HIV Testing and Service Delivery Among Black Females — 61 Health Department Jurisdictions, United States, 2012–2014

Stein, Roger B.; Pierce, Taran; Hollis, NaTasha D.; Smith, Jennifer A.

doi:10.15585/mmwr.mm6504a3

Cited by 11 publications

(8 citation statements)

References 3 publications

(2 reference statements)

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“…Current targeted HIV prevention strategies focus primarily on MSM communities where HIV incidence is highest; yet women, particularly African American women in the U.S., also account for a substantial percentage of new HIV infections (Stein, 2016). Consistent with this public health messaging, we found that women were less likely to perceive themselves to be at risk for HIV than MSM or even heterosexual men.…”

Section: Discussionmentioning

confidence: 99%

Exploring Gender Differences in PrEP Interest Among Individuals Testing HIV Negative in an Urban Emergency Department

Ridgway

Almirol

Schmitt

et al. 2018

AIDS Education and Prevention

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PrEP is greater than 90% effective at preventing HIV infection, but many people who are vulnerable to HIV choose not to take PrEP. Among women, men who have sex with women (MSW) and men who have sex with men (MSM) who tested HIV negative in our emergency department, we assessed behavioral risk factors, self-perception of HIV risk, and interest in PrEP linkage. Women had lower odds of perceiving any HIV risk versus no risk compared to MSM (uOR=0.39, 95% CI 0.18–0.87), while Whites had greater odds of perceiving themselves as high risk compared to Blacks (aOR=0.35, 95% CI 0.13–0.99). Age and self-perception of risk were not associated with PrEP interest, but patients who were objectively classified as “at risk” had greater odds of interest in PrEP than those not at risk (p<0.01). Discordance between HIV risk self-perception and objective risk demonstrates the limitation of relying on patient self-referral for PrEP based on their own subjective risk perception.

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Section: Discussionmentioning

confidence: 99%

Exploring Gender Differences in PrEP Interest Among Individuals Testing HIV Negative in an Urban Emergency Department

Ridgway

Almirol

Schmitt

et al. 2018

AIDS Education and Prevention

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“…Black women experience disparities in HIV treatment and care. Data from 61 health department jurisdictions indicated black women newly diagnosed with HIV and linked to HIV care within 90 days of diagnosis increased from 33.8% in 2012 to 50.1% in 2014 (Stein, Pierce, Hollis, & Smith, 2016). However, this was below the national target of 85%.…”

Section: Introductionmentioning

confidence: 99%

Social and structural determinants of HIV treatment and care among black women living with HIV infection: a systematic review: 2005–2016

2018

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Black/African American (black) women comprised 59% of women living with HIV at the end of 2014 and 61% of HIV diagnoses among women in 2015. Black women living with HIV infection (BWLH) have poorer health outcomes compared with women of other races/ethnicities; social and structural determinants are often cited as barriers and facilitators of care. The objective of this qualitative review was to identify social and structural barriers and facilitators of HIV treatment and care among BWLH. The systematic review was conducted in six-stages using databases such as PubMed, PsycINFO, and Google Scholar: 1) searched for studies that enrolled BWLH published between January 2005 and December 2016, 2) excluded unpublished reports and commentaries, 3) limited the search to our primary keywords, 4) limited our search to studies that included participants living with HIV infection that were >60% black and 100% female, 5) extracted and summarized the data, and 6) conducted a contextual review to identify common themes. Of 534 studies retrieved, 16 were included in the final review. Studies focused on: ART medication adherence (n = 5), engagement/retention in care (n = 4), HIV care and treatment services (n = 3), viral suppression (n = 1), and addressing multiple HIV care outcomes (n = 3). Main barrier themes included lack of family and/or social support, poor quality HIV services, and HIV-related stigma, particularly from healthcare providers; facilitator themes included resilience, positive relationships between case management and support services, high racial consciousness, and addressing mental health. Interventions that decrease these noted barriers and strengthen facilitators may help improve care outcomes for BWLH. Also, more HIV stigma-reduction training for healthcare providers may be warranted.

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“…One potential data source for this work might be the National HIV Prevention Program Monitoring and Evaluation (NHM&E) system, which collects current and prior HIV testing data, referrals to specific HIV prevention activities and “intervention completion” each time a client enrols in or completes an intervention after HIV testing at a CDC directly funded CBO [21]. Available publications, presentations and reports from NHM&E data focus primarily on HIV testing results [22–24]. Collating and publishing data on referrals and completion of HIV prevention services, as well as indication for HIV testing, would be an important contribution – albeit a labour-intensive one – to informing HIV prevention service coverage and building local or national HIV prevention continua.…”

Section: Discussionmentioning

confidence: 99%

Towards an integrated primary and secondary HIV prevention continuum for the United States: a cyclical process model

Horn

Sherwood

Remien

et al. 2016

Journal of the International AIDS Society

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IntroductionEvery new HIV infection is preventable and every HIV-related death is avoidable. As many jurisdictions around the world endeavour to end HIV as an epidemic, missed HIV prevention and treatment opportunities must be regarded as public health emergencies, and efforts to quickly fill gaps in service provision for all people living with and vulnerable to HIV infection must be prioritized.DiscussionWe present a novel, comprehensive, primary and secondary HIV prevention continuum model for the United States as a conceptual framework to identify key steps in reducing HIV incidence and improving health outcomes among those vulnerable to, as well as those living with, HIV infection. We further discuss potential approaches to address gaps in data required for programme planning, implementation and evaluation across the elements of the HIV prevention continuum.ConclusionsOur model conceptualizes opportunities to monitor and quantify primary HIV prevention efforts and, importantly, illustrates the interplay between an outcomes-oriented primary HIV prevention process and the HIV care continuum to move aggressively forward in reaching ambitious reductions in HIV incidence. To optimize the utility of this outcomes-oriented HIV prevention continuum, a key gap to be addressed includes the creation and increased coordination of data relevant to HIV prevention across sectors.

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HIV Testing and Service Delivery Among Black Females — 61 Health Department Jurisdictions, United States, 2012–2014

Cited by 11 publications

References 3 publications

Exploring Gender Differences in PrEP Interest Among Individuals Testing HIV Negative in an Urban Emergency Department

Exploring Gender Differences in PrEP Interest Among Individuals Testing HIV Negative in an Urban Emergency Department

Social and structural determinants of HIV treatment and care among black women living with HIV infection: a systematic review: 2005–2016

Towards an integrated primary and secondary HIV prevention continuum for the United States: a cyclical process model

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