![]() Īs such, science that seeks to advance health equity in HIV requires an understanding of what is needed from the perspective of the target population and how that information can be translated to practice to promote equity. Effectively ending the epidemic necessitates addressing barriers that impede engagement in biomedical and behavioral prevention and wide scale implementation and utilization of existing interventions. Thus, merely having the tools to end HIV is insufficient. ![]() Īmong women, there are numerous multilevel barriers to engagement in existing HIV prevention approaches, including poverty, incarceration, unemployment, distrust of providers and locations where HIV prevention services are offered, displeasures associated with safer sex practices, intimate partner violence, challenges related to gendered power, cultural issues, stigma associated with HIV and women’s sexual behavior, and a lack of intervention strategies that address risk across multiple levels. For example, continuing a 30 year trend, Black women account for the majority of women living with HIV/AIDS, making Black women 15 and 5 times more likely to contract HIV than White women and Latinas, respectively. Moreover, racial/ethnic disparities persist. Furthermore, although rates of diagnoses have declined among women, nearly every hour a woman tests positive for HIV. ![]() Despite these successes, HIV remains a glaring example of health inequity in the US, frequently concentrating in socially disadvantaged groups with epidemic rates only in certain types of communities – communities with high numbers of marginalized individuals (including, but not limited to, non-Hispanic Black, Latinx, low income, gay, and transgender communities). As indicated in the national Ending the Epidemic initiative, such accomplishments suggest that the knowledge, tools, and resources needed to end the HIV/AIDS epidemic currently exist. ![]() The resulting development and implementation of targeted and tailored public health programs, awareness campaigns, and interventions have contributed to major accomplishments in HIV prevention, including decreases in sexual and perinatal transmission as well as increases in span and quality of life for people living with HIV/AIDS (PLWHA). The United States (US)’ National AIDS Strategy prioritizes promotion of HIV prevention service utilization and provision of community-based services to improve access to and awareness of these services in US communities. Trial registrationĬ: NCT00995176, prospectively registered. Conclusionsįindings may be useful for enhancing women’s engagement in and uptake of behavioral and biomedical HIV prevention resources, improving policy, and addressing multilevel risk factors. We conducted additional analyses to identify contradictory patterns in the data, which revealed an additional three themes: 1) Address Structural Risk Factors, 2) Increase Engagement via Pleasure Promotion, 3) Expand Awareness of and Access to Prevention Resources. Thematic analyses revealed four themes describing women’s most frequently stated ideas for improving prevention efforts: 1) Promote Multilevel Empowerment, 2) Create Engaging Program Content, 3) Build “Market Demand”, and 4) Ensure Accessibility. Focus group and interview participants in the qualitative sub-study ( N = 288) were from four cities in the eastern US. Methodsĭata analyzed for the current study were collected via a qualitative sub-study within the HIV Prevention Trials Network Study 064 (HPTN 064), a multisite observational cohort study designed to estimate HIV incidence among women residing in communities with elevated HIV prevalence who also reported personal or partner characteristics associated with increased risk of HIV acquisition. This qualitative study identifies suggestions for increasing access to, engagement in, and impact of HIV prevention among women living in cities in high HIV burden counties in the eastern US. Merely having the tools to end HIV is insufficient.
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