This document summarizes findings from focus groups with HIV-positive black women and community providers in the Southeast U.S. regarding barriers to HIV prevention, care, and services for black women. Major themes included the impact of history, culture, abuse, stigma, and mental health issues. Considerations for improving support included holistic support groups, affordable housing, transportation, culturally-relevant prevention messages, education for women, clinician sensitivity training, community-specific interventions, advocacy, and engaging HIV-positive black women in decision-making. The focus groups provided insights to better address the complex needs of black women at high risk for HIV.

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.

5. Health Equity

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