Abstract
There has been promising improvement in recent years in decreasing overall HIV incidence, however this decrease has not been proportionately experienced by all individual/groups across the US. In the year 2020, the Black/African American community held the highest new HIV diagnosis, 8.1 times as high for Black persons compared to White persons. Black women accounted for nearly 60% of new HIV diagnoses among women in the US in 2018. This disproportionate burden of HIV can be attributed to several factors that are best understood through an intersectionality framework with a socio-ecological approach. Three aims give us insight into individual, interpersonal and neighborhood level determinants that impact health outcomes for Black women living with HIV (BWLWH) and Black individuals placed at risk for HIV.This dissertation aimed to (1) use network analysis to understand the associations between different sources of support with mental health symptoms, coping, and risk of viral non-suppression in a sample of BWLWH, (2) utilize latent class analysis and time-to-event analysis to characterize BWLWH by experiences of microaggression, interpersonal violence, lifetime trauma, economic stability, self-efficacy, resilience and health behaviors and understand the uptake of COVID-19 vaccines, (3) utilize a multigroup latent class analysis to understand the impact of economic stability, medical mistrust, and barriers to care on HIV prevention through PrEP awareness and HIV-related conversations with a doctor in a community sample of Black individuals of diverse gender identities. Findings revealed that friend support was inversely correlated with risk for viral non-suppression, COVID-19 vaccine uptake was high and did not differ by class, and economic stability and barriers to care impact HIV prevention. Findings are pertinent to intervention development in the areas of interpersonal support systems for BWLWH and highlight the importance of the impact of intersectional adversities on health-related knowledge among Black individuals living with or placed at risk for HIV.