The Exchange coalition--identifying and addressing structural factors affecting HIV prevention in African American...

From 1992 to 2002, African American women accounted for almost 70% of all newly diagnosed cases of HIV among women (CDC, 2002). Systemic issues such as poverty, domestic violence, mental illness, and limited access to culturally competent HIV/ health care services facilitate high infection rates among these women (OMH, 2005) and render many prevention/treatment messages ineffective. In response, Community Education Group (CEG) formed "The Exchange"-a national advocacy group comprised representatives from various organizations and agencies. To inform the groups formation CEG conducted a formative survey at three conferences to assess interest and need of such a group.

Using a convenience sample, CEG surveyed care providers, health specialist, and social/behavioral scientists from various organizations at three conferences about: (1) primary issues facing African American women at risk of and living with HIV/AIDS, (2) their interest in building a coalition with organizations with differing foci, and (3) what they believe to be the top health issues facing these women.

Of the 1,186 surveys, 96.7% believed a coalition would provide effective advocacy, 77.3% were willing to build a coalition, and the top three issues affecting rates of infection were health care (62.8%), access to affordable treatment (50%) and unknown partner risk (47%).

Survey respondents felt that a coalition of organizations with differing foci to address the systemic conditions of African American women is needed if we are to have an effect on their rates of HIV/AIDS.