Bridging Disciplinary Boundaries (January 11 - 14, 2007)

African-American and Latina women are disproportionately impacted by HIV/AIDS and by many contextual psychosocial issues that complicate their experiences living with this disease. One of these issues, heavy alcohol use, has been linked to accelerated progression of HIV disease, impaired HIV medication efficacy, lower levels of HIV treatment adherence and a greater likelihood of engaging in risky sexual behaviors. Little comprehensive research has been done, however, on the use of alcohol among HIV-positive African-American and Latina women or on the specific issues that underlie this phenomenon. This exploratory study used a series of focus groups to identify the issues related to alcohol use among HIV-positive African Americans and Latino/as. This paper examines the narratives articulated in four of those focus groups, comprised of (1) HIV-infected and affected African-American women, (2) HIV-infected and affected Latina women, (3) service providers who work with HIV-positive Latinas and alcohol-related issues and (4) service providers who work with HIV-positive African-American women and alcohol-related issues. All participants were selected on the basis of personal life experience with both HIV and alcohol use and were asked to discuss open-ended questions focused on the intersection of HIV, alcohol use and racial/ethnic identity in their own lives and communities. Transcripts of recorded focus group conversations were content analyzed using the constant comparison method. Participants in each focus group discussed their perspectives on the prevalence, dimensions and origins of alcohol use among HIV-positive women in their own ethnic communities, as well as the problems created by this phenomenon and the best ways to address it. In describing their perceptions of the issues related to this alcohol use, participants articulated a number of common themes. All participants identified initial diagnosis, ongoing HIV stigma and related depression as precursors to use alcohol among HIV-positive women in their communities and identified family, social support, social networks and religion/spirituality as potentially supportive influences for the reduction or avoidance of alcohol use. Latina participants also discussed degree of acculturation as a significant issue in relation to alcohol use among HIV-positive Latinas. Analysis reveals great congruence between the perspectives of service consumers and service providers within each ethnic group in relation to factors influencing alcohol use, suggesting that providers understand these service consumers' life circumstances. Analysis reveals less congruence between service consumers' and service providers' perspectives regarding the best ways to intervene in alcohol issues for HIV-positive African-American and Latina women. Providers in both ethnic groups emphasized the need for systemic change around issues of gender and social inequality and consumers in both groups emphasized the need for concrete assistance, interpersonal support and religious guidance. Analysis also reveals some culturally specific perceptions and experiences that divide African-American and Latina service consumers, particularly in relation to the impact of domestic violence on alcohol use and the impact of alcohol use on childrearing and family functioning. It is recommended that awareness of the themes and dynamics identified through this content analysis be incorporated into service delivery targeting alcohol use among HIV-positive African American and Latina women.