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Symposia

Program / Treatment Design

The Adaptation of Evidence-Based Interventions to Address Intersectional Self-Stigma in Diverse Populations: Core Principles, Treatment Strategies, and Preliminary Outcomes

4 - (SYM 80) Development and Implementation of Actprep: An Acceptance-based Prep Intervention for Engaging Young Black MSM in the South Using the Adaptome Model

Sunday, November 23, 2025
2:56 PM - 3:13 PM CST
Location: Foster 2, Level 2
Keywords: Stigma, ACT (Acceptance & Commitment Therapy), Vulnerable Populations
Recommended Readings: Hatzenbuehler, M. L., Phelan, J. C., & Link, B. G. (2013). Stigma as a fundamental cause of population health inequalities. American journal of public health, 103(5), 813-821.,   Turan, J. M., Elafros, M. A., Logie, C. H., Banik, S., Turan, B., Crockett, K. B., ... & Murray, S. M. (2025). Challenges and opportunities in examining and addressing intersectional stigma and health. Focus, 23(1), 70-84.,   Earnshaw, V. A. (2020). Stigma and substance use disorders: A clinical, research, and advocacy agenda. American Psychologist, 75(9), 1300.,   ,  
Abstract Body

Young Black men who have sex with men (YBMSM) in the Southern U.S. face disproportionate HIV rates and significant barriers to pre-exposure prophylaxis (PrEP) uptake. Mississippi (MS) ranks among the top states for unmet PrEP need, necessitating interventions that address both structural and psychological barriers. One underexplored approach is integrating Acceptance and Commitment Therapy (ACT) into PrEP interventions to enhance psychological flexibility and reduce internalized stigma surrounding PrEP use. This study surveyed and interviewed 20 PrEP-eligible YBMSM and 10 clinic staff in MS between October 2021 and April 2022. Surveys assessed structural barriers, PrEP stigma, and psychological flexibility, while qualitative interviews explored internalized experiences, health behaviors, personal values, and intervention adaptation needs using the Adaptome Model. Data were coded in NVivo and analyzed thematically. This presentation will discuss qualitative interview findings and preliminary pilot results. YBMSM cited side effects, cost, and the burden of a daily prescription as key barriers. Clinic staff reported that fear of being perceived as HIV-positive was the most significant deterrent to PrEP uptake. Levels of psychological flexibility varied widely among participants. Four key themes emerged: thoughts, emotions, associations, memories, and sensations (TEAMS) related to PrEP and HIV; health behaviors and medication perceptions; values shaping PrEP decisions (e.g., relationships, health, intimacy, longevity); and adaptation needs for ACT-PrEP implementation. Findings highlight the role of internalized stigma and avoidance in PrEP uptake among YBMSM. The ACT-informed intervention aims to help individuals navigate distressing TEAMS, reframe stigma, and align PrEP use with their core values. The presentation will also share preliminary pilot outcomes, providing insights into the feasibility and initial impact of ACTPrEP on PrEP engagement.