Abstract
African-American women constitute the most significant population exposed to HIV infection in the USA. They are about 20 times more likely to be HIV positive than white females of the same age range. AIDS as the outcome of the virus infection, as well as cervical cancer and other severe comorbidities of HIV, are one of the leading causes of death for young black women. The causes of such high rates of the problem include racism in the medical sphere, intimate partner violence, substance abuse, and mental health issues. These factors contribute to risky behaviors and expose individuals to virus infection.
It is proven that prevention is a powerful tool capable of reducing HIV occurrence. However, a lot of research is devoted to the examination of general preventive interventions, and only a few are addressing the causes and possible ways of HIV prevention in black females specifically. Therefore, it is vital to introduce a multifaceted program that would provide culturally sensitive interventions aimed at skills acquisition, protective sexual behaviors, and self-management.
Introduction
Modern healthcare systems around the world are engaged in the investigation of the causes, prevalence, and outcomes of the human immunodeficiency virus (HIV) that might lead to acquired immunodeficiency syndrome (AIDS). These medical issues severely threaten the well-being of humanity and lead to increased mortality rates. HIV is both a medical and social issue due to the ways it might be acquired and the danger for health it causes in the result.
Sexual, physical, and emotional abuse, as well as excessive substance use, frequently become a trigger for HIV infection because these factors increase the level of women’s exposure to hazardous interactions. Due to such circumstances, women cannot maintain protective behaviors and are less in control of their health. In consequence of broad research, it was found that specific population groups are more exposed to being infected with HIV than others; in particular, African-American females (Billings et al. 1263; CDC National Prevention Information Network; Seth et al. 1438).
Statistics say that 1 in 32 black women is infected with HIV as opposed to 1 in 526 white females, which is approximately 20 times higher for African-American women and this number grows yearly (Billings et al. 1263). Such dangerously rapid spread of the disease must be urgently addressed, and effective ways of prevention need to be found and applied.
It is vital to develop an adequate system of preventive interventions created specifically for African-American women regarding the particularities of their culture, lifestyle, and social background. In fact, multiple research studies have proven that competent preventive interventions aimed at education and treatment lead to a significant decrease in HIV rates among black females (Billings et al. 1263; CDC National Prevention Information Network).
Therefore, this study examines the statistics of the virus spread, the roots of infection, current findings concerning this issue, preventive techniques, and further steps to resolve the issue. Medical guidelines, credible scholarly sources, and adequate statistical data are utilized to conduct reliable research. For African-American women who are at a high risk to be HIV infected, it is vital to maintain and promote preventive HIV interventions because negligence in prevention might lead to incurable diseases. The interventions aimed at behavioral education, as well as substance abuse and mental health treatment among African-American women, are the most effective because they address the main causes of HIV occurrence.
Statistical Research about HIV Prevalence in African-American Females
Various statistical measurements examining the diverse factors influencing HIV and AIDS occurrence unanimously register that African American women are the most frequently exposed population. Overall, HIV and AIDS infection rates are diverse and vary depending on gender, race, ethnicity, economic status, social background, geographical location, and sexual orientation (Fletcher et al. 350).
According to Seth et al., “African Americans are disproportionately impacted by HIV and other sexually transmitted infections” (1438). However, constituting only 13% of the US population, African-American women “account for nearly 65% of all new HIV infections among American women” (Fletcher et al. 349). Several sources provide striking numbers showing that black women are proven to be 20 times more likely to be infected than white women (Billings et al. 1263; Seth et al. 1439; Williams et al. 13). Such considerable statistical data suggests that there are severe reasons that put the African American female population at such a high risk.
HIV and AIDS cause multiple adverse outcomes for people who suffer from these health conditions. They are exposed to marginalization in social and structural dimensions, racial discrimination, and isolation, thus increasing HIV vulnerability (Fletcher et al. 350-351). Moreover, the threat that this virus imposes is very significant and often leads to high mortality rates caused by virus-related health complications. It is proven that people with HIV suffer more severe illnesses than those who are HIV negative (Fletcher et al. 349).
In particular, research has found that virus-positive females are at a high risk of different comorbidities, one of which is cervical cancer (Williams et al. 13). Since many people with HIV are not aware of it, they are not provided with the necessary prevention and treatment, develop AIDS, and are at very high risk of dying. For instance, as CDC informs, in 2002, HIV was a number one cause of death for young African-American women in the age between 25 and 34 years (“HIV among Women”).
All the above-mentioned numbers indicating the prevalence of HIV and AIDS in black females in the US, as well as the severe comorbidities leading to high mortality rates, call for immediate action. It is vital to research and analyze the leading causes of HIV infection to be able to address them in the development of substantial preventive programs. The experiences of existing protective interventions need to be studied to introduce the best practices that have shown their efficacy.
The Main Causes of HIV Infection
Intimate partner violence (IPV) is one of the significant causes that ultimately increase the level of HIV occurrence among black females. As national HIV/AIDS surveillance data shows, “HIV diagnosis among African American women accounted for the largest proportion of HIV diagnoses among women” (Seth et al. 1438). The high rates of infection that occur in this population take their roots in the IPV exposure that is higher in black women than in their white counterparts.
Young African-American females experiencing IPV are more likely to have sexually transmitted infections and HIV. The reason why such a connection is possible is that these women are usually sexually, physically, and psychologically abused and, therefore, are “engaging in risky sexual behavior” and are deprived of an ability to use protective measures, thus being at risk of infection (Seth et al. 1439).
IPV victimized black females experience inconsistent condom use during sexual intercourse, fail to communicate contraceptive use, often have several partners, and early beginning of sexual life (Seth et al. 1439). All these issues contribute to the level of threat and need to be addressed in preventive programs.
Racism is considered to be a cause of health disparities and in black women. Prather et al. suggest that such social factors influencing health as inequality in education, unemployment, and poverty lead to limitations in healthcare and expose black females to risky lifestyles (664). The sexual and reproductive health of African American women is highly dependent on socio-cultural determinants. According to Prather et al., this population is exposed to three-dimensional racism forms, including institutional, personality mediated, and internalized racism (666). These levels of racism lead to insufficient healthcare provision, sub-standard tests, and examinations that impede accurate health issues detection and obstruct the ability to provide timely treatment.
Both, isolation based on racism and IPV victimization might lead to mental health disorders in the analyzed population. Psychological issues often hinder proper prevention and treatment. Thus, they need to be addressed in the programs aimed at the reduction of HIV occurrence. Similarly, substance abuse is a threat to the health conditions of all populations. As for African-American females, drug use intensifies the danger of HIV infections due to two reasons (Robinson et al. 1-2).
Firstly, substances and the way of their consumption are hazardous to the immunity system and might lead to health problems. Secondly, drug addicts are more exposed to unsafe sexual behaviors and, thus, are more often exposed to HIV infection. Moreover, HIV-positive drug-using females unaware of their condition but leading uncontrolled and unprotected sexual life infect others, consequently causing an HIV epidemic (CDC National Prevention Information Network). Therefore, it is essential to incorporate all the causes of HIV and AIDS prevalence to provide appropriate preventive programs for individuals in need.
Evidence for Prevention Effectiveness
Many preventive programs have been developed to stop the epidemic of HIV and AIDS for black females. For example, the participation in HIV behavioral program Safe Sistah showed positive results for those who finished the educational intervention (Billings et al. 1272). These women were taught different behavioral skills aimed at communicating safe sex practices with their partners. Ultimately, the rate of condom use increased, thus ensuring better HIV protection in the women who were members of the program. Besides, CDC practices regular funding for HIV prevention in the analyzed population that provides multiple positive results (“HIV and African American Women”).
Despite the overall significant contribution of preventive interventions in clinical settings and counseling, there is a considerable gap in addressing the socio-cultural aspect of the infection occurrence. According to Tufts et al., more HIV interventions are designed for women in general, but only a few address African American females in particular (1). Thus, it is essential to research a culturally specific background of the virus infection in black women to develop the most effective culturally sensitive preventive practices to help reduce HIV prevalence.
Preventive Interventions Capable of Reducing HIV Prevalence in African-American Females
When developing preventive programs for women with HIV, it is vital to incorporate social, cultural, economic, and healthcare factors that prove to be decisive in the disease infection. Since many HIV-positive women do not know about their status, raising awareness about the issue is vital. When people receive information about possible hazardous consequences of their risky behaviors and the ways to protect themselves from the virus, they will be more likely to attend preventive interventions and use acquired skills. The directions which should be utilized when developing an intervention include the following components.
Firstly, HIV behavioral interventions aimed at preventive skills teaching, such as condom use in long-term relationships and denying sex without being subject to intimate partner violence. Secondly, substance abuse and mental health treatment, including mental health treatment for females who were sexually or emotionally victimized and interventions for substance-using women who are at the highest risk of being HIV infected.
It is believed that the main task of a preventive program is to teach women the primary skills of partner communication. It might be explained by the fact that IPV reduces the safety of sexual intercourse and might be an obstacle for preventive procedures. Therefore, skills learning should include condom use negotiation, practicing safe sex after alcohol consumption, as well as effective insisting on regular protection even with constant partners (Seth et al. 1444-1445; Tsai et al. 1531).
Failing to address IPV in preventive programs might lead to a significant gap in help provision for a big part of victimized females who are at risk. Thus, contextual and culture-specific factors need to be considered when developing HIV intervention programs. It is necessary to eliminate any cultural, social, or economic determinants that promote IPV to reduce HIV prevalence (Seth et al. 1444-1445). The victims of abuse should be provided with psychotherapeutic care aimed at behavioral change.
Self-management education is also an essential component of a valid preventive program. For African-American women at risk of HIV infection, it is necessary to learn the skills of self-monitoring procedures, acquire “culturally relevant and gender-specific” protective behaviors, and assign for a regular medical check-up (Tufts et al. 4-5).
Such self-management skills would be a significant contribution to the preventive procedures due to the ultimate capability of women to take care of themselves while leading a healthy and safe lifestyle. To succeed at the provision of care described in the preventive guidelines, there has to be an equal, and racism-free healthcare environment fostered and promoted (Prather et al. 664). Also, the specially designed informational data should be available in the communities and poor neighborhoods to encourage safe sex, increase the accessibility of centers for HIV prevention.
General Recommendations
To develop a system of proper HIV preventive programs, it is necessary to cultivate cultural sensitivity and competence in medical workers and therapists working with racially disparate populations. Funding should be provided for the professionals’ education and training, as well as the popularization of the data concerning the high risk of HIV and AIDS occurrence in black females. Such interventions will improve the quality of service and will increase the level of timely detection of health issues in the analyzed population, as well as will enhance the scope of preventive and treatment procedures (Pelligrino et al. 1).
More importantly, multifaceted preventive programs incorporating educational, behavioral, mental health, and substance abuse interventions should be appropriately funded. The more centers for HIV at-risk African-American Women will be available, the more individuals will attend. Funds should be directed at informational popularization of the issue to increase the rate of timely tests. It will consequently benefit the overall health condition of the population and reduce the mortality rates caused by HIV-related diseases and AIDS.
Conclusion
The causes of HIV are interconnected and have a complicated, multifaceted nature. Intimate partner violence as the main reason for unprotected sex and consequent disease infection has other hazardous outcomes. It intensifies risky behaviors, mental health issues, substance abuse, and limited willingness to find help. Thus, contextual and culturally relevant interventions should be implemented to address the needs of African-American women. Timely disease detection, proper medical and therapeutic work of the professionals within preventive and treatment programs will significantly reduce the HIV occurrence among the at-risk population.
Works Cited
Billings, Douglas W., et al. “A Randomized Trial to Evaluate the Efficacy of a Web-Based HIV Behavioral Intervention for High-Risk African American Women.” AIDS and Behavior 19.7 (2015): 1263-1274.
CDC National Prevention Information Network. “Georgia: New Program Helps Reduce HIV Risk in African-American Women.” The Body. 2014: n.pag. Web.
Fletcher, Faith, et al. “She Told Them, Oh That Bitch Got AIDS”: Experiences of Multilevel HIV/AIDS-Related Stigma Among African American Women Living with HIV/AIDS in the South.” AIDS Patient Care and STDs 30.7 (2016): 349-356.
“HIV Among Women.” Centers for Disease Control and Prevention. 2019: n.pag. Web.
“HIV and African American Women.” Centers for Disease Control and Prevention. 2015: n.pag. Web.
Pelligrino, Nicole, et al. “Incarcerated Black Women in the Southern USA: A Narrative Review of STI and HIV Risk and Implications for Future Public Health Research, Practice, and Policy.” Journal of Racial and Ethnic Health Disparities 4.1 (2017): 9-18.
Prather, Cynthia, et al. “The Impact of Racism on the Sexual and Reproductive Health of African American Women.” Journal of Women’s Health 25.7 (2016): 664-671.
Robinson, Allysha C. “Substance Use, Mental Illness, and Familial Conflict Non-Negotiation Among HIV-Positive African-Americans: Latent Class Regression and a New Syndemic Framework.” Journal of Behavioral Medicine 39.1 (2016): 1-12.
Seth, Puja, et al. “Abuse Impedes Prevention: The Intersection of Intimate Partner Violence and HIV/STI Risk Among Young African American Women.” AIDS and Behavior 19. 8 (2015): 1438-1445.
Tsai, Alexander C., et al. “Prospective Study of The Mental Health Consequences of Sexual Violence Among Women Living with HIV in Rural Uganda.” Journal of Interpersonal Violence 31.8 (2016): 1531-1553.
Tufts, Kimberly Adams, et al. “Novel Interventions for HIV Self-Management in African American Women: A Systematic Review of mHealth Interventions.” Journal of the Association of Nurses in AIDS Care (2014): 1-27.
Williams, Michelle, et al. “Structural and Sociocultural Factors Associated with Cervical Cancer Screening Among HIV-Infected African American Women in Alabama.” AIDS Patient Care and STDs 29.1 (2015): 13-19.