A recent study led by Dr. Melonie Walcott, DrPH in International Health, and Dr. Janet M. Turan, professor in the department of health care organization and policy at the University of Alabama at Birmingham, explores how poverty and other essential factors produce a risk environment for sub-optimal care for HIV and contribute to existing health disparities among low-income women with the condition who reside in the southern United States. UAB co-investigators were Dr. Mirjam-Colette Kempf, associate professor in the School of Nursing and department of health behavior; and Dr. Jessica S. Merlin, assistant professor in the department of infectious diseases.
The researchers “conducted a qualitative study in 2012, involving in-depth interviews with 14 stakeholders (service providers and representatives of community-based organizations) and seven focus-group discussions with 46 women living with HIV (89 percent African American).” They took a thematic approach to qualitative coding and the social ecological model guided data analysis. Data were coded and analyzed using NVivo qualitative software.
Study findings indicate that such structural community factors as poverty, reduced opportunities for employment, limited access to healthcare, stigma related to HIV status, and challenges in obtaining transportation, as well as the availability of illicit substances, may work not only independently but also in synergy to influence women’s behavior in seeking and maintaining HIV care.
The authors suggest that “[i]nterventions designed to improve engagement in HIV care should address structural factors to bolster low-income women’s ability to engage in care.”
“Structural Community Factors and Sub-optimal Engagement in HIV Care among Low-Income Women in the Deep South of the USA” was published online in December 2015 in the journal Culture, Health & Sexuality.