What HIV-Positive Young Women Want from Behavioral Interventions: A Qualitative Approach

Abstract

Young women living with HIV in the United States face many social and psychological challenges, including involvement in health care and secondary prevention efforts. The factors that put these young women at risk for HIV acquisition initially, such as poverty, gender roles, cultural norms, and limited perceived control over sexual relationships, continue to place them at risk for both adverse mental and physical health outcomes that impact their daily lives and secondary prevention efforts. This study utilized focus groups with young HIV-positive women in order to better understand their perceived problems and pressures and to inform a developmentally appropriate secondary prevention intervention for young HIV-positive women that could be implemented in clinical care settings. Focus groups with young HIV-positive women were convened in three U.S. cities: Baltimore, Chicago, and Tampa. A total of 17 young, HIV-positive women, age range 17-24 (mean age = 21), participated in the focus groups. This article describes the psychological and social challenges these young women face as well as their suggestions regarding secondary HIV prevention intervention components.

Taking into Account the Quality of the Relationship in HIV Disclosure

“…As a result of improved treatment, HIV status disclosure now has to be negotiated many times, with different persons, throughout a normal lifespan [6]. This has resulted in an emerging interest in investigating the effects of disclosing at the personal level, for example by asking people living with HIV (PLWH) about the benefits of disclosure, and the negative consequences of disclosure, as informed by their personal experiences [7].…”

EVOLUTION—Taking Charge and Growing Stronger: The Design, Acceptability, and Feasibility of a Secondary Prevention Empowerment Intervention for Young Women Living with HIV

“…The primary empowerment focus for the intervention was empowerment at the individual level of analysis, which includes cognitions, emotions, and behaviors, and is often experienced as a sense of control, a critical awareness of one's social and physical environment, and action to exercise control. [17][18][19] The content areas and framework of EVOLUTION were developed from focus groups collected by Hosek and colleagues 3 with young women living with HIV. Based on the qualitative findings and an extensive literature review of existing primary and secondary HIV interventions for women, a draft curriculum was outlined.…”

“…The YAT met weekly during the curriculum development to provide feedback on the content, wording, and formatting of the materials to ensure the intervention was acceptable and developmentally appropriate. 3 Once the entire curriculum was developed, the first iteration of the experimental intervention (n = 22) was piloted at the three participating sites. Feedback from the interventionists' logs and participant session and program evaluation forms were then brought back to the YAT and the research team so that edits to the content and format of the intervention could be made accordingly.…”

“…Even after their diagnosis, some young women continue to engage in risky sexual behavior that not only places their sexual partners at risk of infection, but also places them at higher risk for secondary sexually transmitted infections (STIs) and HIV re-infection. 3, 4 Sturdevant and colleagues found that young women living with HIV had more lifetime sexual partners and that the age difference of their sexual partners was greater than that of young uninfected women. 5 They also found that the greater age difference among sexual partners was associated with less condom use.…”

“…7 Despite the need for interventions tailored to the unique life circumstances of young women living with HIV (YWLH), there have not been any published secondary prevention interventions to date designed specifically for this population. 3,[8][9][10] In a qualitative study by Hosek and colleagues 3 of what young women wanted from HIV interventions, YWLH asked for a comprehensive, gender-specific intervention that went beyond traditional HIV/AIDS prevention education to address the psychological and social issues that impact their lives. These findings support current recommendations for behavioral interventions for people living with HIV that address the moderating factors of sexual risk behavior and treatment adherence such as social support, mental health, and poverty.…”