Exploring the life experiences of Afro-Caribbean immigrant women living with HIV: a phenomenological investigation
Over 35 million individuals across the globe are living with HIV, nearly one-half of whom are women (UNAIDS, 2013). In the most affected areas, Sub-Saharan Africa and the Caribbean, women comprise up to 60% of those living with HIV (UNAIDS, 2012, UNAIDS, 2013). Little research has focused the life experiences of Afro-Caribbean immigrant women living with HIV. Prior studies primarily emphasized epidemiological data (Hoffman, Ransome, Adams-Skinner, Shiun, & Terzian, 2012) and high risk behaviors and attitudes (Braithwaite & Thomas, 2001; Gillespie-Johnson, 2005; Hoffman, et al., 2008; Shedlin, et al., 2006). This phenomenological study explored the life experiences of eight Afro-Caribbean adult immigrant women from the English-speaking Caribbean living in New York City who were HIV positive. Participants were identified with the assistance of key informants in the Afro-Caribbean community. A semi-structured interview guide facilitated discussion around topics such as immigration status, coping, self-perception, formal and informal support networks. Participants were given a $25 Metro Card or grocery gift card as a "thank you" for their time. Data were analyzed according to Creswell's (2007) Simplification of the Stevick-Colaizzi-Keen Method of Phenomenological Analysis created by Moustakas (1994). This entailed bracketing, identification of meaning units and themes, construction of individual textural and structural descriptions. A composite description encapsulated the "essence" of the phenomenon. These Afro-Caribbean women portrayed specific cultural nuances related to disclosure and the accompanying stigma and discrimination. Maintaining secrecy.to ensure the safety of families who remained in home countries was of utmost importance. The women relied heavily on community support networks facilitated by caseworkers, social workers and medical professionals. Additionally, they focused on self-care and spirituality. These elements, combined, defined their overall experiences. Social workers can assist in enhancing the quality of life of this population by identifying specific challenges and creating culturally-appropriate and gender-specific interventions, including prevention/education programs. Advocacy should focus on immigration issues and programming specific to immigrant populations. The unique experiences shared by these Afro-Caribbean women living with HIV supports further investigation with other sub-populations within the group such as with women, non-English speaking Caribbean populations, and more recently diagnosed women.