Empowering Women

I talk a lot about empowering women. It's a pretty broad term, with several implications. When I think about what it means to actually empower someone, for me it always comes back to education. What better way can we empower someone than to give them the knowledge needed to make their own autonomous decisions? 

Here is an interesting video:

It addresses the role of women in living with and fighting HIV/AIDS. My favorite part is when they talk about how the best way to keep a girl healthy and protect her from violence is to educate her. Knowledge truly is power. It is of the utmost importance that girls and women have access to it.

Here is another video that demonstrates the importance of knowledge. These are two strong women who are living healthy lives with HIV, but did not have the information they needed early on.

Here's to strong women, and the men that participate in the cause with them!

A Look at Health Disparities

I recently met with a professor of nursing at UAB, and what she said shocked me. She said that since she is African-American, and I am Caucasian, then the chances of her contracting HIV/AIDS is astronomically higher than the chance of it affecting me. (To be clear, her area of research involves health disparities and other factors that affect people with HIV/AIDS.) Even though I knew about health disparities, I didn't realize it was so prevalent with this disease. HIV is a virus that can affect anyone. If given the opportunity, it would not discriminate against its victims. Even still, there are obvious disparities that cannot be ignored.

One study I read cites that between 2001 and 2004, the rate of HIV/AIDS diagnoses among African American women was 20.9 times higher than that for Caucasian women. They are also at a significantly higher risk for STI's, including high-risk strains of HPV. While cervical cancer incidence and mortality has fallen in the US in recent years, there is still a disparity among African American women (Andrasik, Rose, Pereira, & Antoni, 2008).

A study done in Thailand determined that of several variables including nadir CD4 count, income, hormonal contraceptive use, antiretroviral use, condom use, parity, and number of lifetime sexual partners, a low CD4 count and income were the only two variables significantly associated with cytological abnormalities in the sample the studied (Mangclaviraj, et al. 2008).

While these studies can't be directly generalized to the population of patients at the 1917 Clinic, they can still provide insight into the severity of these health disparities. Living with HIV/AIDS is enough for any woman to face. The color of her skin should not be another thing she has to worry about in relation to her prognosis.

So what can we do? Obviously, this is a societal problem that will be difficult (though possible) to change. For the individual, perhaps recognizing the risks is the first step. After that, it is up to the health care providers and their patients to be proactive in addressing the risks African American women face. By no means should we assume that African American women will automatically have a poorer outcome. However, we can't deny that these women are being done a disservice based on the statistics. It is that knowledge, combined with quality care given on a patient-by-patient basis, that will enable the provider and the patient to reach the best treatment plan possible.

References:

Andrasik, M., Rose, R., Pereira, D., & Antoni, M. (2008). Barriers to cervical cancer screening among low-income HIV-positive African American Women. Journal of Health Care for the Poor and Underserved, 19(3), 912-925.

Mangclaviraj, S., Kerr, S., Chaithongwongwatthana, S., Ananworanich, J., Hirschel, B., Emery, S., Cooper, D., Chotopparatpattara, P., Ruxrungtham, K. (2008). Nadir CD4 count and monthly income predict cervical squamous cell abnormalities in HIV-positive women in a resource-limited setting. International Journal of STD and AIDS, 19, 529-532. doi: 10.1258/ijsa.2007.007222.

Forward Progress

As of this week, I'm about half-way done with my allotted hours for my service learning project with the Clinic. I'm excited about the progress I've made, and a little overwhelmed about what's next as well! I hope to accomplish a lot between now and the time I fulfill my time commitment. Here's what I have in mind:

1. I want to track how many women actually kept the appointments I scheduled for them. Doing this will let us know if the phone calls are working, or if we need to try a new approach.

2. Once we have an idea of how effective the phone calls are, I plan to meet with another Honors in Nursing student who is interested in continuing with the project next semester. We'll be able to discuss her role in the project, how she can continue what I've started, and also make it her own.

3. If time permits, I would love to shadow Truus. She has been such a role model for me so far, and I would love to see her working with patients.

On July 20th, I am partnering with another Honors in Nursing student and giving a presentation at the Jasper House. (You can visit her blog at: http://healthylivingwithaidsalabama.blogspot.com/.)The Jasper House is a residential care facility that serves people who are HIV positive, have a mental illness, and a low income. Some more information can be found here:

http://www.aidsalabama.org/direct-housing-programs.asp

I'm going to speak to the female residents about the importance of cervical screening. I'm really looking forward to the opportunity to work with these women, and share what I've learned. I'll post about it and let you all know how it went!

I thought I'd take a minute to discuss the current status of my project with the 1917 Clinic. The purpose of the project is to provide a needed service to the Clinic through academic learning, civic engagement and meaningful community service. I created a list of goals and objectives to help narrow my focus. They are as follows:

1. Academic learning: I will enhance my own learning through a review of the literature and studying the link between HIV/AIDS and cervical cancer.

2. Civic engagement: I will engage in meaningful civic learning by serving a population of women who are HIV positive, and at greater risk for cervical cancer, among many other health and psychosocial risks.

3. Community service: I will help improve patient screening at the 1917 Clinic by encouraging women to schedule pap tests and providing education as to the importance of these tests.

As discussed in the previous post, women with HIV/AIDS are up to five times more likely to develop cervical cancer. Studies have also found that a woman's t-cell count and her income are two of the most significant predictors of whether or not she will develop cervical cancer. I have already seen this health disparity first-hand at the Clinic, and it is my goal to do everything I can to combat it.

So far, I have scheduled about 30 pap tests. Talking with the women on the phone, I've learned a lot about their health perceptions, barriers and facilitators to taking care of themselves. As a nursing student, I am interested in health promotion and helping people achieve their optimum healthy state. Talking to these women about their barriers and facilitators helps me better understand the whole picture.

The next step is tracking which patients come in for the appointments I've scheduled, and which patients either cancel or fail to show. My mentor, Truus, and I are working to obtain that data and will report on it at the end of the summer. Since I've only been there a few weeks now, the data would not give an accurate summary of the progress we've made.

I hope this blog will serve as a way for me to post updates on my project, and get feedback. Any ideas/suggestions are greatly appreciated. Thank you!

Welcome!

Hello and welcome to my blog! I am new to the blogging world, but thought this would be a good way to give frequent updates about a group of women I've come to truly care about. They are the women in my community, country, and all over the world who live with HIV/AIDS.

Did you know that women with HIV are up to five times more likely than non-infected women to develop cervical cancer? For African American women and women from low income backgrounds, those numbers increase even more. The CDC recommends yearly pap tests for HIV positive women after their first year of HIV diagnosis, and semiannual pap tests during the first year. However, many patients do not maintain these appointments. For that reason, I have paired up with the 1917 Clinic in an effort to improve cervical cancer screenings among its female patients. My goal is to help educate and empower women with HIV to maintain these appointments and take care of their overall health.

Thirty years ago, we saw some of our first AIDS cases in the United States. At the time, scientists and doctors didn't really have an understanding of what we were up against. HIV/AIDS was like a death sentence, and people didn't live long with the disease. Now, with the advancement of antiretroviral therapy and overall healthcare, patients are living much longer after an HIV diagnosis. While this marks a tremendous accomplishment, it also brings with it a new problem: co-morbidity. A prime example of that is cervical cancer. And it is now our job to fight it along with the HIV virus.

I hope this blog will serve as a source of information and inspiration. I will post updates about my work at the Clinic, as well as articles, news clippings, and anything else I find that is pertinent to the subject matter. With all of us working together, we can take care of the women living around us who suffer from this virus and reduce their chances of developing cervical cancer, among other deadly co-morbidities.