Strategies for Enhancing HIV Care and Racial Equity for Black Women

On August 7, 2025, the UConn Health Disparities Institute released significant insights aimed at enhancing care for Black women living with HIV, as part of the Black Women First Initiative (BWF). This initiative, established in 2020, marked a pivotal moment in public health as it was the first focused effort to address the specific needs of Black women affected by HIV since the onset of the epidemic in 1981.

The BWF initiative provided funding to twelve community-based organizations and clinics nationwide, empowering them to develop and implement strategies that improve access to care and treatment for Black women living with HIV. This initiative also included an evaluation and technical assistance framework managed by UMass, Lowell.

Despite Black women comprising less than 14% of the U.S. female population, they represent 54% of new HIV diagnoses. This stark disparity is attributed to a range of historical and structural factors, including limited economic and educational opportunities, exclusion from effective HIV prevention messaging, and various social determinants of health that hinder their access to quality care and preventive measures such as pre-exposure prophylaxis (PrEP).

The authors of a recent essay published in the American Journal of Public Health emphasize that the disproportionate impact of HIV/AIDS on Black women is fundamentally rooted in systemic racism rather than biological differences. They argue that racism creates barriers to high-quality healthcare, including HIV treatment.

In addressing these challenges, the authors highlight the importance of centering Black women's voices and experiences in the development of interventions. The meaningful involvement of Black women in the design, implementation, and evaluation of these initiatives was identified as a crucial step towards dismantling the racism inherent in health systems.

However, the authors assert that these efforts must be expanded. They advocate for a comprehensive approach to advancing the health of Black women with HIV, which encompasses changes to funding mechanisms, service delivery models, and success metrics. They note that while discussions around racism and racial equity have begun, significant investment in time, resources, and targeted efforts is still needed.

The essay concludes with a series of expert recommendations aimed at addressing and dismantling racism in future initiatives focused on improving care for Black women with HIV:

• Funders, particularly in the private sector, should acknowledge racism as the primary cause of health inequities and define its manifestations across various levels. They should support initiatives that aim to dismantle racist policies and reshape practices in alignment with the needs of Black women.
• Organizations and institutions need to critically assess their practices, procedures, and policies to identify and rectify oppressive structures.
• Research and evaluation frameworks should be co-developed with Black women living with HIV, including mechanisms to monitor and measure the impact of racism at multiple levels.
• Community partnerships should be leveraged to provide comprehensive services, filling gaps in on-site care. By utilizing the strengths of various partners, organizations can enhance their capacity and accessibility to resources for the communities they serve.

These recommendations underscore the urgent need for systemic change to ensure that Black women living with HIV receive the equitable care they deserve.