Leveraging Bundled Interventions to Address Intersectional Barriers to Care for Black Women With HIV, the Black Women First Initiative, 2020.

Abstract

The 2020 initiative Improving Care and Treatment Coordination: Focusing on Black Women With HIV funded by the US Department of Health and Human Services Office of the Assistant Secretary for Health's Minority HIV/AIDS Fund and Health Resources and Services Administration's HIV/AIDS Bureau Ryan White HIV/AIDS Program aimed to enhance health and well-being for cisgender and transgender Black women with HIV through bundled interventions at 12 US sites. The initiative's intersectional approach involved Black women with HIV in program development and implementation. Quantitative data from 743 participants highlighted disparities in employment and housing, emphasizing the need for holistic, culturally sensitive care. In quantitative responses, participants, regardless of gender identity, reported HIV-related stigma and racial discrimination, with transgender women qualitatively reporting additional gender-based inequities that affect their HIV health outcomes and quality of life. We summarize findings from the initiative and provide recommendations to address intersectional barriers to care to improve health and well-being among Black women with HIV. Results of this initiative suggest that a flexible, responsive health care system that emphasizes a broad service delivery model reflecting the participants' diverse identities can improve health outcomes. (<i>Am J Public Health</i>. 2025;115(S1):S68-S74. https://doi.org/10.2105/AJPH.2025.308022).