Complex Lives: Exploring Resiliency Among African American Female Kinship Care Providers Living with HIV/AIDS

Background and Purpose: This study describes the experiences of middle age African American female kinship care providers who are also living with HIV/AIDS. Kinship care is the full time care, nurturing, and protection of children by relatives, members of their tribes or clans, or other adults who have a family relationship to a child (CWLA, 2000). Historically, many African American women have served as kinship care providers for children in the family. These parenting responsibilities present even greater challenges for an increasingly disproportionately high number of African American women in this age group who also are living with HIV/AIDS. Even though there have been technological innovations in treating and managing HIV infection, in the African American community in the United States (U.S.), HIV/AIDS is a public health crisis (CDC, 2009a). While African Americans comprise 12% of the total U.S. population, they continue to account for almost half (46%) of cases at all stages of HIV/AIDS, compared with all other races and ethnicities. African Americans also represent nearly half (45%) of new infections each year (CDC, 2009b), and the rate of infection for African American women is 20 times the rate for White women of similar ages (CDC, 2009a). Despite the existing separate bodies of research on African American women with HIV/AIDS and on African American kinship caregivers, significant research with a specific focus on resiliency within this population of African American kinship care providers with HIV/AIDS has not been conducted.

Methods: Semi-structured in-depth interviews were conducted with 24 African American women living with HIV/AIDS who are also serving as informal kinship care providers residing in the greater Boston, MA area. Interviews were transcribed verbatim employing a qualitative description (QD) approach (Sandelowski, 2000) and thematic analyses was conducted with the transcripts by two coders using the qualitative analysis software HyperResearch. This inductive approach utilized consensus coding to refine and/or update their processes of interpreting each woman's experiences within a set of categorical groups. In order to organize the vast amount of qualitative data, the researcher used the following data reduction techniques: Each woman served as a unit of analysis, and each category of experiences and behaviors was counted.

Results: The analyses provided descriptive data about why African American women living with HIV/AIDS serving as informal kinship care providers do not access services for caring for their grandchildren, nieces, and/or nephews. Prominent explanations included: (a) stigma behind their HIV/AIDS status, (b) negative perspectives of child welfare services, (c) their resiliency, and (d) strengths in familial and/or community resources.

Conclusions and Implications: This study provides new information for social workers, child welfare workers, and health care providers who serve this population in ways that support and assist their needs. More importantly, it provides the perspective of African American women as both kinship caregivers and persons living with HIV/AIDS. Findings further suggest the relevancy and utility of models of resiliency as a conceptual framework with this population and in social work practice.