271233 An analysis of social factors affecting the usage of HIV/AIDS services by African American women in Washington, DC USA

Monday, October 29, 2012

Abby Charles, MPH , The Institute for Public Health Innovation, CommonHealth ACTION, Washington, DC
Suzanne Randolph, PhD , Center for Community Prevention and Treatment Research, The MayaTech Corporation, Silver Spring, MD
Jennifer Jue, MPH , Positive Pathways, Washington AIDS Partnership, Washington, DC
Michael Rhein, MPA , CommonHealth ACTION, Washington, DC
Background: Washington, DC has a highly generalized HIV epidemic (3.2% of the population). DC also has a high unmet care need, with 46% of PLWHA in DC not receiving consistent HIV medical care. Women make up 30% of new infections. There has been little research on the social factors affecting utilization of HIV medical care by African American women in Washington, DC.

Methods: Supported by AIDS United, Positive Pathways (PP) is a new intervention by the Washington AIDS Partnership (Washington, DC) that utilizes peer Community Health Workers (CHWs) to support out-of-care African American women and their sexual partners to access and utilize HIV medical care in DC. Data on needs/barriers to accessing HIV medical care for PP enrollees were collected by the CHWs at baseline, 45 days, and 6, 12, and 18 months after enrollment. Data were analyzed using SPSS.

Results: From July to December 2011, Positive Pathways enrolled 202 individuals. 70% of participants were women who faced the following needs and barriers to utilizing HIV medical care: lack of money, homelessness, needed substance abuse treatment, oral health services, HIV medical services/food security (equal percentages reporting), fear/stigma/denial (equal percentages reporting), and lack of transportation.

Conclusions: HIV services must be designed to address the social factors that negatively affect access and utilization for women. This may increase the cost of HIV service delivery in the short term but the number of women receiving HIV medical care will increase and the high costs of untreated HIV will decrease in the long term.

Learning Areas:
Assessment of individual and community needs for health education
Implementation of health education strategies, interventions and programs
Program planning

Learning Objectives:
1) Describe the Positive Pathways Intervention 2) Define the role of the peer Community Health Worker in Positive Pathways 3) List at least two social barriers that affect access to HIV medical care for persons enrolled in Positive Pathways 4) Discuss strategies to address the social factors that negatively affect access and utilization of HIV services for women

Keywords: HIV/AIDS, Access to Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked as the Program Manager for Positive Pathways since the project inception in March, 2011. Over the course of my career I have coordinated multiple peer-driven community based initiatives to affect HIV prevention and care in the District of Columbia. I have experience and interest in designing peer programs to enhance health care access and delivery and improve health outcomes in all communities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.