HIV/AIDS Among Black Women and Girls: Understanding the Context of Their Lives to Provide Effective Interventions

By: Dr. Ivy Turnbull
VicePresident and Chair of Public Policy for the National Black Women’s HIV/AIDS Network, Inc.

The National Black Women’s HIV/AIDS Network (NBWHAN) was developed in 2006 in response to the alarming disparity in HIV infection rates between black and white women, and the lack of policies to address the disparity. At the time, women constituted 28 percent of HIV/AIDS cases in the United States, with approximately 69 percent being non-Hispanic black women (Centers for Disease Control and Prevention, 2003). The NBWHAN is a coalition of HIV positive and negative black women and girls that came together to provide a voice and representation for black women with HIV/AIDS. One of our main focus areas is calling for interventions that take into consideration the context of black women’s lives, as well as providing recommendations to health officials and leadership in local, state and federal government to address this public health crisis.

NBWHAN recognized that interventions for prevention and care could only be effective, if they took into account the social, political, economic, environmental and cultural conditions that shape the lives of black women and girls. To do so, we felt strongly that health and government officials needed to examine the HIV/AIDS disease burden through a social determinants of health framework as they impact how we live, grow, work and play. These conditions can influence health outcomes because they affect the ability of individuals to access the type of preventative care and treatment that is necessary for good health. Black women and girls struggle with access to primary care due to lack of employment and insurance coverage, and barriers such as the lack of transportation. Interventions that do not address the context of black women’s and girls’ lives are not effective strategies and as a result, can leave them vulnerable to disease. We could not tolerate the death of another one of our women or children, so we developed recommendations to policymakers as part of our advocacy work.

We knew we had to do something, and were committed to being the voice and bringing the needs of black women and girls with HIV to the forefront, into the national dialogue. NBWHAN’s work and advocacy paid off and in 2010, Dr. Vanessa Sharpe became the first African- American woman who was openly living with HIV to be selected to serve on the Presidential Advisory Council on HIV/AIDS. Through face-to-face meetings with members of Congress, focus groups conducted with women in communities with high incidence rates of HIV/AIDS, conference discussions, and workshops, NBWHAN put forth recommendations to the White House Office of National AIDS Policy in 2015 to include the following into the National HIV/AIDS Strategy (Updated until 2020):

  • The Centers for Disease Control and Prevention (CDC) should use evidence-based interventions that are culturally appropriate and tailored towards black women and girls in their High Impact Prevention (HIP) portfolio.
  • Who should strengthen collaboration between HIV primary care, family planning and reproductive health services and health departments to promote HIV prevention strategies such as pre-exposure prophylaxis (PrEP). PrEP is a pill that has been proven effective in lowering the risk of HIV contraction in high-risk groups.
  • The CDC and Health Resources and Services Administration (HRSA) should address social determinants of health as part of effective HIV prevention and care efforts for black women and girls.
  • Support the utilization of geo-mapping data and gender-specific monitoring of community viral load to identify populations at greatest risk and in need of targeted HIV prevention services.

NBWHAN continues to provide a voice to black women and girls living with and at risk of HIV. It strives to reduce the burden of morbidity, mortality and stigma of HIV associated with gender, race and socioeconomic inequalities.