Boston College, in partnership with Sistah Powah, a grassroots community initiative of older women living with HIV/AIDS, and Women of Color AIDS Council/Women Connecting and Affecting Change (WCAC), a well-established HIV/AIDS prevention center for women is expanding a successful HIV/AIDS education prevention program geared to older African American women living with HIV/AIDS in addition to obtaining ethnic-specific data on how best to approach prevention for seropositive, poor, older African American women in the inner city of Boston. Funding for this project comes from The Norbert Hardner Foundation
Economic, community, societal, emotional and cultural considerations are included in the design of this effective positive prevention programs for economically challenged women of color. This group is one of the fastest growing cohorts of HIV seropositive people with sobering health related consequences that include quality of life, and the cost of and access to health care. Although research has examined the types of prevention that are most effective, few studies have taken into account all of the above factors while focusing exclusively on the high-risk group of African American women.
The principal investigator, Dr. Rosanna DeMarco, a community health clinician and researcher at Boston College is collaborating with SistahPowah and WCAC to discover positive prevention education methods that are gender sensitive and culturally relevant for women of varying ethnic and socioeconomic backgrounds, and to share evaluation findings with other AIDS Service organizations to address common prevention needs of older African American women of living with HIV/AIDS. The study will build on this partnership to establish an HIV/AIDS prevention program that has been demonstrated by current research to affect greater healthcare adherence, decreased perceived stigma, and increased self-advocacy in intimate relationships.
This prevention project is relevant because it addresses a public health function of improving the health of individuals through self-care as well as advancing the health of families and communities. It addresses the significant factors of racism, poverty, and lack of power among African American women as complicated experiences which contribute to the difficulty of this group getting what they need to stay well.
project goals
The purpose of this project is to reduce health disparities among seropositive African American women in the inner city of Boston, Massachusetts through the effects of a tailored prevention programs. African American women have specific social, emotional, economic, community, societal, and cultural considerations that need to be addressed1. The incidence of HIV is increasing particularly in women of color (77% of all women with HIV). AIDS is the leading cause of death for African-American women in the United States aged 25-44 1. There is a higher rate of HIV from heterosexual transmission among African Americans nationally. Locally, heterosexual transmission is the predominant mode of exposure for women of color with partners of unknown risk and HIV status 1, 2.
The specific aim of this project is to examine the efficacy of a multidimensional prevention at one AIDS Service Organization (ASO) on three key outcome behaviors relevant to positive prevention in African American women: 1) adherence, 2) stigma, and 3) self-advocacy in intimate relationships. Adherence is the ability to minimize transmission of HIV through condom use, taking all medications as prescribed, keeping health care appointments, and health care screening 3. Stigma is the perception that one is evaluated as undesirable or imperfect by societal standards 4. Self-advocacy is the ability to address positive self-care needs through direct communication of needs and feelings in intimate relationships 5. The prevention education program is made up of 3 steps: 1) mindfulness meditation (M), 2) viewing four individual film clips that together make up a complete tailored African American HIV positive consumer-generated film called “Women’s Voices Women’s Lives©” (F), and 3) a narrative writing exercise (W). The components of this prevention approach is initiated at the group level, are gender specific and culturally relevant, and are directed to a group affected by health disparities.