Tensions in empowerment- or community-based HIV prevention interventions: lessons learned from ETOILE, a...

Area of Science:

• Public Health
• Sociology
• Health Equity

Background:

• Human immunodeficiency virus (HIV) disproportionately affects marginalized communities in high-income nations.
• Community-based and participatory research with empowerment approaches are used to engage these groups.
• Cross-national comparisons are needed to understand contextual influences on research implementation.

Purpose of the Study:

• To examine how national contexts influence the implementation of empowerment-based HIV prevention research.
• To compare experiences between research teams in the United States and France.
• To identify factors affecting the success of community-based HIV research.

Main Methods:

• A qualitative, self-reflective study (ETOILE) involving three research teams (two US, one France) from 2019-2022.
• Engaged HIV prevention scientists and community partners in focus groups and intervisitations.
• Utilized a grounded analytic approach to identify emergent themes.

Main Results:

• Communication about structural racism varied, with the French team facing more within-project tension due to national context and research history.
• Data disaggregation by race, ethnicity, and class shapes understanding of HIV epidemics.
• Involvement of community members and Black researchers is crucial but challenging for community access and trust.

Conclusions:

• National context critically influences the implementation of empowerment-based HIV prevention research.
• Addressing structural racism and power dynamics requires culturally sensitive approaches.
• Recommendations are provided for conducting effective community-based research in diverse national settings.