Women of Color HIV Initiative reveals data on Hispanics

Results have just been released from The Women of Color HIV Initiative, a prospective study of more than 920 women enrolled in HIV care at one of nine sites (six urban and three rural) across the United States between 2010 and 2013. The goal of the initiative was to investigate how HIV impacts African American and Hispanic women in relation to barriers to care, treatment adherence, viral suppression, substance abuse, and violence.

Though African American women surpass Hispanic women in terms of HIV rates, both ethnicities are disproportionately affected by HIV when compared to non-Hispanic whites. The Women of Color HIV Initiative took a deeper look at what it means to be a woman of color with HIV.

SEE ALSO: Less than half of HIV+ Hispanics are receiving this, say experts

“Across the United States, Black/African American and Latina women are disproportionately affected by HIV, and many face daily struggles to engage in and remain in HIV primary care,” special issue Guest Editor Arthur E. Blank, PhD., said in a press release. “The articles in this issue use a variety of traditional and novel research approaches to document the barriers women of color face, and the factors that contribute to engaging and retaining them in care.”

Specifically, the reports looked at activity impairment and the issues that led to such an inability to function among female HIV patients of color. Findings from the report included:

• 1 in 3 women reported an activity impairment and impairment was more common in urban women.
• Women treated at urban sites were more likely to be Hispanic, unemployed and less educated.
• Urban women tended to report more barriers to care, substance abuse, and sexual risk behaviors.
• Urban women more frequently transferred to their current care provider from another provider.
• In urban women, an activity limitation was associated with increasing age, multiracial/other ethnicity, being disabled or not working, and being new to HIV care or receiving sporadic care.
• AIDS, pneumonia, and thrush were the most common HIV-related conditions reported by women. Women’s health issues included history of sexually transmitted infection reported by 50 percent of the women, and yeast infections (more frequent in rural women).
• In rural women, increased time since HIV diagnosis, and history of wasting were associated with a self-reported limitation.
• Histories of hypertension, diabetes, and heart problems were related to an activity limitation in both urban and rural sites.
• About one-fifth of each group was newly diagnosed with HIV, and the urban rural differences were very small in those who were new to care.
• Being over 30 years of age was associated with a three- to fourfold increased risk of an activity limitation for urban women but was not a significant variable for rural women.
• Urban women reported more frequent use of heroin, cocaine, and injected drugs.
• Urban women reported statistically significant greater experience of having had sex with someone who used drugs in the last 3 months (3.2 percent), having never had unprotected sex (17.3 percent), and less likely to ever have had sex with someone known to have HIV(38.9 percent), but more likely to have had sex with someone HIV+ in the last 3 months (47.4 percent).

In conclusion, researchers noted that urban women, who were more likely to be Hispanic, faced a significantly different set of HIV barriers compared to rural women.

“…in large urban areas, women may experience greater social isolation despite large populations around them. There are often more safety net services in large urban areas such as homeless shelters, soup kitchens, and other local resources delivered through faith-based or secular charity organizations,” wrote study authors. “…the social isolation among urban women may also occur as result of fragmented social, economic, and health services, driven by disparate public policies that require participants meet contradictory conditions of service. These conditions may vary from program to program within a city or state. In order to receive income support, one might need to prove residence. To receive housing support, one must meet lower income requirements that may mean concealing sources of income or being incentivized to not work or work fewer hours in order to receive benefits.”

SEE ALSO: Significant decline in the number of Latin American babies with HIV

The Women of Color HIV Initiative showed that even though there are more points of access for urban women in regards to HIV treatment and care, some barriers have yet to be addressed. Some of these are personal barriers, such as motivation and dealing with embarrassment.

“Despite the availability of well-established HIV care systems in the local study sites, and an articulated national policy that is meant to attract and engage people in care, WOC (women of color) frequently reported needing “more information” as their number one barrier,” read the study. “Needing will-power or other motivating factors (“getting back on track on one’s own,” “learn to live with it”) and dealing with stigma (“might be judged” and “embarrassed/uncomfortable”) were the next most commonly described barriers.”

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