New program helps reduce HIV-risk in African-American women

Dr. Lara Stepleman is a psychologist at the Medical College of Georgia at Georgia Regents University. Credit: Phil Jones

A new community program is helping African-American women embrace good health by enabling treatment of substance abuse and mental health problems that increase their risk of HIV infection or spreading the virus.

SHE PREVAILS, which is funded by a three-year, $1.6 million grant from the Substance Abuse and Mental Health Services Administration, begins with screenings in community centers such as St. Stephens Ministry and Harrisburg Family Health Care Inc., said Dr. Lara Stepleman, psychologist at the Medical College of Georgia at Georgia Regents University.

"We want to help become empowered to take care of their sexual health, to protect themselves, to negotiate complex relationships," Stepleman said. "The idea behind all of this it to help reduce HIV spread."

Screening and referral will occur for 1,600 women in 15 nearby counties. Then 280 women, whose problems include substance abuse, will receive a six-month comprehensive follow-up that guides them through effective treatment, said Stepleman, the program's Director.

"If you are not treating substance abuse and you are uninfected, you are at risk for making poor choices that could get you infected and, if you are infected and untreated, you are likely making poor choices that could infect someone else," Stepleman said.

"We want to meet African-American women where they are and, ideally, help them get to a healthier place. So we're building a bridge between identification of a need for treatment and willingness to get treatment," Stepleman said.

The funding agency's request for proposals was looking for programs to address substance abuse issues in target populations. Substance abuse and HIV risk in African-American women definitely addresses a need in the Augusta region, Stepleman said.

A majority of the women in the GR Health System HIV clinic are black and, in Georgia, the rate of black women with an HIV diagnosis is 12 times that of white women, according to the Centers for Disease Control and Prevention.

By the time many of these women seek help for their infection, they are already very sick, said Stepleman, who is also Director of HIV Psychological Services at GR Health System.

"As matriarchs of their families who feel more obliged to take care of others than themselves, we were seeing women die because they did not care for their physical or emotional needs and, in some cases, would not tell anyone that they were HIV-positive. We want to provide a much broader package for these women who are struggling," she said.

Navigators will help prepare the women for successful by addressing important collateral issues such as securing safe, affordable housing and dealing with unhealthy sexual relationships. They'll also help the women gain access to care, which can be a major hurdle, particularly for the uninsured. Program participants also will attend classes about HIV prevention, and treatment is available for women who also have a history of sexual, physical and /or emotional abuse.

MCG and the GR Health System already had a treatment navigator in the HIV clinic to help male and female patients with problems access care. The expansion of services through SHE PREVAILS included hiring a second navigator. The new screening efforts augment two-decade old efforts in the community by the Ryan White team in the Section of Infectious Diseases.

"Many people have been working for a long time to make this happen and we are in an area where it is really needed," Stepleman said.

Team members include Treatment Navigators Kena Arnold and Elizabeth Brown and HIV Peer Educator Kathleen Childs; as well as Risk Reduction Services Coordinator Walidah Walker; Director of Trauma Services Amy House; Medical Director Cheryl Newman; and Program Evaluator Kristina Kintziger.

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