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Women-centered HIV care practices that facilitate HIV care retention and viral suppression in the presence of adverse sociocultural factors

Award Number: R01MD013563
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/12/2018
PERIOD OF PERFORMANCE END DATE: 04/30/2025

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Women-centered HIV care practices that facilitate HIV care retention and viral suppression in the presence of adverse sociocultural factors - PROJECT SUMMARY Achieving high rates of retention in human immunodeficiency virus (HIV) care and adherence to antiretroviral therapy leads to high rates of viral suppression, which not only reduces mortality and improves quality of living, among people living with HIV infection, but also reduces HIV transmission within affected communities. HIV care outcomes among women have been suboptimal; in 2014, viral suppression was 52.6% among African Americans, 57.9% among Whites, and 59.8% among Latinas compared with 66.0% among White men. Women living with HIV infection are more likely to face barriers to successful HIV care such as child care burden, abuse, and extreme poverty than men. In addition, women, in particular women of color, can face multiple layers of stigma including those related to their race, ethnicity, HIV infection, drug use, and poverty status. Partly because the HIV epidemic initially affected mostly men, the HIV care system is not designed to meet women's special needs. Implementing women-centered HIV care has been proposed nationally and internationally as a way to address women's needs. However, this idea has not been well operationalized for HIV care and has not been examined in the context of the United States health care system including the Ryan White Program, which serves 65% of women living with HIV in the United States. Our central hypothesis is that the more women-centric a system is, the higher the likelihood of HIV care retention and viral suppression among women. The objective of this application is to identify effective provider and system women-centered HIV care practices within the Ryan White Program that positively influence HIV care retention and viral suppression among women experiencing sociocultural challenges. We will accomplish this objective with a mixed methods study examining patient intake and billing data from women enrolled in the Miami-Dade County Ryan White Program, conducting in-depth interviews with case managers, health care providers, administrators, and women living with HIV, and conducting a survey of 600 women living with HIV in the Miami- Dade County Ryan White Program. We propose the following three specific aims: 1) Identify sociocultural factors that influence HIV care retention and viral suppression, including those unique to women and those having a differential impact on African American, Haitian and Latina women; 2) Ascertain current and potential health care provider and system women-centered HIV care practices that may mitigate the effect of adverse sociocultural factors on HIV care retention and antiretroviral therapy adherence; 3) Identify specific health care provider and system women-centered HIV care practices that most strongly influence HIV care retention, adherence, and viral suppression among all women and in African American, Haitian and Latina women. This project addresses the National HIV/AIDS Strategy goals to increase access to care, improve health outcomes, and reduce HIV-related health disparities and the Trans-NIH Plan for HIV-Related Research call for research to promote HIV care engagement and to reduce disparities in treatment outcomes.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = -$352 )
2025	2022	FLORIDA INTERNATIONAL UNIVERSITY	11200 SW 8TH ST	MIAMI	FL	33199	MIAMI-DADE	USA	Minority Health and Health Disparities Research	000	5	8/8/2025	NON-COMPETING CONTINUATION	-$352
														Subtotal = -$352

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2022	FLORIDA INTERNATIONAL UNIVERSITY	11200 SW 8TH ST	MIAMI	FL	33199	MIAMI-DADE	USA	Minority Health and Health Disparities Research	000	5	4/11/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $437,691 )
2022	2022	FLORIDA INTERNATIONAL UNIVERSITY	11200 SW 8TH ST	MIAMI	FL	33199	MIAMI-DADE	USA	Minority Health and Health Disparities Research	000	5	4/17/2022	NON-COMPETING CONTINUATION	$437,691
														Subtotal = $437,691

Issue Date FY: 2021 ( Subtotal = $478,029 )
2021	2021	FLORIDA INTERNATIONAL UNIVERSITY	11200 SW 8TH ST	MIAMI	FL	33199	MIAMI-DADE	USA	Minority Health and Health Disparities Research	001	4	4/1/2021	SUPPLEMENT FOR EXPANSION	$45,724
2021	2021	FLORIDA INTERNATIONAL UNIVERSITY	11200 SW 8TH ST	MIAMI	FL	33199	MIAMI-DADE	USA	Minority Health and Health Disparities Research	000	4	3/31/2021	NON-COMPETING CONTINUATION	$432,305
														Subtotal = $478,029

Issue Date FY: 2020 ( Subtotal = $585,631 )
2020	2020	FLORIDA INTERNATIONAL UNIVERSITY	11200 SW 8TH ST	MIAMI	FL	33199	MIAMI-DADE	USA	Minority Health and Health Disparities Research	001	3	4/6/2020	NON-COMPETING CONTINUATION	$540,263
2020	2020	FLORIDA INTERNATIONAL UNIVERSITY	11200 SW 8TH ST	MIAMI	FL	33199	MIAMI-DADE	USA	Minority Health and Health Disparities Research	000	2	1/2/2020	SUPPLEMENT FOR EXPANSION	$45,368
														Subtotal = $585,631

Issue Date FY: 2019 ( Subtotal = $444,754 )
2019	2019	FLORIDA INTERNATIONAL UNIVERSITY	11200 S W 8TH ST MARC 430	MIAMI	FL	33199	MIAMI-DADE	USA	Minority Health and Health Disparities Research	001	2	5/2/2019	NON-COMPETING CONTINUATION	$444,754
2019	2018	FLORIDA INTERNATIONAL UNIVERSITY	11200 S W 8TH ST MARC 430	MIAMI	FL	33199	MIAMI-DADE	USA	Minority Health and Health Disparities Research	000	1	5/2/2019	NEW	$0
														Subtotal = $444,754

Issue Date FY: 2018 ( Subtotal = $478,211 )
2018	2018	FLORIDA INTERNATIONAL UNIVERSITY	11200 S W 8TH ST MARC 430	MIAMI	FL	33199	MIAMI-DADE	USA	Minority Health and Health Disparities Research	000	1	9/12/2018	NEW	$478,211
														Subtotal = $478,211

Grand Total All Awards = $2,423,964

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Women-centered HIV care practices that facilitate HIV care retention and viral suppression in the presence of adverse sociocultural factors

Award Number: R01MD013563

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/12/2018

PERIOD OF PERFORMANCE END DATE: 04/30/2025

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