Paper: Perceptions and Experiences of HIV-Positive, African-American Women from HIV Diagnosis to Primary Care (40th Biennial Convention (October 31st- November 4th, 2009))

Sunday, November 1, 2009: 3:05 PM

Larry Slater, BSN, RN
Neurosurgical Intensive Care Unit, University of Alabama at Birmingham Hospital, Birmingham, AL

Presentation File (PDF Format)

Learning Objective 1: The learner will be able to delineate the prevalence of delay in initiation of HIV care following an HIV diagnosis.

Learning Objective 2: The learner will be able to describe specific factors relating to HIV-Positive, African-American women that affect their entry into care and continued utilization of care.

Since the onset of the HIV/AIDS epidemic, healthcare professionals have struggled with HIV-positive individuals delaying primary medical care after diagnosis and underutilizing care after entering the healthcare system. Research has shown that African-American (AA) women are at increased risk for delayed care and subsequent underutilization of routine care. The purpose of this IRB-approved study was to examine the lived experience of HIV-positive, AA women, including: (1) their perceptions and experiences of their initial HIV diagnosis, post-diagnosis counseling, first entry into primary care, and current care; and (2) trends from HIV diagnosis to the present in healthcare utilization, alcohol and drug use, condom use, and general demographic variables (income and employment, insurance availability, transportation, living arrangements, and education). A self-completed participant survey aided in the determination of individual timelines from HIV diagnosis to current care and provided demographic information at various points along the timeline. Audio taped interviews were then conducted with nine HIV-positive AA women to capture perceptions and experiences along the individualized timelines. Content analysis was used to determine themes at each point along the timeline. Paired t-test analyses were used to assess health behaviors across time. The major themes that emerged were: (1) death sentence, fright, and embarrassment (initial HIV diagnosis); (2) understanding, good or better, and impersonal (post-test counseling); (3) medications and support (first primary care visit); and (4) medications and living (current care). Results showed significant increases (p<0.01) in healthcare utilization and condom use and a significant decrease (p<0.05) in employment since diagnosis. This study explored the complex issues and emotions that affect the lives of HIV-positive, AA women. Nurses must be aware of these issues in order to establish and maintain a therapeutic relationship with newly diagnosed AA women that will ensure quick entry into primary care and continued routine care throughout their lives.

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