Online Program

Age, barriers and other factors related to HIV retention by women of color

Tuesday, November 3, 2015 : 8:30 a.m. - 8:55 a.m.

Elizabeth Eastwood, PhD, Dept Health & Nutrition Sciences, CUNY School of Public Health, Brooklyn College, Brooklyn, NY
Jeffrey Birnbaum, MD, MPH, Dept. Pediatrics, Downstate Medical Center, SUNY School of Public Health, Brooklyn, NY
Jennifer Lee, MPH, Pediatrics, SUNY Downstate Medical Center, Brooklyn, NY
Arthur E. Blank, PhD, Department of Family Medicine and Social Medicine, Center for the Evaluation of Health Programs/Division of Research, Bronx, NY
Background: Women of color in the US share a disproportionate burden of HIV infection compared to other groups and have significant challenges remaining in care.

Objective: Age related risk exposure may compete with engagement and retention in HIV care.

Methods: Enhancing Access for HIV+ Women of Color’ Initiative through the Special Projects of National Significance (SPNS), enrollment 2010- 2014 at 10 sites around the US, followed HIV+ women and compares women of childbearing ages 18-24, 25-34, and 35-44. In-person interviews included socio-demographic, barriers to care, risks, HIV medication, AIDS diagnosis, and 18 month retention.

Results: 549/ 921 were <45: 87 (15.8%) aged 18-24: 190 aged 25-34 (34.8%), and 272 aged 35-44(49.5%).  67% were African American, 28% Latina and 5% multi-ethnic. 15.5% had an AIDS diagnosis;13.9% unstably housed; and 27.8% domestic violence.  Among age groups, youngest <25 were more likely to be newly diagnosed (P<.05); ages 35-34 have sporadic or lost care; ages 35-44 least likely to be newly diagnosed. Youngest had highest retention rates (75.8%) and all other >60%. Substance abuse and sexual risks increase with age.  Use of ART, adherence, illness/disease were also positively related to age.  Only 31% of all women reported knowing their CD4 count and 18% reported knowing their VL.

Conclusions: Important age differences exist in HIV-related health, mental health, disease burden, and retention. HIV engagement must be based on life-course needs. Low health knowledge among all ages underscores the need for more health education to optimize health and bridge gaps along the HIV Care Continuum.

Learning Areas:

Implementation of health education strategies, interventions and programs

Learning Objectives:
Evaluate and describe how to tailor interventions with age and life-course consideration.

Keyword(s): HIV/AIDS, HRSA

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been conducting research on HIV among vulnerable populations since the 1990s. I use quantitative methods to explore relationships among barriers to care and other social and behavioral factors. Results from my work appear in peer-reviewed journals and at public health meetings.
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.