Domestic Violence and HIV - Health Equity in the Intersection

HEALTH EQUITY AND HIV 
Achieving the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, and economic or social condition. Health equity means everyone has a fair opportunity to be as healthy as possible regardless of their socially determined circumstances. To achieve this, we all need to face and work through institutional and discriminatory barriers within and outside of the healthcare system. These include racism, sexism, poverty and unequal distribution of resources.

THE INTERSECTION

Health equity can be fairly complicated to achieve for some communities, including those living with HIV. Even though HIV is considered a chronic condition, with the right treatment people with living HIV can live relatively healthy lives for decades. Medications can control the infection and prevent progression.

Nevertheless, there are several indicators of certain communities being disproportionally exposed to the virus and facing bigger obstacles when accessing services.

• HIV affects the Black and Latinx communities disproportionately. Racism has denied Black women adequate access to quality health care, while nearly 1 in 5 Latinx have avoided medical care due to concern of being discriminated against or treated poorly.

• Poor women are more affected by HIV than women and men in the general US population. 

• HIV prevalence is substantially higher for trans women than for cis women.

• Women are less likely to achieve HIV viral suppression than men.   

• Violence and fear of violence can worsen health disparities and health outcomes.

WHAT WE CAN DO

The best way to achieve health for people living with HIV is for them to have access to quality healthcare, including medications, and continue treatment consistently.

If treatment is delayed or no longer working, HIV will harm their immune system and increase the chances for transmitting HIV to others, getting sick, and developing AIDS.

However, a person who is facing immediate hardship may not be able to fully utilize the tools available to treat and manage the virus. 

Below, we include suggestions that can be implemented at different levels to promote health equity. Because equity takes social injustice into account, different needs call for different levels of support and resources and it will be the advocate’s and organization’s role to determine which ones are needed for each survivor.

Advocates

• Use trauma-informed care that recognizes individual experiences;

• Screen for non-medical factors influencing health for a specific survivor;

• Analyze and work through internal racial bias that might influence your approach towards the needs of specific communities;

• Connect with culturally specific organizations that can provide support and linguistically appropriate services to Black, Indigenous, Latinx LGBTQ+, and nonEnglish speaking survivors;18 and

• Help your organization work towards health equity by analyzing and working through its internal organizational needs.

Organizations

• Make health equity a strategic priority: make sure the organization’s vision, mission, and goals articulate its commitment to equity;

• Build infrastructure to support health equity: include it in job descriptions and workplans; make sure it is represented, valued, and supported by the board of directors, staff, and volunteers. Center the voices of those most marginalized and oppressed and follow their lead at every step in the process. This requires intention and ongoing accountability to Black, Indigenous, and People of Color;

• Address multiple determinants of health: make space for the intersectional nature of survivors’ lives and make sure that your messaging and programming reflect your understanding of the ways multiple forms of oppression interconnect;

• Work through racism and other forms of oppression: do the internal work necessary toward becoming an anti-racist organization and committing to racial justice; and

•Partner with the community to improve health equity: meaningful and transformational partnerships are intentional, fair, and beneficial to all involved.