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Understanding the Barriers that Reduce the Effectiveness of HIV/AIDS Prevention Strategies for Puerto Rican Women Living in Low-income Households in Ponce, PR: A Qualitative Study

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Abstract

Background The HIV/AIDS epidemic has been strongly felt in Hispanic/Latino communities. Estimates of AIDS prevalence among Latinos in the US reveal that just nine States and the Commonwealth of Puerto Rico account for 89% of the Latinos living with AIDS in 2004. Previous research reveals social and cultural factors play an important role in HIV prevention. Methods Four focus groups were conducted, with 39 women, ages 21–67, participating in the discussions. The objectives of this research were to assess knowledge regarding HIV transmission among women living in low-income households, to ascertain barriers to safe sex in this population, and to elicit opinions about effective prevention strategies. Results Our results suggest that participants recognized HIV/AIDS modes of transmission and risk behaviors, as well as their barriers to practicing safe sex. They identified promiscuity, unprotected sex, infidelity, drug and alcohol use, and sharing syringes as behaviors which would place them at risk of HIV/AIDS transmission. They specifically identified lack of negotiating skills, fear of sexual violence, partner refusal to use condoms, and lack of control over their partner’s sexual behavior as barriers to practicing safe sex. Finally results also indicate that current HIV/AIDS prevention strategies in Puerto Rico are inadequate for these women. Discussion To address these issues the authors suggest cultural and social factors to be considered for the development of more effective HIV/AIDS prevention programs.

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References

  1. Center for Disease Control and Prevention. HIV/AIDS Surveillance Report, 16. Atlanta, GA, USA; 2004.

  2. Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 13. Atlanta, GA, USA; 2001.

  3. The Henry Kaiser Family Foundation. HIV/AIDS policy fact sheet: Latinos and HIV/AIDS. Available online: www.statehealthfacts.org. 2005.

  4. Puerto Rico Department of Health. Surveillance Report: April 30, 2007. San Juan, PR; 2007.

  5. Herrera C, Campero M. La vulnerabilidad e invisibilidad de las mujeres ante el VIH/SIDA: constantes y cambios en el tema. Salud Pública México. 2002;44(6):554–64.

    Google Scholar 

  6. UNAIDS. Gender and HIV/AIDS: a technical update. Geneva, Switzerland; 1998.

  7. Montesinos L, Preciado J. In: Francoeur RT, editor. The international encyclopedia of sexuality, vol. IV. New York: The Continuum Publishing Company; 2004.

  8. Norman L. The constructions of masculinity and femininity within the caribbean context: relations to family, gender and HIV/AIDS. Jamaica: Specialist Paper Commissioned by Ford Foundation: Caribbean Gender Ideology Project, University of the West Indies; 2003.

    Google Scholar 

  9. World Health Organization. Integrating gender into HIV/AIDS programmes: a review paper. Geneva, Switzerland; 2003.

  10. Pico I. Machismo y Educacion. Rio Piedras: Editorial Universidad de Puerto Rico; 1989.

    Google Scholar 

  11. O’Leary A, Wingood G. Interventions for sexually active heterosexual women. In: Peterson JL, DiClemente RJ, editor. New York: Klumar Academic/Plenum Publishers, 2002.

  12. Logan TK, Cole J, Leukefeld C. Women, sex, and HIV: social and contextual factors, meta-analysis of published interventions, and implications for practice and research. Psychol Bull. 2002;128(6):851–85.

    Article  CAS  PubMed  Google Scholar 

  13. Institute of Medicine, Speaking of Health. Assessing health communication strategies for diverse populations. Washington, DC: National Academies Press; 2002.

  14. Institute of Medicine. The future of the public’s health in the 21st century. Washington, DC: National Academies Press; 2003.

    Google Scholar 

  15. US Department of Health and Human Services. CDC HIV/AIDS fact sheet: HIV/AIDS among Hispanics. Atlanta, GA: US. Available online: http://www.cdc.gov/hiv/pubs/facts/hispanics.htm; 2006.

  16. Kreuter M, McClure S. The role of culture in health communication. Annu Rev Public Health. 2004;25:439–55.

    Article  PubMed  Google Scholar 

  17. Hunt DE, Hammett T, Smith C, Rhodes W, Pares-Avila JA. Outreach to sexual partners. In: Brown BS, Beschner GM, editors. Handbook on risk of AIDS: injection drug users and sexual partners. Westport, Connecticut: Greenwood Press; 1993.

    Google Scholar 

  18. Davis RE, Flannery DD. Designing health information delivery systems for Puerto Rican women. Health Educ Behav. 2001;28:680–95.

    Article  CAS  PubMed  Google Scholar 

  19. Raffaelli M. Gender socialization in Latino/a families: results from two retrospective studies. Sex Roles J Res. 2004; 1–24.

  20. Wilson B, Miller R. Examining strategies for culturally grounded HIV prevention: a review. AIDS Educ Prev. 2003;15(2):184–202.

    Article  PubMed  Google Scholar 

  21. Kellerman SE, Drake A, Lansky A, Klevens M. Use of and exposure to HIV prevention programs and services by persons at high risk for HIV. AIDS Patient Care ST. 2006;20(6):391–8.

    Article  Google Scholar 

Download references

Acknowledgements

This study was sponsored by NCRR Grant U54RR19507. The project is part of the Puerto Rico Comprehensive Center for the Study of HIV Disparities (PR-CCHD), as a collaborative effort of the University of Puerto Rico, Medical Sciences Campus, the Universidad Central del Caribe, School of Medicine, and the Ponce School of Medicine. The authors would like to recognize the collaboration of Machuca & Associates, as well as thank the women who participated in the study for their time and effort. We also thank Bob Ritchie from the RCMI Program Publications Office (Grant #2 G12 RR003050-21) for his contribution to the editing of the manuscript.

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Authors and Affiliations

  1. Masters of Public Health Program, Ponce School of Medicine, P.O. Box 7004, Ponce, PR, 00732-7004, USA

    S. Abreu & L. R. Norman

  2. Clinical Psychology Program, Ponce School of Medicine, Ponce, PR, USA

    A. C. Sala & E. M. Candelaria

  3. AIDS Research Program, RCMI, Ponce School of Medicine, Ponce, PR, USA

    L. R. Norman

Authors
  1. S. Abreu
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  2. A. C. Sala
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  3. E. M. Candelaria
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  4. L. R. Norman
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Corresponding author

Correspondence to L. R. Norman.

Appendix

Appendix

  1. 1.

    What do you know about HIV/AIDS? [¿Qué ustedes saben sobre el VIH/SIDA (Virus de Inmunodeficiencia Humana]?

    1. a.

      What is HIV? [¿Qué es VIH?]

    2. b.

      What is AIDS? [¿Qué es SIDA?]

  2. 2.

    In your understanding, what are some of the practices and/or risk behaviors that can lead to the acquisition of HIV, AIDS, or other sexually transmitted diseases? [¿Cuáles entienden ustedes que son algunas prácticas o comportamientos (conductas de riesgo) para adquirir el VIH, SIDA u otras enfermedades de transmisión sexual?]

  3. 3.

    What alternatives do you think that women have to decrease the risk of becoming infected with HIV/AIDS? [¿Qué alternativas ustedes piensan que tenemos las mujeres para reducir el riesgo de adquirir VIH/SIDA?]

  4. 4.

    What ways do you have of reducing the risk of becoming infected with HIV/AIDS or in which ways would you reduce other women’s risk of being infected with HIV/AIDS? [¿Qué maneras tienen ustedes de reducir el riesgo de contraer VIH/SIDA o de qué maneras reducirían ustedes el riesgo de otras mujeres de contraer VIH/SIDA?]

  5. 5.

    If you were told that you had a sexually transmitted disease or HIV, What would be your sources of support? Who would help you? [Si les dijeran que tienen una Enfermedad de Transmisión Sexual o VIH ¿cuáles serían sus fuentes de apoyo? ¿Quiénes las ayudarían?]

  6. 6.

    Do you have anything else to add to what has been discussed today? [¿Tienen algo más que añadir a los que hemos discutido?]

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Abreu, S., Sala, A.C., Candelaria, E.M. et al. Understanding the Barriers that Reduce the Effectiveness of HIV/AIDS Prevention Strategies for Puerto Rican Women Living in Low-income Households in Ponce, PR: A Qualitative Study. J Immigrant Minority Health 12, 83–92 (2010). https://doi.org/10.1007/s10903-008-9178-7

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  • DOI: https://doi.org/10.1007/s10903-008-9178-7

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