Transcript Powerpoint - Aids 2012

AIDS 2012 Oral Abstract Session
Gender: Reducing Vulnerability and Reinforcing
Empowerment Opportunities
Correlates of Critical Consciousness in
African American Women with and
at-risk for HIV
June 25, 2012
Gwendolyn Kelso, MA1, Ruth C. Cruise, MA1, Sannisha Dale, MA, EdM,1
Kathleen Weber, RN, BSN,2 Mardge Cohen, MD2, Leslie R. Brody, PhD1
1Boston
University Psychology Department, Boston, MA
2Cook County Health & Hospital Systems, Chicago, IL
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Washington D.C., USA, 22-27 July 2012
Critical Consciousness
Capacity to critically reflect and act upon
one’s sociopolitical environment1
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African American Women:
Vulnerability
• Racial disparities in HIV infection and
mortality2, 3
• Structural factors create vulnerability4
- Racial and gender discrimination relate to illicit
drug use and depression5-7
• Illicit drug use, depression, race and HIVrelated health outcomes8-10
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Washington D.C., USA, 22-27 July 2012
African American Women:
Empowerment
• Critical Consciousness: capacity to critically reflect and
act upon sociopolitical environment1
- Empowerment
- Individual coping11
- Social change
• Related to:
- Education12, 13
- Decreased likelihood of smoking cigarettes12
- Longevity14
- Physical and mental well-being15
- Commitment to career and future16
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Present Study
• Among African American women with and at
risk for HIV:
- What demographic characteristics are
associated with critical consciousness?
- How does perceived discrimination relate to
critical consciousness?
• Does critical consciousness and perceived
discrimination differ by HIV status?
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Washington D.C., USA, 22-27 July 2012
Participants
• Recruited from the Women’s Interagency HIV Study
(WIHS), Chicago site
• 73 HIV+, 25 HIV- demographically-matched African
American women
• Mean age 45 (SD = 9.42)
• 44% grades 7-11, 33% grade 12, 22% college
• 38% ≤$6,000, 30% $6,001 - 12,000
• 21% employed
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Modified Detroit Area Study Discrimination Scale17
30 items, rated on a scale from 1 to 5
“You are treated with less courtesy than other people.”
“How much do you think your race had to do with this?”
“How much do you think your gender had to do with this?”
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Washington D.C., USA, 22-27 July 2012
Critical Consciousness13
Four dimensions, 20 items, 1 to 5 scale
•
•
•
•
Identification with African American women
Power discontent with the distribution of social
power of different groups
Rejection of system legitimacy: attributions of
social problems to system causes
Collective action orientation: joining with others
to work towards change
Indicator of critical consciousness: “How much do you
think that political and social change is necessary
for women/African Americans?”
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Washington D.C., USA, 22-27 July 2012
Results
CRITICAL
CONSCIOUSNESS
PERCEIVED GENDER
DISCRIMINATION (PGD)
PERCEIVED RACIAL
DISCRIMINATION (PRD)
†p
•
•
AGE
EDUCATION
EMPLOYMENT
INCOME
.17†
.23*
.22*
.29**
.04
-.20
.25*
.17
-.14
.08
-.13
-.07
PGD
PRD
.30** .36**
< .10, *p < .05, **p < .01.
No differences by HIV status
HIV-negative women, M = 4.38, SD = .71, endorsed
greater need for social and political change on behalf
of African Americans than HIV-positive women, M =
3.82, SD = 1.09, t (94) = 2.33, p <.05
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Washington D.C., USA, 22-27 July 2012
Conclusions
• Among African American women with and at risk for HIV:
- Older age, education, and employment related to
higher critical consciousness
- HIV-negative women endorsed greater belief in political
& social change on behalf of African Americans
- Critical consciousness positively related to perceived
gender and racial discrimination
• Future research should examine:
- the direction of these relationships
- critical consciousness in relation to health outcomes
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Washington D.C., USA, 22-27 July 2012
References
1Freire,
P. (1970). Pedagogy of the Oppressed. New York: Seabury Press.
for Disease Control and Prevention: National Center for Health Statistics (2005). Deaths: Leading Causes for 2002. National Vital
Statistics Report, 53.
3Centers for Disease Control and Prevention (2008). HIV Prevalence Estimates -- United States, 2006. Morbidity and Mortality Weekly Report,
57, 1073-1076.
4Newman, P.A., Williams, C.C., Massaquoi, N., Brown, M., & Logie, C. (2008). HIV prevention for Black women: Structural barriers and
opportunities. Journal of Health Care for the Poor and Underserved, 19, 829-841.
5Ro, A. & Choi, K.-H. (2010). Effects of Gender Discrimination and Reported Stress on Drug Use among Racially/Ethnically Diverse Women in
Northern California. Women’s Health Issues, 20, 211–218.
6Landrine, H. & Klonoff, E. A. (1996). The schedule of racist events: A measure of racial discrimination and a study of its negative physical and
mental health consequences. Journal of Black Psychology, 22, 144-168.
7Landrine, H., Klonoff, E. A., Gibbs, J., & Manning, V. (1995). Physical and psychiatric correlates of gender discrimination: An application of the
Schedule of Sexist Events. Psychology of Women Quarterly, 19, 473-492.
8Cook, J.A., Grey, D., Burke, J., Cohen, M.H., Gurtman, A.C., Richardson, J.L., … Hessol, N.A. (2004). Depressive symptoms and AIDS-related
mortality among a multisite cohort of HIV-positive women. American Journal of Public Health, 94, 1133-1140.
9Cook, J., Grey, D., Burke-Miller, J., Cohen, M., Vlahov, D., & Kapadia, F. (2007). Illicit drug use, depression and their association with highly
active antiretroviral therapy in HIV-positive women. Drug and Alcohol Dependence, 89, 74–81.
10Cohen M.H., Cook J.A., Grey D., Young M., Levine A.M., Tien P., … Wilson T.E. (2004). Medically eligible women not on highly active
antiretroviral therapy: The importance of abuse, drug use and race. American Journal of Public Health, 94, 1147-1151.
11Neville, H. A., Coleman, M. N., Falconer, J. W., & Holmes, D. (2005). Color-blind racial ideology and psychological false consciousness
among African Americans. Journal of Black Psychology, 31, 27-45.
12 Zucker, A.N., Stewart, A.J., Pomerleau, C.S., & Boyd, C.J. (2005). Resisting gendered smoking pressures: Critical consciousness as a
correlate of Women’s smoking status. Sex Roles, 53, 261-272.
13Gurin, P., Miller, A. H., & Gurin, G. (1980). Stratum identification and consciousness. Social Psychology Quarterly, 43, 30-47.
14LaVeist, T. A., Sellers, R., & Neighbors, H. W. (2001). Perceived racism and self and system blame attribution: Consequences for longevity.
Ethnic Discrimination, 11, 711-721.
15Sellers, S. L., Neighbors, H. W., Bonham, V. L. (2011). Goal‐striving stress and the mental health of college‐educated Black American Men:
The protective effects of system‐blame. American Journal of Orthopsychiatry, 81, 507-518.
16Diemer, M. A. & Li, C.‐H. (2011). Critical consciousness development and political participation among marginalized youth. Child
Development, 82, 1815-1833.
17Williams, D. R., Yu, Y., Jackson, J., & Anderson, N. (1997). Racial differences in physical and mental health: socioeconomic status, stress,
and discrimination. Health Psychology, 2, 335-351.
2Center
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