Drug-Using Women's Communication with Social Supporters about HIV/AIDS Issues
Falkin, Gregory P., Strauss, Shiela M., Journal of Drug Issues
Communication about health issues such as HIV/AIDS is essential for people, especially women, to obtain the social support they need either to prevent illness or manage it. This article compares the kinds of HIV-related issues that HIV positive and HIV negative substance-abusing women (N=211) in New York City talk about with various types of supporters. Despite the stigma associated with AIDS and their unconventional lifestyles, both groups of women talked to a broad spectrum of supporters about a variety of HIV-related issues, though this was more the case for HIV positive women. Although the main topic that both groups discussed with their supporters was their HIV status, the women also talked about risk reduction, their supporters' HIV status, HIV testing, how to live with AIDS, information about HIV/AIDS, and the emotional impact of AIDS (e.g., fear of infection, reactions to learning test results, and the impact of knowing others who have died from the disease).
Communication about health issues like HIV/AIDS is essential for people, especially women, to obtain the social support they need to prevent illness and manage it (Nishino & Schunck, 1997). Women often receive support just by talking to significant others who listen sympathetically. These conversations also provide an opportunity to make their supporters aware of the women's concerns and their need for various forms of social support. For drug-abusing women who face a daily struggle to satisfy basic needs and desires for drugs as well as for food and shelter, HIV/AIDS does not often loom as the most profound ways, often because one or more loved ones have died from AIDS. Moreover, although many of them continue to engage in drug use and sexual risk behaviors, they have also taken steps to reduce the risk of spreading or contracting HIV and to seek medical treatment if they have the virus. To the extent that HIV/AIDS is a significant concern to them, they are likely to have conversations with others in their social worlds about various aspects of the illness and its consequences (Nishino & Schunck). Because research has not documented the kinds of HIV-related issues that drug-abusing women discuss with their social supporters, we do not know the salience that various issues have for them or to whom they turn for support. Knowing the topics they discuss with various supporters simultaneously provides an indication of the importance of HIV/AIDS in their lives, the salience of specific issues (e.g., risk reduction, HIV testing, and living with AIDS), the social support that they need. and on whom they count for support in relation to these issues.
For the most part, the literature on women's communication about HIVrelated issues has focused narrowly on two topics: negotiations between at-risk women and their male partners about condom use (Amaro, 1995; Kline et al., 1992) and HIV-positive women's disclosure of their HIV status to their sexual partners and family members (Armistead et al., 1999; Gielen et al., 1997; Levy et al., 1999; Simoni et al., 1995). This research has typically been conducted by researchers interested in understanding the degree to which risk reduction is practiced, with disclosure viewed as a means of reducing transmission of the virus. In emphasizing these specific issues, however, and the people that women talk to about them, there is often an underlying assumption that communication about safer sex and one's HIV status are the two HIV-related issues that are of primary concern to the women (though the individuals with whom they discuss them are not necessarily viewed as supportive). It is only by asking the women themselves to identify the topics that they talk about with various supporters that we can gain a true understanding about the salience of various HIV-related issues in their lives and the people they turn to for support. Accordingly, this article delineates and compares the kinds of HIV-related issues that HIV-positive and HIV-negative substance-abusing women talk about with various types of supporters and the extent to which they have these conversations. …