Voices from the Unheard: Perceptions of HIV among Middle Class Black Women in Atlanta

"I care about sex, I care about my health": A mixed-methods pre-test of a HIV prevention mobile health app for Black women in the southern United States

BACKGROUND

Black women experience higher rates of adverse sexual and reproductive health and HIV outcomes, however the use of mHealth to address these health disparities in this population has been inadequate. This study involved a one-month pre-test with Black women living in metro-Atlanta to evaluate the usability, acceptability, and engagement of an HIV prevention app SavvyHER.

METHODS

An explanatory mixed-methods design was employed in which quantitative data was collected through weekly cross-sectional surveys, and qualitative data was collected through semi-structured in-depth interviews. Descriptive and ANOVA analysis was conducted for the quantitative data using STATA software. Qualitative data was analyzed through qualitative descriptive methods on Atlas.ti.

RESULTS

Participants had high levels of acceptability towards the app and used SavvyHER moderately. The most frequently used features were live groups (2.96 ±0.22, 95% CI 2.51,3.41), viewing resources and educational information (2.77 ± 0.21, 95% CI 2.33,3.20), and mental health monitoring (2.73 ±0.21, 95% CI 2.29,3.12). The least used features were pregnancy symptom monitoring (1.92 ±0.27, 95% CI 1.38,2.47) and STI symptom monitoring (2.0 ±0.25, 95% CI 1.48,2.52). In qualitative interviews, several women discussed how the ability to engage in active discussions and join live sessions with other end-users was a favorable aspect of SavvyHER. Although the app's primary focus was on sexual and reproductive health and HIV prevention, women were more likely to access mental health monitoring and physical activity monitoring features. Women expressed their fondness of the app design and interface as it was reflective of the diversity of Black women.

CONCLUSION

Further research is needed to explore the efficacy in using SavvyHER and additional mHealth interventions to enhance Black women's sexual and reproductive health and overall wellness.

Innovative perception analysis of HIV prevention messaging for black women in college: a proof of concept study

BACKGROUND

Black women in college are disproportionately affected by HIV, but have not been a population of focus for HIV prevention campaigns. This study used content from a preexisting HIV media campaign to assess its relevancy and acceptability among Black women in college.

METHODS

Media viewing and listening sessions were convened with Black women enrolled at an HBCU (n = 10) using perception analyzer technology-hardware and software tools that are calibrated to gather and interpret continuous, in-the-moment feedback. Matched pre-and-post-test responses from focus groups were obtained from the perception analyzer data. Descriptive statistics and t-tests were used to characterize the data.

RESULTS

Students were more likely to personally identify with media content that included profound statements, along with memorable people and actors [95% CI: 1.38, 2.27]. In over half of the vignettes, participants reported that content representing students' society, culture, or interests was missing.

CONCLUSIONS

HIV prevention media campaigns may offer potential in increasing HIV awareness and risk perceptions; further research is needed to evaluate optimal content tailoring for both cultural and climate relevancy.

Talking with My Sistahs: Examining Discussions About HIV Risk and Prevention Outcomes Within Black Women Sistah Circles

Black women's health is in a state of crisis. Though Black women make up roughly 12% of the US population, they account for 66% of new HIV cases. One understudied barrier to Black women's sexual health is their communication about the topic of HIV with others and proclivity to dismiss HIV-related information based on self-exemption. Using a group-centered approach called the "sistah circle," this study examines group gatherings of Black women to assess their communication about HIV and determine potential gaps in their understanding of information and HIV-related behavior. Data were derived from five focus groups, with four Black women in each group engaging in a facilitated discussion. Findings from the project extend knowledge about how socializing agents such as school, parents, church, and interventionists have the potential to delay or deter Black women from engaging in communication that supports risk-reducing behaviors and prevention efforts.

Living in Between: A Grounded Theory Study of Depression Among Middle-Class Black Women

Empirical evidence consistently has linked the identification and treatment of depression among low-income Black women. Research on depression and Black women also suggests Black women are a monolithic group who experience depression similarly. The purpose of this qualitative study was to gain a deeper understanding of how the identity of middle-class Black women may shape their experiences with depression. Using grounded theory as the guiding method, I conducted 30 in-depth, semistructured interviews with Black women between 30 and 45 years old who self-identified as middle class. The core experience of depression among middle-class Black women was “living in between” because they straddled two worlds—one Black world and one White world—with competing sociocultural messages about depression. Two major categories emerged that informed the experiences of depression among the middle-class Black women in this study: (a) strategies to deal with depression and (b) minimizing depression. Each of these categories highlighted consequences for the women’s mental health. The women also described coping strategies for managing these experiences. Implications for research and practice are included.

Applying a Nursing Perspective to Address the Challenges Experienced by Cisgender Women in the HIV Status Neutral Care Continuum: A Review of the Literature

ABSTRACT

The field of HIV research has grown over the past 40 years, but there remains an urgent need to address challenges that cisgender women living in the United States experience in the HIV neutral status care continuum, particularly among women such as Black women, who continue to be disproportionately burdened by HIV due to multiple levels of systemic oppression. We used a social ecological framework to provide a detailed review of the risk factors that drive the women's HIV epidemic. By presenting examples of effective approaches, best clinical practices, and identifying existing research gaps in three major categories (behavioral, biomedical, and structural), we provide an overview of the current state of research on HIV prevention among women. To illustrate a nursing viewpoint and take into account the diverse life experiences of women, we provide guidance to strengthen current HIV prevention programs. Future research should examine combined approaches for HIV prevention, and policies should be tailored to ensure that women receive effective services that are evidence-based and which they perceive as important to their lives.

Social and Environmental Influences on Sexual Behaviors of College Black Women: Within Group Diversity Between HBCU vs. PWI Experiences

Black women carry a disproportionate number of new HIV infections in the USA. Studies that have assessed HIV risk perception along with HIV prevention interventions for Black women have primarily focused on Black women of low socioeconomic status. Few studies have assessed HIV risk perceptions and sexual behavior among college-educated Black women of higher socioeconomic status despite their high risk of HIV. College-educated Black women are most likely to acquire HIV while in college, and there has been a marked absence of research assessing the environmental and cultural influences present throughout college-campuses, coupled with evaluating how these factors shape sexual behaviors. We conducted surveys with Black female students attending a historically Black college and Black female students attending a predominately White university, and compared baseline differences in sexual behaviors among both populations. Results showed that for participants attending the historically Black college certain sociocultural elements, such as music and media, had a significantly stronger influence on sexuality and sexual behaviors compared with students attending predominately White universities. The development of future HIV prevention interventions for Black women necessitates an understanding of the diverse microcultures that Black women come from. This research is high priority for college-educated Black women given this population's lack of inclusion in HIV prevention research.