Exploring meaningful experiences of black women with HIV: a qualitative study of relational care practices and spirituality
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Abstract
Black women living with HIV share a common history of oppression and marginalization as people of African descent, as women, and as individuals living with HIV. The purpose of this study is to explore meaningful and health-giving relationships of Black women living with HIV in Massachusetts, a largely marginalized and invisible group of people, and to discover the relational experiences that they identify as contributing to their psychological and spiritual well-being. The method includes a literature review of therapeutic approaches drawn from medical science, psychology, and Black feminism. The medical literature in nursing and community health care reveals the value of holistic approaches to care for Black women with HIV, especially care that affirms the women’s strengths and internal resources, including spiritual life. The psychotherapeutic and Black feminist/womanist literature reveals the value of attending to Black women’s experience and trusted relationships. The research method of this dissertation also includes a qualitative study with seventeen self-identified Black women who are HIV-positive, with varied religious and spiritual beliefs, from the Boston area, using semi-structured interviews to elicit their experiences. Drawing on principles of grounded theory and an ethogenic approach to analysis, the results reveal that participants value relationships that offer institutional support and intimate support. Such relationships that offer institutional support are: relationship with support groups facilitated by health clinic staff; relationship with trustworthy, accessible, skilled medical caregivers; and relationship with medication and medication providers. The relationships that offer intimate support are: relationship with comfortable spaces and special people, like homes and family members; relationship with self; and relationship with divinity, named in diverse ways. The study concludes with the recommendation that community leaders, medical professionals, and psychotherapists improve their expertise in relational care, especially the forms of care that Black women living with HIV name as meaningful to their psychological and spiritual wellbeing.