Daily Microaggressions and Related Distress among Black Women Living with HIV during the Onset of the COVID-19 Pandemic and Black Lives Matter Protests

Objetivo: identificar os avanços e desafios das políticas públicas destinadas às mulheres negras vivendo com HIV. Método: trata-se de um estudo bibliográfico, tipo revisão integrativa. Realizaram-se as buscas nas bases de dados LILACS, BDENF, IBECS, MEDLINE e na Biblioteca Virtual SciELO. Compôs-se a amostra por 18 artigos avaliados pelo instrumento CASP e classificados de acordo com os níveis de evidência. Apresentaram-se os resultados em forma de figuras e tabela. Resultados: informa-se que, na análise das 18 publicações encontradas, 11 (61,1%) estavam na base de dados LILACS; 6 (33,3%), na Biblioteca Virtual SciELO e 1 (5,55%), na BDENF. Emergiram-se, da análise temática dos artigos, duas categorias: vulnerabilidade e o racismo institucional como fatores que dificultam o acesso aos serviços de saúde e comprometem a assistência às mulheres que vivem com HIV, sendo os fatores de preservação da epidemia nesta população. Conclusão: evidenciaram-se fragilidades no aspecto das contribuições das políticas públicas na mudança de paradigmas sociais antigos atrelados ao HIV, fato confirmado pelo papel de destaque da vulnerabilidade como protagonista da realidade vivenciada pelas mulheres negras. Descritores: Grupos Étnicos; Políticas Públicas; Mulheres; HIV; Vulnerabilidade em Saúde; Racismo; Saúde da Mulher.ABSTRACTObjective: to identify the advances and challenges of public policies aimed at black women living with HIV. Method: this is a bibliographical study, type integrative review. We searched the databases LILACS, BDENF, IBECS, MEDLINE and the SciELO Virtual Library. The sample was composed by 18 articles evaluated by the CASP instrument and classified according to the levels of evidence. Results were presented in the form of figures and tables. Results: it is reported that, in the analysis of the 18 publications found, 11 (61.1%) were in the LILACS database; 6 (33.3%), in the SciELO Virtual Library and 1 (5.55%), in the BDENF. Two categories emerged from the thematic analysis of the article: vulnerability and institutional racism as factors that hinder access to health services and compromise the care of women living with HIV, being the factors that preserve the epidemic in this population. Conclusion: weaknesses in the aspect of the contributions of public policies in the change of old social paradigms linked to HIV have been evidenced, a fact confirmed by the prominent role of vulnerability as protagonist of the reality experienced by black women. Descriptors: Ethnic Groups; Public Policy; Women; HIV; Population Vulnerable; Racism; Women´s Health.RESUMENObjetivo: identificar los avances y desafíos de las políticas públicas dirigidas a las mujeres negras que viven con el VIH. Método: se trata de un estudio bibliográfico, tipo revisión integrativa. Se realizaron busquedas en las bases de datos LILACS, BDENF, IBECS, MEDLINE y la Biblioteca Virtual SciELO. La muestra estuvo compuesta por 18 artículos evaluados por el instrumento CASP y clasificados según los niveles de evidencia. Los resultados se presentaron en forma de figuras y tablas. Resultados: se informa que, en el análisis de las 18 publicaciones encontradas, 11 (61.1%) se encontraban en la base de datos LILACS; 6 (33.3%), en la Biblioteca Virtual SciELO y 1 (5.55%), en la BDENF. Del análisis temático del artículo surgieron dos categorías: la vulnerabilidad y el racismo institucional como factores que dificultan el acceso a los servicios de salud y comprometen la atención de las mujeres que viven con el VIH, siendo los factores que preservan la epidemia en esta población. Conclusión: Se evidenciaron debilidades en el aspecto de las contribuciones de las políticas públicas, a cambio de paradigmas sociales antigos, vinculados al VIH, un hecho confirmado por el papel de destaque de la vulnerabilidad como protagonista de la realidad experimentada por las mujeres negras. Descriptores: Grupo Étnico; Políticas Públicas; Mujeres; VIH; Vulnerabilidad em Salud; Racismo; Salud de la Mujer.

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3242 Stressful experiences and adherence to HIV care among Black Women Living with HIV: A qualitative analysis

Journal of Clinical and Translational Science ◽

10.1017/cts.2019.174 ◽

2019 ◽

Vol 3 (s1) ◽

pp. 74-74

Author(s):

Crystal Chapman Lambert ◽

Chastity McDavid ◽

Tammi F. Thomas ◽

Kiko King ◽

Andres Azuero ◽

...

Keyword(s):

Social Support ◽

Black Women ◽

Physical Abuse ◽

Traumatic Events ◽

The United States ◽

Stressful Events ◽

Hiv Care ◽

Care Clinic ◽

Women Living With Hiv ◽

Living With Hiv

OBJECTIVES/SPECIFIC AIMS: Our primary objective was to understand the relationship between incident or recent stressful events and adherence to HIV care in the context of other person, environment, and HIV-specific stressors in a sample of Black women living with HIV (WLWH). METHODS/STUDY POPULATION: Thirty in-depth interviews were conducted with Black women living with HIV who receive care at an academic HIV primary care clinic in the Southern region of the United States to elicit stressful events influencing adherence to HIV care. Semi-structured interview guides were used to facilitate discussion regarding stressful events and adherence to HIV care. Interviews were audiotaped and transcribed verbatim. Transcripts were independently coded using a theme-based approach by two experienced coders, findings were compared, and discrepancies were resolved by discussion. RESULTS/ANTICIPATED RESULTS: Participants described frequently experiencing incident stressful events including death or serious illness of a close friend or family member, and relationship, financial, and employment difficulties. Furthermore, participants reported experiencing traumatic events such as sexual and physical abuse during childhood and adolescents. While experiencing traumatic events such as sexual and physical abuse during childhood and adolescence may be distressing, these events did not influence adherence to HIV care. However, incident stressful events as defined above did influence adherence to HIV care for some participants, but not for others. For participants who reported that stressful events did not influence adherence to HIV care, factors such as personal motivation, access to social support, and adaptive coping strategies facilitated their engagement in care. DISCUSSION/SIGNIFICANCE OF IMPACT: Experiencing stressful events, incident or traumatic, is common among Black WLWH and have the potential to negatively influence adherence to HIV care. Thus, Interventions aimed at identifying and addressing stress, social support, and coping are essential to improve adherence to HIV care behaviors.

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