections (STIs) due to limited control over their partner’s use of condoms or other prevention measures. Women-controlled options like Pre-exposure prophylaxis (PrEP) and long-acting reversible contraceptives (LARCs) can help women stay healthy and stop HIV or unplanned pregnancies. Through our work in the Threads Research Lab, we have learned about what women find acceptable, how they perceive risk, and where they would like to get information about this. In our research, we have found that women who exchange sex and who are members of networks with higher rates of HIV diagnosis are more likely to consider PrEP an acceptable option.

Partner-independent reproductive and sexual health strategies can prevent HIV and unintended pregnancies by expanding the menu of options for protection.


Select Projects

Development and Evaluation of a PrEP Decision Aid for Women Seeking Domestic Violence Services in Baltimore, (R34MH127986) Willie (Co-PI), Meyer (Co-PI), Alexander (Co-I) National Institutes of Mental Health
In this 3 year project (2021 - 2024), we are developing and testing an HIV-prevention decision aid designed for women survivors seeking IPV services.

​​Systems and Sociocultural Factors Influencing Women-Controlled Strategies to Prevent HIV and Unintended Pregnancies among Intimate Partner Violence-Exposed Latinas, JHU Center for AIDS Research, (P30AI094189), National Institutes of Allergy and Infectious Disease
In this 2 year study (2019-2021), we investigated perceptions of PrEP and LARC among Latinas, as well as provision of PrEP and LARC through the healthcare system in Baltimore City and D.C. Metro area.

Feasibility of a Multi-Sector Collaboration to Increase Contraceptive Use and Initiate PrEP Uptake among Intimate Partner Violence-Exposed Women, (R24HD042854), Eunice Kennedy Shriver National Institute of Child Health and Human Development and Hopkins Population Center
In this 2 year study (2019-2021), we investigated perceptions of PrEP and LARC among survivors as well as provision of PrEP and LARC through the healthcare system in Baltimore City.

Select Publications

*Huang AK, Nguyen M, German D, Alexander K.A., Charlton BM, Glick JL. (In Press) Health care utilization and care-seeking behavior among vulnerablized sexual minority women (SMW): A socio-ecological approach. 2024. Journal of Health Care for the Poor and Underserved.  https://muse.jhu.edu/article/928634

Wilson, P.R., Jagasia, E., Lee, J., Hill, K., Peay, A., Murray-Browne, S.Q., Alexander, K.A., Campbell, J. and Sharps, P. (2023). Passport to Freedom: A Trauma-Informed Mindfulness Program for Previously Incarcerated Women. Journal of Psychosocial Nursing and Mental Health Services, pp.1-9. https://doi.org/10.3928/02793695-20231206-02

Alexander, K.A., Mpundu, G., Duroseau, B., Osian, N., Chambers, R., McCree, D., Tobin, K.E., Willie, T.C. (2023) Intervention approaches to address intimate partner violence and HIV: A scoping review of recent research. Current HIV/AIDS Reports, Epub ahead of print. PMID: 37768511 https://doi.org/10.1007/s11904-023-00668-8

Alexander, K.A., Sharps, P., Addison, H., Bertrand, D., Bauman, A., Braithwaite-Hall, M., Yarandi, H.N., Callwood, G., Jemmott, L.S., Campbell, J.C. (2023) Development of an HIV/STI and partner violence health promotion intervention for abused US Virgin Islands women. Health Promotion International, 38(4). PMCID: PMC10340080 https://doi.org/10.1093/heapro/daad072

Tobin, K.E., Heidari, O., Winiker, A., Pollock, S., Davey-Rothwell, M., Alexander, K.A., Owczarzak, J., Latkin, C. (in press) Peer-approaches to improve HIV/AIDS care outcomes: A scoping review focused on behavioral mechanisms. Current HIV Reports. https://doi.org/10.1007/s11904-022-00611-3

Sharpless, L., Kershaw, T., Hatcher, A.M., Alexander, K.A., Katague, M., Phillips, K., Willie, T.C. (in press) Intimate Partner Violence (IPV) and Patient-Provider Communication about HIV Pre-Exposure Prophylaxis (PrEP): The Moderating Role of IPV-Specific Medical Mistrust. Journal of Acquired Immune Deficiency Syndrome. https://journals.lww.com/jaids/abstract/2022/07010/ipv,_prep,_and_medical_mistrust.6.aspx

Jeffers, N.K., Zemlak, J., Celius, L., Willie, T.C., Kershaw, T., Alexander, K.A. (in press) 'If the partner finds out, then there's trouble': Provider perspectives on safety planning and partner interference when offering HIV Pre-exposure Prophylaxis (PrEP) to women experiencing intimate partner violence (IPV). AIDS and Behavior. https://doi.org/10.1007/s10461-021-03565-6

Willie, T.C., Alexander, K.A., Kershaw, T., Campbell, J.C., Stockman, J.K. (2021) No longer the exception, but the standard: Integrating trauma-informed policy and pre-exposure prophylaxis (PrEP) implementation for women. Women’s Health Issues, 31(5), 415-419. https://www.whijournal.com/article/S1049-3867(21)00055-4/fulltext

Caplon, A., Alexander, K.A., Kershaw, T., Willie, T.C. (2021). Assessing provider-, clinic-, and structural-level barriers and recommendations to pre-exposure prophylaxis (PreP) uptake: A qualitative investigation among women experiencing intimate partner violence, intimate partner violence service providers, and healthcare providers. AIDS and Behavior,25, 3425-3436 https://doi.org/10.1007/s10461-021-03297-7

Willie, T.C., Kershaw, T., Campbell, J.C., Alexander, K.A. (2017). Intimate partner violence and PrEP acceptability among low-income, young Black women: Exploring the mediating role of reproductive coercion, AIDS and Behavior, doi: 10.1007/s10461-017-1767-9 https://doi.org/10.1007/s10461-017-1767-9

 Alexander, K. A., Teitelman, A. M., Jemmott, L. S., & D’Antonio, P. (2014). Addressing sexual health behaviour during emerging adulthood: A critical review of the literature. Journal of Clinical Nursing. [Epub ahead of print] doi: 10.1111/jocn.12640. https://doi.org/10.1111/jocn.12640

Alexander, K. A., & Fannin, E. F. (2014). Sexual safety and sexual security among young black women who have sex with women and men. Journal of Obstetric, Gynecologic, and Neonatal Nursing: In Focus Series on GLBT Health, 43, 509-519. doi: 10.1111/1552-6909.12461. https://doi.org/10.1111/1552-6909.12461

Alexander, K. A., Coleman, C. L., Deatrick, J. A., & Jemmott, L. S. (2012). Moving beyond safe sex to women-controlled safe sex: A concept analysis. Journal of Advanced Nursing, 68(8), 1858-1869. doi: 10.1111/j.1365-2648.2011.05881.x.  https://doi.org/10.1111/j.1365-2648.2011.05881.x

Alexander, K.A. (2016) Emotions and sexual safety decision making among Black young women. Journal of Black Sexuality and Relationships, 2(4), 33-55, doi: 10.1353/bsr.2016.0014. https://dx.doi.org/10.1353/bsr.2016.0014.

Brawner, B. M., Alexander, K. A., Fannin, E. F., Baker, J. L., & Davis, Z. M. (2015). The role of sexual health professionals in developing a shared concept of risky sexual behavior as it relates to HIV transmission. Public Health Nursing, 33(2), 139-150. doi: 10.1111/phn.12216. https://doi.org/10.1111/phn.12216

Collaborations

Center for Interdisciplinary Research on AIDS, Yale University
https://cira.yale.edu/

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