Strengthening the Research Workforce of Latina/Hispanic Female Investigators to Address HIV Contextual Factors Affecting Women with HIV
Location: San Diego, CA; Pre-Conference Learning Institute at American Public Health Association Annual Meeting
National Institute of Mental Health
Division of AIDS Research
Women with human immunodeficiency virus (HIV) diagnoses are less likely to be virally suppressed than men. The prevalence of diagnosed HIV infection among Hispanics/Latinos in the United States is approximately twice that of non-Hispanic whites. Various sociodemographic, behavioral, social, and clinical variables may be contributing to disparities in viral suppression among women and the higher rates of HIV infection in Hispanics/ Latinos. Further, Hispanic/Latina women continue to be underrepresented in the biomedical research enterprise.
These observations provide the relevant background for this meeting.
The purpose of this meeting was to address diversity mentoring programs to strengthen the HIV research workforce of Latina/Hispanic female investigators and to address contextual factors affecting women living with HIV. A principal goal of the meeting was to integrate and coordinate relevant research and training aspects relating to HIV diversity and HIV disparities for underrepresented women. In addition, participants were asked to consider challenges and opportunities in these areas as well as an appropriate research agenda.
Meeting participants were:
- Expert research investigators in the areas of HIV diversity-mentoring and HIV disparities-contextual factors;
- Representatives from the consumer-advocacy community in the relevant areas addressed;
- Representatives from the sponsoring agency, National Institute of Mental Health (NIMH)-Division of AIDS Research (DAR).
Participants were selected by the program committee (David M. Stoff, Leandra Stubbs, National Institute of Mental Health, Carmen Zorrilla, Silvia Rabionet, University of Puerto Rico). Drs. Zorrilla and Rabionet co-chaired this meeting which took place on November 10, 2018, in San Diego, CA. The meeting was divided into two components: The morning focused on HIV diversity-mentoring issues and the afternoon focused on HIV disparities-contextual issues.
The meeting format consisted of the following:
- Presentations by expert investigators on HIV diversity-mentoring in the morning and on HIV disparities-context in the afternoon;
- Discussions by consumer-advocate on each component in the morning and in the afternoon;
- Large-group discussion, guided by discussion questions on the agenda, after the HIV diversity-mentoring component in the morning and after the HIV disparities-context component in the afternoon.
Diversity/Mentoring (Morning session)
- How can we improve the pool of qualified and accessible mentors in the HIV research workforce and increase recruitment/retention of mentees (primarily Latina women) for the long term?
- How can mentoring programs be strengthened to address institutional mentoring climate (e.g., implicit bias, stereotype threat, and microaggressions)?
- What strategies can be used in mentoring programs to prevent the “leaky pipeline” (i.e., attrition loss)?
- How can we build upon mentoring programs so that they are long-term and self-sustaining?
- What innovative models of diversity mentoring (e.g., peer mentoring, transdisciplinary mentoring) can be developed to improve immediate and long-term mentee outcomes?
- What are the most promising strategies to leverage diversity mentoring programs with other existing training programs, partnerships, and infrastructure development?
Disparities/Context (Afternoon session)
- What strategies should be developed to incorporate appropriate context into HIV interventions and thereby increase intervention potency and durability for the benefit of Latina women?
- What social and sexual network approaches should be developed to improve HIV prevention and care in underrepresented, vulnerable subpopulations?
- What community, clinic and provider level strategies and combination behavioral-biomedical HIV approaches should be developed that reduce the risk of women’s infection in high prevalence communities, improve engagement in HIV medical care, and improve treatment adherence and retention?
- What research should be conducted on mechanisms by which cultural experience impacts HIV acquisition risk trajectories and identifies time- points and circumstances to optimally target intervention?
- What studies should be conducted to evaluate the impact of policies on the social environment that serves as facilitators or barriers to HIV prevention and care?
- How can we incorporate the U=U (Undetectable equals Untransmittable) message in prevention and care that addresses women’s vulnerabilities and strengths?
- How can researchers effectively incorporate HIV+ women or women at risk as research partners and empower women through research?
Panel discussions, held after the morning and afternoon sessions provided a unique opportunity for networking and sharing information on emerging issues for each of the main topics (i.e., mentoring and disparities). Some of the mentoring-related issues addressed included:
(1) mentored research programs for Latina investigators (and others from underrepresented groups) such as clinical network-based scholars program (e.g., HIV Prevention Trial Network), Centers for AIDS Research’s Adelante program and NIMH-supported R25 programs in HIV;
(2) possible reasons for why research academic pathways leak more for minorities and women than for others;
(3) strategies for developing novel mentoring programs to target key transition points from one career stage to another.
Some of the disparities-related issues addressed included:
(1) Challenges in prevention (e.g., stigma, history of sexual abuse, relationship empowerment, disproportionate burden of family responsibilities) and in syndemic-related conditions (substance abuse, violence/trauma, mental illness, HIV) for Latina HIV-infected and their family;
(2) Utility of socioecological model for program development (individual, relationship, community, institutional, societal levels) including multiple factors driving women’s HIV risk, poverty/economic insecurity as key factor, economic empowerment and structural/policy changes.