Mental Health and Treatment Engagement among Low-Income Women of Color Living with HIV

Low-income women of color are disproportionately more likely to contract HIV, struggle with treatment adherence, and have compromised health as a result of HIV infections in comparison to White and more affluent women. The current study is a secondary analysis aimed at examining the association between stress, symptoms of depression, trauma exposure, healthcare engagement, and adherence self-efficacy, among low-income women of color with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). Structural equation modeling is used to identify latent mental health symptoms that may influence one another, as well as outcomes involving treatment engagement. Participants contributing to this dataset (n = 134) were low income, women of color (primarily African American) living with HIV or AIDS, receiving care at a major medical center in the northeastern United States. Findings indicate significant indirect associations between perceived stress and the outcome of medical appointment attendance. Significant mediators of this indirect relationship include depressive symptoms, parenting stress, and adherence self-efficacy. Implications for health and behavioral health practice and policy interventions are drawn. Areas in need of future research are identified.

Women of Color in the Health Professions: A Scoping Review of the Literature

Women of color (WoC) in the health professions encounter challenges in advancement to higher positions, disparities in wages, discrimination, lack of expectation to achieve leadership positions, and absence of extensive support networks. Articles in the literature have addressed race and/or gender in the context of professional development. However, applying an intersectional lens or framework to better understand the contextual issues of professional development for WoC remains to be addressed. Thus, this scoping review aimed to (i) identify health professions literature that addresses disparities affecting WoC, and (ii) describe strategies and approaches to support WoC in the health professions. Methods: The literature searches were conducted in multiple databases, including PubMed and MEDLINE (Ovid); and Google and Google Scholar were used to "hand search" further articles including gray literature. Three independent reviewers reviewed and screened articles for inclusion in accordance with a guide. Search included articles on pharmacy or healthcare professions, published in English, and which met three content criteria: racial disparities/inequities, professional development/career advancement, and women or gender disparities Results: A total of 31 articles were included-medicine (17), nursing (1), pharmacy (7), other (4), and multiple health professions (2). Key findings included underrepresentation of women and minority groups, inequities in professional advancement and leadership positions for WoC, and greater dissatisfaction and attrition among minority and women professionals. Conclusion: WoC face unique and distinct challenges and barriers in their professional careers resulting from the intersectionality of not only race and gender, but also lived experiences and opportunities. Strategies to improve diversity and representation should include an intersectional framework or lens and be critically evaluated.

Representative Survivorship: A Look Into the Race-Evasiveness of Title IX and Understanding the Barriers to Reporting for Women of Color

While there are many cultural norms that serve as barriers to Women of Color reporting sexual assault on college campuses, there are also several institutional and systemic barriers. This paper explores some of these barriers and argues for Title IX, a policy that addresses issues of sexual assault on college campuses, to encompass and protect more than a person's sex alone. In addition to the legal system, institutions of higher education have a long-standing history of discrimination against racial and ethnic minority groups, in particular with addressing sexual assault crimes. This paper argues that specific measures need to be outlined in Title IX that acknowledge and redress the effects of institutional harms on the BIPOC community. This paper also discusses how adopting a restorative justice and intersectional approach to policy reform will aid in building a supportive relationship between survivors and their educational institutions.

Health Experiences of Women University Students of Color and Women International Students in the United States During the First Year of the COVID-19 Pandemic: Findings From a Transnational, Virtual Photovoice Study

Women university students in the United States who are students of color and international students consistently experience health disparities. These were exacerbated due to the COVID-19 pandemic and racial upheaval following the murder of George Floyd. Within that context, this study aimed to explore the health and well-being experiences of women students of color and international women students at a university in the Midwestern United States in 2020-2021. This participatory, transnational study utilized a virtual adaptation of Photovoice with 14 participants who joined the study from five different countries. Participatory elements included participant co-researchers co-leading development of the photo "mission," icebreakers, naming of the project, design of the project logo, choosing photos for discussion and exhibits, initial analysis of emergent themes, and approval and editing of photos for exhibit. Inductive thematic analysis revealed three themes: (1) grief and loss, (2) barriers and facilitators to social health, and (3) fear and stress from simultaneous social stressors. Data was not mutually exclusive with some photos and narratives illustrating more than one theme. The women experienced grief and loss while negotiating effects of social isolation and adapting to maintain social health. Negative mental and emotional health experiences were amplified as the social context of police brutality and anti-immigrant sentiments overlaid the stress of the pandemic. Study results demonstrate need for increased and tailored health and social service support for women students of color and international women university students.

Challenges to Help-Seeking Among Women of Color Exposed to Intimate Partner Violence

Women exposed to intimate partner violence (IPV) often rely on support from their informal support networks to obtain resources that may mitigate IPV. This study explored the challenges women of color encounter in seeking advice and information from their informal support networks (i.e., family, friends, neighbors, community members) regarding IPV support services. In-depth interviews were conducted with 29 IPV survivors who self-identified as Black or Hispanic. Data were analyzed using grounded theory methodology. Results showed that participants lacked informational support, both in their communities and in their interpersonal relationships with family and friends. Communities treated IPV as normal and propagated the belief that women's responsibilities were to men and family. Family and friends discouraged IPV information seeking and advised that IPV should be kept private to avoid community shaming. The community environments also lacked information about resources for women experiencing IPV. The lack of information from their informal support networks appeared to delay participants' help-seeking. As the frequency and severity of violence escalated, some participants engaged in independent information searching, using social media and online information sources as well as conventional media like radio and newspapers. Others received information from first responders in the wake of a violent emergency. Participants described the information they received online or from first responders as empowering, encouraging them to engage in support services. Similarly, they felt empowered by the information they received from social workers, counselors, and victims' advocates, and they wished to use what they learned to help other women in similar circumstances. Women experiencing IPV and their communities need more information regarding IPV support services. Successful interventions for IPV survivors and their support networks may necessitate community-level education and altering biased perceptions of gender-appropriate behaviors.

Flames of transformation: Igniting better mental and physical health for racialized and gendered North Americans

COVID-19 is catalyzing both crises and opportunities for communities of color. The crisis of high mental and physical morbidities and mortalities exposes persistent inequities while providing opportunities to celebrate the power of rejuvenated anti-racism movements, fueled partly in response to the extremism of ultra-conservative governments, the circumstances to reflect deeply on racism because of forced stay-at-home-orders, and digital technologies primarily driven by youth. In marking this historical moment of longstanding anti-racism and decolonial struggles, I assert the importance of foregrounding women's needs. In analyzing racism, rooted in colonialism and white supremacy, and its impacts on mental and physical health status, I focus on improving racialized women's lives within the larger context, concentrating on the determinants of health. I contend that fanning the flames to scathe the racist and sexist foundations of North American society will break new ground for sharing wealth, bolstering solidarity and sisterhood, and ultimately improving Black, Indigenous, and Women of Color (BIWOC) health. Canadian BIWOC earn approximately 59 cents to the dollar earned by non-racialized men, creating vulnerabilities to economic downturns, such as the one Canada is currently in. BIWOC care aides, at the bottom of the healthcare hierarchy, are emblematic of other Black, Indigenous, and People of Color (BIPOC), who face risks of frontline work, low wages, poor job security, unpaid sick days and so forth. To that end, policy recommendations include employment equity initiatives that hire groups of racialized women who consciously express solidarity with each other. Cultural shifts within institutions will be key to providing safe environments. Improving food security, internet access and BIWOC-related data collection linked to community-based programming while prioritizing research on BIWOC will go a long way toward improving BIWOC health. Addressing racism and sexism within the healthcare system, aiming for equitable diagnostic and treatment foci, will require transformative efforts including determined leadership and buy-in from all levels of staff, long-term training and evaluation programs, audited by BIPOC communities.

Comfort in seeking support from sexual violence prevention education health services among college women

Objective: Explores racial differences of sexual violence-(SV) health service-(HS) outcomes among college women: (1) seeking support from a confidential-resource-(CR) and (2) reporting SV to the Title IX office. Participants: Data was collected from all ages of women (N = 583) and grade levels from one-large university on the Pacific-coast. Methods: Logistic-regression of HS outcomes were performed using the Fall 2016 American College Health Association-NCHA-II-survey. Results: The following variables increased the likelihood of women seeking support from the two health-services: (#1CR) relationship-status, race, and experiencing sexual-violence. WOC were 7x more likely to seek support if physically-assaulted, and WW were 3.9x more likely to seek support if a graduate student. (#2Title IX) year in school, physical-assault, and receiving prevention-education after the first-year in college. Overall, there were significant differences by race in the variables that influenced WW and WOC's comfort or likelihood to seek support. Conclusion: Colleges need to consider the disproportionate impact of SV on WOC.

Women of Color Student Survivors' Perceptions of Campus Sexual Assault Prevention Programming

This article presents a qualitative study of 44 Women of Color undergraduate student survivors' perceptions of campus sexual assault prevention programming using the framework of standpoint theory. Participants held perceptions concerning online training prior to college, the in-person presentations they attended during new student orientation, and the lack of information relayed through prevention programs about sexual assault perpetration. Findings highlight the need for continued research investigating the standpoints of Women of Color students to better inform implementation of prevention efforts.

Internalized HIV-related stigma in women of color obtaining care at an HIV specialty center in Los Angeles County, California

The current study examined the role of internalized HIV-related stigma in antiretroviral therapy adherence, viral load, and retention in care among women of color living with HIV in Los Angeles County, California. African American and Hispanic/Latino women 18 years of age and older completed a one-time brief survey between September 2017 and February 2018. Descriptive statistics, and univariable and multivariable logistic regressions were used to analyze the data. Seventy-six participants enrolled in the study and 74 completed the entire survey. Seventy-six percent of respondents were Hispanic/Latino, 24% were African American, 71% were unemployed, and 54% had less than a high school education. Thirty-five percent were defined as having "high" stigma with a score in the upper quartile of the scale. Being unemployed, having a high school education or less, and not meeting the Health Resources and Services Administration's annual retention in care measure were associated with "high" stigma. When controlling for education and employment status, those reporting "high" stigma vs. "low" stigma were 18.8 times more likely to not meet the criteria for annual retention in care (OR = 18.8, 95% CI = 1.9-189.2, p = 0.013). Stigma-reduction interventions targeting healthcare settings may be necessary to improve patient retention and engagement in care.

Undue burdens created by the Texas Abortion Law for vulnerable pregnant women

The new Texas abortion law requires the physician to determine whether a fetal heartbeat is present and prohibits abortion after a heartbeat has been documented. An exception is allowed when a "medical emergency necessitated the abortion." These and other provisions of the statute are to be enforced through "civil actions" brought by private citizens. This article identifies 3 populations of vulnerable women who will experience undue burdens created by the Texas abortion law. We begin with an account of the concept of undue burden in the jurisprudence of abortion, as expressed in the 1992 US Supreme Court case, Planned Parenthood v. Casey of Southeastern Pennsylvania. We then provide an evidence-based account of the predictable, undue burdens for 3 populations of vulnerable women: pregnant women with decreased freedom of movement; pregnant minors; and pregnant women with major mental disorders and cognitive disabilities. The Texas law creates an undue burden on these 3 populations of vulnerable women by reducing or even eliminating access to abortion services outside of Texas. The Texas law also creates an undue burden by preventably increasing the risks of morbidity, including loss of fertility, and mortality for these 3 populations of vulnerable women. For these women, it is indisputable that the Texas law will create undue burdens and is therefore not compatible with the jurisprudence of abortion as set forth in Planned Parenthood v. Casey because a "significant number of women will likely be prevented from obtaining an abortion." Federal courts should therefore strike down this law.

Navigating white academe during crisis: The impact of COVID-19 and racial violence on women of color professionals

Scholars have shown that women of color experience racial and gender aggressions in different workplaces but strategically in predominantly white institutions. This article explores how women of color professionals in academic institutions perceive their experiences during this time of multiple pandemics induced by COVID-19 and racial violence. By examining research on women of color in academe and other white institutional spaces, we discuss how systemic racism is embedded within organizational practices that sustain racial inequality. Drawing on data from a qualitative online survey of women of color in academe (n = 25), our theoretically grounded research employs Black feminist thought as a methodological practice to examine how COVID-19 and racial violence have impacted women of color through the continued perpetuation of racial and gender inequities. The findings provide important insights on how institutional responses to public discourses about racism can influence the experiences of women of color and their career trajectories.

Why so Few, Still? Challenges to Attracting, Advancing, and Keeping Women Faculty of Color in Academia

From its earliest beginnings, the university was not designed for women, and certainly not for women of color. Women of color in the United States are disproportionately under-represented in academia and are conspicuous by their absence across disciplines at senior ranks, particularly at research-intensive universities. This absence has an epistemic impact and affects future generations of scholars who do not see themselves represented in the academy. What are the barriers to attracting, advancing, and retaining women faculty of color in academia? To address this question we review empirical studies that document disparities in the assessment of research, teaching, and service in academia that have distinct implications for the hiring, promotion, and professional visibility of women of color. We argue that meaningful change in the representation, equity, and prestige of women faculty of color will require validating their experiences, supporting and valuing their research, creating opportunities for their professional recognition and advancement, and implementing corrective action for unjust assessment practices.

Recruiting young women of color into a pilot RCT targeting sexual health: Lessons learned and implications for applied health technology research

Objective To evaluate different recruitment methods to enroll participants into a mHealth pilot RCT: banner ads on Facebook and OkCupid, and targeted electronic outreach (e.g., emails to community-based organizations and to professors at local colleges). Participants: Between October 2015 and May 2016, 114 college-aged Black and Latina women 18 to 24 participated in the study. Methods: Recruitment methods compared online banner ads on social media to targeted electronic outreach. Individual banner ad images were compared by impressions, clicks, and cost by enrolled participants. Results: More targeted electronic recruited participants enrolled than via banner advertisements. Banner ads with images of women yielded a higher click-through-rate and was more cost effective versus the logo alone. Conclusions: Recruiting young women of color may be facilitated through known and trusted adults, such as college professors, rather than through anonymous banner advertisements on social media.

Acknowledging the intersection of gender inequity and racism: Identifying a path forward in pharmacy

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Gender affirmation and social exclusion amongst trans women of color in Australia

INTRODUCTION

Transgender (trans) women of color navigate the intersected identity frames of gender, race, social class and sexuality, whilst facing multiple layers of stigma, discrimination and violence during and following gender affirmation. However, little is known about the ways in which trans women of color negotiate gender affirmation, in the context of the risk of social exclusion and violence.

AIM

This article discusses the experience and construction of gender transitioning and gender affirmation for trans women of color living in Australia, associated with the risk of social exclusion or violence.

METHOD

In-depth interviews and photovoice were conducted with 31 trans women of color, analyzed through theoretical thematic analysis informed by intersectionality theory.

RESULTS

The following themes were identifed: 1) 'Gender affirmation: A bittersweet experience', with three subthemes: 'Self-empowerment is tempered by family rejection', 'Migration facilitates gender affirmation' and 'Gender affirmation and social support'; 2) 'Being a trans woman of color', subthemes: 'Bodily agency and passing', 'Femininity as pleasure and cultural self-expression', and 'Resisting archetypal White hetero-femininity'; 3) 'Hormones, surgical intervention and navigating the health system'.

CONCLUSION

Gender transitioning and gender affirmation involved the intersection of gender, cultural, social class and sexual identities, accomplished through personal agency and with the support of significant others. To ensure that policy and support services meet the needs of trans women of color, it is critical that the voices of such multiply-marginalized women are at the center of leadership, program and policy development.

Thick trust, thin trust, social capital, and health outcomes among trans women of color in New York City

Introduction: Many trans women of color communities experience high HIV seroprevalence, extreme poverty, high rates of victimization and substance use, and poor mental health. Greater knowledge of trans women of color social capital may contribute toward more effective services for this marginalized population. Methods: These data come from a mixed-methods study that examined trans/gender-variant people of color who attended transgender support groups at harm reduction programs in NYC. The study was conducted from 2011 to 12, total N = 34. The qualitative portion was derived from six focus group interviews. Results: Two support groups stood out as exhibiting very strong alternative kinship structures. One group was comprised of immigrant trans Latinas, and the other group were trans women of African descent living with HIV. Both groups demonstrated ample cultivation of "trust capital" in the form of "thick trust" (bonding capital) and "thin trust" (bridging/linking capital) both inside and outside/beyond the support groups. Thick trust included the cultivation of intimacy, support in primary romantic relationships, and community leadership. Thin trust included networking with a variety of organizations, increased educational opportunities, and cultural production. Discussion: Participants "opened up to social capital" through the process of trusting as a series of (1) risks; (2) vulnerabilities; and (3) reciprocities. A solid foundation of thick trust resulted in a social, psychological, and emotional "base." Upon this foundation, thin trust was operationalized resulting in positive material, economic, and quality-of-life outcomes, leading to an expanded space of capabilities.

Reporting Intimate Partner Violence and Sexual Assault: A Mixed Methods Study of Concerns and Considerations Among College Women of Color

Introduction: The purpose of this study was to explore how women of color affiliated with a large public university in the United States evaluated involving authorities in cases of intimate partner violence (IPV) and/or sexual assault (SA) and to discover if structural stressors such as racism or sexism influenced their thinking. Methodology: Surveys on perceived ethnic discrimination, depression, trauma history, stress, social support, resilience, and sleep disturbance were completed by 87 self-identified women of color. All women also participated in one of several focus groups on IPV and SA. Results: Roughly half of participants had experienced SA and about a third experienced IPV. Participants identifying as Latinx/Hispanic or Black/African American reported the greatest experiences of structural stressors and also felt there was not always a potential safety gain with reporting IPV and/or SA. Discussion: The results of this study suggest universities must create more culturally competent environs of safety for women of color.

A Transdisciplinary Conceptual Framework of Contextualized Resilience for Reducing Adverse Birth Outcomes

Research in preterm birth has focused on the disparate outcomes for Black, Hispanic, and Latina women as compared with White women. However, research studies have not focused on centering these women in frameworks that discuss how resilience is embodied. This article is a presentation of our transdisciplinary contextual framework of resilience, building on work that centers Black, Hispanic, and Latina women, as well as historical oppression and trauma resilience frameworks developed by transcultural psychiatry, psychology, public health, anthropology, medicine, nursing, sociology, and social work. To develop the model, we reviewed 115 articles and books (1977-2019), which were then evaluated and synthesized to develop a transdisciplinary framework of contextualized resilience to enable a better understanding of the complex interplay of medical and social conditions influencing preterm birth. The framework includes multiple ecological layers that cross the individual, familial and intimate, community, structural, policy and law, and hegemonic domains.

Current and emerging treatment strategies for hair loss in women of color

Hair loss is common in women of color, and is associated with significant psychosocial complaints. Early clinical recognition and prompt initiation of intervention with medical treatment is critical to halt the disease process. In this article, we review the clinical presentations of nonscarring and scarring alopecias in women of color, use of dermoscopy for early recognition of the disease process, and medical, procedural, and surgical interventions. In conditions that result in scarring alopecia, such as late-stage traction, frontal fibrosing, or central centrifugal cicatricial alopecia, patients may benefit from procedural interventions, such as hair transplantation, platelet rich plasma injections, low-level laser therapy, or scalp therapy.

Reproductive Rights, Reproductive Justice: Redefining Challenges to Create Optimal Health for All Women

The World Health Organization (WHO) defines reproductive health as the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive Justice is the complete physical, mental, spiritual, political, social, and economic wellbeing of women and girls, based on the full achievement and protection of women's human rights. While these concepts are similar, the latter was an approach that grew out of the need to better articulate the language and realities of women of color as it related to sexual and reproductive health issues. The current U.S. reproductive health agenda is polarized to a choice or abortion issue without any alignment to other issues that predominantly impact women of color within the reproductive health framework. This article acknowledges the history and challenges of reproductive health and rights, while offering a non-polarized, more inclusive ethical course of action, using an optimal health approach with new alliances for the reproductive justice movement today.

Women of Color Reflect on HIV-Related Stigma through PhotoVoice

HIV-related stigma affects people living with HIV (PLWH), especially in communities of color. In our study, African American and Latina/Hispanic women living with HIV (WLWH) described experiences of stigma through PhotoVoice, a community-based participatory method of documentary photography. Ten WLWH from Los Angeles documented stigma experiences through photographs for up to 5 weeks and discussed their images during a focus group or semi-structured individual interview. Qualitative interpretive phenomenological analysis of participant narratives and photographs revealed lack of education and cultural myths as the main triggers of the stigma our participants faced. Stigma was experienced in health care settings, and participants identified depression, fear of intimate relationships, and nondisclosure of HIV status as its consequences. Social support and faith were noted as key coping mechanisms. WLWH recommended involving PLWH and public health officials in stigma reduction campaigns and youth education. PhotoVoice was perceived as a useful tool for education and self-improvement.

Temporary temptation

Abstract As our society changes, adapting to the current needs of the community, one thing has remained virtually unchanged-the lack of standards of beauty that honor and include women of color. From magazines to music to models we are constantly bombarded with images that don't represent the hues and body types that accurately depict the diaspo-ras of women in our culture. Naively we watch television shows that condition our minds, and it shows in our perceptions of beauty. Those perceptions create impossible standards that women are expected to reach within relationships. While this has been an issue that has been talked about openly in the heterosexual community, it is still a subject that has yet to be broached by lesbian women of color. This poem speaks to the experience of women of color, lesbian or straight, who have been used, rejected or left because they did not fit the "American" standard of beauty. It is the beginning of a dialogue that needs to be continued.

Correlates of overweight and obesity among lesbian and bisexual women

BACKGROUND

Recent studies find lesbians at greater risk for overweight and obesity than heterosexual women. While this may reflect differences in attitudes concerning weight and body shape, little is actually known about risk factors within this group. This study examines correlates of obesity and exercise frequency among lesbians and bisexual women.

METHODS

Data from a snowball sample (n = 1209) of lesbians/bisexual women living in Los Angeles Country were utilized. Overweight was defined as BMI >/= 25 kg/m(2); obesity as BMI >/= 30. Associations between sociodemographic characteristics, exercise frequency, health indicators, and weight-related measures were evaluated to identify independent predictors of BMI and exercise frequency.

RESULTS

Prevalence of overweight and obesity among lesbians varied by racial/ethnic background. Higher BMI was associated with older age, poorer health status, lower educational attainment, relationship cohabitation, and lower exercise frequency. Higher BMI, perceptions of being overweight, and reporting a limiting health condition were identified as independent predictors of infrequent exercise. Women were generally quite accurate in self-perceptions of weight status.

CONCLUSIONS

Correlates of overweight and obesity among lesbians and bisexual women are generally comparable to those observed in studies of heterosexual women. Evidence that lesbians' higher BMI is associated with higher levels of fitness is not supported.

Lesbian and Bisexual Women's Experiences of Victimization: Mental Health, Revictimization, and Sexual Identity Development

SUMMARY The prevalence and correlates of a variety of victimization experiences among a large, ethnically diverse national sample of 2,431 lesbian, bisexual, and gay women (LBG) is examined. Most participants (62.3%) report experiencing bias related victimization because they are LBG. Overall, 30.8% of participants report being harshly beaten or physically abused in childhood and 21.2% in adulthood; 39.3% report sexual victimization before the age of sixteen and 36.2% at age sixteen or older. Each type of victimization was significantly related to current psychological distress, and the more types of victimization (sexual or physical, in childhood or adulthood) a participant experienced, the greater her psychological distress. Participants who were victimized in childhood were four times more likely to experience the same type of victimization (sexual or physical) as an adult and about twice as likely to experience the other type of victimization in adulthood. In addition, there were significant differences in history of victimization by race/ethnicity. Native American participants reported the highest rates followed by Latinas, African Americans, Asian Americans, and Whites.

Abuse, Social Support, and Depression Among HIV-Positive Heterosexual, Bisexual, and Lesbian Women

SUMMARY A nonprobability sample of HIV-positive mostly African American and Puerto Rican women in New York City were surveyed regarding abusive experiences, social support, and depressive symptoms. Seventy-five percent reported experiencing physical or sexual abuse at some point in their lives. Multiple regression analyses controlling for relevant sociodemographic variables indicated that child physical and sexual abuse and adult sexual abuse were significantly associated with depressive symptomatology (i.e., CES-D scores). HIV-related social support had a significant negative correlation with CES-D scores but did not have a moderating impact on the effects of physical or sexual abuse. Lesbian/bisexual women reported higher rates of lifetime sexual and physical abuse than heterosexual women. However, there were no differences between the groups in total CES-D scores. Lesbian/bisexual women had significantly greater support from friends and groups/organizations than the heterosexual women. The implications of the findings for future research and the provision of services for HIV-positive women are considered.