Comparative Effectiveness of Individual Versus Group-Level Interventions to Increase PrEP Uptake and Reduce HIV/STI Incidence

The HIV diagnosis rate among African-born Black women is the highest of all Black individuals living in the US. Correct and consistent use of condoms and use of pre-exposure prophylaxis (PrEP) are two effective means of decreasing HIV risk among women, but they remain suboptimal among Black women. The specific aims of this study are: 1. To culturally adapt two widely utilized, evidence-based HIV prevention interventions originally designed for US born Black women (Sister-to-Sister (S2S) and Sisters Informing Sisters about Topics on AIDS (SISTA)) for use by African-born women. To ensure the interventions resonated with African culture, they were given new names. The adapted S2S program was renamed as 'Dada Kwa Dada' (DKD), and the SISTA adaptation as 'DADA.' In Swahili and various other languages across East and West Africa, 'dada' means 'sister'. 2. To conduct a randomized controlled comparative effectiveness trial (RCT) to determine the effectiveness of adapted versions of S2S versus SISTA on increasing condom use and PrEP uptake among African-born women. This study compares the effectiveness of an individual versus a group-level intervention to increase pre-exposure prophylaxis (PrEP) uptake, condom use, and HIV testing and decrease the incidence of HIV and other sexually transmitted infections (STIs).