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Tips From the Frontlines on Providing the Best Possible HIV Care for Women

April 5, 2011

Bethsheba Johnson, G.N.P.-B.C., A.A.H.I.V.S.

Bethsheba Johnson, G.N.P.-B.C., A.A.H.I.V.S., is an associate medical director of St. Hope Foundation in Houston, Texas.

We marked U.S. National Women and Girls HIV/AIDS Awareness Day on March 10. The theme this year was "Now it's time for you to decide: What can you do?" Although the day is meant to raise awareness among the general population, and although it passed weeks ago, in my opinion we need to have that awareness every day as health care providers. We regularly see people in our HIV agencies/organizations that, if health education had reached them the way it should, would have never walked through the door in the first place.

This year, I had the honor of speaking at the inaugural "Sisters with Voices (SWV): Empowering Health Living," sponsored by St. Hope Foundation in Houston, Texas, on March 9. Ninety women from the community came together at United Way of Greater Houston for a brilliant evening of empowerment and health education. A diverse group of women was in attendance, spanning many races and ages and including HIV-positive women, attorneys, public health workers, health care providers and YWCA workers who care for young women.

During and after the meeting there was lots of discussion. I questioned my colleagues in various disciplines about what they thought was important for health care providers to know in providing the best care possible for women.

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Myrtle Oates, M.D., from the St. Hope Foundation, was a featured speaker at this event. An obstetrician-gynecologist, she really underscored the need for providers to address safer-sex negotiation for women and their sexual partners. She stated that "the first thing necessary is to establish a safe, non-judgmental atmosphere for a frank discussion so that information may flow freely between provider and patient. In this way, our patients will be empowered with information. 'Knowledge is power' is not just a slogan. It is the truth, which we so desperately need in our armamentarium."

When asked how she speaks about safer sex in her practice, Dr. Oates shared what she tells her patients: "That safer sex is pleasurable; is freely consented to by both parties; reduces the risk of passing on sexually transmitted diseases; reduces the risk of unwanted pregnancies; and is emotionally safe. The responsibility of taking care of one's emotional well-being is a mandate that may be new to the client, but will pay big dividends if accomplished."

Pamela Tyler, B.S.W., is a medical case manager at Peabody Health Center/AIDS Arms, Incorporated in Dallas,Texas. She has 20 years of experience in the field. She suggested that providers encourage their female patients "to do something for themselves. Women spend so much time taking care of others that they neglect themselves."

Ms. Tyler's comment has never been truer. Every day I'm sure you see examples of this in your patient population. These are women who do not make time for an annual Pap test or mammogram because they are working, raising children or caring for older adults in the family.

Suzanne Carlberg-Racich, Ph.D., M.S.P.H., from the Midwest AIDS Training and Education Center and the Chicago Recovery Alliance in Chicago, Ill., reminds us that, "If you want to maintain a respectful, open and non-judgmental relationship with your patient or client, you meet them where they are, not where you want them to be."

What one of my colleagues, Jennifer Klein, M.S.N., F.N.P.-B.C., A.A.H.I.V.S., a nurse practitioner, would like health care professionals to know is: "Who a patient is doesn't mean that they aren't in the risk pool for HIV."

Jennifer is so right! I still have not been offered an HIV test by my health care provider since I've been in Texas! What, I don't look like I could have sex or do drugs? Just because I'm a mature woman with a job?

Finally, a current client, Ms. M, a 56-year-old African-American woman who has been HIV positive for 14 years, told me to inform health care providers that it is important not to make patients "feel like a disease, but a person. ... Show care and support in a family-like environment." She also said it would be helpful for providers to have resources available regarding how to begin to date after an HIV diagnosis, and where patients could meet other singles interested in a relationship. She says, "It is hard wondering: Who will want me?"

Powerful comments from Ms. M.

So what can you do? Talk to your female patients about their needs and barriers to care. Stay tuned for my next blog entry on this topic, in which I'll discuss the latest in HIV research of particular relevance to women.


Selected Resources

  • AIDS Arms, Inc. is the largest nonprofit HIV/AIDS service organization in North Texas, serving over 7,000 at-risk and HIV-infected individuals every year. It offers a host of programs and services both for individuals at risk for becoming infected with HIV and those living with the disease. Its mission is to combat HIV and AIDS in the community by improving the lives and health of individuals living with the disease and preventing its spread. Its services and a staff of more than 90 employees from medical, social service, prevention and education professions are geared to compassionately respond to this mission in cost-effective ways.
  • Chicago Recovery Alliance (CRA) is a unique organization in that it directly involves the community of people affected by HIV and drug use in the provision of support around those issues. The CRA Web site includes information on harm reduction outreach and needle exchange, abscess identification, overdose prevention, hepatitis and better vein care, which it provides in multiple-language booklets.
  • Midwest AIDS Training and Education Center (MATEC) is one of several regional AIDS Education and Training Centers (AETC) funded by the Ryan White CARE Act (Part F) that conduct targeted, multi-disciplinary education and training programs for health care providers treating persons with HIV.
  • St. Hope Foundation was established in 1999 and is an African-American, community-based nonprofit organization with three health centers that serve 1,600 active patients in the Houston area. Its mission is "to provide excellent and innovative health and prevention services to persons living with (or at risk for) HIV/AIDS in an effort to achieve the best clinical outcomes possible and greatly maximize the person's quality of life."

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