HRSA's Ryan White HIV/AIDS Program and Women and Girls HIV/AIDS Awareness Day

Women account for nearly one fourth of people living with HIV infection in the United States (CDC data) and 26.9% of Ryan White HIV/AIDS Program (RWHAP) clients (2017 Ryan White HIV/AIDS Program Annual Client-Level Data Report). Minority women comprise 83.8% of RWHAP female clients, of whom 61.6% are African American, 19.4% are Latina, and 16.2% are white.

This heavy burden is driven by an environment of poverty, lack of access to health care, and addiction. Female RWHAP clients have lower incomes than male clients, according to the 2017 report.

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Viral Suppression among Women Aged 13 and Older Served by the RWHAP, 2010–2017—United States and 3 Territories

Viral suppression among female RWHAP clients has risen from 66.3% in 2010 to 85.2% in 2017. The program is actively investing in programs to increase treatment success and reduce disparities in outcomes.

HIV Health Outcomes among Women

Data on health outcomes of RWHAP clients come from the HRSA RWHAP Annual Client-Level Data Report (RSR), which issues an annual report on RWHAP client characteristics and health outcomes. The RSR also provides insights into HIV health outcomes by gender and other client characteristics. 

• From 2010 through 2017, viral suppression increased from 66.3% to 85.2% among female RWHAP clients, similar to increases seen among all RWHAP clients and male RWHAP clients. Rates among RWHAP transgender clients have also climbed dramatically but still lag.

From 2010 to 2017, the proportion of RWHAP clients achieving viral suppression jumped from 69.5% to 85.9%.

• The percentage of Black/African American women who were virally suppressed (84.1%) was slightly lower than the national RWHAP average (85.9%) and all RWHAP female clients (85.2%). Viral suppression among Hispanic women was 87.4%. 
• Although the rate of viral suppression among transgender women (transgender male-to-female clients) increased to 80.9% in 2017, it remained the lowest rate of viral suppression across gender subpopulations.

Resources on Women and HIV

This site features TA and training manuals and initiative focusing on women living with HIV. Below are highlights:

• Women of Color: Enhancing Access is an implementation guide developed under the Integrating HIV Innovative Practices (IHIP), a HRSA initiative that is turning Special Projects of National Significance (SPNS) innovation into practice with manuals, curricula, webinars, and tools. See the National HIV Curriculum, developed by HRSA's AETC Program, with chapters on working with special populations.
• Various RWHAP SPNS initiatives have investigated innovative models of HIV/AIDS care for minority and underserved populations, including women. See SPNS Transgender Women of Color Initiative Intervention Manuals, from the initiative Enhancing Engagement and Retention in Quality HIV Care for Transgender Women of Color and the effort's of the Transgender Evaluation and Technical Assistance Center (2012-2017).
• Outcomes from another SPNS effort, Enhancing Access for Women of Color Initiative (2009-2014), are summarized in Women of Color: Enhancing Access.
• Building Care/Prevention Capacity along the HIV Care Continuum in Southern Metro Areas, funded under the Secretary’s Minority AIDS Initiative Fund, is implementing innovative models of service delivery to improve minority population health along the HIV care continuum. The focus will be on men who have sex with men (MSM), youth, cisgender and transgender women, and people who inject drugs (PWID). See the slides from the 2018 Ryan White Conference, Southern Initiative: Building Capacity to Improve Outcomes among Minority Populations.
• Building Leaders of Color Living with HIV is a project aimed at increasing participation in RWHAP planning bodies, medical care and support teams, boards of directors, and other mobilization efforts. The project also promotes leadership development for transgender women of color and supports efforts to expand the capacity of HIV prevention and care delivery systems.

RWHAP Part D: A Focus on Women

While all aspects of RWHAP deliver care to women living with HIV, Part D is focused on HIV/AIDS services for women, infants, children, youth, and their families. See the RWHAP Part D WICY Fact Sheet and the list of RWHAP Part D grantees.