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

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.