Implementing women-centered HIV care has been proposed nationally and internationally as a way to address women’s health needs. However, this idea has not been well operationalized for HIV care nor has it been examined in the context of the United States health care system. More importantly, because the HIV epidemic initially affected mostly men, the HIV care system is not designed to meet women’s special needs.
Dr. Mary Jo Trepka, professor in Florida International University Robert Stempel College of Public Health and Social Work’s department of epidemiology, has received a 5-year grant for $2.2 million from The National Institute of Health (NIH) to study women-centered HIV care practices that facilitate HIV care retention and viral suppression in the presence of adverse sociocultural factors.
“There is a critical need to improve HIV care outcomes and reduce health disparities among women living with HIV infection for their individual benefit and the benefit of their communities,” said Dr. Trepka. “Achieving high rates of retention in HIV care and adherence to antiretroviral therapy leads to high rates of viral suppression, which not only reduces mortality but improves quality of living among people living with HIV infection and reduces HIV transmission within affected communities.”
HIV care outcomes among women have been suboptimal; in 2014, viral suppression was 52.6 percent among African Americans, 57.9 percent among whites, and 59.8 percent among Latinas compared with 66.0 percent among white men. Women living with HIV infection are more likely to face barriers to successful HIV care such as childcare burden, abuse, and extreme poverty. In addition, women, particularly women of color, can face multiple layers of stigma including those related to their race, ethnicity, HIV infection, drug use, and poverty status.
The objective of the study is to identify effective provider and women-centered HIV care practices within the Ryan White Program, which serves 65 percent of women living with HIV in the United States. Researchers will examine practices that positively influence HIV care retention and viral suppression among women experiencing sociocultural challenges.
Using a mixed methods study, researchers will examine patient intake and billing data from women enrolled in the Miami-Dade County Ryan White Program. The study will also include in-depth interviews with case managers, health care providers, administrators, and women living with HIV, and a survey of 600 women living with HIV in the Miami-Dade County Ryan White Program.
Researchers hypothesize that the more women-centric a system is, the higher the likelihood of HIV care retention and viral suppression among women.
This project addresses the National HIV/AIDS Strategy goals to increase access to care, improve health outcomes, and reduce HIV-related health disparities and the Trans-NIH Plan for HIV-Related Research call for research to promote HIV care engagement and to reduce disparities in treatment outcomes.
“The research and work conducted at Stempel College is directly relevant to the health of our communities and efforts to eliminate the health disparities among us,” said Dr. Tomás R. Guilarte, dean of Stempel College.