WOMEN
[Main List]
Fact Sheets
What are Black women’s HIV prevention needs?
Center for AIDS Prevention Studies, University of California, San Francisco (CAPS, UCSF), March 2009
http://caps.ucsf.edu/pubs/FS/Blackwomen.php
Microbicides and Female-Controlled Prevention Technologies: Related Resources
http://hivinsite.org/InSite?page=kbr-07-02-04
This resource page provides journal articles, guidelines, research summaries, policy reports, and educational information for providers and patients. HIV InSite. Reviewed March 2008.
Pregnancy and HIV
http://www.aidsinfonet.org/factsheet_detail.php?fsnumber=611
A discussion of special considerations for women with HIV during pregnancy, including how to reduce the risk of infecting a newborn baby and reduce the risk for the mother. AIDS InfoNet. Revised April 2008
HIV/AIDS among Women who have Sex with Women
http://www.cdc.gov/hiv/topics/women/resources/factsheets/wsw.htm
This CDC Fact Sheet examines statistical issues, risk factors, and prevention issues for women who have sex with women. June 2006.
Reports
Beard H.
Getting Real: Black Women Taking Charge in the Fight against AIDS
A report from the Black AIDS Institute. Dec. 2005
http://www.blackaids.org/ShowArticle.aspx?pagename=ShowArticle&articletype=RESOURCE&articleid=171&pagenumber=1
What Works in HIV Prevention for Women of Color
http://www.thebody.com/content/art33671.html
This guide is intended as a resource for community-based organizations (CBOs) hoping to expand or improve their HIV prevention services to women of color. It describes the theoretical foundations of targeted HIV prevention interventions as well as the practical experiences of organizations successfully fighting HIV infection among women of color. AIDS Action Council, 2001
Women and HIV/AIDS in Prisons and Jails
Prison and HIV/AIDS-related Publications
http://www.nmac.org/index/prison-initiative-publications
The National Minority AIDS Council has a series of free publications on HIV-prevention needs of incarcerated and recently release populations. Learn about the impact of HIV/AIDS on women prisoners and the programs specifically designed to meet their needs with this booklet. It offers pertinent HIV/AIDS facts and statistics, as well as explains why incarcerated women require HIV/AIDS prison programs different from those for men. (Regularly updated)
Articles and Presentations
Addressing the Unique Needs of African American Women in HIV Prevention
Nabila El-Bassel 1*, Nathilee A. Caldeira 1, Lesia M. Ruglass 1, Louisa Gilbert 1
AJPH published April 16, 2009, 10.2105/AJPH.2008.140541 [Abstract] [PDF] ne5@columbia.edu
Abstract
African American women continue to be disproportionately affected by the HIV/AIDS epidemic, yet there are few effective HIV prevention interventions that are exclusively tailored to their lives and that address their risk factors.
Using an ecological framework, we offer a comprehensive overview of the risk factors that are driving the HIV/AIDS epidemic among African American women and explicate the consequences of ignoring these factors in HIV prevention strategies.
We also recommend ways to improve HIV prevention programs by taking into consideration the unique life experiences of adult African American women.
Structural and Social Contexts of HIV Risk Among African Americans
Samuel R. Friedman 1*, Hannah L.F. Cooper 2, Andrew H. Osborne 1
AJPH published April 16, 2009, 10.2105/AJPH.2008.140327 [Abstract] [PDF] friedman@ndri.org
Abstract
HIV continues to be transmitted at unacceptably high rates among African Americans, and most HIV prevention interventions have focused on behavioral change. To theorize additional approaches to HIV prevention among African Americans, we discuss how sexual networks and drug-injection networks are as important as behavior for HIV transmission. We also describe how higher-order social structures and processes, such as residential racial segregation and racialized policing, may help shape risk networks and behaviors. We then discuss 3 themes in African American culture—survival, propriety, and struggle—that also help shape networks and behaviors. We conclude with a discussion of how these perspectives might help reduce HIV transmission among African Americans.
Reducing Psychosocial and Behavioral Pregnancy Risk Factors: Results of a Randomized Clinical Trial Among High-Risk Pregnant African American Women
Jill G. Joseph 1, Ayman A.E. El-Mohandes 2, Michele Kiely 3*, M. Nabil El-Khorazaty 4, Marie G. Gantz 4, Allan A. Johnson 5, Kathy S. Katz 6, Susan M. Blake 2, Maryann W. Rossi 1, Siva Subramanian 6
AJPH published April 16, 2009, 10.2105/AJPH.2007.131425 [Abstract] [PDF]
kielym@nih.gov
Abstract
Objectives. We evaluated the efficacy of a primary care intervention targeting pregnant African American women and focusing on psychosocial and behavioral risk factors for poor reproductive outcomes (cigarette smoking, secondhand smoke exposure, depression, and intimate partner violence).
Methods. Pregnant African American women (N=1044) were randomized to an intervention or usual care group. Clinic-based, individually tailored counseling sessions were adapted from evidence-based interventions. Follow-up data were obtained for 850 women. Multiple imputation methodology was used to estimate missing data. Outcome measures were number of risks at baseline, first follow-up, and second follow-up and within-person changes in risk from baseline to the second follow-up.
Results. Number of risks did not differ between the intervention and usual care groups at baseline, the second trimester, or the third trimester. Women in the intervention group more frequently resolved some or all of their risks than did women in the usual care group (odds ratio=1.61; 95% confidence interval=1.08, 2.39; P=.021).
Conclusions. In comparison with usual care, a clinic-based behavioral intervention significantly reduced psychosocial and behavioral pregnancy risk factors among high-risk African American women receiving prenatal care.
Effects of Fear of Abuse and Possible STI Acquisition on the Sexual Behavior of African American Adolescent Girls and Young Women
Jerris L. Raiford 1*, Ralph J. DiClemente 1, Gina M. Wingood 1
AJPH published April 16, 2009, 10.2105/AJPH.2007.131482 [Abstract] [PDF]
jraifor@sph.emory.edu
Abstract
Objectives. We examined the interactive effects of fear of abuse and knowledge of sexually transmitted infections (STIs) on sexual risk behaviors in a sample of African American young adult women.
Methods. We recruited 715 African American young adult women aged 15 to 21 years from a variety of health clinics and assessed them for fear of abuse because of negotiating condom use, knowledge of STIs, and several sexual risk behaviors.
Results. Overall, 75% of African American young adult women reported inconsistent condom use in the past 60 days. Surprisingly, under relatively higher levels of fear, young adult women with high STI knowledge were more likely than were those with low STI knowledge to exhibit inconsistent condom use in the past 60 days (89% vs 80%; 2=4.32; P.04) and during the last sexual intercourse with a main sexual partner (76% vs 70%; 2=8.06; P.01).
Conclusions. Most HIV prevention interventions focus on increasing knowledge about the transmission of STIs. However, other contextual factors such as fear of abuse because of negotiating condom use may heighten the risk of HIV infection. Our findings highlight the need for combining dating violence prevention activities with STI and HIV prevention programs targeting African American young adult women.
Explaining Racial Disparities in HIV/AIDS Incidence among Women In The U.S.: A Systematic Review.
Stat Med. 2008 Jun 12. [Epub ahead of print]
Tillerson K.
Department of Mathematics, Spelman College, Atlanta,
Surveillance data indicate that HIV incidence among Black women is more than 20 times that among White women and more than 4 times that among Hispanic women. Several studies have examined HIV risk factors by race/ethnicity including high-risk sex, drug use, inconsistent disclosure of same-sex behavior by male partners, and sexually transmitted diseases (STDs). We formed these risk factors into four hypotheses that attempt to explain the higher incidence of HIV infection among Black women. We further conducted a literature review by searching three online databases for studies published between 1985 and 2006 addressing the four hypotheses. Literature suggests that Black women are no more likely to have unprotected sex, have multiple sexual partners, or use drugs than women of other racial/ethnic groups. However, some studies suggest that Black women are more likely to have risky sex partners and STDs. We also found that Black men are less likely to disclose their same-sex behavior to female partners. These four hypotheses are insufficient in explaining the greater burden of HIV among Black women. Future investigations should continue to explore these and other social and behavioral factors such as poverty, health-care access, and receptivity to prevention messages to explain racial/ethnic disparities in HIV incidence.
The Healthcare Experiences of Women with HIV/AIDS: Insights from Focus Groups
http://www.kff.org/hivaids/upload/The-Healthcare-Experiences-of-Women-with-HIV-AIDS-Insights-from-Focus-Groups-PDF-2.pdf
This focus group study of lower-income women with HIV/AIDS offers a vivid picture of the range of obstacles that women with HIV/AIDS may face when seeking medical care and support services, and identifies areas where improvement can be made to enhance their access to quality care and information. Issues explored include: barriers to care, relationships with providers, unique challenges that women face in managing their illness, and effects of HIV/AIDS on their lives. Kaiser Family Foundation, 2003
African American women and HIV/AIDS: a national call for targeted health communication strategies to address a disparity.
Arya M, Behforouz HL, Viswanath K.
Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA.
AIDS Read. 2009 Feb;19(2):79-84, C3.
African American women are disproportionately affected by the HIV/AIDS epidemic in the United States. To address this disparity, the CDC released a call for targeted communication campaigns in African American communities. The mass media is an HIV/AIDS information source used by African Americans, and media initiatives can be cost-effective for delivering HIV prevention messages. Needed is research in communities at risk to determine the messages needed and the preferred formats and channels with which to deliver the messages so that targeted communication campaigns can be part of the multifaceted approach to ending the HIV/AIDS disparity affecting African American women.
PMID: 19271331 [PubMed - indexed for MEDLINE]
An HIV/AIDS crisis among African American women: a summary for prevention and care in the 21st century.
Rose MA, Sharpe TT, Raliegh K, Reid L, Foley M, Cleveland J.
Division of HIV/AIDS/ National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. marose@cdc.gov
J Womens Health (Larchmt). 2008 Apr;17(3):321-4
http://www.ncbi.nlm.nih.gov/pubmed/18328016?ordinalpos=2&itool=Email.EmailReport.Pubmed_ReportSelector.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=4&log$=relatedarticles&logdbfrom=pubmed
The meeting, HIV/AIDS and African American Women: A Consultation Supporting CDC's Heightened National Response to the HIV/AIDS Crisis among African Americans, provided a forum to address gaps in prevention and HIV/AIDS infection for African American women. Health researchers, community-based organization leaders, and representatives from both healthcare and non-healthcare sectors took this opportunity to discuss and develop a variety of priorities and suggestions for HIV/AIDS prevention. Four focus areas were provided for meeting attendees to promote discussion and strategy development. The resulting list of priorities and suggestions for HIV/AIDS prevention may provide future steps for researchers, communities, and physicians to increase prevention and decrease infection rates. Novel, innovative, and participatory approaches are needed within and outside the public arena to decrease the gaps in HIV/AIDS prevention for African American women.
MID: 18328016 [PubMed - indexed for MEDLINE]
Associations between CYP2B6 Polymorphisms and Pharmacokinetics after a Single Dose of Nevirapine or Efavirenz in African Americans.
Haas DW, Gebretsadik T, Mayo G, Menon UN, Acosta EP, Shintani A, Floyd M, Stein CM, Wilkinson GR.
Departments of 1Medicine, 2Microbiology and Immunology, 3Biostatistics, and 4Pharmacology, Vanderbilt University School of Medicine, and 5Department of Medicine, Meharry Medical College, Nashville, Tennessee; 6Department of Medicine, University of Alabama at Birmingham, Birmingham.
J Infect Dis. 2009 Mar 15;199(6):872-880
http://www.journals.uchicago.edu/doi/abs/10.1086/597125?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dncbi.nlm.nih.gov
Background. Polymorphisms in CYP2B6 affect the steady-state plasma concentrations of nevirapine and efavirenz. In many resource-limited countries, a single dose of nevirapine has been widely prescribed to pregnant women at delivery, to reduce mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1). We characterized associations between genetic polymorphisms and the pharmacokinetics of single doses of nevirapine and efavirenz. Methods. Plasma drug concentrations were determined over the 13-day period after administration of a 200-mg oral dose of nevirapine to nonpregnant, HIV-negative African Americans. A 600-mg oral dose of efavirenz was subsequently administered, and pharmacokinetic sampling was repeated. Pharmacokinetic parameters were estimated using a noncompartmental approach. Primary analyses involved 2 CYP2B6 polymorphisms (516G-->T and 983T-->C) known to predict increased steady-state plasma nevirapine and efavirenz exposure. Exploratory analyses involved another 51 polymorphisms in CYP2B6, ABCB1, CYP3A4, and CYP3A5. Results. On the basis of the composite CYP2B6 516/983 genotype, the 34 participants comprised 10 extensive, 17 intermediate, and 7 slow metabolizer genotypes. The composite CYP2B6 516/983 genotype was significantly associated with plasma drug exposure and clearance for efavirenz but not nevirapine. Exploratory analyses suggested possible associations between additional CYP2B6 polymorphisms and the pharmacokinetics of nevirapine and efavirenz. Conclusions. Selective pressure for drug-resistant HIV-1 after administration of single-dose nevirapine may not differ substantially according to CYP2B6 516/983 genotype. Additional polymorphisms, genes, and populations warrant further study.
PMID: 19239339 [PubMed - as supplied by publisher]
Adaptation of an HIV Prevention Curriculum for Use With Older African American Women
Judith B. Cornelius, PhD, RN; Linda Moneyham, DNS, RN, FAAN; and Sara LeGrand, MS
http://www.oneloveca.org/_files/_files/5245_california-CorneliusOlderAAfemHIVp08.pdf
Although African American women over 50 years of age represent the fastest growing group with HIV infection, little attention has been given to their HIV risk reduction needs. This study adapted an HIV risk reduction curriculum for use with older African American women based on input from a sample of women from the target population. Four focus group interviews were conducted with 30 African American women from three churches regarding adaptation of the Sisters Informing Sisters on Topics about AIDS (SISTA) curriculum for older women and the feasibility of implementing the curriculum in a church setting.
The Use of Epidemiologic and Other Data in Selecting Behavioral HIV Prevention Interventions for African-American Women
By Tanya Telfair Sharpe, PhD, Marlene Glassman, PhD, Charles Collins, PhD
"http://www.oneloveca.org/_files/_files/5252_women-and-health-SharpeAfrFemHIVr07.pdf
We describe a “research to practice” method by which public health policymakers and HIV prevention service providers can integrate the findings of national surveillance with other sources of public health data. We suggest developing a comprehensive risk profile, based on multiple sources of data, to inform the selection and implementation of evidence-based behavioral interventions (EBIs) for African-American women.
Decreased CD8 Cell-Mediated Viral Suppression and Other Immunologic Characteristics of Women Who Transmit HIV to Their Infants
By Susan Plaeger, Saul Bermudez, Yeshi Mikyas, Nina Harawa, Ruth Dickover, Dustin Mark, Maryanne Dillon, Yvonne J. Bryson, Pamela J. Boyer, and Janet S. Sinsheimer
http://www.journals.uchicago.edu/doi/abs/10.1086/314746
CD8 T cell function, lymphocyte surface phenotype, serum markers of immunologic activation, and viral burden were assessed in 75 human immunodeficiency virus (HIV)–infected pregnant women, including 9 who transmitted infection to their infants. Serial studies during and after pregnancy showed no significant differences in levels of cell surface or serum activation molecules in transmitting compared to nontransmitting mothers, with the exception of a postpartum increase in tumor necrosis factor a in transmitting women. The Journal of Infectious Diseases 1999;179:1388–1394
Does a History of Trauma Contribute to HIV Risk for Women of Color? Implications for Prevention and Policy
By Gail E. Wyatt, PhD, Hector F. Myers, PhD, John K. Williams, MD, Christina Ramirez Kitchen, PhD, Tamra Loeb, PhD, Jennifer Vargas Carmona, PhD, Lacey E. Wyatt, MD, MPH, Dorothy Chin, PhD and Nicole Presley, BA,MEd, Gail E. Wyatt, John K. Williams, Tamra Loeb, Jennifer Vargas Carmona, Dorothy Chin, and Nicole Presley, et. Al.
http://www.ajph.org/cgi/content/abstract/92/4/660
We investigated history of abuse and other HIV-related risk factors in a community sample of 490 HIV-positive and HIV-negative African American, European American, and Latina women. American Journal of Public Health April 2002, Vol 92, No. 4 660-665
Correlates of Consistent Condom Use Among HIV Positive African American Women
By Jerris L. Raiford PhD, Gina M. Wingood ScD, MPH, and Ralph J. DiClemente PhD
http://www.ingentaconnect.com/content/haworth/wh/2007/00000046/F0020002/art00005 The present study used social-cognitive theory and the theory of gender and power to identify correlates of consistent condom use among African American women living with HIV. Conclusion: These findings suggest that HIV interventions may enhance consistent condom use among African American women living with HIV by targeting women’s self-efficacy to communicate with their partners and women's perception of personal and partner-related barriers to condom use. Women & Health, Volume: 46 Issue: 2/3, 2007, p. 41 – 58
Another Look at HIV in African American Women: The Impact of Psychosocial and Contextual Factors
By Marie-Claude Jipguep and Kathy Sanders-Phillips of Howard University and Lisa Cotton, Federal Bureau of Prisons
http://jbp.sagepub.com/cgi/content/abstract/30/3/366
This study tested a conceptual model that integrates structural and psychological determinants of HIV prevention for African American women. The sample consisted of African American mothers (N = 129) of children in Head Start programs. Higher levels of perceived stress were associated with higher levels of HIV risk; higher levels of perceived racism were related to higher HIV prevention behavior. A combined psychological functioning score, representing levels of depression and anger, significantly moderated the relationships of perceived stress and racism to prevention behavior. Journal of Black Psychology, Vol. 30, No. 3, 366-385 (2004)
HIV Risk Reduction Among African-American Women: Development of a Gender and Culture-Specific Prevention Model
By Yancey EM, Goodin LM, Wang M. Morehouse School of Medicine, Atlanta, GA
http://gateway.nlm.nih.gov/MeetingAbstracts/102261928.html
Recent data continues to highlight the disproportionate rate of HIV/AIDS infection among African-Americans, as well as, the continued escalation and prevalence of HIV/ AIDS infection among women and women of color. Even though the annual HIV/AIDS infection incidence began to decline in 1996, the rate for African-American women continued to increase, with African-American women representing nearly half of all reported AIDS cases in 2000. Because few studies exist focusing on this population, we developed and implemented a culture, gender-specific model that assessed the psychosocial indices of HIV risk behavior reduction among 17-44 year old African-American women from five different communities in Atlanta, Ga. Abstr Book 2003 Natl HIV Prev Conf July 27 30 2003 Hyatt Regency Atlanta Hotel Atlanta Ga Natl HIV Prev Conf 2003 Atlanta Ga. 2003; abstract no. MP-168.
African American Women's Programs
The SISTA Project
A peer-led program to prevent HIV infection among African American young adult women.http://www.effectiveinterventions.org/go/interventions/sista
The SiHLE Program
The SiHLE intervention is a small group, skills training intervention to reduce risky sex behavior among African American adolescent females.
http://www.cdc.gov/hiv/topics/research/prs/resources/factsheets/SiHLE.htm