Addressing Racism Against Black Women in Healthcare is Key to Ending the HIV Epidemic in the United States

Forty years after the HIV / AIDS epidemic, black women still bear the highest HIV burden of any woman.

Black women 13% of the female populationAccording to, in 2018, it accounted for more than half of all women in the United States with HIV diagnosis. Data from the US Centers for Disease Control and Prevention.. White women, who make up 62% of the female population, Occupy 21% Of HIV diagnosis.

Black women too Unlikely Than white women Receive antiretroviral therapy Very effective in preventing HIV infection Die from HIV-related causes..

Includes this year’s World AIDS Day theme End inequality With HIV and AIDS care. But in order to deal with inequality, we need to investigate their root causes. In the United States, the most prominent reasons for these disparities are: Structural and systematic racism..

I am a co-founder and director of the Research Center at Columbia University. Social intervention group..Over 1,000 black women in the last 30 years [living with or at risk for HIV] Participating in the center’s research Causes and Dynamics of HIV, Substance Abuse, Gender-Based Violence..These include: Intervention study Practice new strategies and assess their impact.

We have identified three approaches to help improve access to health and health care for women at risk.

Work on the context and experience of life

Many women who participated In our study They told us that their healthcare providers rarely pay attention to their living conditions.

Life contexts include racism, discrimination, poverty, homeless history, imprisonment, partner violence, stigma, and trauma.Black women are often Lack of integrated medical services At the same time as dealing with these co-occurring problems Their needs are often ignored That means, by their healthcare provider They are not receiving the treatment they need..

The data support the personal experience of these women.Most black women 3 times more likely to live in poverty To Die from pregnancy-related causes Than a white woman.They are also likely to Do low-paying work that does not bring health benefits..

Black Americans overall No health insurance Than their white counterpart.They are often Lost insurance coverage sooner..

To help overcome these inequality, the Social Intervention Group has developed an intervention called “Emphasis on African-American Women on the Road to Health.” Or E-WORTH.. This study was designed to help black women reduce HIV infection and improve access to care, and evaluated whether the method would actually improve the health of participants.

E-WORTH is a new cultural adaptation of HIV intervention for black women. Project value, Selected as CDC best practices..

Culturally coordinated HIV care

A total of 352 women participated Our E-WORTH intervention study, Started in November 2015 and ended in August 2019. Interventions included a one-hour individual HIV test and orientation session, and a 90-minute group session four times a week.

These sessions include the risk of HIV and other sexually transmitted diseases, the use of appropriate condoms, sexual intercourse skills, risk reduction goals, strengthening links to social support and services, and screening for intimate violence. Included raising awareness about referrals to safety plans and anti-violence services.

Participants were provided with the opportunity to discuss their experience of barriers to medical and other services and how racism affected access to services.

These unique intervention components have had a positive effect. At 12 months of follow-up, women with 5 sessions of E-WORTH intervention were 54% less likely to test positive for sexually transmitted infections than women who participated in 1 session of HIV testing intervention. understood. They also reported 38% less condom-free vaginal or anal intercourse activity.

The findings show that implementing culturally coordinated and designed HIV / sexually transmitted disease interventions for black women is likely to reduce the disproportionate burden of these infections in this population. Suggests.

Studies show that black women often do not receive proper care. Care providers often do not believe their pain is genuine.. Several participants of E-WORTH reported In their overall experience with the healthcare system, “no one believes in me.”

In contrast, women participating in E-WORTH reported because of the trust and respect shown by facilitators and research staff. Feeling to hear and believe..

These same women also sometimes blamed clinical staff for being infected with HIV, Do not discuss or provide treatment or care options, This will prevent you from accessing or continuing care.

To deal with the context of life, E-WORTH is interwoven with the afrocentric themes of trauma and resilience. These take advantage of the historical and living experience of African Americans, from slavery to Jim Crow law to mass imprisonment of black individuals. The multimedia sequence of sessions is deliberately infused with conversations about systematic issues such as historical oppression, race, culture, and over-repression of the black community. Disproportionate amount criminal law..

The facilitator of the intervention session led a discussion exploring that crossing identities related to race and ethnicity are at the heart of the HIV epidemic in black women. The script used by the facilitator featured afrocentrism based on input from a previous focus group of black women, including the character name. Afrocentric graphics such as purple for royalty were used.

The need for structural racist training with black doctors

Researchers found it Health outcomes for black patients improve When they are treated by a black doctor.In addition, black women are more likely to trust their doctors Live in their community..

However, Recent research only 5.4% of American doctors are black, And only 2.8% of them are female..

Another recent study Suggests to create a medical education program in Historically Black College You can increase the number of black doctors.This supports other studies to confirm The importance of these schools By expanding the ranks of black American doctors.

However, increasing the number of black providers is only part of the solution. Less than half of the US medical school Provide some guidance or training to deal with structural racism and racial disparities in health care.

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Over the past few years, medical schools and related medical colleges have been Training for the next generation of medical professionals To deal with racism.

Research is structural racism Strong driving force for health inequalities, NS There is a wide gap In the literature about Impact of these trainings About the medical care of medical staff and the health outcome of the patient.This emphasizes the need for more attention This kind of research..

The foundation of racial discrimination in the medical system

In late 2020, the American Medical Association declared Structural racism is a public health threat He emphasized the urgent need to prepare US health care workers to remedy it.

“Without changes in systematic and structural levels, health inequality will continue to exist.” Written by Willalda V. Edwards, AMA Board Member.. “Declaring racism as an urgent public health threat is the first step in the right direction to promote medical and public health fairness.”

Social intervention groups continue to develop and evaluate solutions to curb the HIV crisis in black women. Our findings suggest that when these women are actively engaged in all stages of health care services and research, they can improve their health and livelihoods. However, this also requires healthcare professionals to address the structural racism inherent in the healthcare system.