Reducing HIV Risk Behaviors Among Black Women Living With and Without HIV/AIDS in the U.S.: A Systematic Review
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SUBSTANTIVE REVIEW
Reducing HIV Risk Behaviors Among Black Women Living With and Without HIV/AIDS in the U.S.: A Systematic Review Amber I. Sophus1 · Jason W. Mitchell2 Accepted: 2 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract This systematic review provides an examination of the status of HIV/AIDS prevention interventions for Black, heterosexual women in the U.S. from 2012 to 2019. Using PRISMA guidelines, 28 interventions were identified. Over half of the interventions were: conducted in the southern region of the U.S.; evaluated using a randomized controlled trial; focused on adults; used a group-based intervention delivery; were behaviorally focused and theoretically driven. None included biomedical strategies of PrEP, nPEP, and TasP. Few interventions included adolescent or aging Black women; none included their sex/ romantic partners. Future studies dedicated to addressing the specific needs of subpopulations of Black, heterosexual women may provide opportunities to expand and/or tailor current and future HIV/AIDS prevention interventions, including offering participants with options to choose which, and the level of involvement, of their sex/romantic partner(s) in their sexual health decision-making. While strides to improve HIV prevention efforts with Black, heterosexual women have occurred, more is needed. Keywords HIV prevention interventions · Systematic review · Black women · United states
Introduction In 2018, more than 7000 women were diagnosed with HIV in the United States [1]. Of these diagnoses, 85% (n = 6014) were attributed to heterosexual contact; more than 1000 cases were due to injection drug use [1]. Women’s risk for HIV can increase due to their partner(s) high-risk behaviors, such as unprotected sex with other partners (male or female) and/or injection drug use [2]. There is also a differentiation in HIV risk due to age. The 2017 Centers for Disease Control and Prevention (CDC) HIV Surveillance Report [3] noted women over the age of 25 had higher percentages of new HIV diagnoses (25–34: 27%; 35–44: 23%; 45–54: 20%) Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10461-020-03029-3) contains supplementary material, which is available to authorized users. * Amber I. Sophus [email protected] 1
Office of Public Health Studies, University of Hawai’i at Mānoa, 1960 East‑West Road, Honolulu, HI 96822, USA
Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
2
compared to adolescent women (13–24: 14%) and women over the age of 55 (> 55: 16%). However, not all women are equally affected by HIV. Since 2014, Black women have accounted for the largest numbers of HIV diagnoses among females [1]. Black women currently account for 13% of the U.S. female population, yet in 2018, represented 58% of HIV diagnoses with 92% of these being attributed to heterosexual contact [1]. Unlike other female racial groups, Black women are at greater risk fo
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