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Black Women and HIV/AIDS:
Findings from Southeast Regional Consumer
and Provider Focus Group Interviews

2011 National HIV Prevention Conference

                  MICHELLE BATCHELOR, NASTAD
                  NIASHA A. BROWN, UNC
Session Agenda

 Review Goals and Objectives
 Overview of NASTAD
 NASTAD’s Black Women’s Portfolio
 View “Street Conversations” video clip
 Black Women Issue Brief II
  – Recommendations and Considerations
Session Goals and Objectives

Goal:
Highlight the perspectives shared during focus group
discussion of HIV positive women and community providers
for consideration when designing, targeting and
implementing culturally relevant programs and interventions
for black women
Objectives:
    Engage in meaningful discussion of existing resources
    to respond to the identified needs of black women
    Identify or provide suggestions to address the unmet
    needs of black women
NASTAD’s Mission

NASTAD strengthens state and territory-based
leadership, expertise, and advocacy and brings
them to bear in reducing the incidence of HIV
and viral hepatitis infection and on providing
care and support to all who live with HIV/AIDS
and viral hepatitis.
Health Equity
Black Women’s Portfolio:
                          Regional Forum Series
 Provide participating teams the opportunity to
  examine and prioritize the barriers to providing
  programs and services targeting black women in their
  jurisdiction
 Support participating teams with the development of
  a year long action plan
 Provide technical assistance to jurisdictions on
  issues impacting the implementation of their action
  plans
Black Women’s Portfolio:
                         Additional Resources
 Women and Girls Sexual Health Summit
 Technical Assistance/Capacity Building Assistance
 Program Profiles
 Webinars
 Listserv
 Black Women Issue Briefs I and II
 Street Conversations Video Toolkit

             www.NASTAD.org
Street Conversations

   2009
   Flip cameras
   Four women in Southern region
   Two questions:
    – From your perspective, why are Black women
      getting infected with HIV?
    – What should we do about it?
Black women Issue Brief II:
                      Southeast Focus Groups
 Summer 2009
 Southeast region of the United States:
  – Florida
  – Kentucky
  – Louisiana
  – Mississippi
  – North Carolina
  – South Carolina
Black women Issue Brief II:
                     Southeast Focus Groups cont.

Methodology
 Semi-structured focus group interviews
 Each state hosted a minimum of three separate focus groups
 Groups ranged in size from three to 18 participants
   – health department staff
   – community service providers
   – consumers of services
 Facilitators shared similar backgrounds, race and gender as
  participants
Black women Issue Brief II:
                    Southeast Focus Groups cont.
Methodology
 Broad questions were used to facilitate and guide
  discussions:
   – How would you describe the HIV epidemic among black
     women in your state?
   – How would you describe the specific issues and
     problems that put black women in your area at risk?
   – How would you describe access to prevention services
     for black women at risk for HIV?
 Probing questions were used to explore issues and salient
  points mentioned by participants
Black women Issue Brief II:
                     Southeast Focus Groups cont.
Major Themes and Findings: Understanding The
 Complexity of Black Women’s Lives
 History, Culture, Faith and the Black Family
 Sexuality and Sexual Communication
 Impact of Abuse and Violence
 Stigma and Disclosure
 Dependency
 Substance Use and Mental Health
Black women Issue Brief II:
                                     Considerations

Holistic and Varied Support Groups
 Groups that address a range of topics relevant to the
  “entire person”
 Provide information and resources regarding childcare,
  employment and healthcare
 Participation is dependent on the availability of childcare,
  transportation and flexible schedules
 Peer-to-Peer support
Black women Issue Brief II:
                      Southeast Focus Groups cont.

Affordable Housing
 Accommodate women and families living with HIV/AIDS
 Offer rent support that reflects the housing market in each
  community
 Establish terms and conditions that are in line with what
  landlords can provide
 Expand to include more units to accommodate the
  growing numbers of homeless and transient populations
Black women Issue Brief II:
                    Southeast Focus Groups cont.

Transportation
 Participants also expressed how the lack of reliable
  transportation, limited public transportation
  resources and infrequent [bus] routes make
  transportation options scarce and influence a
  woman’s ability to participate in programs
Black women Issue Brief II:
                        Southeast Focus Groups cont.
Prevention Messages, Media and Social
  Marketing
 Various literacy level and educational levels
 Images of black women
 Messaging campaigns which indicate that HIV/AIDS should
  be a concern for black women

      “If I was in charge, there would be more information on the
      internet, more information on the radio, commercials on
      television about HIV.” (Mississippi consumer)
Black women Issue Brief II:
                     Southeast Focus Groups cont.
Comprehensive Sex Education for All Women
 For women and girls of all ages
 Many adult women served by health departments have
  misconceptions about reproductive health, contraceptive
  methods, and HIV/STD prevention
 Misconceptions and/or silence is often passed on to
  children
 Targeted and comprehensive education could create
  opportunities for women to access prevention services and
  health care in their communities
Black women Issue Brief II:
                         Southeast Focus Groups cont.
Clinician Education and Sensitivity
 Many patients assume that if the doctor does not bring up sexual
  and reproductive health, then it is not important
 Participants noted that positive experiences communicating with
  their healthcare providers can produce sustained health-seeking
  behavior
 A participant shared that the presence of accurate information
  immediately following her HIV-positive diagnosis made a
  difference in her long-term health
 Other participants noted that some health care providers make a
  quick assessment of their patients’ risk based on the general
  characteristics of a patient’s gender, age, sexual orientation,
  marital status or history of reported substance use
Black women Issue Brief II:
                        Southeast Focus Groups cont.
Interventions (including “Home-grown”) Specific to
  Black Women
 Provide both group-level and individual-level interventions
 Cuts across the various aspects of a women’s identity
 Florida’s Sistas Organizing to Survive (SOS)
   – draws on black women’s common role of being gate
      keepers, nurturers, and spiritual leaders in their community
   – engages the existing social networks of black women to
     provide accurate HIV prevention information
   – allow flexibility in the approach and consider the time of the
     day or week that interventions are offered
Black women Issue Brief II:
                   Southeast Focus Groups cont.

Advocacy
 Black women policy issues and concerns addressed
  at the local, state and national levels
 Guidance to become their own advocates
Black women Issue Brief II:
                       Southeast Focus Groups cont.
Community Collaborations and Partnerships
 (including Faith)
 Facilitate awareness and support to meet the needs of black
  women
 Collaborate with faith leaders who were willing to integrate
  HIV/AIDS education, risk reduction, and testing into larger
  community health events
 Allow a platform for faith leaders to better respond to the
  realities and challenges of their parishioners
Black women Issue Brief II:
                    Southeast Focus Groups cont.

HIV Positive Black Women in Decision-Making
 Engage women who are living with HIV to become civically
  engaged in their local and regional community as both
  political advocates and community partners
 Improve recruitment and education to get a greater
  response and participation from people who represent the
  community the CPG is designed to serve
ACKNOWLEDGEMENTS

 Michelle Batchelor, M.A., Senior Manager, Health
  Equity
 Joy Mbajah, M.A., Manager, Prevention
 Lynn Shaull, M.A., Senior Associate, Prevention
 Sophia A. Nur, Ph.D., Fellow
 Niasha A. Brown, M.A., NASTAD consultant
 Jacqueline Coleman, M.Ed, MSM., NASTAD consultant
 NASTAD thanks all the health department and
  community stakeholders who participated in the focus
  group process for their honest and open participation
Discussion
What is currently being done to address some of
the considerations that were presented?
  – Holistic and Varied       – Clinician Education and
    Support Groups              Sensitivity
  – Affordable Housing        – Interventions Specific to
  – Transportation              Black Women
  – Prevention Messages,      – Advocacy
    Media and Social          – Community Collaborations
    Marketing                   and Partnerships
  – Comprehensive Sex         – HIV Positive Black
    Education for All Women     Women in Decision-
                                Making
Discussion
How can we better address some of the
considerations presented?
  – Holistic and Varied       – Clinician Education and
    Support Groups              Sensitivity
  – Affordable Housing        – Interventions Specific to
  – Transportation              Black Women
  – Prevention Messages,      – Advocacy
    Media and Social          – Community Collaborations
    Marketing                   and Partnerships
  – Comprehensive Sex         – HIV Positive Black
    Education for All Women     Women in Decision-
                                Making
Discussion


What other issues do we need to consider to
fully address HIV/AIDS among Black women?
Thank You!!!

Michelle Batchelor, MA          Niasha A. Brown, MA.
Senior Manager, Health Equity   UNC, NASTAD consultant
mbatchelor@NASTAD.org           nabrown@email.unc.edu



 For additional information on NASTAD’s
  resources for Black women visit:
  www.NASTAD.org

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Black Women and HIV/AIDS: Findings from Southeast Regional Consumer and Provider Focus Group Interviews

  • 1. Black Women and HIV/AIDS: Findings from Southeast Regional Consumer and Provider Focus Group Interviews 2011 National HIV Prevention Conference MICHELLE BATCHELOR, NASTAD NIASHA A. BROWN, UNC
  • 2. Session Agenda  Review Goals and Objectives  Overview of NASTAD  NASTAD’s Black Women’s Portfolio  View “Street Conversations” video clip  Black Women Issue Brief II – Recommendations and Considerations
  • 3. Session Goals and Objectives Goal: Highlight the perspectives shared during focus group discussion of HIV positive women and community providers for consideration when designing, targeting and implementing culturally relevant programs and interventions for black women Objectives: Engage in meaningful discussion of existing resources to respond to the identified needs of black women Identify or provide suggestions to address the unmet needs of black women
  • 4. NASTAD’s Mission NASTAD strengthens state and territory-based leadership, expertise, and advocacy and brings them to bear in reducing the incidence of HIV and viral hepatitis infection and on providing care and support to all who live with HIV/AIDS and viral hepatitis.
  • 6. Black Women’s Portfolio: Regional Forum Series  Provide participating teams the opportunity to examine and prioritize the barriers to providing programs and services targeting black women in their jurisdiction  Support participating teams with the development of a year long action plan  Provide technical assistance to jurisdictions on issues impacting the implementation of their action plans
  • 7. Black Women’s Portfolio: Additional Resources  Women and Girls Sexual Health Summit  Technical Assistance/Capacity Building Assistance  Program Profiles  Webinars  Listserv  Black Women Issue Briefs I and II  Street Conversations Video Toolkit www.NASTAD.org
  • 8. Street Conversations  2009  Flip cameras  Four women in Southern region  Two questions: – From your perspective, why are Black women getting infected with HIV? – What should we do about it?
  • 9. Black women Issue Brief II: Southeast Focus Groups  Summer 2009  Southeast region of the United States: – Florida – Kentucky – Louisiana – Mississippi – North Carolina – South Carolina
  • 10. Black women Issue Brief II: Southeast Focus Groups cont. Methodology  Semi-structured focus group interviews  Each state hosted a minimum of three separate focus groups  Groups ranged in size from three to 18 participants – health department staff – community service providers – consumers of services  Facilitators shared similar backgrounds, race and gender as participants
  • 11. Black women Issue Brief II: Southeast Focus Groups cont. Methodology  Broad questions were used to facilitate and guide discussions: – How would you describe the HIV epidemic among black women in your state? – How would you describe the specific issues and problems that put black women in your area at risk? – How would you describe access to prevention services for black women at risk for HIV?  Probing questions were used to explore issues and salient points mentioned by participants
  • 12. Black women Issue Brief II: Southeast Focus Groups cont. Major Themes and Findings: Understanding The Complexity of Black Women’s Lives  History, Culture, Faith and the Black Family  Sexuality and Sexual Communication  Impact of Abuse and Violence  Stigma and Disclosure  Dependency  Substance Use and Mental Health
  • 13. Black women Issue Brief II: Considerations Holistic and Varied Support Groups  Groups that address a range of topics relevant to the “entire person”  Provide information and resources regarding childcare, employment and healthcare  Participation is dependent on the availability of childcare, transportation and flexible schedules  Peer-to-Peer support
  • 14. Black women Issue Brief II: Southeast Focus Groups cont. Affordable Housing  Accommodate women and families living with HIV/AIDS  Offer rent support that reflects the housing market in each community  Establish terms and conditions that are in line with what landlords can provide  Expand to include more units to accommodate the growing numbers of homeless and transient populations
  • 15. Black women Issue Brief II: Southeast Focus Groups cont. Transportation  Participants also expressed how the lack of reliable transportation, limited public transportation resources and infrequent [bus] routes make transportation options scarce and influence a woman’s ability to participate in programs
  • 16. Black women Issue Brief II: Southeast Focus Groups cont. Prevention Messages, Media and Social Marketing  Various literacy level and educational levels  Images of black women  Messaging campaigns which indicate that HIV/AIDS should be a concern for black women “If I was in charge, there would be more information on the internet, more information on the radio, commercials on television about HIV.” (Mississippi consumer)
  • 17. Black women Issue Brief II: Southeast Focus Groups cont. Comprehensive Sex Education for All Women  For women and girls of all ages  Many adult women served by health departments have misconceptions about reproductive health, contraceptive methods, and HIV/STD prevention  Misconceptions and/or silence is often passed on to children  Targeted and comprehensive education could create opportunities for women to access prevention services and health care in their communities
  • 18. Black women Issue Brief II: Southeast Focus Groups cont. Clinician Education and Sensitivity  Many patients assume that if the doctor does not bring up sexual and reproductive health, then it is not important  Participants noted that positive experiences communicating with their healthcare providers can produce sustained health-seeking behavior  A participant shared that the presence of accurate information immediately following her HIV-positive diagnosis made a difference in her long-term health  Other participants noted that some health care providers make a quick assessment of their patients’ risk based on the general characteristics of a patient’s gender, age, sexual orientation, marital status or history of reported substance use
  • 19. Black women Issue Brief II: Southeast Focus Groups cont. Interventions (including “Home-grown”) Specific to Black Women  Provide both group-level and individual-level interventions  Cuts across the various aspects of a women’s identity  Florida’s Sistas Organizing to Survive (SOS) – draws on black women’s common role of being gate keepers, nurturers, and spiritual leaders in their community – engages the existing social networks of black women to provide accurate HIV prevention information – allow flexibility in the approach and consider the time of the day or week that interventions are offered
  • 20. Black women Issue Brief II: Southeast Focus Groups cont. Advocacy  Black women policy issues and concerns addressed at the local, state and national levels  Guidance to become their own advocates
  • 21. Black women Issue Brief II: Southeast Focus Groups cont. Community Collaborations and Partnerships (including Faith)  Facilitate awareness and support to meet the needs of black women  Collaborate with faith leaders who were willing to integrate HIV/AIDS education, risk reduction, and testing into larger community health events  Allow a platform for faith leaders to better respond to the realities and challenges of their parishioners
  • 22. Black women Issue Brief II: Southeast Focus Groups cont. HIV Positive Black Women in Decision-Making  Engage women who are living with HIV to become civically engaged in their local and regional community as both political advocates and community partners  Improve recruitment and education to get a greater response and participation from people who represent the community the CPG is designed to serve
  • 23. ACKNOWLEDGEMENTS  Michelle Batchelor, M.A., Senior Manager, Health Equity  Joy Mbajah, M.A., Manager, Prevention  Lynn Shaull, M.A., Senior Associate, Prevention  Sophia A. Nur, Ph.D., Fellow  Niasha A. Brown, M.A., NASTAD consultant  Jacqueline Coleman, M.Ed, MSM., NASTAD consultant  NASTAD thanks all the health department and community stakeholders who participated in the focus group process for their honest and open participation
  • 24. Discussion What is currently being done to address some of the considerations that were presented? – Holistic and Varied – Clinician Education and Support Groups Sensitivity – Affordable Housing – Interventions Specific to – Transportation Black Women – Prevention Messages, – Advocacy Media and Social – Community Collaborations Marketing and Partnerships – Comprehensive Sex – HIV Positive Black Education for All Women Women in Decision- Making
  • 25. Discussion How can we better address some of the considerations presented? – Holistic and Varied – Clinician Education and Support Groups Sensitivity – Affordable Housing – Interventions Specific to – Transportation Black Women – Prevention Messages, – Advocacy Media and Social – Community Collaborations Marketing and Partnerships – Comprehensive Sex – HIV Positive Black Education for All Women Women in Decision- Making
  • 26. Discussion What other issues do we need to consider to fully address HIV/AIDS among Black women?
  • 27. Thank You!!! Michelle Batchelor, MA Niasha A. Brown, MA. Senior Manager, Health Equity UNC, NASTAD consultant mbatchelor@NASTAD.org nabrown@email.unc.edu  For additional information on NASTAD’s resources for Black women visit: www.NASTAD.org