Project THANKS: Turning HIV/AIDS into New Knowledge for Sisters

By: Elizabeth Yuko, Ph.D.

Many people with HIV/AIDS are living with not just one, but two or more chronic diseases. While cures to the diseases may not yet exist, there are ways to help people manage and improve their health and well-being.

Project THANKS is helping people – particularly, women of color – do just that.

Project THANKS – which stands for Turning HIV/AIDS into New Knowledge for Sisters – is an innovative and evidence-based intervention. The project aims to assist women in managing and improving their overall health and nutritional status when faced with complications associated with substance abuse disorders, HIV and other chronic diseases.

The program is targeted to meet the unique personal, familial, and cultural needs of women of color.  Project THANKS is implemented over seven group sessions, and is currently being piloted at Well of Hope Community Development Corporation, Inc. in Paterson, NJ. The program begins with a needs-assessment focus group to tailor the intervention sessions, and to meet the specific needs of the agency.  In order to enhance the women’s problem solving, decision-making skills, and sense of agency, each session incorporates techniques that help the women set realistic goals, monitor their own progress and serve as sources of social support for one another in a shared group setting.

With the help of a trained peer leader, the women are encouraged to engage in a dialogue and reflect upon the personal, social, environmental, and political forces that create inequity across the health care continuum.  They are also encouraged to discuss the various ways in which they can get involved to promote social change in their own community.  During the sessions, a variety of presentations and hands-on activities are used to demonstrate the principles of healthy eating, physical activity, and other ways to manage their chronic disease symptoms more effectively.  At the end of each session, the women are encouraged to partner with a peer, and devise “action steps” or strategies that they can implement on their own. It takes approximately 7 to 8 weeks for the intervention to be implemented from start to finish.

Project THANKS was developed by Dr. Meena Mahadevan, and Dr. Ndidiamaka Amutah, Assistant Professors of Health and Nutrition Sciences at Montclair State University. Mahadevan had been working with Well of Hope (a harm reduction agency) since September 2010 in examining the barriers to optimum nutrition among ethnic minority HIV-positive substance abusers. This work resulted in two conference presentations and a manuscript in a peer-reviewed journal. A grant application was then submitted by Mahadevan to the New Jersey Department of Health and Human Services to pilot an intervention that would help these individuals to take charge of their own health and reduce the nutritional complications associated with HIV and other chronic diseases. Mahadevan and Amutah were notified that they received the grant in April 2013.

Amutah’s expertise lies in the areas of maternal and child health. With her valuable input and expertise, the intervention was fine-tuned and implemented this past spring. The program’s culturally sensitive curriculum includes components that have been adapted from Center for Disease Control’s compendium of evidence-based HIV-prevention interventions for African-American women, namely the Holistic Health Recovery Program (HHRP), and SISTA.

While there are other interventions that address HIV prevention and substance abuse treatment, Project THANKS is unique in that it attempts to teach women to manage their chronic disease symptoms (diabetes, hypertension, heart disease) along with HIV and substance abuse.

The women are recruited through a flyer posted at the agency. Interested and willing participants are asked to contact their case managers in order to be screened for the eligibility criteria. The technique of time-space sampling in street recruitment was also used to ensure an appropriate balance of individuals with differing degrees of services exposure.

Mahadevan and Amutahin are the process of evaluating the intervention, but the responses from the participants have been overwhelmingly positive. According to Mahadevan, the participants are appreciative of the skills they teach them to take better care of their overall health, and especially the knowledge and training needed to manage the multiple complications associated with the dual diagnosis of HIV and a chronic disease.

“The ultimate public health goal of our project is to identify features in the social and psychological environments of HIV-positive black women with chronic diseases that if integrated into existing harm reduction services can help offset the human and economic costs of poor health in this multiply vulnerable population,” Mahadevan said.

Dr. Meena Mahadevan and Dr. Ndidiamaka Amutah, Assistant Professors of Health and Nutrition Sciences at Montclair State University can be reached at mahadevanm@mail.montclair.edu or amutahn@mail.montclair.edu.

An abstract for an article on Project THANKS is available here.


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