In 2009, black women accounted for 30% of the estimated new HIV infections among all blacks. Most (85%) black women with HIV acquired HIV through heterosexual sex.
The estimated rate of new HIV infections for black women was more than 15 times as high as the rate for white women, and more than three times as high as that of Latina women.
Austin Outreach and Community Service Center, Inc. (AOCSC) designed Innovative programs needed to reduce the incidence rate of HIV infection among AA women, particularly marginalized, resource-poor AA women.
Targeted changes for outcome measures address core barriers to HIV prevention (eg, poor self-worth, fatalism, depression, poor perception of future quality of life) in order to increase a person's vigilance around health promotion and reduce high-risk behavior.
Saddled with obstacles such as poverty, poor access to health care and the lack of stable housing and unemployment, many women do not obtain appropriate care and treatment. Worse, few evidence-based, sanctioned programs are tailored to meet Black women's needs.
Early prevention messages, targeted primarily at gay, White men, did little to impact the AA community and failed to acknowledge how poverty, institutional racism, a biased criminal justice system, disenfranchisement, and gender inequality contribute to the disproportionate number of HIV infection cases among AA women.
Programs for AA women were developed beginning in the mid-1990s and continue to use cultural- and gender-appropriate materials to build ethnic pride and incorporate cultural- and gender-specific themes to promote condom use.
This report presents the types of outcome measures targeted by an African-centered HIV prevention program as compared to prevention programs targeting behavior change as measured primarily through condom use.
THE SISTA BEHAVIORAL MODEL
This group-level, gender- and culturally- relevant intervention, is designed to increase condom use with African American women. Five peer-led group sessions are conducted that focus on ethnic and gender pride, HIV knowledge, and skills training around sexual risk reduction behaviors and decision-making.
The intervention is based on Social Learning theory as well as the theory of Gender and Power. The SISTA project specifically targets sexually active African-American women with focus on specific risk behaviors.
AOCSC’s PREVENTION PROGRAM: ILLUSTRATION
AOCSC’s AFRICAN AMERICAN WOMEN’S EMPOWERMENT PROJECT GOALS; is to enhance the capacity of women so that they are better able to engage in health-promotion and life-sustaining activities.Behavioral change is targeted in the context of* cognitive restructuring (changing the way women think and feel about themselves and the world),* cultural realignment (reinstilling traditional "cultural" values in women to infuse protective factors), and* character development (reconfiguring the way women think about health and well-being).
PARTICIPANTS The program comprised 2-hour sessions per group. Trained AA facilitators deliver the intervention (behavioral skills practice, group discussions, lectures, role-playing, , and take-home exercises) in a community-based setting.
Key program components include the following: Understanding the History andSurvival of African Americans; Meaning of Being a Black Woman; Collective Meaning in Community; HIV: Facts, Transmission, and Control; Substance Abuse: Domestic Violence; Forming an Attitude of Health Promotion and Disease Prevention; and Where Do I GoFrom Here?-Forming a Path and a Plan to continue safer sex practices.
AOCSC programs are targeted to provide services to adult African American and Latino men and women, especially women who at highest risk for HIV/AIDS/STD/TB and viral Hepatitis.
Risk behaviors from this population include active drug use, unprotected heterosexual sex.
This target population may include women who are living with AIDS and those who have tested positive for HIV.
Race or Ethnicity |
Estimated Number of Diagnoses of HIV Infection, |
American Indian/Alaska Native |
189 |
Asian |
470 |
Black/African American |
21,652 |
Hispanic/Latino* |
7,347 |
Native Hawaiian/Other Pacific Islander |
34 |
White |
11,803 |
Multiple Races |
516 |
*Hispanics/Latinos can be of any race.
Transmission Category |
Estimated Number of Diagnoses of HIV Infection, 2009 |
||
Adult and Adolescent Males |
Adult and Adolescent Females |
Total |
|
Male-to-male sexual contact |
23,846 |
- |
23,846 |
Injection drug use |
2,449 |
1,483 |
3,932 |
Male-to-male sexual contactand injection drug use |
1,131 |
- |
1,131 |
Heterosexual contact* |
4,399 |
8,461 |
12,860 |
Other** |
47 |
29 |
76 |
* Heterosexual contact with a person known to have, or to be at high risk for, HIV infection.
** Includes hemophilia, blood transfusion, perinatal exposure, and risk not reported or not identified.
Transmission Category |
Estimated # of AIDS Diagnoses, 2009 |
||
Adult and Adolescent Males |
Adult and Adolescent Females |
Total |
|
Male-to-male sexual contact |
17,005 |
- |
17,005 |
Injection drug use |
3,012 |
1,930 |
4,942 |
Male-to-male sexual contact and injection drug use |
1,580 |
- |
1,580 |
Heterosexual contact* |
3,832 |
6,561 |
10,393 |
Other** |
158 |
155 |
313 |
* Heterosexual contact with a person known to have, or to be at high risk for, HIV infection.
** Includes hemophilia, blood transfusion, perinatal exposure, and risk not reported or not identified.
AOCSC is also concerned about the high incidence of death, amputations, and blindness caused in African American and Latinos due to type 2 Diabetes which in most cases is completely manageable and in many cases can be controlled with diet and exercise. Domestic violence, Breast cancer and Asthma are other concerns that the agency would like to address.
Our future funding request will address these issues. Literature and referrals are available for Diabetes, Domestic Violence, and Breast Cancer.