Constructing spirit-level interventions for African American women living with HIV

African Americans are disproportionately affected by HIV comprising only 12% of the U.S. population but accounting for nearly 50% of all HIV cases (CDC, 2009). HIV surveillance data estimate that one in 30 Black women will be diagnosed with HIV during their lifetime. For many HIV positive African American women, treatment of HIV infection and the subsequent psychological stress is complicated by lack of resources and competing life priorities. These women also face additional challenges such as fear of disclosure and lack of adequate social support. The complexity of challenges faced by African American women who are HIV positive highlight the need to explore their preferred ways of coping. Studies show that minority women tend to utilize alternative coping strategies when faced with dual mental and physical health challenges. Spirituality has been found to have a direct relationship with cognitive and social functioning and inversely related to HIV symptoms among African American women. Psychosocial interventions are a key component to improved quality of life for women living with HIV and spirit-level interventions are shown to buffer psychosocial distress experienced by HIV positive persons. This dissertation will consist of three publishable quality articles that examine issues associated with the function of spirituality in HIV positive women. This first article will review published spiritually oriented interventions and compare, contrast, and critique the various components, sample, and intervention methods to determine the applicability and replicability of these interventions as a basis for increasing treatment options for co-morbid African American women. The second article will offer a conceptual framework incorporating the health belief model and a discussion of Lazarus & Folkman's stress and coping model to examine theoretical frameworks for integrating spirituality into social work practice interventions for HIV positive women. The third article for this dissertation seeks to contribute new information to the literature on the spirituality in the lives of HIV positive women. This article will present data that identifies, defines, and describes various uses of spirituality as a coping mechanism. The article will also discuss historical factors that influence the use of religion and spirituality among African Americans.