Connecting Women to Care Ebony Johnson, MHS A Drop Of Prevention, LLC
Learning Objectives: Avoid verbal cues which reinforce stigma and strain communication between healthcare professionals and women living with HIV Utilize communication strategies which restore and preserve the dignity and respect for women living with HIV I do not intend to discuss any non-fda-approved or investigational uses of any products/devices in this presentation.
An estimated 8,000 women living with HIV give birth per year in the United States (Whitmore, 2009)
Every negative birth, infection prevented, and every person that s living longer and healthier, you will find a celebration of your amazing investment as a provider As Health a provider your role is complex, delicate and requires the essence of compassion and humanity
Factors to Consider When Working With People living with HIV What are my personal feelings about people living with HIV? Do I have enough information about HIV and HIV transmission? Am I prepared to give a positive result? What is my tone and body language saying?
STIGMA & Discrimination can not be standard of care Women living with HIV Experience messages/social pressures To be abstinent, To abandon desires for motherhood and SEX confine their focus on being healthy. Women living with HIV need Providers To be informed To have honest dialogues To be responsive and To be culturally sensitive to the their needs
Voices of Women Living with HIV They say to me, If you do not have children, you are less of a woman. Although I have HIV, I want to be able to fully fulfill my role as a woman and mother. The nurses advised me not to have more children. When I shared that I wanted more children, the nurses shouted at me and reminded me of their previous warnings against having more children It helps when I can tell my doctor what I need or what I want, like having a baby or maintaining a healthy sex life and they listen and help me find the best plan You need to focus on staying healthy and not even begin to think about having children and dating. You do realize that you are positive.. Don t you?
Living with HIV changes the body, not the heart For many women, having children and parenting are fundamental tenants of womanhood. Many cultural, social, and religious stances affirm the correlation between womanhood and motherhood. When women learn their HIV diagnosis, these belief systems and/or needs do not just disappear. For some, the need and desire to have children increases as women feel fearful of waiting and worry about not being able to conceive later due to heavy medication loads and/or deteriorating health.
To Have or Not to Have For women living with HIV, the decision to have, or not have children is essential. It is about the fundamental human needs of all women to be in control of their reproductive health and outcomes. Lack of access to integrated Family Planning and Reproductive Health care leaves women vulnerable, without knowledge of safe and effective options and without access to services or contraceptive products to prevent unplanned pregnancies.
Women living with HIV have the same difficulty in condom negotiation faced by other women. Too often, women living with HIV even have heightened issues with self image, communication around issues of intimacy and sex and feel option-less because they are living with HIV. Thus provider education and empowerment along with options for reliable and consistent family planning are key.
Respect the Rights of Clients to Have: Choice in having children without being judged Choice in the # & spacing of their children Education on reproductive health options, medications and alternative options Access to quality and confidential care Equal access to reproductive health care Inclusion in decisions to start medication, changing regiments Respectful and humane care
Great Communication with Good Science Promotes Excellent Outcomes Providers now have a plethora of resources available to give guidance on HIV drug interactions with pregnancy and contraceptives Researchers world-wide have worked tirelessly to develop safe and effective HIV drugs to prevent vertical transmission
We each have a unique role to play in the continuum of care HIV standards of care change rapidly and you should not feel the need to have all of the answers. Your role is to connect the client to a facility where she can get specialty care, guidance & get those questions answered by an HIV Specialist
As Providers, you are an Essential Entry Point for women who are often not experienced with HIV or medical care It is important to: Provide a balance of focus on the health benefits of both HIV Care and prevention for the women, intimate partners and potential children Present referrals for care as an option Be aware that many women living HIV may be fearful of discrimination or disclosure by medical providers
Factors to Consider when making an HIV Care referral A client newly diagnosed may be in shock or denial May need time to process and understand what an HIV positive result means May not retain or understand important HIV information that you share directly after a positive test result May need time and support to accept her diagnosis and come to a place where she can talk honestly and make healthy decisions
Factors to Consider when making an HIV Care referral (Cont.) May initially need help identifying a family member, friend or community provider that they can talk to and get informed about HIV May miss the 1 st appointment this is not a professional failure. Reschedule & be patient
Making a successful referral Include the name & number for a Direct Contact Schedule appointment for HIV care at at time of appointment if possible Partner with your support team (Social workers, advocates, resource parents, peer educators, etc) to make 1-3 reminder calls (newly diagnosed or experienced patients)
Making a successful referral Keep the client focused on her opportunity to ask questions and learn at her appt. Follow-up on referrals at next appointment. Reinforce the expectation of quality care & confidentiality at all appointments!!!
As Providers your role is complex, delicate and requires the essence of compassion and humanity For each client that you serve with respect, humanity and care You represent Change, Health and Possibility & I am honored to partner with you to create a healthier world
Create the change you want to see in the world The next step is yours.. engage women living with HIV in option-based dialogues because together you can create healthy women, healthy children and healthy communities. We are counting on You!
Our Partnership Doesn t End Here I am available for: In-Service Trainings Curriculum Development Disclosure Support Client Education Advocacy and more Contact me @ Ebony Johnson (202) 491-3970 adropofprevention@hotmail.com