Researchers from Duke University School of Nursing in Durham, N.C., are turning to a ubiquitous locale — beauty salons — to help raise HIV prevention awareness among Black women in the South. Salons are often considered safe spaces for intimate conversations.
The numbers highlight the stark need: Black women, who make up 13% of the U.S. population, account for 64% of new HIV infections among U.S. women. They also make up 69% of all new HIV infections in the South, according to the Centers for Disease Control and Prevention.
Schenita D. Randolph, PhD, MPH, RN, CNE, and her research partner, Ragan Johnson, DNP, APRN-BC, both assistant professors at Duke University, developed a strategy to help prevent HIV spread in their region by focusing on Black women who have not been exposed to the virus.
The strategy involves training stylists to start conversations about HIV, educating women about HIV prevention, and linking them to prevention medication (pre-exposure prophylaxis or PrEP).
The research team received two-year funding from Gilead Sciences, which manufactures the HIV prevention medication Truvada, to put a pilot program in place.
Randolph explained that 44% of the people who could benefit from PrEP in the U.S. are African American (500,000). However, only 1% in that group have been prescribed PrEP, despite evidence that if taken once a day it can lower a person’s risk for getting HIV through sex by more than 90%.
Despite recent progress that has seen new HIV diagnoses decrease by 21 percent from 2010 to 2016, black women still accounted for 6 in 10 new HIV infections among women in 2016.
…Prep is one way for black women to protect themselves from the virus.
“When we look at the use of Prep, we find that there are disproportionate uses of the drugs. We find that communities of color use Prep less than other communities. Some are not even aware that Prep is out there,” Angarone said.
…Cost also plays a crucial role in black women seeking treatment. Public health experts believe that making Prep and HIV-treatment medications, such as Truvada, affordable to all populations is vital.
“Cost plays a significant role in women seeking treatment. They want to know that insurance covers it. Insurance coverage for Prep is also important,” Angarone said.
“Ultimately, the health of black women has to be made a priority,” Angarone said.
“We have to ask ourselves as a community, how do we get all of the testing strategies that have been working for other populations in place to bring about similar outcomes to the African American female community?”
This story is part of Made In Philly, a series about young residents shaping local communities.
When Shanaye Jeffers was in fourth grade, she often skipped touch football and double-dutch jump rope at recess to read a book on puberty. In fifth grade, she jumped at the chance to do a school project on childbirth.
Most girls don’t know about the inner workings of their bodies, sexual-health experts say — especially black teenage girls, who often face stigma against asking questions at home and are poorly served by sex-education school curriculums tailored for a white majority.
“Sex ed is not serving young black women really at all,” said Jeffers, now a 28-year-old obstetrics and gynecology resident at Thomas Jefferson University Hospital. She’s trying to change that. As Philadelphia site director for Daughters of the Diaspora, a nonprofit founded in 2012 to teach black teenage girls about reproductive health and self-esteem, Jeffers is working to give other girls the same knowledge and passion to take charge of their health that she had as a child.
To dig deep into black women’s sexual health requires us to admit that resources and research are simply not there.
As a result, a reimagined view is in order: How and where do we begin? With black women talking with other black women about their health? There’s only one way to gather information about our bodies, experiences, and sexualities — and that’s through conversation.
Four women shared their thoughts on what it means to stay sexually healthy. With everything that was discussed, sexual health turns into something more than just clinical. It’s not about going to the doctor and making sure we know our statuses. It’s about our overall wellbeing.
There are several things these women talked about that were very important. These women are queer, black, and from different places in the world. They challenged themselves to investigate what sexual health IS for black women today. How can we create community with each other? How can we care for each other and inform one another on how to take care of our bodies?
New research shows that young people living with HIV suffer fewer virus-related symptoms when they’re able to map out their own long-term health goals. Data also found that when this type of planning, referred to as end-of-life care, isn’t mapped out by the youth or a family member, young people living with HIV are more likely to suffer negative health outcomes.
The study, published in the journal Pediatrics, evaluated 105 mostly black adolescents (93 percent African-Americans) aged 14 to 21 and their families who received care from six U.S. hospital-based HIV clinics between July 2011 and June 2014. One-third of the family participants were also poz themselves.
Lead investigator Maureen E. Lyon, a clinical health psychologist at Children’s National Health System at The George Washington University School of Medicine and Health Sciences in Washington, D.C., tested an intervention known as Family Centered pediatric Advance Care Planning (FACE pACP). In one-hour sessions, one group of youths and their families went through advance care planning, while another group received traditional assessments.
The advanced care sessions involved discussions assessing the youths’ values, beliefs, and life experiences while determining when to begin end-of-life discussions. They also involved decision-making, discussions of death and dying, preparing guardians to respect youths’ wishes, and providing directives to be followed in case the youths are unable to speak for themselves.
After a year of evaluations, the investigators found almost 75 percent of the advanced care planning participants reported having fewer disease related symptoms, compared to 27 percent reporting a high level of symptoms.
I remember the time when I was little, before I had a degree or the knowledge to verbalize that something was wrong: All I knew was the feeling of suffocating. Continually fighting to breathe, fighting to get through, fighting to wake up each morning.
I am not sure whether I was angry at nature or nurture. Whether I was angry at my inability to never fit in, to never seem to know how to shut up or just fold. My inability to accept a “yes” and just swim along the tides. Would HIV have been more bearable if I simply knew how to assimilate? I get a house with a white picket fence, monogamous sex, church three times a week, stay at home? Would it have been more bearable if I had known my mother, black HIV-positive woman, before she gave me up?
Why is that? Well, I think it’s because I didn’t grow up in a black household. My adoptive mother was a Boriqua queen who ran the house and the heart of my father (both were born and raised in Puerto Rico). I was black and, back then in 2000s when everyone my age thought being “Spanish” was looking like JLo or Pitbull, I wasn’t allowed to claim what my Afro-Latina stepmother did. (She often told me she was black, and once, that my white-passing father’s family did not want my caramel-toned stepmother in the family.) While I value her experiences, I needed to see other little black girls with Latinx last names and who loved merengue just as much as I did. There was no “Afro-Latina” then in the South Florida where I grew up. I had no right to be as proud of my parents’ culture as they were, although I was raised as stereotypically as you can get: loud bilingual momma, yuca and yellow rice on the stove, a mechanic father with plenty of machismo. There was no one to help me navigate the world as a black woman. Maybe my anger came because I understood things I couldn’t yet speak.
Stories of my biological mother are few and far between, pieced together and passed to me by the nursing staff of my former hospital in Broward County, where I was born in 1991. I know she was a woman living with HIV when there was inadequate treatment. I know she was black, a mother of at least nine children, dealing with drug addiction and HIV, and she never got to know me. I assume she used drugs because I was born with drugs in my system. I read my hospital report, which says that this beautiful black woman had more demons than I could ever come to understand. Before black spaces, I would have assumed she was doing drugs, running around sleeping with folks to fuel her life. Before black spaces, I would have read my chart and hated her more for passing so much onto me with little support — for making me deal with the so-much before I even learned how to walk. Truth is, black spaces helped me realize that she could only do as much as her chains would let her: I lived. I’m here writing and excelling. A black momma did that, not only did she, but with the weight of oppression on her shoulders. Mission complete. I think she did exactly as she was supposed to do with all against her.
The story was that she named me and that was it. Did she plan a name in the midst of her heightened addiction? Did she pray for forgiveness? To die? To separate from her blackness as I did? Was it her blackness that aided in her losing me to another momma? For a black women with HIV and children in the midst of drug addiction, police and jails and judgmental doctors and child protective services in the 1990s demonstrated a lot of disdain for her, her choices, and the children she birthed.
A report on the state of HIV/AIDS in the African-American community highlighted an alarming health disparity gap—while Black Americans represent 12% of the population, they now account for close to 50% of the total reported HIV/AIDS cases in the US.
Laurencin and his co-authors call for a more assertive approach to the HIV/AIDS epidemic in the African-American community, noting that their call to action a decade ago has not successfully addressed the situation. In fact, some aspects have worsened: the number of African-American males diagnosed with HIV increased 29% from 2005 to 2016.
From 2005 to 2016, the number of cases of HIV/AIDS in Black women and female adolescents from heterosexual contact increased 75% from 2,392 to 4,189 and during the same time, there was a 76% increase in diagnoses of heterosexual Black men.