Overview
Adverse Childhood Experiences (ACEs) have been associated with risky sexual behaviors which increase the risk of STDs and HIV infection. Due to high rates of bacterial STD and HIV infection in Miami-Dade and Broward counties, a trauma-informed project is proposed as a solution to address that issue. The proposed project aims to utilize a trauma-informed approach to prevent the infection and spread of STDs among people residing in Miami-Dade and Broward County, Florida who have experienced at least one ACE. The project will include weekly Trauma-Informed Sexual Educational workshops, weekly mobile STD testing clinics, and distributed print materials that provide helpful resources about ACEs and STDs. The project activities will be administered by a multi-disciplinary team that are certified in trauma-informed care recruited from the local, target population.
Public Health Framework
The public health framework utilized in this program involves a multi-sector, multidisciplinary approach. The program incorporates the elements of the sectors identified in the Trauma-Informed Philanthropy guide (2016) of behavioral health, education, LGBTQ issues, and health care. Services provided in the project will be advised or performed by professionals in a variety of disciplines such as healthcare providers, educators, and project outreach coordinators. All professions from varying disciplines will be recruited from target population communities and receive adverse childhood experiences training as a part of the trauma-informed multidisciplinary approach.
The project’s activities mainly align with the primary prevention level (WHO, 2021), as the aim of the activities is to prevent the infection and spread of STDs. If any participants receive a positive result during screening for STDs, those participants will be provided resources that guide them through the following steps to receive appropriate treatment in the community. This action will provide access to secondary and tertiary prevention for the individuals but won’t be directly provided by the program.
Trauma-Informed Principles
Utilizing SAMHSA’s trauma-informed principles as a guideline to build our trauma-informed program, we have incorporated the following principles: peer support and mutual self-help, safety, collaboration and mutuality, empowerment, and diversity (Substance Abuse and Mental Health Services Administration, 2014). The principle of safety will be incorporated into the project by ensuring that all settings where the project will be implemented are physically safe and welcoming. Additionally, the project implementers will undergo trainings that will allow them to become trauma-informed. As a result, project implementers will be mindful when discussing potentially triggering topics and will be equipped with resources to support participants and ensure their mental and emotional well-being. Collaboration and mutuality will be incorporated into this project through understanding and meeting the health needs of this vulnerable population through community engagement strategies. For example, the trauma-informed sexual education workshop and mobile STD testing clinics will address the needs of at-risk individuals, encouraging healthy behaviors and preventing the spread of STDs within the Miami-Dade and Broward counties. Through the trauma-informed sexual education workshops and encouragement of safe sex practices, this project allows participants to make healthy life-style changes resulting the in the SAMHSA principle of empowerment, voice, and choice. Peer support and mutual self-help will be implemented into this project by having an intervention team containing representatives that fit the criteria of the target population to help recruit, guide, and educate participants during the intervention. The project implementers and intervention team will provide participants with all project-relevant information and take the time to listen to participants in order to establish trustworthiness and transparency. Additionally, the project implementers and intervention team will encourage honest feedback from program participants to ensure that the needs of the community are being met in an efficient and effective manner.
Social-Ecological Model
This project will address all levels of the CDC Social-Ecological Model (SEM) (CDC, 2020), presenting a framework for prevention and intervention. At the individual level, this program considers the biological and behavioral factors associated with the acquisition or transmission of STDs. The programs will address these factors by educating participants about various sexual health topics. Educating individuals about these topics can help them partake in safe behaviors that prevent the transmission or acquisition of STDs.
At the relationship level of the SEM, this program acknowledges an individual’s close relationships influences an individual’s knowledge, beliefs, and attitudes. This program promotes attitude change about STDs, reduces stigma surrounding safe sex discussions, and increases knowledge about healthy relationships, therefore impacting an individual’s relationship positively, leading to more support in regard to STD-related situations.
At the third level, the program will utilize settings such as schools, workplaces, and neighborhoods. This program will address the community level by directly incorporating community organizations to assist with achieving our goals and broadening our reach to the community. The program will address community norms, using this community environment to provide valuable information and resources to all individuals.
At the societal level, this program considers the societal factors that create the climate in which discussing safe sex practices and seeking treatment or testing for STDs is stigmatized. To create change at the societal level, we will address the beliefs and the stigma associated with them at the societal level by openly having educational workshops and encouraging testing for STDs.
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