{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T05:45:54Z","timestamp":1791783954429,"version":"4.3.4"},"reference-count":64,"publisher":"Wiley","issue":"S5","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Black Americans and individuals in the Southern United States bear a disproportionate burden of HIV. To address stigma, a key contributor to these inequities, we developed\n                      <jats:italic>Cutting Out Stigma<\/jats:italic>\n                      (\n                      <jats:italic>COS<\/jats:italic>\n                      ), a barbershop\u2010based education and multimedia intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We recruited and trained Tennessee (U.S.) barbers as\n                      <jats:italic>COS<\/jats:italic>\n                      Men's Health Ambassadors and invited them to participate in a 6\u2010month\n                      <jats:italic>COS<\/jats:italic>\n                      pilot implementation trial from September 2024 to March 2025.\n                      <jats:italic>COS<\/jats:italic>\n                      barbers provided sexual health education, referrals to HIV (and other ancillary) services for barbershop clients and shared relevant study and barber\u2010created social media posts. Using the RE\u2010AIM framework, we assessed reach (social media and barbershop\u2010based), preliminary effectiveness (barber\u2010level HIV knowledge improvement, role effectiveness and resource connection), intervention adoption and implementation (feasibility, acceptability, appropriateness at baseline and endline). Data sources included validated pre\u2010 and post\u2010implementation surveys, social media analytics, weekly self\u2010report forms and in\u2010depth interviews (IDIs). Quantitative data were summarized descriptively, with mixed\u2010effects models estimating change over time; IDI analyses helped interpret effectiveness outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty\u2010seven barbers completed COS training. Among 57 successfully contacted post\u2010training, 50 barbers (87.7%) enrolled in the pilot trial across 26 barbershops. The pilot reached an estimated 4464 barbershop client encounters, with 62.0% of barbers engaging \u22656 clients weekly. Estimated social media reach averaged 57,462 users monthly. Implementation outcomes remained high: baseline\/endline scores were 4.8\/4.8 for feasibility, 4.9\/4.9 for acceptability and 4.8\/4.9 for appropriateness (each out of 5). HIV knowledge improved following training, and barbers reported high effectiveness as health ambassadors (median effectiveness 8 of 10; IQR: 7\u20139). Barbers facilitated an estimated 3096 referrals, primarily for HIV testing (71.0%) and pre\u2010exposure prophylaxis (PrEP) (70.0%). IDIs helped explain these patterns: barbers described moving from transmission myths towards actionable understanding of HIV prevention, reported shifts in personal attitudes as they grew in their new role, and perceived normalizing HIV discussion and making resource referrals as \u201cshop talk\u201d that could reduce community stigma. Barbers also described client\u2010level early prevention behaviours (e.g. condom uptake, PrEP inquiries), though they felt fear of judgement created intention\u2212behaviour gaps for a few clients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      <jats:italic>COS<\/jats:italic>\n                      demonstrated high feasibility, acceptability and suggested preliminary effectiveness in reducing HIV stigma and promoting prevention through trusted barbershop settings. Integrating community\u2010based and digital strategies offers a promising model to tackle HIV stigma and advance Ending the HIV Epidemic goals.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.70195","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T06:18:03Z","timestamp":1791526683000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cutting Out Stigma: Findings From a Pilot Implementation Trial of a Barbershop\u2010Based HIV Stigma Reduction and Health Promotion Intervention in the Southern United States"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5475-8816","authenticated-orcid":false,"given":"Jessica M.","family":"Perkins","sequence":"first","affiliation":[{"name":"Peabody College Vanderbilt University  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruitian Xeno","family":"Hu","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madison","family":"Humphrey","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3503-3289","authenticated-orcid":false,"given":"Shawnika J.","family":"Hull","sequence":"additional","affiliation":[{"name":"Rutgers University, School of Information and Communication  Rutgers New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9415-3590","authenticated-orcid":false,"given":"Konor","family":"von Kraut","sequence":"additional","affiliation":[{"name":"Peabody College Vanderbilt University  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel","family":"King","sequence":"additional","affiliation":[{"name":"Luxury Mobile Barbering  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Nelson","sequence":"additional","affiliation":[{"name":"Distinguished Gentlemen Barbershop  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4715-1346","authenticated-orcid":false,"given":"Carolyn M.","family":"Audet","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1927-9841","authenticated-orcid":false,"given":"Zhihong Xeno","family":"Yu","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan E.","family":"Shepherd","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Hurt","sequence":"additional","affiliation":[{"name":"Street Works  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0666-4767","authenticated-orcid":false,"given":"Aima A.","family":"Ahonkhai","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Division of Infectious Diseases Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Center for AIDS Research Harvard University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301864"},{"key":"e_1_2_10_3_1","volume-title":"Deeper Look: HIV in the South","year":"2025"},{"key":"e_1_2_10_4_1","volume-title":"The Impact of HIV on Black People in the United States","year":"2024"},{"key":"e_1_2_10_5_1","volume-title":"National Black HIV\/AIDS Awareness Day Toolkit 2025","year":"2025"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2017.02.003"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000327438.13291.62"},{"key":"e_1_2_10_8_1","unstructured":"HIV\u2010Related Stigma Research as a Priority at the National Institutes of Health\u2014ProQuest [Internet]. 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