Did you know that about 260,000 women live with HIV in the United States? According to the Centers for Disease Control, about 19% of new HIV diagnoses annually are women. Although diagnoses have decreased by 7% over the past few years, HIV remains one of the most latent epidemics.
During the COVID-19 pandemic, the entire world has had a taste of what the HIV+ community has been living with for decades. Despite the success of antiretroviral treatments, the stigma of HIV patients is still present, and barriers for communities of color remain difficult to overcome.
Particularly in the case of Latina and Black women, inequities become more evident due to systemic barriers and the juncture of being a person of color, a woman, and HIV+.
A new study published by AIDS Behav found that women living with HIV, especially Latina and Black women, experience stigma and face structural discrimination because of multiple aspects of their identity. Latina and Black women are more likely to receive poor health care and experience worse health outcomes, including a disproportionate impact of HIV.
The study examined the intersection between provider communication and health literacy and its impact on HIV health outcomes among women enrolled in the Women’s Interagency HIV Study, a U.S. cohort study examining the impact of HIV on women.
Led by Henna Budhwani, Ph.D., of the University of Alabama Birmingham, the mixed-methods study collected data between 2017 and 2018 through focus groups, interviews, and self-administered surveys using validated measures.
A total of 92 women were included. The majority (89%) were Black; the remainder were Latina. All participants were at least 25 years old, and more than half (57%) were older than 50 years. Most (65%) had known their HIV status for more than ten years. More than half (53%) had an annual income below the federal poverty line.
The study found that communication dramatically influences the quality of interactions between women living with HIV and health care providers. When patients feel stigmatized by their providers, they are less likely to trust them and follow their recommendations, and they are more likely to miss appointments. Poor communication, such as the use of unclear medical terms, also negatively influences adherence.
“Taken together, these results show how improving communication can improve the quality of patient and provider interactions, leading to greater trust and improved health outcomes,” the researchers wrote. “Improving the health literacy of women living with HIV can help achieve this goal, as can provider communication that is respectful, clear, stigma-free, and appropriate to a patient’s health literacy level.”