Healthy Mothers, Healthy Futures: HIV Equity in Black Maternal Care

February 7th is National Black HIV/AIDS Awareness. In the Perinatal Space, we need to provide centering for Black Mothers, protection for Black Babies, and address Mental Health.

Why This Matters

Black communities continue to be disproportionately impacted by HIV in the United States. When we narrow that focus to the perinatal period (pregnancy through 12 months postpartum), the conversation becomes even more critical.

In the perinatal space, HIV is not just a medical diagnosis — it intersects with:

• Maternal mortality disparities

• Stigma and medical mistrust

• Intimate partner violence

• Depression and perinatal mood disorders

• Access to prenatal and postpartum care

For Black women, these layers compound risk.

Key Issues in the Perinatal Context

1️⃣ Routine HIV Screening in Pregnancy

• HIV testing is recommended during pregnancy and again in the third trimester for high-risk populations.

• Early diagnosis + antiretroviral therapy (ART) can reduce perinatal transmission to less than 1%.

💡 Message: Early testing saves the lives of both mother and baby.

2️⃣ Mental Health & HIV Diagnosis

Receiving an HIV diagnosis during pregnancy can trigger:

• Acute anxiety

• Depression

• Shame and isolation

• Fear of disclosure

• Trauma reactivation

Black mothers may also face:

• Cultural stigma

• Faith-based shame narratives

• Fear of child welfare involvement

• Partner violence risk after disclosure

As a PMHNP lens:

Untreated perinatal depression affects medication adherence, prenatal engagement, and bonding.

Mental health support is not optional — it is essential care.

3️⃣ Intimate Partner Violence (IPV) Connection

HIV risk and perinatal IPV are closely linked. Black women experience disproportionate rates of both.

Screening during prenatal visits should include:

• HIV risk

• Safety assessment

• Emotional wellbeing

  
  

4️⃣ Structural Barriers

• Insurance gaps postpartum

• Transportation barriers

• Implicit bias in OB care

• Limited culturally congruent providers

Health equity requires more than awareness — it requires systems change.

A PMHNP Call to Action

✔ Normalize HIV conversations in prenatal mental health assessments

✔ Screen for depression AND HIV-related stigma

✔ Address medication adherence with compassion, not judgment

✔ Collaborate with OB, infectious disease, and social work

✔ Provide psychoeducation about healthy pregnancies with HIV

✔ Advocate for postpartum continuity of care

National Black HIV/AIDS Awareness Day reminds us that protecting Black mothers is protecting Black families. In the perinatal space, early HIV testing, access to treatment, and mental health support can reduce transmission rates to near zero. Stigma should never be a barrier to care. HIV is preventable. Perinatal transmission is preventable. Stigma is preventable. What we need is access, equity, and compassion in care. Black mothers deserve all three

🖤 #NBHAAD #BlackMaternalHealth #PerinatalMentalHealth

Kesha Nelson, PhD, MSN/Ed, RN, APRN-CNP, PMHNP-BC, ADHD-CCSP

Director of Mental Health – BLACK BERRY & JUICE

The BLACK Collaborative Inc.