African American women's perceptions of HIV prevention communication with their reproductive health providers

Abstract

AFRICAN AMERICAN WOMEN’S PERCEPTIONS OF HIV PREVENTION COMMUNICATION WITH THEIR REPRODUCTIVE HEALTH PROVIDERS By Valerie Nichole Burge-Hall, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2015. Major Director: Joann T. Richardson, Ph.D., Associate Professor, Health Education and Promotion, Department of Kinesiology and Health Sciences In spite of a decline in HIV incidence rates among African American women, they still bear the most significant disease burden among U.S. women. Findings from numerous studies indicate probable explanations for the disparity, such as the impact of poverty, limited healthcare access, low literacy, and living in areas with high HIV rates. Additionally, many study results provide insight regarding prevention strategies. However, the aim of this study is to explore African American women’s perceptions regarding what HIV prevention communication, if any, occurred with their reproductive health providers (RHPs). In this study, 20 African American women with unknown HIV status participated in face-to-face interviews designed to explore their perceptions about HIV prevention communication with their RHPs. Audio-taped interviews were transcribed verbatim and coded using NVivo10 software. Guided by constructs of the Health Belief Model, inductive and deductive coding yielded four key themes: (1) patients’ lack of expectation to receive information; (2) failure of RHPs to initiate and offer information; (3) patients’ desire to receive information; and (4) patients’ recommendations regarding their preferred methods to receive HIV prevention communication. Results indicated that RHPs missed prime opportunities to initiate and offer HIV prevention information during routine reproductive health visits with women at greatest risk. These findings and recommendations for practice will be useful when designing, implementing and evaluating HIV prevention patient education protocols. The recommendations provide strategies to help RHPs seize every opportunity to address HIV prevention with this highly vulnerable population.