REHABILITATION SERVICE UTILIZATION AMONG AFRICAN AMERICAN WOMEN LIVING WITH HIV/AIDS: USING THE BEHAVIORAL MODEL FOR VULNERABLE POPULATIONS

African American women represent one of the largest groups disproportionately living with and affected by HIV/AIDS yet African American women have largely been unrepresented in the federal-state rehabilitation system. As pharmaceutical treatment options improve and individuals with HIV/AIDS are living longer and healthier lives, research exploring the appropriateness of rehabilitation services has increased. Accordingly, it has become more necessary to address the needs of this population. As the largest service provider for people with disabilities, the state-federal rehabilitation system has the potential to be a vital resource for African American women living with HIV/AIDS. The purpose of this study is to identify and examine variables related to and predictive of the utilization of rehabilitative services among a sample of African American women living with HIV/AIDS in the United States who volunteered to complete the National Working Positive Coalition - Vocational Development and Employment Needs Survey (NWPC-VDENS). The sample for this study was 313 African American women living with HIV/AIDS who were recruited from AIDS service organizations and national networks throughout the United States. Participants voluntarily completed the NWPC - VDENS, which explored their needs in the areas of education, training, employment, and health. The behavioral model for vulnerable populations was utilized as a framework to organize and examine predisposing, enabling and need constructs as they related to the utilization of rehabilitative services among African American women living with HIV/AIDS. This study used descriptive, bivariate and binary hierarchical logistic regression statistical analyses to determine the extent to which the constructs were predictive of the use of vocational rehabilitative services. The bivariate analyses produced no statistically significant differences between users and non-users of vocational rehabilitation services for either the predisposing or need variables. Three enabling characteristics, receipt of income benefits, knowledge of services, and reasonable access were all found to have statistical significance in the bivariate analyses. At least one variable from each construct was statistically significant in the regression model. Receipt of income benefits and knowledge of rehabilitation services were found to be predictive of the utilization of vocational rehabilitation services. Study findings framed from previous research, study limitations, implications, and recommendations for future research were acknowledged

Common Threads: An Integrated HIV Prevention and Vocational Development Intervention for African American Women Living with HIV/AIDS

Current policies and initiatives call for the integration of social determinants of health into HIV/AIDS prevention and care interventions. According to the World Health Organization’s Commission on Social Determinants of Health, the lower a person’s socioeconomic status, the worse the health outcomes. One way to alleviate poverty among African American women with HIV/AIDS is to help foster their vocational development and economic empowerment. The National HIV/AIDS Strategy Implementation Plan specifically directs federal agencies to find ways to integrate people living with HIV/AIDS into broader employment initiatives. The purpose of this manuscript is to examine medical, psychosocial, financial/legal and vocational social determinants of health through the lens of the Client-Focused Considering Work Model (Goldblum and Kohlenberg, 2005). The authors then apply this model to the development of a culturally sensitive, integrated HIV prevention and vocational development intervention: Common Threads