The missing element: Incorporating culturally-specific clinical practices in HIV prevention programs for African-American females.

Abstract: African American females are disproportionally affected with new cases of HIV. High risk sexual practices contribute significantly to the incidence and prevalence of this public health problem. It is critical for advance practice nurses to acknowledge the relevance of cultural sensitivity when providing optimal care to African-American females. This article describes behavioral change interventions tailored to address cultural and socioeconomic aspects of HIV prevention among African-American females who attend historically black colleges and universities and is relevant for the African-American community at large. Key Words: Advance Practice Nurses, African American Females, HIV, Cultural Competence, Historically Black Colleges and Universities Since the onset of the acquired immunodeficiency disease syndrome (AIDS) epidemic in the early 1980s, racial and ethnic minority populations have been disproportionately affected by human immunodeficiency virus (HIV) and AIDS (Vinh-Thomas, Bunch & Card, 2003). The Center for Disease Control and Prevention [CDC], (2008) found that an estimated 56,300 people were newly infected with HIV in the U.S. in 2006. The African-American female was disproportionally affected, with incidence rates 15 times as high as white women and four times greater than Hispanic /Latino women. The HIV racial disparities and gender inequalities have contributed to an unnecessary health care crisis in the 21st century. Race and ethnicity may be a common factor in identifying populations at risk, but there are many variables that contribute to the diversity among African-Americans (Wyatt, Williams & Myers, 2008). Although race and ethnicity have not been identified as risk factors for the transmission of HIV, testing rates for HTV are riigher for blacks than for members of other races and ethnicities (CDC, 2008). No studies were identified in a review of literature that made this connection despite the higher rates. One mode of exposure that places the AfricanAmerican female at risk for contracting HIV is associated with heterosexual practices that result in higher exposure to HIV A study by Laurencin, Christensen & Taylor (2008) suggests that African- American females are likely to be infected with HIV as a result of sexual activity with men who are infected with HIV. The primary purpose of this article is to increase awareness among advanced practice nurses of the importance of integrating culturally-specific clinical practices in interactions with African- American females who participate in high risk sexual practices. THE INFLUENCE OF PSYCHOLOGICAL FACTORS ON RISKY SEXUAL PRACTICES The HIV/AIDS risk-related sexual practices on college campuses are prevalent. The risky sexual practices among conventional and unconventional college students are often associated with a new sense of autonomy, a new sense of decision-making ability and pressure to embrace the social norms of the campus environment pertaining to a variety of sexual behaviors. Social pressure for unprotected sexual activity has been round to drive college students' participation in high risk sexual practices (Hightow, MacDonald, Pilcher, Kaplan, Foust, Nguyen, 2005). Currently there is insufficient knowledge related to the incidence of HIV transmission among AfricanAmerican females who attend historically black colleges and universities (HBCUs) (Wyatt et. al (2008); Payne, Beckwith, Davis, Flanigan, Simmons, Crockett, Ratcliff, Brown & Sly (2006); Foreman (2003). The CDC (2009) has identified further study as a priority; calling for interventions to address practices related to HIV transmission among college age African-American females as well as members of the African-American community at large. The HBCU campus environment contains multiple factors known to positively influence the risk of sexual contact. One contributing factor is the gender-ratio imbalance created by the underrepresentation of African-American males on college campuses. …