Dale Sannisha K, Safren Steven A
a Department of Psychology , University of Miami , Miami , FL , USA.
b Department of Psychiatry , Massachusetts General Hospital , Boston , MA , USA.
AIDS Care. 2018 Aug;30(sup5):S18-S26. doi: 10.1080/09540121.2018.1503225. Epub 2019 Jan 10.
Black women living with HIV (BWLWH) represent the highest percentage of women with HIV in the U.S. and experience worse health outcomes than other women living with HIV, in part due to experiences of trauma, racism, HIV-stigma, and stressors they face as women. However, their own stories of resilience in the face of multiple adversities and insights of community stakeholders may inform our field on how to best empower this population to strive despite adversities. Thirty BWLWH in the U.S. and fifteen community stakeholders were interviewed about women's experiences and adaptive coping strategies used to cope with trauma, racism, HIV-stigma, and gender-related stressors. Interviews were coded using thematic content analysis. A major theme that spanned across interviews with BWLWH and community stakeholders was that resilience was fostered by members of their "village". In the midst of or following adverse experiences BWLWH used social support from their children, grandchildren, other family members, friends/peers, and caring providers in order to overcome their adversities and focus on their health and well-being. Promoting resilience among BWLWH requires an understanding of the most adaptive strategies utilized to "bounce back" following or in the face of adversities. Our findings highlight that both BWLWH and community stakeholders recognize social support from their "village" as an importance resilience resource. Research and applied efforts need to be geared at strengthening both BWLWH and their "village" in order to promote resilience and reduce health disparities.
感染艾滋病毒的黑人女性(BWLWH)在美国感染艾滋病毒的女性中占比最高,且与其他感染艾滋病毒的女性相比,她们的健康状况更差,部分原因在于她们所经历的创伤、种族主义、艾滋病毒污名化以及作为女性所面临的压力源。然而,她们在面对多重逆境时展现出的坚韧故事以及社区利益相关者的见解,或许能让我们这个领域了解如何最好地赋能这一群体,使其在逆境中仍能奋进。研究人员对美国的30名感染艾滋病毒的黑人女性和15名社区利益相关者进行了访谈,了解女性应对创伤、种族主义、艾滋病毒污名化和性别相关压力源的经历及适应性应对策略。访谈采用主题内容分析法进行编码。在对感染艾滋病毒的黑人女性和社区利益相关者的访谈中贯穿的一个主要主题是,她们的“村庄”成员培育了她们的复原力。在经历逆境期间或之后,感染艾滋病毒的黑人女性利用来自子女、孙辈、其他家庭成员、朋友/同龄人以及关爱她们的提供者的社会支持,来克服逆境并关注自身的健康和幸福。要增强感染艾滋病毒的黑人女性的复原力,需要了解她们在逆境之后或面对逆境时用于“恢复元气”的最具适应性的策略。我们的研究结果表明,感染艾滋病毒的黑人女性和社区利益相关者都认识到来自其“村庄”的社会支持是一种重要的复原力资源。研究和应用工作需要着眼于增强感染艾滋病毒的黑人女性及其“村庄”的力量,以促进复原力并减少健康差距。