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

Women account for 19% of new HIV diagnoses in the United States (CDC, 2017) and 26.5% of Ryan White HIV/AIDS Program (RWHAP) clients (HRSA, 2018). Minority women comprise 84% of RWHAP female clients, of whom 62.1% are African American, 19% are Latina, and 16% are white.

This heavy burden is driven by an environment of poverty, lack of access to health care, and addiction. The majority of female RWHAP clients are low income, according to the 2018 report and summarized in the HRSA Fact Sheet, Female Clients: Ryan White HIV/AIDS Program, 2018 (January 2020).

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HRSA HIV/AIDS Bureau, RWHAP Annual Client-Level Data Report, 2018

HIV Health Outcomes among Women

Data on health outcomes of RWHAP clients come from the HRSA RWHAP Annual Client-Level Data Report, 2018 (RSR), an annual report on RWHAP client characteristics (including gender) and health outcomes. In summary:

• From 2010 through 2018, viral suppression increased from 66.3% to 86.8% among female RWHAP clients receiving HIV medical care, similar to increases seen among all RWHAP clients (rose from 69.5% to 87.1%) and male RWHAP clients. Rates among RWHAP transgender clients have also climbed dramatically but still lag.
• The percentage of Black/African American women who were virally suppressed (85.7%) was slightly lower compared to the national RWHAP average (87.1%) and all RWHAP female clients (86.8%). Viral suppression among Hispanic women receiving RWHAP HIV medical care was 88.7%.
• Although the rate of viral suppression among transgender women (transgender male-to-female clients) increased to 81.1% in 2018, 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 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 RWHAP Part F Special Projects of National Significance (SPNS) innovation into practice with manuals, curricula, webinars, and tools.
• The National HIV Curriculum (NHC), developed by HRSA's RWHAP Part F AETC Program and the University of Washington, offers continuing education credits and a robust online learning experience. Their HIV in Women topic covers contraception, conception, and other key issues. The HIV in Sexual and Gender Minority Populations chapter reviews epidemiology and care issues for cis- and transgender women.
• Various RWHAP SPNS initiatives have investigated innovative models of HIV 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 efforts of the Transgender Evaluation and Technical Assistance Center (2012-2017).
• 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.

RWHAP Part D: A Focus on Women

While all aspects of RWHAP deliver care to women with HIV, Part D is focused on HIV services for women, infants, children, and youth. See the RWHAP Part D WICY Fact Sheet (August 2019) and the list of RWHAP Part D recipients.