“Bringing Testing to the People”: A Discussion of an HIV-Testing Outreach Project Targeting Impoverished Women

HIV-related health disparities are differences in the incidence, prevalence, mortality, and/or burden of HIV and related adverse health conditions that exist among specific population groups. Health disparities exist within the impoverished or low-income housed population in Puerto Rico with respect to HIV. Formative research findings with women who live in public housing revealed a three percent self-reported HIV positive serostatus (Norman, et. al., 2008). However, due to the stigma associated with HIV in Puerto Rico, especially within the residents of public housing, this figure is likely to be an underestimation of the real seroprevalence (Norman, et. al., 2009). The vast majority is unemployed (95%) and has no visible means of monetary support. As such, they qualify for “Reform, as the local Puerto Rico Health Reform program (Reforma de Salud de Puerto Rico in Spanish), is called. This is a government-run program which provides medical and healthcare services to indigent and impoverished citizens of Puerto Rico. It is run by means of contracting services of private health insurance companies, as opposed to the traditional system of government-owned hospitals and emergency centers. The Reform is administered by the Puerto Rico Health Insurance Administration and, as of December 31, 2005, provides healthcare coverage to over 1.5 million Puerto Ricans, which equals to 37.5% of the island population (PR Department of Health, 2010). While these persons qualify for Reform, many of them have no means of accessing needed health care due to the costs of or lack of transportation.