African- American Women African- American Women and HIV/AIDSand HIV/AIDS

Frances E. Ashe-Goins, R.N. M.P.HFrances E. Ashe-Goins, R.N. M.P.H

Deputy Director and Director of Deputy Director and Director of Policy and Program Development Policy and Program Development

U.S. DHHS-Office on Women’s U.S. DHHS-Office on Women’s HealthHealth

OWH Mission OWH Mission

To improve the health and well-being To improve the health and well-being of women across the lifespan by of women across the lifespan by coordinating women's health coordinating women's health programs, promoting health programs, promoting health education and disease prevention, education and disease prevention, and leading efforts and fostering and leading efforts and fostering partnerships to eliminate health partnerships to eliminate health disparities.disparities.

AIDS Incidence CasesAIDS Incidence Cases

AIDS RatesAIDS Rates

HIV/AIDS and Women HIV/AIDS and Women through 2003through 2003

According to a 1998 CDC study of Job Corps According to a 1998 CDC study of Job Corps entrants aged 16-21 years, African American entrants aged 16-21 years, African American women in the study were 7 times as likely as white women in the study were 7 times as likely as white women and 8 times as likely as Hispanic women to women and 8 times as likely as Hispanic women to be HIV+.be HIV+.

Sixty-seven percent of the AIDS diagnoses were in Sixty-seven percent of the AIDS diagnoses were in African American non-Hispanic women, 16% in African American non-Hispanic women, 16% in Hispanics, 15% in White non-Hispanic women, 1% Hispanics, 15% in White non-Hispanic women, 1% in Asian-Pacific Islanders and <1% in American in Asian-Pacific Islanders and <1% in American Indians/Alaskan NativesIndians/Alaskan Natives

African American and Hispanic women together African American and Hispanic women together represented about 25% of all US women, yet they represented about 25% of all US women, yet they accounted for 83% of AIDS diagnoses reported in accounted for 83% of AIDS diagnoses reported in 20032003

HIV/AIDS and Women HIV/AIDS and Women through 2003through 2003

In 2001, HIV/AIDS was among the top 4 causes of In 2001, HIV/AIDS was among the top 4 causes of death for African American women aged 20-54 death for African American women aged 20-54 years and the number 1 cause of death for years and the number 1 cause of death for African American women aged 25-34 yearsAfrican American women aged 25-34 years

In 2003, the rate of AIDS (50.2/100,000) for In 2003, the rate of AIDS (50.2/100,000) for African American women was approximately 25 African American women was approximately 25 times the rate (2.0/100,000) for white women times the rate (2.0/100,000) for white women and 4 times the rate (12.4/100,000) for Hispanic and 4 times the rate (12.4/100,000) for Hispanic women.women.

The leading cause of HIV infection among African The leading cause of HIV infection among African American women was heterosexual contact; the American women was heterosexual contact; the next leading cause was injection drug use.next leading cause was injection drug use.

Cultural IssuesCultural Issues

Gender Role…in the World of SexGender Role…in the World of Sex Male/Female socialization (power …Male/Female socialization (power …

limits female assertion)limits female assertion) Secrets and SexSecrets and Sex Empathetic to Minority Male Empathetic to Minority Male

OppressionOppression Hygiene…douching, over the counter Hygiene…douching, over the counter

yeast creamsyeast creams Distrust…Disbelief Distrust…Disbelief

Culture cont.Culture cont.

Myths Around SexualityMyths Around Sexuality Social and Information Network Social and Information Network

(HIV/AIDS whispered, closeted)(HIV/AIDS whispered, closeted) Stigma (discrimination, isolation)Stigma (discrimination, isolation) Little, poor or no communication with Little, poor or no communication with

Healthcare Providers (influenced by Healthcare Providers (influenced by ethnicity, race, gender, class, ethnicity, race, gender, class, language, etc) language, etc)

Socio-Economic FactorsSocio-Economic Factors

Poverty…low income…part-time Poverty…low income…part-time employmentemployment

Limited education…functional illiteracyLimited education…functional illiteracy Outside mainstream (weak messages back Outside mainstream (weak messages back

in the neighborhood)in the neighborhood) No relationship to Public Models of PWAs No relationship to Public Models of PWAs

(the FACE of AIDS)(the FACE of AIDS) Little or No Influence on Decision Makers Little or No Influence on Decision Makers

and/or Program Designers and/or Service and/or Program Designers and/or Service ProvidersProviders

Socio-Economic Factors Socio-Economic Factors Cont.Cont.

Limited Time..No TimeLimited Time..No Time Limited Access to Primary Care/ Limited Access to Primary Care/

Prevention Screening…no money…no Prevention Screening…no money…no insuranceinsurance

Living in severely distressed Living in severely distressed communitiescommunities

Violence in communities and FamiliesViolence in communities and Families

Other Risk FactorsOther Risk Factors

MigrationMigration The “The “NEEDNEED” to Reproduce” to Reproduce Societal Norms (young women/older Societal Norms (young women/older

men; concurrent partners of malesmen; concurrent partners of males Histories of Trauma (childhood sexual Histories of Trauma (childhood sexual

abuse, incest, domestic violence)abuse, incest, domestic violence) Male Female Ratio Deficit (Blacks in Male Female Ratio Deficit (Blacks in

30’s where whites are in their 60’s) 30’s where whites are in their 60’s)

Other Risk FactorsOther Risk Factors

MigrationMigration The “The “NEEDNEED” to Reproduce” to Reproduce Societal Norms (young women/older Societal Norms (young women/older

men; concurrent partners of malesmen; concurrent partners of males Histories of Trauma (childhood sexual Histories of Trauma (childhood sexual

abuse, incest, domestic violence)abuse, incest, domestic violence) Male Female Ratio Deficit (Blacks in Male Female Ratio Deficit (Blacks in

30’s where whites are in their 60’s) 30’s where whites are in their 60’s)

OWH HIV Prevention Strategies GroupOWH HIV Prevention Strategies Group

Formed in 2003, presents women from a Formed in 2003, presents women from a broad cross-section of HIV/AIDS service broad cross-section of HIV/AIDS service providers in public, private, and nonprofit providers in public, private, and nonprofit sectors and consumers.sectors and consumers.

Meets bi-annually to explore issues critical Meets bi-annually to explore issues critical to women infected and impacted by to women infected and impacted by HIV/AIDS, and to propose potential HIV/AIDS, and to propose potential collaborations and partnerships to address collaborations and partnerships to address the ongoing epidemic of HIV/AIDS in the the ongoing epidemic of HIV/AIDS in the lives of American womenlives of American women

OWH/Minority AIDS Initiative OWH/Minority AIDS Initiative HIV/AIDS Funded ProgramsHIV/AIDS Funded Programs

1.1. Model Mentorship ProgramModel Mentorship Program

2.2. Incarcerated/Newly Released WomenIncarcerated/Newly Released Women

3.3. HIV Prevention for women in the rural HIV Prevention for women in the rural south south

4.4. Prevention for young women attending Prevention for young women attending Minority Institutions Minority Institutions

5.5. HIV Prevention in the U.S. Virgin IslandsHIV Prevention in the U.S. Virgin Islands

6.6. HIV Prevention/Care for Women in HIV Prevention/Care for Women in Puerto-RicoPuerto-Rico

The Model Mentorship Program for The Model Mentorship Program for Strengthening Organizational CapacityStrengthening Organizational Capacity

Projects for mentorship between minority Projects for mentorship between minority health organizations and women-based and/or health organizations and women-based and/or AIDS service organizations (ASO). AIDS service organizations (ASO).

Programmatic, administrative, fiscal, and Programmatic, administrative, fiscal, and technical assistance is provided to expand the technical assistance is provided to expand the organizational capacity of smaller organizational capacity of smaller organizations.organizations.

Small organizations become better prepared Small organizations become better prepared to operate their agencies and implement to operate their agencies and implement successful HIV/AIDS programs independently. successful HIV/AIDS programs independently.

FY 2004-05 Contractors (cont’d)FY 2004-05 Contractors (cont’d)

MODEL MENTORSHIP "MENTOR"MODEL MENTORSHIP "MENTOR" Behavior Assessment, Inc. (Los

Angeles, CA) Matrix Public Health Consultants, Inc.

(New Haven, CT) Hinton Hoyt & Associates (Takoma

Park, MD) Community Education Group, Inc.

(Washington, DC)

FY 2004-05 Contractors (cont’d)FY 2004-05 Contractors (cont’d)

MODEL MENTORSHIP "PROTEGE”MODEL MENTORSHIP "PROTEGE” Ministerio Esperanza de Vida, Inc. (Orlando,

FL) Women of Color AIDS Council (Dorchester,

MA) African Advocates Against AIDS (Cary, NC) Chambers & Associates (Grand Chain, IL) Women’s Project (Little Rock, AR) Mujeres Unidas Contra el SIDA (San Antonio,

TX) Emma’s Harvest Home (Mobile, AL) K.I. Services, Inc.(Alexandria, VA)

Incarcerated and Newly Released Women with Incarcerated and Newly Released Women with HIV/AIDS/STDs ProgramHIV/AIDS/STDs Program

Demonstration projects to build a Demonstration projects to build a continuum of healthcare and support continuum of healthcare and support services provided for incarcerated and services provided for incarcerated and newly-released minority women living with newly-released minority women living with HIV/AIDS/STDs. HIV/AIDS/STDs.

FY 2004-05 ContractorsFY 2004-05 Contractors

INCARCERATED & NEWLY RELEASED INCARCERATED & NEWLY RELEASED WOMEN LIVING WITH HIV/AIDSWOMEN LIVING WITH HIV/AIDS

Action for Community Development Inc. (Boston, MA)

AIDS Foundation Houston, Inc. (Houston, TX)

Positive Outcomes, Inc. (Harwood, MD)

Minority Institutions Initiative Minority Institutions Initiative FY 2004FY 2004

HIV prevention project designed for HIV prevention project designed for young women attending Historically young women attending Historically Black Colleges and Universities Black Colleges and Universities (HBCU), Hispanic Serving Institutions, (HBCU), Hispanic Serving Institutions, and Tribal Colleges and Universitiesand Tribal Colleges and Universities

Hispanic Serving Hispanic Serving InstitutionsInstitutions

James Bowman and Associates w/ Houston Community College (Austin, TX)

The Granato Group w/ New Jersey City College (Mclean, VA)

Florida International University (Miami, FL)

National Latina Health Network w/ Passaic College (Washington, DC)

Historically Black Colleges and Universities

The Carter Consultancy w/Jackson State U (Alexandria, VA)

James Bowman and Associates w/ Huston Tillison (Austin, TX)

The Institute for Successful Leadership w/ Bethune Cookman (Orlando, FL)

HERMES, LLC w/North Carolina Central University (Chapel Hill, NC)

The Helix Group, Inc. w/ Bowie State U (Camp Springs, MD)

The Granato Group w/ U of DC (Fairfax, VA)

Tribal CollegesTribal Colleges

Southwestern Indian Polytechnical Institute (Albuquerque, NM)

Rachel Pacheco/Diné College (Tsaile, AZ)

OWH Funded ProgramsOWH Funded Programs

HIV Prevention in the Rural SouthHIV Prevention in the Rural South Demonstration projects for women-Demonstration projects for women-

based organizations to provide based organizations to provide HIV/AIDS prevention education HIV/AIDS prevention education services to women living in the rural services to women living in the rural South. South.

FY 2004 Contractors (cont’d)FY 2004 Contractors (cont’d)

HIV PREVENTION EDUCATION HIV PREVENTION EDUCATION WITH WOMEN IN THE RURAL WITH WOMEN IN THE RURAL

SOUTHSOUTH

HEROES (Columbia, LA) Building Bridges, Inc. (Jackson, MS) Columbus Wellness Center

(Columbus, GA)

The HIV Prevention for Women Living in the U.S.

Virgin IslandsThis program targets women at risk for

acquiring HIV with culturally competent, gender-specific approaches:

Helping Others in a Positive Environment, Inc. (St. Thomas, VI)

Community Education Group (Washington, DC)

The HIV Prevention for Women Living with HIV/AIDS in Puerto

Rico

This program develops and implements culturally competent , secondary HIV prevention education addressing gender-specific issues, stigma, shame, and access to care.

Asociacion Puertorriquena de Servicios y Ayuda al Paciente con SIDA (Cidra, PR)

Concilio de Salud Integral de Loiza, Inc. (Loiza, PR)

OWH HIV/AIDS Funding Opportunities can be found at:

www.4woman.gov

All HHS grant opportunities can be found on:

www.grants.gov

http://fedgrants.gov/Applicants/HHS/index.html

““Quote of the day”Quote of the day”

"This is the beginning of a new day. You "This is the beginning of a new day. You have been given this day to use as you have been given this day to use as you will. You can waste it or use it for good. will. You can waste it or use it for good. What you do today is important because What you do today is important because you are exchanging a day of your life for you are exchanging a day of your life for it. When tomorrow comes, this day will be it. When tomorrow comes, this day will be gone forever; in its place is something that gone forever; in its place is something that you have left behind...let it be something you have left behind...let it be something good." good."

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