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Resilience resources among African American women living with HIV in Southern United States

Qiao, Shana; Ingram, LaDreaa; Deal, Morgan L.a; Li, Xiaominga; Weissman, Sharon B.b

doi: 10.1097/QAD.0000000000002179
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Objectives: African American women living with HIV (WLH) often face various challenges to access to and benefit from healthcare across the HIV treatment cascade. Despite experiencing multiple forms of ongoing adversity, some African American WLH are able to adapt and stand strong. The current study aims to identify resources at various socioecological levels that facilitate resilience and explore how these resources interact with each other.

Design: Guided by the theories of resilience, we collected qualitative data through in-depth interviews with 14 African American WLH in South Carolina, United States.

Methods: Participants were purposely recruited and interviewed in private settings in 2016. With appropriate consent, each interview was recorded and was transcribed verbatim. Data analysis was conducted using NVivo 11.0.

Results: The participants described six major resilience resources including first, internal strength; second, religion and spirituality; third, hopefulness about life and future; fourth, self-awareness and self-care; fifth, social support from family and community; and sixth, HIV-related health facilities. The themes that occurred in qualitative data also show how resilience resources at the family/community level and institutional level affected individual resources, and how these resources collaborated with each other.

Conclusion: The findings suggest that resilient African American WLH maintain hope in the face of adversity and seek out and obtain social support. Self-care, social support, and health facilities are particularly critical resources for African American WLH. Comprehensive interventions are needed to integrate these resources across multiple socioecological levels to enhance resilience and treatment outcomes in African American WLH.

aDepartment of Health Promotion Education and Behavior, South Carolina SmartState Center for Healthcare Quality (CHQ)

bDepartment of Internal Medicine, School of Medicine, University of South Carolina, Columbia, South Carolina, USA.

Correspondence to Shan Qiao, Department of Health Promotion Education and Behavior, South Carolina SmartState Center for Healthcare Quality (CHQ), University of South Carolina, Columbia, South Carolina, USA. E-mail: sqiao1@gmail.com, SHANQIAO@mailbox.sc.edu

Received 26 March, 2018

Revised 9 February, 2019

Accepted 11 February, 2019

Copyright © 2019 Wolters Kluwer Health, Inc.