Journal Articles: Gender

"The prevalence of HIV/AIDS in African and Caribbean communities in Ontario has grown by 85% in the last 5 years and 22-59% of these infections occurred after settlement in Ontario (Remis, 2004)." -Tharao (Page 1)

Authors: Tiffany C. Veinot; Esther Tharao, Notisha Massaquoi, Senait Teclom; Christopher Fulcher and Catherine Kaukinen

The readings this week have given me a lot to think of in terms of my essay and my eventual masters project. I know I’ve said it before, but this is a complicated issue with so many different directions from which to approach it. The readings have yet to become repetitive but there is a definite trend among them, which is that the circumstances of the lives of many black women in Canada make them more vulnerable to contracting HIV/AIDS and makes living with the disease more of a challenge.

What I came to realize while reading the texts this week is that we seem to know the facts surrounding black women and HIV/AIDS. The next step should be asking how we address it and what policy steps may need to be taken to deal with a huge increase in numbers. I think that is where my research project will enter the discussion, with a focus on services related specifically to black people and women.

Two things stood out in the readings this week: the role African and Carribean women play in efforts to address the problem of HIV/AIDS in their community and the shift in the readings in beginning to suggest policy efforts. In the report Women’s Health in Women’s Hands, Tharao writes “All the research respondents agreed that African and Caribbean women were juggling too many priorities to even think about HIV/AIDS.” The women had other priorities in their lives that took precedence. Added to that is that fact that the people working in AIDS services are often not black women. Which means the women are getting care from people who may find it harder to relate to them, as mentioned in the readings last week.

The lack of a community push to address HIV/AIDS among black was also mentioned frequently in the readings. This is in stark contrast to initiatives by some community services and groups that target gay men.

Veinot’s reading, which emphasized the importance of an integrated approach to dealing with HIV/AIDS was especially interesting. She asserts that prevention, support and treatment of the disease are fundamentally intertwined. According to Veinot the three work naturally together and are the most successful when they are approached in conjunction with one another.

Veinot’s integrated approach to HIV/AIDS reminds me in some ways of Collins’ theory of intersectionality, both make sense in the context of the HIV/AIDS epidemic. It is not a simple disease so the answer to dealing with it could never be simple. This integrated approached, while focused on in Veinot’s reading, comes up in almost all four of this week’s texts. In addition the texts all provide policy recommendations on how to turn the theories and ideas they outline into practical policy and action. I think it’s important to do exactly, to explain how a theory can work in the real world and suggest ways to implement the ideas raised.

More than anything right now it seems actions needs to be taken. The issues have been identified, a lot of their root causes have been brought to light, the next step—the one that has yet to be taken—is to do something to change the current statistics. That’ll take black women themselves, AIDS service workers, policy makers and researchers and, most importantly, the will to change.

Journal Articles - Treatment

"'It was appalling to me to see the loss of legacy that is happening in all of these AIDS service organizations and I think that it goes right back to funding.'" - Roy Cain and Sarah Todd (Page 275)

Authors: Sarah Flicker et. al; Roy Cain and Sarah Todd, Cain & Todd; Raisa B. Deber et. al

This set of readings centre around treatment. An interesting theme that emerged almost immediately in all of the articles is how dramatically treatment and services for people with HIV/AIDS has changed in the years since the beginning of the epidemic. The Cain and Todd reading states explicitly that the introduction of highly active anti-retroviral therapy (HAART) drugs changed the landscape of AIDS services organization and the jobs of AIDS services workers. It went from being about palliative care and preparing for death, to dealing with how live with AIDS and the factors that may have lead to clients contracting the disease in the first place (e.g. intravenous drug use).

While none of the readings deal directly with black women, they are all based on studies conducted in Ontario. They create a clear picture of the current treatment landscape from the perspective of the people who work with clients who have HIV/AIDS. To be honest, it all seems somewhat bleak. The first Cain reading discusses how changes to legislation and funding has negatively impacted the quality and type of care that people with HIV/AIDS receive from social service organizations. While it highlights a number of important points, I found myself wondering what exactly were the policy changes that the workers were dealing with. The second one discusses how the introduction of HAART has also changed the way people with HIV/AIDS are treated.

The most interesting point that both Cain/Todd articles highlight is how the changes in the AIDS services landscape have impacted workers who perhaps entered the field because of a link to the community impacted by AIDS and are now dealing with people who are worlds apart from them. It is sad on both sides, for the new types of clients with HIV/AIDS—those dealing with poverty, addictions, abuse and other factors—and the workers who got into the field when many of their clients were gay males who were dying. Now the clients are different, need more support in terms of day-to-day help and rarely die. I couldn’t help but picture poor black women as I read about service workers who had trouble relating to their clients who needed housing and other help.

It is a strange and interesting set of circumstances. It is also very important that these issues have been brought to light by the studies because this disconnect and the challenges social service workers face play a huge role in the quality and type of care that people with HIV/AIDS (including black women) receive from AIDS service organizations. The studies point directly to a problem or challenge, the recognition of which may be the first step in coming up with new solutions and approaches to treatment and care.

At the same time it isn’t all bad news. The studies showed that there are still people working in AIDS service organizations who care and who are trying, despite numerous obstacles to help in the lives of people living with AIDS. They also point to the power of policy and advocacy.

The shift away from advocacy among service workers is probably a huge detriment to improving treatment. Without the people on the front lines (behind those with the disease) fighting for change in policy from governments rather than simply working around the obstacles erected by bureaucrats the chances of effectively combating HIV/AIDS here in Canada is severely compromised. There was a community element or incentive among the first AIDS service workers discussed in the readings that needs to be reignited I think in order to bring about positive change.

Despite the fact that these were all studies with small sample sizes, they were more effective to me than many of the theory based books I’ve read to date because they were based on interviews with real people. They show clearly the challenges and triumphs of dealing with HIV/AIDS and also, in a very human way, show that despite the challenges like funding and red tape, there is a way forward. It’s really a matter of taking that path. Somebody has to choose to challenge and change the status quo. I’m going to be reading reports by AIDS services organizations that focus on helping black women. I hope to find in them the seeds of people attempting to do just that.

This may be naïve of me, but for some reason in spite of it all the readings this week made a solution to the challenges of treating and supporting people with HIV/AIDS seem plausible and definitely possible.

Journal Articles - HIV/AIDS and Black Women

"Recognize where you are within this country and system. Black women we are at the bottom, period. And if you know that then you can operate on a better ground, you can fight your battles differently (under 30 focus group)." -Williams et. al (Page 18)

Authors: Lauren L. Josephs & Eileen Mazur Abel; Peter A. Newman, et. al; Esther Tharao and Notisha Massaquoi; Charmaine C. Williams et. al

The readings this week were, once again, part of a natural progression in understanding what impacts and effects HIV/AIDS has on black women and black communities in Canada. All four were journal articles based on qualitative studies with groups of black women in Canada meant to understand a particular element of how HIV/AIDS affects black women.

All of the studies recognized from the outset the diversity of this group within Canada when it comes to education, immigration status, income and experience. But at the same time they used questionnaires and focus groups to attempt to understand how this diverse group that is so significantly (and at this point somewhat inexplicably) affected by HIV/AIDS conceptualizes the disease and its place in their lives.

The studies began to provide answers and suggest areas for further research. All of the readings date to the early 2000s which seems to be when researchers and healthcare practioners began to notice and address the disportionate rate of infection of HIV/AIDS among women and especially black women in North America.

The readings have now moved away from theory and have begun to focus on the practical and real life impact of HIV/AIDS among black women. I think it is an absolutely necessary step, critical in fact, to begin to talk to the groups impacted by a particular trend once theories have been established about why it may be happening. Theory can only take you so far before you need to actually go out there and try to figure out what is going on—the readings this week represent that step. The authors are mostly social work professors and HIV/AIDS community workers with a direct link to the group of women (black women) discussed in this course and this set of readings.

What I found especially interesting that came from all of the readings is the emphasis the women in the studies put on the need for “culturally competent” treatment and prevention strategies. It’s a smart term that makes more sense to me than "culturally sensitive" in relation to HIV/AIDS strategies for minority women. It becomes less about sensitivity and more about being effective.

The readings all attempt to understand the root causes of the high number of HIV/AIDS diagnoses in black women in Canada. They all come back to what seems to be a triad of reasons that have come up in most of the readings: gender, race and poverty or economic disadvantage. The quotation used above speaks to that and the challenges black women face on a day-to-day and what makes them vulnerable as group.

Josephs et. al’s intimate partner violence study was especially interesting to me because it addresses an issue that has come up a few times in the course, whici is the disadvantage many black women face in relationships and their lack of power when it comes to asserting the use of safe sex strategies. It was also the first, but not the last, of the readings to point out that current HIV/AIDS prevention strategies and campaigns are ineffective in black communities because they were mostly established in the 80s when the disease was socially constructed as a white, male, homosexual disease. Josephs’ study points to the need to move beyond those understandings of HIV/AIDS.

Josephs makes an assertion that rings true for this set of readings and for course itself when he writes, “Understanding the cultural factors that impact the spread of HIV is vital to the developing culturally competent intervention and prevention strategies,” (227). It is a theme that has emerged in the course and is one that seems to point the way for the next step in dealing with HIV/AIDS among black women, which is putting in place prevention strategies that speak directly to the realities of the lives of black women in North America. I’m interested to see if and when that step will be taken by policy makers and AIDS community workers.

African American Women and HIV/AIDS: Critical Responses

“..We are guided by our desire to privilege the voice of African American women, arguably, the most disenfranchised and least understood population in AIDS-related research and literature on women.” – Gilbert and Wright (page xii)

Authors: Dorie J. Gilbert & Ednita M. Wright

This book represents a shift in the readings from talking about the disease and its abstract impact on the lives of people who have it to talking with and about women living with HIV/AIDS, specifically black women in America. It is an important and necessary shift at this point in the course. I have had the chance to get familiar with concepts and theories that surround HIV/AIDS among black women and to develop a better understanding of the disease itself and approaches to dealing with it in both academia and in medicine.

I am more than ready to begin to deal more with what it means for a black woman, a human being, to contract and live with HIV/AIDS. Gilbert and Wright’s book is particularly useful because it not only discusses familiar concepts and ideas surrounding the HIV/AIDS epidemic, but it also speaks directly to African American women and considers solutions that have been sought to the challenge of HIV/AIDS among black women. This reading put a human face, that of a black woman, on this discussion of the disease.

It also highlights the factors that make African American women more vulnerable to contracting the disease. In this part of the discussion the text mirrors many of Collins’ ideas about the intersectionality of race, gender and class and the authors add stigma to the conversation. They even have a section that notes specifically that not enough is known about black sexuality, a lack that Collins’ book begins to address (16).

Many of the sociocultural causes of the spread of HIV/AIDS among African Americans, and women in particular, that the authors point out have come up in other readings and were things that I had figured out on my own. This includes factors like poverty, institutional racism and gender. But Gilbert and Wright also point out other interesting potential roots of the epidemic of HIV/AIDS among black women in America. This includes substance abuse, which has been hinted at in other readings, but Gilbert and Wright go into a detailed discussion about the history and roots of this problem among African American women and men and how it encourages the spread of HIV/AIDS.

The authors also point out disparities in health and mental health care and access as important factors. The gender imbalance among African Americans (more available women than men) is another interesting factor they also discuss. It speaks to the vulnerability argument that Collins’ makes in her book. Because there are less black men to go around, they argue, black women are more willing to accept less from a partner including overlooking infidelity in order to keep them and the security they often represent.

The text also builds on what Triechler introduced in her book about the social construction of HIV/AIDS. They agree that it was first established as a white gay male disease which left little room for other groups being infected with the virus. The authors attribute this initial construction of the disease to why early prevention campaigns targeted to the gay community had little impact among African Americans—they didn’t speak to them culturally.

The reading discusses how a group of nine women interviewed by one of the authors were each coping with having HIV/AIDS and their personal circumstances. Wright describes their situations as “living with dying,” (151). The details provided about the women’s state of mind and how they have lived and dealt with living with this disease is exactly what I’m interested in addressing for my masters project.

My original intent was to read select chapters of this book because I didn’t expect it to be relevant in its entirety to this course, because of its focus on American women. I think I’m right about it not being completely relevant to the course, but its content is important in terms of helping me understand the details of the issue for black women in North America, which is why I will finish the rest of the book for my own personal (and academic) purposes.

Women's Health in Canada: Critical Perspectives on Theory and Policy

“As the pandemic enters its third decade, making useful sense of how to address women’s experiences of HIV/AIDS remains a challenging task.” - Meredith Raimondo

Ed: Marina Morrow

This week’s readings were particularly useful. They helped bring together a lot of concepts that have come up over the course of the readings and put them into a Canadian context. They highlighted the interconnectedness of different elements of both the disease and debates surrounding it. This is particularly true in terms of understandings of gender, which was discussed in the introduction; the role poverty plays in conceptualizations of health in Canada in the Reid chapter and the impact of HIV/AIDS on women in the chapter by Meredith Raimondo.

The introduction of the text addresses the debates around the concepts of gender and sex as social and biological terms. An interesting point made in the reading is the fact that gender refers not only to men and women but also to the relationship between them. Added to that is the placement of transgendered, transsexual and others that exist beyond the binaries of male/female. Women’s health is Canada is not as simple as one might think.

The reading focused on women and HIV/AIDS was especially beneficial. As the quotation above hints at, addressing women’s experiences in the AIDS pandemic is what’s being talked about at this point. The debate is only beginning now in terms of the disease as it relates specifically to women. This means that addressing forms of gendered treatment and prevention may still be overlooked. The same tension I talked about in my earlier posts regarding theory and practice in dealing with HIV/AIDS appears in Raimondo’s discussion of women and the disease.

This reading also supplies some of the statistics to back up what I’ve been inferring about women and HIV/AIDS since the beginning: that women are at risk of HIV/AIDS at an increasing rate. According to the reading there was a 48 percent increase in the number of Canadian women living with HIV from 1996 to 1999 and those numbers have continued to rise (386). The percentage of women among newly reported diagnoses also grew steadily from 2001 to 2003 (386).

The final idea that was introduced in this reading and that I expect to follow up on during my research is the concept of vulnerability. Vulnerability, in the context of women’s health and HIV/AIDS, is based on the idea that the social implications of being female make women uniquely vulnerable to contracting HIV/AIDS. It is essentially a concept of vulnerability as it stems from social factors, it “…emphasizes the social factors shaping the AIDS pandemic,” (390). Raimondo also notes that ethinicity, race, class and age are also important distinctions that shape rates of HIV infection in women.

This highlights an important point that was brought up a number of times in the course of these readings, which is the fact that gender is intertwined with other factors that all work in conjunction to impact women’s health. Raimondo writes that “while genders is clearly a factor in social vulnerability, it is not the only, or in some cases, the most important factor,” (392). She adds, “An attention to vulnerability requires attention to the complex contexts of women’s lives,” (392), this is an important point to make and one that I have tried to remain aware of in the context of this course.

Women, including black women, have specific circumstances in which they live their lives and taking those into account are necessary when trying to understand how a disease like HIV/AIDS impacts them as a group. Life is complex as is this disease, which means while doing research as it relates to women and HIV/AIDS, it is important to always be sensitive to those realities. The challenge of this project will be to keep these in mind throughout the process because it is very easy to oversimplify and gloss over things for the sake of getting to the heart of the story.

Race, Ethnicity and Women’s Health

“Where the type of health care products and services available responds to the needs of a diverse population, progress towards health care equity is possible…” –Shariff et. al (page 125)

Ed: Carol Amarantunga

In the course of these readings I’ve developed an interest in health policy and how theories and research may lead to health care and policy that is sensitive to culture. What I mean by “sensitive to culture” is a type of practical, clinical approach to care at hospitals and family doctors that take into account the potentially different needs of a person from a place like Jamaica, who may prefer a more holistic approach to health care. Or it could mean that a hospital has staff able to translate for non-English or French speakers so that patients are better able to express their concerns and understand their diagnoses. It is a direction in health care policy that I think could and would make a difference in lives of black women living with and at risk of contracting HIV/AIDS.

Based on the reading this week and last week, I’ve chosen my essay topic for this course. Accessibility of health care is especially an issue for new Canadians and is something that affects the quality of life of persons living with AIDS and those at high risk of contracting the disease. Because black women in Canada are often (although not always) immigrants, culturally sensitive health care could play a role in combating the spread of HIV/AIDS in this group or in mitigating the damaging affects of having the disease.

The roles ethnicity and race play in health care, access to health services and policy in Canada directly relate to the issue of HIV/AIDS among black women in Canada, especially when it comes to treatment and care. I don’t have a clear thesis or focus at this point, but these readings have definitely helped me recognize my interests.

The readings this week come from on text on race, ethnicity and women’s health. The chapter I read examines the immigrant experience as it relates to health and health care. I think this was an important topic to address in this course because of the fact that a significant percentage of black women in Canada are immigrants.

I found Wanda Thomas Bernard’s chapter on inclusion especially interesting because it looks at theories based on exclusion and inclusion and addresses them from the practical experiences of immigrant women in Canada.

While the readings are regionally focused and all based on research conducted in the immigrant community in the East, the researchers draw conclusions that add to the larger national discussion of ethnicity and health care. I think they were important for me to read because they gave me a sense of the type of research being conducted around the issues of health care, access, ethnicity and immigration and the questions being asked related to them.

My only concern while reading these chapters was that the research seemed to be there, but there was no evidence that the work actually translated to policy. It’s a question I think I will look into for my own knowledge.

Another important element of this set of readings is the perspective from which the researchers address the issue. The readings this week build on what Bhopal discussed in his text. While Bhopal’s work is based on epidemiology and research affecting policy from the point of view of the researcher, the readings this week approach the issues of race and ethnicity and how they relate to health from the perspective of immigrant or “other” race or ethnicity. They rely on qualitative research conducted in PEI, an admittedly limited pool, to draw conclusions about the female immigrant health experience in Canada.

In these readings the reader gets to hear directly from the people who the research is being conducted based on through quotations and relation of answers in the study. It helped me realize that there is a certain level of validity to this type of qualitative research when it relates to groups that are often marginalized and not given a voice in wider society.

The readings this week felt less personal this week in that I didn’t find myself comparing my experience to those related in the text. But they were just as important as any other I’ve encountered to date because of the broad perspective they offer.

Ethnicity, Race, and Health in Multicultural Societies: Foundations for Better Epidemiology, Public Health, and Health Care

“Race has played a major role in the way societies work and intereact and the cocept has been abused in the past to justify inequalities.” -Raj S. Bhopal (Page 10)

Author: Raj S. Bhopal

This reading is an introduction to a text that focuses on improving health using race and ethnicity in multidisciplinary epidemiological settings. I found it relevant to this course because it directly addresses a key element of the discussion of HIV/AIDS among black women: race. But the author approaches race and also ethnicity from the perspective of an epidemiologist and discusses how taking into account race and ethnicity in research may help or hinder advances in medical research and policy.

This introduction is especially useful because it discusses the concepts of race and ethnicity theoretically, socially and scientifically. It also addresses how human understandings of the two terms have evolved over time. On a more practical level, Bhopal discusses how race and ethinicity may be used as variables in research. This made me wonder how gender and race could be used as variables in HIV/AIDS research.

But at the end of the day, the reasons why HIV/AIDS seems to be affecting black women disportionately to other women and groups are more social than biological. Bhopal’s work speaks to this idea simply because he discusses the power of race and ethnicity in forming prejudices and biases. He also addresses the history of using race based theories to explain the inferiority of some races compared to others and while he sees the benefits of using both race and ethnicity in research he does so with caution all while acknowledging the negative that may come out of it. He writes, “since interest in, and the influence of, research on ethnicity and race is increasing it is important that the conceptual basis of the work is sound,” (9). He seems to be saying that people are going to use the two concepts as variables whether we like it or not, so the next essential step is to clearly define and understand the terms. For that reason Bhopal spends a lot of time explaining and discussing the differences between the two terms.

He goes on to talk about their influence. He writes, “Directly or indirectly, race and ethnicity have a major impact on populations’ health patterns,” (7). The indirect impacts (social results of being from a particular racial group) are what I am most interested in in my research and how ackowldeing them in AIDS related research may help in addressing the spread of HIV among black women. If this type of research would be beneficial or capable of… helping black women deal with the challenge of HIV/AIDS.

Bhopal acknowledges that race is social rather than biological construction but still asserts that is a useful tool for analysis. He devotes an entire section in the reading to discussing the social harm that has been and can be caused by the two concepts. He also makes a good case for the idea of environment as a causal factor in disease, specifically the social conditions of a given group.

I don’t disagree with Bohopal’s assertions, in fact I agree with a lot what he has to say about race and ethinicty. Mainly because he is relying on the facts of social and scientific history in his discussion of race and ethnicity and how the terms have been used and may be used in the future. This is by far the most practical reading I have yet to study because it addresses how these concepts and their use may impact research and then eventually policy.

The policy part is also what I’m interested in. Specifically Bhopal outlines how research using ethnicity or race as variables may influence the development of health services and individual clinical care. Research that looked at treating HIV/AIDS or caring for patients with the virus with a focus on race, so black people, or ethnicity, so a specific cultural group like carribeans, would be beneficial in developing policy and standards of care that could be more considerate of the culutural backdrop of a patient’s experiences and their specific needs.

A large majority of clinical care is focused on the general population, perhaps to the detriment of patients in minority groups. A more targeted approach to care could make a huge difference and research that encourages finding that out I think at least is important.

This is a reading from which real and positive results could be developed from. It is important work for that reason.

"Black Sexual Politics and the Challenge of HIV/AIDS"

"Understanding how ideas about Black masculinity and Black femininity affect interpersonal relationships is intrinsically important, and it is necessary for addressing HIV/AIDS." -Patricia Hill Collins (Page 290)

Author: Patricia Hill Collins

In this section all of Collins’ ideas converge on the very practical results and reality of the current state of black sexual politics: HIV/AIDS. The issue of AIDS among black people in America and around the world is a important example of why black sexual politics matter.

Before beginning the text I was most interested in reading this chapter and the conclusion because it has the most relevance for the topic at hand, HIV/AIDS among black people. The entry point of black sexual politics is also important because it includes black men in the discussion. I’ve been having trouble doing that in my research. Despite Collins’ thorough investigation of black sexual politics and the new racism, I found this section something of a disappointment.

Collins spends most of the first part of the chapter discussing the idea of honest bodies and the dishonest body politics of black sexuality. While an interesting discussion of the metal, spiritual and physical aspects of sexuality, I did question what it had to do with HIV/AIDS. It seems to come out of nowhere.

That being said, when she does eventually get to a discussion of HIV/AIDS and how black sexual politics play a role in the spread of the disease, Collins does a good job of tying her theories into the practical realities of the disease. She shows how the social conditions of blacks exacerbated by black sexual politics and male and female gender identities allow for the continuing spread of HIV. She states this explicitly when she writes, “The issues raised by the HIV/AIDS epidemic suggest the need for a progressive Black sexual politics is far from an abstract, academic concern,” (296).

And it really is not just about abstraction, despite the detailed discussion of “honest bodies.” While reading this section and the conclusion I noticed a strange dichotomy present itself in the tension between Collins’ practical authority versus her theoretical authority as an academic when it comes to a discussion of HIV. She writes with the same assertiveness I took issue with in previous chapters about AIDS but in some ways lacks the practical qualifications (e.g. medical expertise) to do so. This points to the same tensions that exist in addressing the issue of HIV/AIDS, that being the practical need to find a cure compared to the theories and concepts that attempt to account for its spread between people within a given group or society. Collins does not ever discuss that tension and I assume this is because her text focuses more on theory and politics, moreso than the medical dimension of HIV and AIDS.

Another interesting and important point that Collins brings up is the concept of the “black community.” It is a term that has already appeared a few times in my research and one that I have been cautioned to avoid because, to a certain extent, no single black community exists. It is extremely heterogenous and diverse. Different social classes, ethnicities and cultures of blacks have various ways of dealing with sexuality, community and issues like HIV/AIDS.

Collins suggests that one way of moving towards a progressive black sexual politics may be in “…developing inclusionary definitions of Black community,” (296). She goes on to discuss two ways of understanding the term and acknowledges that it would be hard for black people to conceive of themselves as a single a community and why it may not be beneficial. She notes specifically that having one notion of blackness within a single community will privilege some forms of blackness and disadvantage others (e.g. the mammy over the bad black mother in current conceptions of black women).

Before reading Collins' ideas about community, I found myself defending the idea of the black community and my choice to use the term in my work. Mainly because having black skin connotes certain social experiences that no matter your background is often universal. At least in my opinion. But I recognize that doing so doesn’t take into account personal experiences with race that individual black people have. There is some validity to my defence and more thought needs to be put into reconciling the two views, but even Collins agrees that some concept of community among black people is valuable and to some extent necessary. I think as I continue my research I will be able to come to a better way of understanding and using the term.

Collins has given me a lot to consider and to keep in mind as this project develops. Black sexual politics matter and will continue to matter among black people especially when it comes to issues like HIV/AIDS and its affect on black women.

"Rethinking Black Gender Ideology"

"Domestic violence, the decline of marriage, the spread of HIV/AIDS, substance abuse, adolescent pregnancy, and similar social issues all refelect, in large part, the damage done by prevailing Black sexual politics." -Patricia Hill Collins (Page 199)

Author: Patrcia Hill Collins

This section addresses black gender ideology, both male and female. This wasn’t a section I had intended to read in its entirety, but the issues and ideas that Collins brings up are quite relevant to the overall discussion of black women and HIV/AIDS. Specifically the section highlights the tensions that exist between black women and black men in terms of gender and the larger societal conflicts between and among these groups. How black men and women relate to each other and to society as a whole is an important element of the discussion of HIV/AIDS among black women. This is partly due to the fact that large portions of black women are contracting HIV through heterosexual sex with black partners.

The section also refers to important social and historical roots of what may be factors which put black women more at risk for contracting HIV/AIDS, specifically their marginalized social and economic positions within society. Collins presents ideas surrounding images of black gender through a class lens examining both male and female working class and middle class blacks.

She presents two images each of gender ideologies related to black women and men. According to Collins, black women are depicted in two ways within contemporary North American society. The working class black female is perceived as being a “bitch” and a Bad (Black) Mother, while images of the middle class black woman stem from ideas of modern mammies, black ladies and educated bitches. Working class black men in contrast are defined by images of the athlete and the criminal while their middle class counterparts are relegated to the role of sissies and sidekicks in wider societal depictions.

Collins asserts that these images are widely produced and reproduced through the media and popular culture. She uses examples like Destiny’s Child songs and Danny Glover film roles as evidence. I can’t dispute the fact that some of the images that Collins refers to are quite prevalent in the media (which can include news, television, movies and other outlets of popular culture), but I found myself wondering how true they really are. The images Collins points out are stereotypes. It would be easy to dismiss them as such, but Collins also shows how these stereotypes have real affects on the lives and situations of black men and women and their ability to advance as a group and individually within American society.

I found Collin’s discussion of hegemonic gender ideology and its impact on black gender ideology and relation to black sexual politics especially interesting. The historical views of black men and women tie in to current perceptions of black women and those perceptions exist, according to Collins, in opposition to contemporary hegemonic gender ideologies (i.e. the dominant white male and submissive white female). The main result of this and Collins’ discussion in this section is the continued disadvantaged position of African Americans in American society. Collins also continues to make a case for structural causes of African Americna disadvantage in America without explicitly saying so.

While I found Collins’ discussion in this section intriguing and worth considering, I was somewhat sceptical of a few of her assertions, simply because they were so adamant. Collins’ phrasing doesn’t allow for other interpretations of black gender ideology and black sexual politics. I do not disagree with what she writes, but I did find myself adding caveats to it, saying something doesn’t make it true and Collins’ approach ignores that fact to a certain extent. For example in the section on black female gender ideology Collins concludes at one point that “Aggressive African American women create problems in the imperfectly desegregated post-civil rights era, because they are less likely to accept the terms of their subordination,” (138). This is an interesting point, and perhaps true but the way it is written makes it sound as if it were the gospel—the only truth. In it Collins speaks for an entire group of people and how they are viewed by society. I just think that a caveat of some sort, that this is her interpretation based on her theories, is necessary and is not provided at multiple points in the text.

She speaks with an authority I don’t think is hers in entirety. It just makes me weary in terms of her speaking for all or making assertions about all on both sides of this—black males and females as well as speaking for wider society. This point also makes me wonder who exactly the text is written for; that is, who is Collins’ intended audience, African Americans or people outside of that group? As a black person reading this I can easily agree or disagree with Collins’ points based on my own experiences and those of other blacks close to me. But I would assume that someone who isn’t black reading this text is going to take away different things (not necessarily good or bad) from Collin’ work. Which is what makes me wonder who exactly her audience is—that’s more an issue of my own curiosity than something that needs to be addressed in the text though. I also recognize that her audience would include people from both groups.

With only a few concerns on my part, I think this is an especially valuable text and section in attempts to address African American gender theory. It is an important text in understanding the historical, current and evolving roles of black men and women and their relations to one another.

Black Sexual Politics: African Americans, Gender and the New Racism

".... in the context of the new racism, men and women who rescue and redefine sexuality as source of power rooted in spirituality, expressiveness, and love can craft new understandings of Black masculinity and Black femininity needed for a progressive Black sexual politics." - Patricia Hill Collins (page 51)

Author: Patricia Hill Collins

I've decided to spend two weeks on this book, because so much of the content directly relates to the topic of this course and my eventual research project. Black sexual politics in many ways determine the spread of HIV/AIDS among black people. Going into this reading I assumed the term black sexual politics, referred to the ways in which black people related to and interacted with one another sexually. On one level I was right, but for Collins, sexual politics are somewhat more... political.

In the introduction and the first section of the book titled "African Americans and the new racism" Collins makes a case for a new type of racism that exists within American society. Her definition of the term seems to be something she is working through within the text, because she never explicitly states a clear one. Based on the black experience in America, from African colonialism, through slavery and into the post civil rights era Collin describes the development of a new type of racism that is a deeply imbedded ideological forms of societal slavery. Without stating it explicitly, the new racism that Collins refers to seems related to structuralist theories in that it is a less explicit racism that is deeply embedded in the consciouness of black and non-blacks alike and, more significantly, into the fabrics of contemporary American society. It exists within the structures of society.

The sexual politics that Collins addresses in the text stem from this new racism. She writes that "Black sexual politics occur at the particular intersection of gender, race and sexuality," (6). What Collins argues, essentially, is that gender issues, racism and other forms of social disparities or oppression among Black people in American society are all deeply linked. She explains that achieving social justice requires addressing all levels of oppression or inequality. In the introduction she uses a childhood anecdote about an experience of racism to enter the topic. She concludes that "knowledge and power are deeply linked, and achieving social justice requires attending to both," (3). From there she shows how gender and race issues are also linked.

While what Collins argues makes sense on a basic level, I find myself waiting for her to convince me of it completely while reading the text. I agree that addressing homosexuality among black communities and the struggles of black LGBTQ people is a key element of addressing larger race issues in America, really it only makes sense. But, Collins states it so adamantly that I need her to explain why. She does. She explains the reasons behind LGBTQ people historically having been ignored in a discussion about slavery and emancipation and why the issues the group faces need to be addressed now. What it comes down to for Collins, I think, is that nothing exists in isolation and to assume so will make it that much harder to find solutions to problems like racism and systematic inequities.

So this isn't just a book about black sexuality, but about the interconnectedness of sexuality gender and race. It is heavier on the politics but links them to sexuality and gender and race. Collins also discusses the fact that the black experience of racism and other forms of oppression are gendered, meaning that the black female experience of racism stems from different assumptions about her sexuality or gender and race than the black male's; this then means that how those assumptions play out are also different. For example, Collins explains how racial stereotypes about blacks differ for black men and women, wherein the women are seen as inherently promiscuous and the men naturally hyper-sexual and violent. Collins provides a good explanation for why this perception and others like it matter. It is a part of the foundation of what has become institutionalized racism in many sectors of American society.

One quibble I have with Collins after having completed the first section of the text is how much time she spends on the historical roots of racism towards blacks in America. It is a story that has been told and dissected to death. While her ideas are new and how she applies this history to her concepts are different there were points while the book where I found myself thinking that what Collins had to say was not particularly ground breaking. But as she continues to develop the concept of this "new racism" I expect to get a lot out of this reading.

I think this book will provide a foundation for my understanding of how the spread of HIV/AIDS among black women is occuring and what factors make black women as a group more vulnerable to contracting and or spreading the disease. The next part of the reading addresses female sexuality specifically and the issue of HIV/AIDS.

Being a black female I find myself very much invested in what Collins has to say about this topic. It is very easy to say that this issue (HIV/AIDS, American racism, black sexual politics, etc.) isn't about me because I don't have HIV/AIDS and I don't live in the United States. But the fact is that how black people and women as a group are perceived in the United States and around the world has a direct impact on my life. These issues also play a role in Canada, if only for how certain prejudices about blacks formed out of American history have been normalized and have migrated north of the 49th parallel. I am not separate from this and while Collins is subtle about it, she makes it very clear that this is a topic for every black person (and non-blacks). One can't remove his/her self from the conversations, luckily I don't particularly want to.

The HIV Pandemic: Local and Global Implications

"It should be recognized that an integrated approach is needed; no single intervention operating in isolation is likely to have a significant impact on HIV incidence in a population. What works today may not work tomorrow." - Strathdee et al (page 67)

Editors: Eduard J. Beck, Nicholas Mays, Alan W. Whiteside, José M. Zuniga

I found this week's readings absolutely fascinating. It was dry and mostly based on facts, figures and statistics, but it was information I needed to know and had never encountered before. This was a change from Treichler's theory based text but also a natural next step. The knowledge I gained from last week's readings allowed me to critically evaluate the implications of the information presented in The HIV Pandemic: Local and Global Implications.

For example, I noticed that the text engaged with women as a group only as they related to the topic of mother to child transmission of the disease, which is a trend Treichler mentioned in her text. But while most of the section was focused on treatment of men who have sex with men, it was very good at acknowledging other groups and highlighting the differences in treatment options that exist within different populations both within a country and in other countries in the world.

What especially interested me in this text was the first chapter on prevention programs. Strathdee et al. outline three levels of intervention in the chapter: individual, group and community. While reading the section I began to consider how these intervention methods might apply to my group of interest, black women. The authors describe why each level may or may not be affective within a particular population. They conclude that community level interventions are the most effective based on studies involving men who have sex with men. While reading the descriptions of the different methods I found myself thinking that the community level would also be the most effective with black women in Canada because of the challenges of sustainability of the other two because of costs and the pressure on resources. Given the programs that currently exist in Ontario that target black women as a group, I have to conclude that others have agreed with me as they are primarily community level initiatives.

Other elements of the text were quite challenging to get through. Parts of it felt as if I had been transported to a university level chemistry course except that I didn't have any of the pre-requisites. I found myself pausing often to look up terms and information on the behaviour and replication of viruses. This is particularly true of the section on antiretroviral treatment and care of HIV. While complicated, the chapter does give a through explanation of how these drugs work and why they are affective in a North American context.

The section is also successful at providing a basic understanding of the many complexities of treatment. Not only are the drugs themselves hard to pronounce and they way they work harder to understand without a degree in science, but the efficacy of these treatments and their availability vary by country and level of development. The reading makes it very clear that access to certain regimens and treatment and prevention methods vary depending on the ability of a society or group within a society to afford them. This is especially relevant when it comes to my particular group of interest, because this is a very diverse group with varying levels of access to care and treatment. That being said, the fact that they are in Canada puts their treatment options far above many similar populations in other parts of the world.

The reading also makes it clear that while there has been a lot of development in treatment of HIV since it was first discovered, treatment of the virus is an ongoing and sometimes arduous process. Joep MA Lang in his chapter on antiretroviral treatments, first explains the many treatment options and how they works and describes how successful they have been. He adds a very important caveat though, which is that antiretrovirals have to be taken throughout life on strict schedule to avoid drug resistance in the virus. This lifelong treatment also leads to chronic toxicity over time with effects that may lead to disfigurement.

When I first became interested in this topic I saw a movie that chronicled the experience of four women in toronto living with HIV or AIDS. Each of them showed their daily regimen of drugs, the image of the one woman who was not taking her pills regularly and had developed full blown AIDS has remained with me. She was virtually emaciated and constantly ill from her disease and the illnesses that come along with it. She eventually died. I think the reason the film and this woman come to mind when I'm reading a very factual text on HIV/AIDS and treatment methods is to remind me that this disease is not about test subjects and chemistry--it is, at the end of it all, about the lives of people.

I learned a lot reading this text, things that I need to know and understand as I move forward with this course and my project. Treatment of this disease is a very complex process, that becomes even more complex as it targets specific groups or societies. But the most important thing I learned is that while HIV/AIDS has a lot to do with chemistry and biology (and that is where an eventual cure will stem from) I can't forget that it is a disease that is also entirely human and social.

A Feminist/Female Perspective

"... the AIDS epidemic is a feminist issue: it shows the cultural silencing of women, their exclusion from debates about their own fate, and their dependence on those who are more powerful to represent them," (Treichler 271).

I have a particular interest in gender and race in the context of HIV/AIDS because my research project is on in HIV/AIDS among black women. I just finished Treichler's chapter on AIDS, identity and gender inscription in How to Have Theory in an Epidemic. It's given me a lot to think about in terms of the role of women in the AIDS epidemic.

This chapter on women shows how, from the outset, women and particularly feminists had to fight for a seat at the table in the AIDS debate. According to Treichler, the disease was considered an upper-class, white male disease for a long period. This means women were not taken into account in terms of research, treatment, understanding the disease or even activism except as they related to men.

Treichler points out that when the disease was primarily characterized as one that mainly affected homosexual males and heterosexuals in the third world, it was that much harder for women to be acknowledged as having a role in the HIV/AIDS epidemic. This means that everything from education and prevention efforts to clinical trials and statistical research excluded or overlooked women. When women were considered it was often in the periphery, so as partners of "at risk" male groups like intravenous drug use.

In the chapter Treichler details the battle to have women, particularly lesbians, included as a potential risk group for HIV/AIDS. I would guess that without being part of the conversation or included as an at-risk group women were perhaps in some ways more vulnerable to contracting HIV. Treichler describes newpaper and magazine articles that essentially told women they weren't at risk of HIV/AIDS at all. Even scientists participated in what I consider a strange practice, there was research that concluded women were more receptacles or carriers of the virus (particularly prostitutes), but were not nearly as susceptible to AIDS as men.

I found myself thinking that if not for activists placing women on the agenda we'd be far behind where we stand in terms of the role of women in the AIDS epidemic. It's terrifying especially given the fact that the number of cases of women diagnosed with AIDS is currently increasing at one of the highest rates in Canada. It makes me wonder just how far behind the scientific research is as it relates to women and HIV/AIDS is now.

I am also left with a lot of questions. What is it about women that make them a risk group? Is there a particular type of woman and if so what is that type? How can an entire sex be categorized into one homogenous group, and if they aren't how can women be categorize?What can be done? is perhaps my most pressing question about the effect of HIV/AIDS on women. I hope that my upcoming readings will help answer some of these questions

As a journalist I seek understanding and to relay that understanding to my audience. This first reading has shown how with a topic like HIV/AIDS there is a lot more to consider and many intertwined elements to the discussion. I will have to tread, not necessarily lightly, but perhaps armed with the knowledge to needed to handle this topic as it deserves to be--recognizing its complexity and its many layers.

How to Have Theory in an Epidemic: A Cultural Chronicle of AIDS

Author: Paula A. Treichler

"AIDS is a war whose participants have been in the trenches for years, surrounded daily by death and dying, yet only gradually has the rest of the population come to know that there is a war at all." - Treichler (page 2-3).

In some ways, HIV/AIDS and research surrounding the disease is extremely practical. It is a deadly disease of the body that demands treatment. This text raises the question of whether theory even has a role in an epidemic, especially one like AIDS that is so widespread and was for so long deadly. Yet Paula Treichler, shows how and why it is important to develop theories to frame and discuss the disease among academics, medical practitioners and AIDS activists. In the process she also highlights the tensions that exist between theory and practice in efforts to understand AIDS.

Treichler begins How to Have Theory in an Epidemic by acknowledging the people who are infected with or who have died from AIDS. This adds a very human element to the discussion and the disease itself that is emphasized throughout the text. I would say this is a necessary inclusion, but AIDS at the end of the day is about people--people living with it, people contracting it, people doing research about it and people acting because of it.

Treichler's book is about the cultural development of AIDS and how the disease came to be understood and positioned in society through different groups and actors (particularly activists, clinicians and academics). She explains in the prologue that she is looking to find out what theory tells us about AIDS and what AIDS tells us about theory. She does this by discussing language and culture. Through these two concepts she addresses the larger question of what the role of theory should be in an epidemic.

What I find interesting about the text is that while Treichler shows why theory is necessary in an epidemic, I don't think she shows how exactly to have theory in an epidemic. For example, in the final chapter, "How to Have Theory in an Epidemic: The Evolution of AIDS, Treatment and Activism," Treichler chronicles the development of the disease with a particular focus on treatment related activism. While the chapter clearly shows the need for theory in discussions and debates surrounding AIDS and in some cases how theory showed up, she does not explain the role of theory or how to bring theory into the conversation. What she does show in this chapter, and what I think is important, is how to develop theory out of practical debates about HIV/AIDS. So in the case of AIDS, at least based on what Treichler writes, theory stems from practice. It's almost backwards influence compared to, for example, a field like psychology where theory influences how a psychiatrist addresses a patient's issues e.g. a Freudian approach to therapy.

Treichler uses the example of community based research programs to show how theory operates in an epidemic. It's different. She says, "this [type of work/research] is what theory in an epidemic requires," (311). She explains the value of these programs and their role in developing theory when she writes, "What is incontrovertible is that the volatile interactions entailed by these broadly inclusive debates--in both the short and long term--will have consequences not only for people with HIV infection but for the culture as a whole," (310).

When I first began to read this text, I was weary. As a journalist, I am not a fan of theory. I prefer concrete concepts and definitions. Treichler seems to understand the need for a practical approach to AIDS, but also the need to properly understand the disease conceptually and how it is viewed within the context of society. The question "what is AIDS?" can and will be answered in so many ways, by so many different people.

As a journalist and a person interested in how AIDS affects a particular population, it is important for me to understand that fact. It is absolutely imperative that I approach the disease with the understanding that not only is it a biomedical issue, but also a cultural one. Treichler's book has in many ways provided a firm foundation from which to approach the rest of my studies and research into this very complex and multifaceted disease. A disease that has changed the lives of peoples the world around.