SPNS initiatives focus on high-needs populations and emerging trends to explore innovative and replicable models of care. While this is the first SPNS project to focus entirely on women, many HIV-positive women have benefitted from SPNS services. One such example was under the Targeted HIV Outreach and Intervention Model Development and Evaluation for Underserved HIV-Positive Populations Not in Care initiative where the University of Miami School of Medicine targeted minority seropositive women and children.
AIDS, Women, and the Ryan White HIV/AIDS Program Today
Approximately 33 percent of Ryan White HIV/AIDS Program clients are women, most of whom are women of color. The Program has so much more to offer women today than it did when it was first enacted into law some 20 years ago. We have moved from a time in the epidemic when treatments were limited and short lasting to one in which treatments offer women the potential for long-term health and a productive life.
The main thrust of today’s Ryan White HIV/AIDS Program is clinical care, primarily to ensure that women reap the benefits of combination antiretroviral therapy. Today, this is the standard for all HIV patients including pregnant women who were previously on a regimen of AZT alone. Antiretroviral therapy use has reduced perinatal transmissions to as low as 1 to 2 percent or less.29
These medications have also significantly reduced mortality rates. Because of the Ryan White HIV/AIDS Program, these so-called miracle drugs are accessible to women who have neither private health insurance nor the financial resources to pay for the medications on their own.
From the beginning, Ryan White HIV/AIDS Program grantees have reached out to women who know their status but are not receiving care. They work with key entry points, such as testing facilities, hospitals, family planning clinics, community health centers, and providers of social services. These investments are paying off: More HIV-positive women are entering and staying in care and fewer children are born with HIV/AIDS.
Ryan White HIV/AIDS Program providers often assist patients in required paperwork to ensure receipt of- and coverage for- services. This assists in breaking down barriers that may keep many women accessing care.
In fact, in many Ryan White-funded clinics perinatal transmission rates are now zero. In instances of infection, most occur among HIV-positive women unaware of their status thus Ryan White providers continue to work with community partners to encourage testing and enrollment in necessary health services.
Of course women are being served in a challenging environment for both them and their service providers. We live in a time of few new financial resources for grantees and a time of economic hardship for many women most at risk for HIV/AIDS. Comorbidities such as mental illness and addiction continue to threaten the health and quality of life for HIV-positive women.
Ryan White–funded clinics across program Parts are continuing to offer “one-stop shopping” where possible to fully address these patient medical, psychosocial, and support services needs. They are also building ever-stronger relationships with organizations that meet the needs of HIV-positive women. A number of Ryan White-funded clinics are securing other funding sources to increase research on prevention methods pertinent to women as well.