African American Women Living With HIV: A Case Study Analysis of Long-Term "Thrivers"

African American women have the highest prevalence of HIV among US women. Among African American women, the incidence rate is nearly 20 times higher than that in Caucasian women, and five times that of Hispanic women. Hence, it is essential that gender-specific and culturally relevant behavioral HIV self-management interventions be developed and trialed for efficacy with these women. An enhanced understanding about how these women view self-management of HIV, how they engage in HIV self-management, and how self-management of HIV impacts their individual health outcomes is foundational to developing effective HIV self-management interventions. The primary aim of this qualitative study was to explore the self-management strategies of African American women who have been living with HIV for 10 or more years. A secondary aim was to explore their perspectives on the acceptability of an electronic platform for intervention delivery for HIV self-management education.

Face to face interviews were conducted with women who are living with HIV. When asked why they agreed to be interviewed the women stressed their desire to help others through their experience. A preliminary content analysis of the transcribed interviews revealed that spirituality, social support, and the impact of time since diagnosis on HIV management knowledge and skills were common themes.

A medical record review highlighted that although all three women were taking antiretroviral medications and had achieved suppression of HIV; they were also managing and adjusting to additional co-morbid conditions. Cardiovascular conditions, diabetes, and cancer were among these co-morbidities.

Despite these challenges, all three women emphasized the value of a positive perspective and on giving back to the community; ‘being diagnosed with HIV got me respect’. Two of the three women currently worked for AIDS Service Organizations and all were community volunteers.

 HIV care and treatment providers must consider the wholeness of their approach when interacting with those living with HIV. Notably, they must engage patients in conversations about harnessing the collective resources of the mind, body, and spirit when employing HIV self-management.