African American Women and HIV/AIDS: Critical Responses

By Dorie J. Gilbert; Ednita M. Wright | Go to book overview

13
Culturally Grounded Responses: HIV/AIDS
Practice and Counseling Issues for African
American Women

Patricia Stewart

There are many ways to approach the subject of counseling relative to African American women living with HIV. To speak of the contemporary concerns of the HIV-positive African American woman, one needs to be mindful of her in the context of her rich and capable role in the family, in the community, in society, and, of course, in history. This chapter broadly addresses the following: (1) salient issues that surface in practice, (2) the importance of addressing causes and conditions for those issues, and (3) key practice strategies—suggestions for insightful, respectful, culturally competent practice, which include counseling. The stress of living with HIV/AIDS is compounded by the stress inherent in being a woman and in being African American and, for many, in being poor. Sandra Crouse Quinn (1993) refers to this phenomenon as the[triple burden.] This chapter discusses counseling issues in practice with African American women living with HIV who also live in poverty, because they are the most visible to the service delivery system and are more likely to need assistance accessing quality mental health care that is affordable. I use interchangeably [African American] and [Black]; the same is true for the words [counseling] and [therapy.] Also, as a social worker, I speak from that disciplinary perspective and refer to other designations, such as [practitioner,] to be inclusive and respectful of other human services helping professionals.


BACKGROUND

For years, as I have been working in the field of HIV, I have been concerned about the vulnerability of women, especially those in long-term and/or [committed] relationships or marriages. This epidemic initially struck gay men and then injection drug users with such fury that prevention and intervention efforts we re focused on them and appropriately so. When I began clinical work in HIV in the early 1990s, there was much concern about the increase in infections among women, but much of that concern was coupled with the exposure to children. At that time, I worked in a hospital-based, family-focused HIV program

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