A support group A Beautiful Seed was developed to give women of color living with HIV/AIDS coping skills to handle stressful situations in their life. This support group met once a week over an 8-week period. A curriculum was created to cover various topics that provided the participants with social skills to decrease their level of depression using Cognitive Behavioral Therapy techniques. The purpose of this study was to answer the question: Will women of color that are living with HIV/AIDS experience lower levels of depression because of attending a support group? A single-system pre-test and post-test design were utilized. Participants were females who identify as women of color and attended an HIV outpatient clinic for their health care and mental health. A PHQ-9 questionnaire was administered to the participants at the beginning and end of the group. The post-test findings indicated that both participants level of depression decreased after attending the support group for 8-weeks.
Part I Literature Review
The Well-Being of Women of Color Living With HIV/AIDS
Introduction-Client System & Social Problem
African-American women are disproportionately affected by the HIV/AIDS epidemic in the United States with alarmingly high numbers among young women of color, especially those of lower socioeconomic status (Amutah, N., 2012). African American and Hispanic women are made up of 86% of the 53,500 females who were diagnosed with the disease in New York in 2005. However, the percentage of the people affected varies (Golden, (2014). The African American Women in New York were 27 times more than the white women, while the Hispanic women were 13 times more than the white women. Additionally, there is an increased rate of the Asian/Pacific Islander women, the Native American women, and refugees from the places where the disease is prevalent such as Haiti, Africa, and the Dominican Republic.
HIV (human immunodeficiency virus) is a virus that weakens the body immune system destroying important cells that fight disease and infection (aids.gov,2010). HIV/AIDS is a medical condition with the continued failure of the physical strength and body functioning. Therefore, there is the recurrent indication of weakness, breathlessness, and fevers (Plach, et al., 2006). There is no cure for AIDS and treatment to date is aimed at delaying the change from HIV positive to AIDS.
The only known method of transmission of HIV is direct contact with blood or body fluids. There are five groups of people at risk for HIV/AIDS; (a) sexually active homosexual men with multiple sex partners, (b) present or past abusers of intravenous drugs, (c) patients who have been transfused with blood or blood products before 1985, (d) heterosexual partners of persons with HIV/AIDS, and (e) hemophiliacs (Grady, 1989).
The nature/cause of the problem among African American women living with HIV/AIDS is lack of prevention education and resources in their community, unprotected sex with sexual partners, drug addiction, lack of affordable health care, support groups, mental health services, or resources. Increasing their prevalence of this disease.
Research indicates the number of color females with HIV/AIDS have increased over the last few years. After the prevalence of HIV/AIDS was discovered, the number of women of color infected have been changing from time to time. For instance, from 1985 to 1999 women of color increased by three times (Plach, et al., 2006). African Americans and Latinos are recognized as a
significant population affected by HIV/AIDS. HIV/AIDS restricts women of color from social and daily undertakings and at times can produce feelings of emotional anguish, and damaged emotional comfort.
Individuals who have been diagnosed or living with HIV/AIDS are at risk developing mental health issues and subsequent psychological symptoms, such as depression (cite). If mental issues are not resolved, individuals with HIV/AIDS are at risk of developing symptoms such as sadness, hopelessness, anxiety, withdrawal, and isolation, (DiPasquale, 1990). The purpose of this study is to determine whether women of color living with HIV/AIDS will have decreased levels of depression and hopelessness after participating in a support group.
Social Welfare Policy
In 2014 the New York Governor Andrew M. Cuomo declared a strategy to stop AIDS outbreak in New York State. It was a social welfare policy aimed at eradicating the prevalence of the disease that many women of color had contracted. The welfare policy was planned to identify the people that had not yet been diagnosed of the disease, and connect them to the healthcare, maintain them in them to maximize virus containment (Turner, 2017). Additionally, the plan would ease contact with Pre-Exposure Prophylaxis (PREP) for people that participate in high threat undertakings to maintain their negative HIV status. New York state aspired at decreasing the number of infected people to 750 by the end of 2020. The social policy program started from community management engagement and various groups partnered to assist the community in several ways. For instance, the New York State Department of Health (NYSDOH) and New York City Department of Health and the Mental Hygiene (NYCDOHMH) worked together with the society heads to assemble significant stakeholders, customers, and society. They wanted to recognize their precedence in the community, and how to deal with the issues of HIV prevalence (Battle & Lemelle, 2017). As such, the stakeholders got a chance to make inquiries and discuss suggestions on how to end the outbreak through society discussions and surveys. These surveys and analyses were publicized and made available to assist all people in the state. In the research, there were approximately 300 suggestions that were revived.
In October 2014, an Ending Epidemic (ETE) Task Force was instituted and worked with giving guidance to accomplish the objective outlined by the governor. The task force was made up of 64 significant stakeholders that represented the public and private organizations leaders with proficiency on HIV/AIDS. They advanced the 2015 Blueprint, plan that was implemented to end HIV in New York (Turner, 2017). It included three points of the Governors strategy and other proposals to stop or minimize the prevalence of the disease in the state and restrain the disease development.
The first development of Integrated HIV Prevention and Care Plan was dependable on the National HIV/AIDS Strategy (NHAS) and The Blueprint ETE objectives. This was aimed at thwarting another disease and enhancing access to the care, guaranteeing stability, and diminishing healthcare unfairness (Bell, 2018). By increasing the ability of viral containment, such accomplishment would enhance New Yorkers understanding of the results of the disease, and reduce the transmission risk (Battle & Lemelle, 2017). People who do not have the information on how the virus is transmitted would be the first ones to benefit. As stated earlier, many people do not know the spread of the disease among women of color. Therefore, these social policies could play a critical role in educating people on how to avoid the disease.
The five-year plan for the 2017-2021 was formed at the route of the Center for Disease Control (CDC), Division of HIV/AIDS Prevention (DHAP), and HRSAs HIV/AIDS Bureau (HAB). It is the partnership with other organizations such as NYCDOHMH, Nassau and Suffolk County Departments of Health, United Way of Long Island and HIV Planning Bodies all over the New York State. Additionally, other people participated in high-risk undertakings, such as service suppliers and others who care about the welfare of their people in society. The strategy established in New York state was also supported by different funding sources that care about the health and well-being of people (Battle & Lemelle, 2017). The research was conducted and indicated those that participated realized a lot of positive changes as compared to the previous undertakings. Through education and other strategies to assist people, there was a drastic drop in figures of individuals distressed by the disease. The number of people infected dropped by half as compared to the last decade. Additionally, the number of people dying from the disease drastically reduced as the occurrence of the illness continues to augment. The convergence of situation has caused novel changes.
Notably, it should be identified that the state also has few resources to care for people who are affected by HIV/AIDS and individuals that require any services (Turner, 2017). Additionally, there are other challenges women of color face that social policy can address to decrease the occurrence of HIV/AIDS. Most people are marginalized, and the condition becomes inevitable. Even though social systems are working hard to reduce the prevalence of HIV/AIDS, they are facing a lot of challenges. For instance, the government may not be supportive, or people may not collaborate by stating publicly they have HIV/AIDS, so they can be helped. Additionally, most women of color face a lot of discrimination in the society (Logie et al., 2016). Therefore, they believe other people share information about their status, thus increasing the prejudice against them.
Section 1 of the strategy is the Statewide Coordinated Statement of Need. The Epidemiologic outline, Part A, gives plan outlines a verdict with the understanding of the sociodemographic, a place character change, and medical attribute of women of color that are infected with HIV/AIDS in the New York City. Part B is concerned with HIV Care Continuum so social policies can establish the best way to assist women of color affected by the disease (Calabrese et al., 2016). Part C of the outline indicates the inventory of ready resources and shows how funds can be used to support women of color that are offered in the New York State. Another section of Part C is to establish prevention measures of HIV/AIDS for women, and address barriers that hinder such services (Logie et al., 2016). For instance, there are some barriers such as social, structural, and program-related obstacles that hinder the provision of services for women of color.
Section II of the Plan changes from needs for women of color too strategies that can be applied in societal setting to assist those with HIV/AIDS. However, Part A shows incorporated HIV prevention strategy. This approach supports women of color by educating them on the best strategies they can use to prevent HIV/AIDS. Part B illustrates the significant stakeholders and corporations that are in place for the advancement of this approach (Calabrese et al., 2016). Additionally, Part C demonstrates social commitment and the role it plays in assisting women of color with HIV. Usually, the community is involved since they understand better about the people in their community and their lifestyle (Bell, 2018). After identifying the problems such women face, they can now come up with the strategies of assisting them.
Section III indicates the mechanisms for observing and improving the plans of social policy, so they can proficiently identify challenges women of color face in New York and ways in which such issues can be addressed. Finally, the appendices give letter and agreement and the source of files that recognize members of the Steering Committee and HIV development organization. It provides valuable information to assist women of color living with HIV/AIDS (Calabrese et al., 2016). Therefore, as a part of the social welfare policy, it can improve record keeping of the people with the color women with the disease and the best way possible to assist them since other organizations and people have alienated such group. The study shows that the social welfare policy has encountered a lot of challenges in their undertakings. However, they have still sustained a proficiency operation in ensuring that women of color be assisted the best way possible and to live a better life like other people in the society.
HIV/AIDS is a community health problem that concerns most women of color in the New York State. To comprehend such predicament, syndemic theory which looks at the numerous unified outbreaks ought to be implemented by the support group. The vulnerability of the HIV affected women has increased as a structural, public, and organic issue interrelate in the situation of community discrimination. In the New York State, women of color are familiar with the syndemic of HIV/AIDS, poverty, and joblessness (Wilson et al., 2014). However, the existing study on the support groups has until now to recognize the strategies of flexibility that can decrease the unhelpful results of a syndemic or investigate the possible better methods of people to reduce the prevalence of the disease among women of color. To comprehend HIV jeopardy as a section of a syndemic and look at the prevention of the disease there are different strategies that the support groups should undertake. For instance, there should be the use of sophisticated systems analysis and other mixed approaches to look at the changes connected to the social conditions and illness (Wilson et al., 2014). There should also be a multidisciplinary and inter-institution partnership of the community health sector and studies to increase their studies and evaluate the prevention measures of the disease among women of color.
This qualitative study focusses on prevention strategies to decrease and prevent HIV/AIDS among black women. Without addressing the sociostructurally affects prevention may be challenging. This article states most prevention interventions are grounded in psychological or social-cognitive theories of behavior that assume that women alone can change their behavior and make informed choices (Teti, M, eta, 2010). By utilizing an ecological model that addresses the societal, community, relational, individual, and risk. You can look at the whole person and address the issues that continue to plague the individual living with HIV/AIDS. The method consisted of a sample size of 184 women who identified as black, low-income level, and different age groups. Women were given information on the use of condoms, discussing with partners their status, and involving the women with therapy to address the behavior.
Over the years, females in the New York City, predominantly poor women of the marginal status have experienced a rise in several individuals distressed by the human immunodeficiency virus (HIV) and obtained the immunodeficiency syndrome. In 2007, research showed that the rate of HIV and AIDS in the New York City per 100, 000 people were 24.9%, whereby 52% were African American while 30% was Hispanic (Wu & Li, 2013). Due to the increased number of women of color with the disease, there are different interventions in the New York City, and United States to address issues concerning women of color.
The Stress Management and Relaxation Training/Expressive Supportive Therapy (SMART/EST) Womens Program (SWP) was established to advance the wellbeing condition of color women and ethnically diverse people affected with HIV/AIDS (Weiss et al., 2011). Over the years, the program advanced and tested different strategies that were proficient for women of color with the disease. Some approaches included multicultural, multilingual healthy lifestyles aimed at helping this population. The SWP intervention is made up of a ten weeks session each consisting of two hours for Cognitive-Behavioral Stress Management/Expressive Supportive Therapy (CBSM+).
This intervention program was implemented to enhance different supportive for women of color. For instance, it would provide information on stress management, the teaching of stress reduction expertise such as muscle relaxation, and deep breathing (Weiss et al., 2011). The intervention would also teach on how to resolve conflicts, especially on an interpersonal level.
Such as irritation management, enhancement of supportive environment for open expression of passing their views, increase their understanding, change of attitude, and how people perceive them thus growing their healthy living (Jones et al., 2011). Additionally, the program was also aimed at encouraging individuals affected to use vigorous predicament resolving and coping approaches instead of inactive, and emotionally based strategies to solve their problems. As such, it would help people too, modify maladaptive cognitive appraisals using cognitive restructuring, reframing strategies, and disputing irrational beliefs (Weiss et al., 2011). With such strategies, women of color affected by the disease would live a positive life in society, interact with others while increasing their lively hood, and enhance a better environment for themselves.
The Womens Empowerment Program (WEP) Intervention was another program advanced to assist the females affected with HIV/AIDS. The involvement was advanced using participatory community model. It formed with the aim of helping women of color adapt the prevalence of the disease. Group females took part in the focus group and recognized the necessity to assist women of color (Kershaw et al., 2016). Another aim of the intervention was to help women of color take care of themselves, enhance their confidence, and develop strategies to improve their networking with other people. Females who participated in the program stated, it implemented a group format that provided social support for women of color (Enriquez et al., 2007). Additionally, women of color affected by HIV/AIDS should be included in the program as facilitators since the female gender affected with HIV/AIDS would view a group led by young people more plausible than ones that were led by healthcare providers only.
WEP intervention operated mainly based on the Self Management of FIV Framework, and it implemented a cognitive reframing in the restorative engagement to assist women of color affected by the disease. As such, it would enhance their social interaction, make them feel that HIV is a disease like any other, and learn how to manage and prevent and HIV related predicament (Azhar, Berringer & Epperson, 2014).
In the Womens Empowerment Program (WEP) Intervention program, Miles involvement was applied from a personal level to a group level and all the data collected to increase the proficiency of the research that would enhance a better environment for the affected women. Fleurys Wellness Motivation Theory of empowerment and Coopersmiths hypothesis of self-confidence were also applied to direct women of color to change their attitude towards themselves because they had the disease (Enriquez et al., 2007). For instance, Fleurys hypothesis supports readiness as an essential factor to any issues that prepares a person for behavioral change (Dworkin et al., 2016). Moreover, Coopersmiths shows that self-esteem is an essential quality of a human being that enhances interaction, and positive thinking is increasing the longevity of lively hood. Therefore, women of color needed such intervention to improve better living in society.
A Beautiful Seed Support group was created to provide women of color coping techniques that will assist with handling life challenges. This group will meet once a week for 8-weeks providing females who identify as women of color Cognitive Behavioral Therapy through Psychoeducation.
A Beautiful Seed is to provide a supportive atmosphere where women could engage in discussions and self-expressions related to their challenges because of living with HIV/AIDS. Aiding women of color to find courage, gain knowledge, and tools that will promote long-lasting change. They will be provided with a curriculum that will cover topics such as communication, perception, the power of thoughts, goals, finding your voice, boundaries, and self-care. This will be an interactive group with homework giving at the end of each group. However, participation is not mandatory.
Part II Methodology
In this study, a single system pre-test and post-test were administered to the participants of the group. The assumption was that by attending a support group participant who experienced depression would experience decrease levels of depression because of attending. Flyers were distributed to females who identified as women of color by their Nurse Practitioner, Primary Care physician, behavioral therapist, or their social worker. Flyers were also posted in the waiting room of the clinic. The flyer provided basic information about the group with contact information for women who considered participating in this study. The women who participated in the study was given a PHQ-9 questionnaire before the start of the group and after to measure their depression level. The sample size was two women within the age range of 55-70. The duration of the group was 8 weeks. It was assumed that by attending the support group for all 8 weeks it could be theorized that the relationship between the support group and the variables could be justified. The limitations of this study were the size of the group, barriers that affected other women of color from attending, and longer meeting time.
The finding shows that both participants scored significantly lower on their PHQ-9 questionnaire during the post-test. The lower scores on the post-test findings indicate that attending social support groups does lower depression.
I recommend the next study to include males and individuals of different ethnicity. The reason for this is due to men that are living with HIV/AIDS also need emotional and social supports. Having more research to identify effective ways to improve data collection can reach more individuals instead of those that are already receiving services for HIV. Future research should give priority attention to barriers that may prevent individuals from attending. These barriers include transportation, child-care, and the social stigma that is placed on individuals living with this disease.
By far, most women affected by HIV/AIDS are the poor and marginalized ones in the society. Women of color have experienced a lot of prejudice for an extended period. From the research, women of color with the disease is more significant than any other population in some states. Women of Color suffer so much due to poverty, and unemployment yet the government cares less. Private and public partnership should be established to enhance strategic planning. Focusing on the challenges women of the color encounter, and efficiently come up with approaches to assist them and their families.
Support groups can enhance the decline of disadvantaged women of color living with HIV/AIDS and their well-being. By implementing support groups in their communities and seek financial support from governmental and nongovernmental organizations that can assist individuals living with this disease. Support groups can also assist women of color by educating them on the ways this disease can be avoided.