Women's HEART: Timely access and retention in HIV/AIDS care

Background: Minorities in the U.S. are over represented among HIV/AIDS cases in women. Data suggests that the same factors that make these women vulnerable to HIV also serve as barriers to accessing and remaining in HIV care. The Women's HEART Project in San Antonio, Texas has developed innovative strategies for timely access and entry into HIV care for minority women. A comparison of preliminary baseline and 3-month data are presented. Methods: Seventy-four HIV+ minority women completed a 90-minute self-report questionnaire assessing socio-demographic, psychosocial and systems barriers at each survey period. A system consisting of patient navigation, outreach, peer advocacy/education, and medical coordination overlaid on existing local services was instituted. Paired samples t-tests, Wilcoxon signed rank sum tests, and McNemar tests were used to compare baseline and 3-month data. Results: Socio-demographic barriers: 41.9% had ≤ high-school education; 79.7% had an income of less than $1000/month; and 53.4% did not have health insurance. Psychosocial Barriers: A third met clinical criteria for a mental health problem. A third also experienced some form of battering in their life. The three most significant systems barriers/unmet needs included dental services, employment, and case management. At 3-month follow-up participant's number of unmet needs significantly decreased, their number of medical visits scheduled significantly increased, and there was a decrease in their barriers to care. Conclusion: The Women's HEART Project has been successful in reducing barriers as well as retaining minority women in HIV care through an enhanced system including intensive outreach, medical coordination, patient navigation, and peer advocacy.