In our grandmother's footsteps: perceptions of being strong in African American women with HIV/AIDS

Resilience in low-income African American women living and aging with HIV

Women are living with HIV into middle and older age and are likely to face multiple comorbidities and stressors as they age. This study focused on understanding how women who experience multiple forms of oppression and ongoing adversity are still able to adapt and stand strong. Using a theoretical framework of resilience and a feminist research ideology, interviews of eight middle-aged and older African American women living with HIV were analyzed. Despite experiences of HIV-related discrimination, trauma, and violence, these women demonstrated a remarkable ability to adapt and maintain support. Implications for research and practice are discussed.

Parenting African American Children With Autism: The Influence of Respect and Faith in Mother, Father, Single-, and Two-Parent Care

PURPOSE

Parents are the most significant contributor to care of children with autism spectrum disorder (ASD), and as such research on African American parenting in ASD is conspicuously absent. Findings relevant to parenting are discussed from a study with urban African American families caring for children with ASD.

DESIGN

An ethnonursing study was conducted with 24 African American family members of children with ASD and 28 professionals. Data were analyzed and reported as themes.

FINDINGS

Two universal themes of were found of respect and faith in God and family that influenced parental care. Two diverse themes of mother's watchful care and father's protective care, along with differences in feelings of isolation and dependence on supports were found among single- and two-parent families. Discussion and Practice Implications: When health care professionals increase their knowledge and understanding of cultural practices in the parental care of children with ASD, they provide health care that is culturally congruent.

“I Had To Be Strong”

Although strength is often embraced as a vital aspect of African American womanhood, African American women’s endorsement of the strong Black woman race-gender schema has received empirical attention because of its association with harmful health outcomes. Thus, there is limited knowledge regarding how African American women simultaneously experience its liabilities (e.g., harmful health outcomes) and benefits (e.g., increased self-efficacy). Qualitative thematic analysis was used to analyze data from 13 African American women who discussed the competing messages experienced when internalizing the strong Black woman race-gender schema. Three tensions were identified: (a) be psychologically durable yet do not engage in behaviors that preserve psychological durability, (b) be equal yet be oppressed, and (c) be feminine yet reject traditional feminine norms. These tensions highlighted that the schema simultaneously produced advantageous outcomes with respect to self-efficacy yet unfavorable implications for self-care. Each tension is discussed with respect to its perceived advantages and disadvantages.

Infected Lives: Lived Experiences of Young African American HIV-Positive Women

This hermeneutic phenomenological study explored the lived experiences of young African American HIV-infected women. Eleven women between the ages of 21 and 35 participated. One pattern, Infected Lives, and three themes--Living Alone With HIV, Living With Unresolved Conflicts, and Living With Multiple Layers of Betrayal--emerged. The pattern and themes portray the very complex and challenging experiences faced by these young women living with HIV infection. They have experienced isolation, abandonment, betrayal, and discrimination in their interpersonal and social systems. They often dealt with conflicts of hope and anguish in the relationships with their children, and portraying strength, while feeling fragile. These complexities negatively influence the ability to fully engage in self-care activities. Implications for future research include further investigation about the experiences of psychological distress experienced post-diagnosis, development and evaluation of holistic nursing interventions, and evaluative research on mass media educational campaigns to reduce HIV-related stigma.

Cultural Preparation for Womanhood in Urban African American Girls

Purpose: Poor sexual health is a significant contributor to morbidity in young African American women. Knowing how sexual knowledge is transmitted to Black girls is needed to develop effective preventive interventions. The purpose of this study was to explore the ways in which Black mothers transmit sexual values and knowledge to their daughters. Design: Interviews were conducted with 14 mothers, aged 25 to 34 years, with daughters aged 8 to 16 years. Data were analyzed using constant comparative analysis. Findings: The themes derived were (a) truth telling, (b) building strength through self-esteem, and (c) spirituality as helper. The overarching cultural theme was “Growing Strong Black Women.” Discussion/Conclusions: Mothers’ discussions with their daughters were infused with cultural meaning derived from their experiences. Black girls’ behavioral responses to their mothers’ strategies need to be studied. Implications: The findings will help nurses develop effective interventions that take into account the cultural realities of Black mothers.

John Henryism, Depression, and Perceived Social Support in Black Women

John Henryism, a construct developed to describe high effort coping, may help explain the observed health disparities between Blacks and Whites. Previous research suggests that John Henryism is associated with negative physical health factors. However, little research has focused on the relationship between John Henryism and psychological distress. Accordingly, in this exploratory study, we examined the relationships between John Henryism, psychological distress, and well-being in a diverse sample of Black women. Results indicate that there is a negative correlation between John Henryism and depressive symptomatology. This finding is in contrast to past research and suggests that John Henryism may be maladaptive to physical health but not mental health. The limitations and implications of the findings are discussed.

Silent endurance and profound loneliness: socioemotional suffering in African Americans living with HIV in the rural south

We explored how community responses to HIV contribute to distress in African Americans living with HIV in the rural South of the United States. We listened to the voices of community members through focus groups and African Americans with HIV through interviews. Community avoidance of HIV, negative views of HIV, and discriminatory behavior powerfully affected the distress of people living with HIV (PLWH). Ongoing distress, coupled with limited support, led to a life in which many PLWH endured their pain in silence and experienced profound loneliness. We conceptualized their experiences as socioemotional suffering--the hidden emotional burden and inner distress of not only living with HIV, a complex serious illness, but also with the societal attitudes and behaviors that are imposed on the illness and on PLWH. To improve the quality of life and health of PLWH, we cannot focus solely on the individual, but must also focus on the local community and society as a whole.

Ideological schisms about HIV/AIDS helping systems in the African American community, with an emphasis on women

This article is an initial exploration about the impact of ideological beliefs on helping services in the African American community. Newly infected HIV/AIDS cases place African Americans at 45% of such new cases, with African American women becoming infected at a rate 18 times that of Whites. Yet, helping services that are organic to African American women should be stronger through a discussion of cultural beliefs held in the community, where the genesis of helping services exists. Values and beliefs should be at the center of community partnerships, public media strategies, generalist-practice curricula in macro-level systems, and creating more space for relationship dialogue between African American men and women, which includes gender and racial distortions. Given the exponentially high numbers of HIV/AIDS cases in the African American community, a more earnest examination of values and beliefs is warranted.

Superwoman schema: African American women's views on stress, strength, and health

Researchers have suggested that health disparities in African American women, including adverse birth outcomes, lupus, obesity, and untreated depression, can be explained by stress and coping. The Strong Black Woman/Superwoman role has been highlighted as a phenomenon influencing African American women's experiences and reports of stress. The purpose of this study was to develop a preliminary conceptual framework for Superwoman Schema (SWS) by exploring women's descriptions of the Superwoman role; perceptions of contextual factors, benefits, and liabilities; and beliefs regarding how it influences health. Analysis of eight focus group discussions with demographically diverse African American women yielded themes characterizing the Superwoman role and personal or sociohistorical contextual factors. Participants reported that the Superwoman role had benefits (preservation of self and family or community) and liabilities (relationship strain, stress-related health behaviors, and stress embodiment). The SWS framework might be used to enhance future research on stress and African American women's health.

Experiência da maternidade no contexto do HIV/Aids aos três meses de vida do bebê

O estudo investigou a experiência da maternidade em portadoras do HIV/Aids aos três meses de vida do filho/a. Participaram seis mães (19 a 30 anos), de nível sócio-econômico baixo, três das quais já eram portadoras da doença quando engravidaram, enquanto as demais souberam no parto. As mães foram entrevistadas e suas respostas foram examinadas por meio de uma análise de conteúdo qualitativa baseada em quatro eixos teóricos: vida-crescimento, relacionar-se primário, matriz de apoio e reorganização da identidade. Os resultados mostraram que as mães tinham muitas preocupações com a possibilidade de infecção do filho/a e com a saúde do bebê, além de sentimentos de incerteza quanto ao futuro, culpa e medo do preconceito. Esses temores pareciam mais intensos para as mães que tiveram seu diagnóstico no parto. O estigma do HIV/Aids, conflitos familiares, dificuldades com o diagnóstico e o tratamento, além de restrições sócio-econômicas e em sua rede de apoio exigiam grande esforço emocional dessas mulheres, sugerindo a necessidade de intervenções psicossociais visando à adesão ao tratamento, à qualidade de vida e ao desenvolvimento do bebê.

My sister, myself: a culture- and gender-based approach to HIV/AIDS prevention

African American women are bearing an excess burden of HIV/AIDS, becoming infected at a rate 25 times that of White American women. This places African American girls at the highest risk for becoming infected with HIV/AIDS. Culturally appropriate prevention strategies are indicated to suppress this trend. Two qualitative research methods were used to evaluate a culture- and gender-based HIV prevention intervention: My Sister, Myself. Community action participatory research was used to engage the community in the development of the intervention for early-adolescent girls. Eight girls participated in the 8-week intervention. Data were collected about culture and gender identification, sexual health knowledge, and future intentions throughout the intervention. Focus groups and observation participation data revealed three major themes: "high aspirations," "needing to know the truth," and "internal, external, and eternal resources." Findings indicate promise for intervention strategies that utilize culture- and gender-based strategies for HIV/AIDS prevention with young girls.

Spirituality

The purpose of this study was to describe how spirituality affected the lives of African American mothers with Human Immunodeficiency Virus (HIV) in the context of coping. This qualitative descriptive study used secondary data of interviews from a larger longitudinal study of parental caregiving of infants seropositive for HIV. Participants were 38 African American mothers with HIV. Data from longitudinal semi-structured interviews were analyzed using content analysis. The women dealt with the stresses of HIV through a relationship with God. Two domains explain this relationship: God in control and God requires participation. The benefits of their relationship with God were a decrease in stress and worry about their own health and that of their infants. It is important for nurses working with mothers with HIV to acknowledge their spirituality and assess how spirituality helps them cope with and manage their illness.