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.