The HIV/AIDS epidemic that started in the 1980s devastated populations around the world, reaching its peak in 2005. International awareness and research efforts have made strides to combat HIV, but the battle is far from over.
The rate of new HIV infections has significantly decreased from 130,400 new infections in 1985 to 39,393 new infections in 2015. While this is good news, there are still populations that are considered high risk for contracting HIV. Among these are low-income Black and Latina women who may not have sufficient resources to protect themselves from HIV infection.
A momentous development in the prevention of the spread of HIV has been the PrEP (Pre-Exposure Prophylaxis) prevention, a pill that can reduce the chance of contracting HIV by up to 99 percent. Although this medication has been available since 2012, access and awareness are still an issue.
Liesl Nydegger, an assistant professor in the Department of Kinesiology and Health Education, is working with local communities in Austin to help find effective interventions for Black and Latina women in high-risk environments for sexually transmitted infections (STIs) and HIV.
“There are obstacles such as housing, transportation, relationships, poverty, gentrification, and structural barriers that make it hard for women to focus on their sexual health,” says Nydegger. “If we can help with basic needs, that would decrease issues such as substance abuse or living with an abusive partner. These supports create positive effects that can trickle down into overall health improvements.”
Nydegger’s study involves a partnership with Austin’s local SafePlace, a shelter for people affected by domestic violence or sexual assault. By interviewing these individuals over three months, she will be able to find longitudinal stresses that contribute to poor health. This research phase will help to inform structural interventions that can be proposed to improve health in these groups. Nydegger is conducting this study alongside Kasey Claborn, an assistant professor in the Dell Medical School’s Department of Psychiatry.
Some of the women in the high-risk group that Nydegger studies have been survivors of childhood sexual abuse, which can have psychological impacts that make it hard for them to have healthy sexual relationships. These include relationships in which the woman was under 16 years old, and more than five years younger than her partner. The age difference creates a power differential that can be carried into adulthood, making it hard for women to negotiate condom use with their current partners.
Nydegger conducted similar interviews with women in Milwaukee and found that there was little awareness for options such as PrEP. “Although women were aware that STIs were prevalent in their community, they did not consider themselves as high-risk for HIV infection. Even more concerning, three of the four women interviewed reported that their doctors were unaware of PrEP,” says Nydegger.
“Advertisements and awareness campaigns for the PrEP option do exist, but they are most often targeted towards men who have sex with men. This group is considered higher-risk for contracting HIV than women, but women have certain vulnerabilities that make it difficult for them to protect themselves from infection.
Women who are in abusive or coercive relationships often do not have the option to negotiate condom use with their partners, which leaves them vulnerable to infection,” says Nydegger. “Options such as PrEP offer a discreet way for women to protect themselves.”