Part six

Excerpts from: Living Positively: Narratives of Forgiveness and Imagination among Women with HIV. Copyright © 2010 Hamaseh Kianfar, Ed. D.

Social and Medical Considerations of HIV in Women

In the summer of 1981, HIV infection and AIDS were diagnosed for relatively few women. Today however, women account for more than 25% of all new HIV and AIDS diagnoses. During the first two years of the epidemic, nearly 75% of the cases of AIDS occurred in white homosexual and bisexual men (Rosenberg 1995: 1372-1375). As the epidemic continued to increase in the United States, women began to constitute one of the

fastest growing groups infected with HIV, making it imperative to understand the unique factors faced by HIV-positive women.

A review of the available literature on HIV or AIDS among women reveals a number of cultural and social issues that need further study. While most research on HIV/AIDS has emphasized behavioral factors, the purpose of my research is to use language as the medium for understanding women with HIV/AIDS. I hope to provide data currently missing from studies that use a clinical and medical approach, help illustrate the major barriers that keep HIV-positive women from receiving and maintaining medical care, and address the stigma and psychological distress that is often associated with having HIV.

Maintaining and receiving appropriate medical care is essential to the overall management of HIV (Hader 2001: 1190). Several studies have shown that while regular health care services are improving, compared to HIV-positive men, HIV-positive women are more likely to use the services in the emergency room than see a regular medical provider for outpatient care (Hader 2001: 1190); (Shapiro 1999: 2305-2315). HIV-positive women also report several barriers to utilizing health care services including difficulty remembering appointments, lack of insurance, not having enough money, lack of transportation and lack of child care (Hader 2001: 1190). A report published by the Henry J. Kaiser Family Foundation (2008: 1) found that HIV-positive women do not receive optimal levels of care compared to HIV-positive men. The HIV Cost and Services Utilization Study (the only nationally representative study of people with HIV/AIDS receiving regular or ongoing medical care) found that women with HIV were less likely to receive combination therapy (taking two or more antiretroviral drugs at a time) and were more likely to postpone medical care because they lacked transportation (26%) or were too sick to go to the doctor (23%) than men (Hader

2001: 1190). Another barrier to maintaining medical appointments is the stigma often associated with having HIV. This stigma negatively affects the lives of women living with HIV, especially in many African-American communities (Galvan et al. 2008).