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Citation
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Johnson KA, Binion S, Waller B, Sutton A, Wilkes S, Payne-Foster P, Carlson C. Front. Reprod. Health 2022; 4: e1008788. |
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Abstract
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Despite repeated calls to action (1), rates of HIV transmission and intimate partner violence (IPV) among low-income, cisgender Black women in the Deep South states of Alabama, Florida, Georgia, Louisiana, Mississippi, South Carolina, and Texas consistently eclipse national averages and disproportionately outpace levels identified among all other women. This high risk group also remains left behind by U.S.’ HIV and IPV research and prevention efforts. They are also projected to be among the most significantly impacted by the recent Supreme Court’s decision to disband Roe v. Wade (2). In view of these risks, and known associations between HIV, IPV, and a lack of access to reproductive services (3), this Opinion serves as an immediate call to action.
In 2019, 8 of 10 U.S. states and 9 out of 10 U.S. metropolitan areas with the highest rates of new HIV diagnoses were in the South, with Deep South states heavily represented among them (4). As many as 9 out of every 10 new HIV cases among women occur in this highly vulnerable group (versus 6 out of 10 cases nationally) (5). In addition, although women are more likely to be tested than men, 90% of new HIV transmissions among women in Deep South states like Alabama and Mississippi (6) are attributed to sexual encounters with male sexual partners, as compared with 77% found elsewhere in the South (4). Disproportionately concentrated among Black women in the Deep South, these higher rates are consistent with earlier findings identifying lower rates of condom negotiation (7) and higher relationship power asymmetries (8). They also consistent with rates of IPV identified in the Deep South that exceed the national average by 12% or higher (9, 10). Yet, there are currently no HIV/IPV prevention interventions that center Deep South specific social and structural factors.
As reflected in Table 1, a narrative literature review of scholarly articles examining “HIV” and “violence” among “Black” or “African American” women in the U.S. reveals that only 12 (or 7%) of a total of 169 articles focused on Black women residing in the Deep South. Of this number, a mere six were written in the past 10 years and none expressly examined the critical intersection of HIV and “intimate partner violence”. In addition, of the 26 of HIV prevention interventions currently in the Centers for Disease Control’s compendium of evidence-based interventions (11), three (or approximately 10%) emanated from the Deep South (12–14). Although one of these emphasized the importance of “sociocultural” and “structural” risks (12), none specifically targeted IPV and/or region-specific differences. While we readily acknowledge these important scholarly contributions, the authors of this Opinion draw attention to these gaps and argue that failing to address them will continue to curtail efforts to end these co-occurring endemics ...
Language: en |