The purpose of the current study was to further our understanding of the subjective experience of middle-age African American women who are HIV+ and on highly active antiretroviral therapy, particularly how self-reported lipodystrophy (LD), levels of body dissatisfaction, body image quality of life, and engagement in disordered eating behaviors are related. Multiple regression, MANOVA, MANCOVA, ANOVA, and chi-square were utilized to test hypotheses. Results revealed that HIV+ and HIV- women did not differ significantly on their levels of body dissatisfaction or drive for thinness. When HIV+ women were examined in more detail a pattern emerged: women who self-reported fat hypertrophy had significantly higher levels of body dissatisfaction, bingeing, but not purging, and dietary restriction and fear of weight gain compared to women who did not self-report LD. About 75% of the sample was overweight or obese, and when BMI was controlled for, these differences persisted for body dissatisfaction and disordered eating behaviors for fat hypertrophy, but not fat atrophy. Overall, the findings indicate that the type of LD, specifically hypertrophy, is more related to body dissatisfaction and disordered eating behaviors, than LD in general. Clinical implications and limitations of these findings are discussed.

Gender role beliefs of African American women in the United States should be investigated in a manner that considers their unique experiences and the distinct background of her cultural sharing group. In this study, gender role beliefs of African American women were examined by addressing the research question: What are the gender role beliefs of African American women for African American men and women? Eight focus groups comprising 44 African American women were conducted. Women were diverse in terms of age, religion, and socio-economic status. An ethnographic phenomenological approach was used to explore views related to gender roles among African American women. Nvivo 8, a qualitative data analysis software program, was utilized to code transcribed focus group data. Eight themes and 11 subthemes emerged from the data and were divided into three categories: gender role beliefs for women, gender role beliefs for men, and relevant contextual factors. Themes for gender role beliefs about women were 1) Having Multiple Roles, 2) Dedication to Care of Others, 3) Perceived Social Inferiority, and 4) Strength. Themes for gender role beliefs about men were 5) Lack of Commitment, 6) Strength, and 7) Mental and Emotional Immaturity. The theme that captured related contextual factors of gender roles was 8) Personal and Socio-historical Experiences of African Americans. Knowledge of gender role views can help provide a better understanding of human behavior and assist in the development of culturally specific interventions.

African American women represent one of the largest groups disproportionately living with and affected by HIV/AIDS yet African American women have largely been unrepresented in the federal-state rehabilitation system. As pharmaceutical treatment options improve and individuals with HIV/AIDS are living longer and healthier lives, research exploring the appropriateness of rehabilitation services has increased. Accordingly, it has become more necessary to address the needs of this population. As the largest service provider for people with disabilities, the state-federal rehabilitation system has the potential to be a vital resource for African American women living with HIV/AIDS. The purpose of this study is to identify and examine variables related to and predictive of the utilization of rehabilitative services among a sample of African American women living with HIV/AIDS in the United States who volunteered to complete the National Working Positive Coalition - Vocational Development and Employment Needs Survey (NWPC-VDENS). The sample for this study was 313 African American women living with HIV/AIDS who were recruited from AIDS service organizations and national networks throughout the United States. Participants voluntarily completed the NWPC - VDENS, which explored their needs in the areas of education, training, employment, and health. The behavioral model for vulnerable populations was utilized as a framework to organize and examine predisposing, enabling and need constructs as they related to the utilization of rehabilitative services among African American women living with HIV/AIDS. This study used descriptive, bivariate and binary hierarchical logistic regression statistical analyses to determine the extent to which the constructs were predictive of the use of vocational rehabilitative services. The bivariate analyses produced no statistically significant differences between users and non-users of vocational rehabilitation services for either the predisposing or need variables. Three enabling characteristics, receipt of income benefits, knowledge of services, and reasonable access were all found to have statistical significance in the bivariate analyses. At least one variable from each construct was statistically significant in the regression model. Receipt of income benefits and knowledge of rehabilitation services were found to be predictive of the utilization of vocational rehabilitation services. Study findings framed from previous research, study limitations, implications, and recommendations for future research were acknowledged.

Thesis advisor: Belle Liang / Research on women's voice and self-silencing has shown that girls begin to silence themselves during adolescence in response to sociocultural pressures to conform to gender norms and as a way to stay relationally connected with others. While the literature on voice for women has been extensive, it has centered primarily on the experiences of European-American women, which may not be generalizable to other ethnic/racial groups. This study extends existing research by examining voice experiences for Asian American women specifically. Given the multiple minority statuses and social roles that are a part of Asian American women's identities, the current study examined the intersecting influences of gender, race, culture, and power, in the experience of voice and authenticity. Specifically, this study explored voice for these women in different social contexts where issues of gender, race and power tend to be salient. Additionally, the study examined the role of racism-related stress and culture in self-silencing. Finally, associations between voice, support for voice, and psychological wellbeing were assessed. Findings indicated that levels of voice, as well as levels of perceived support for voice varied by social context, providing evidence for the importance of social climate in voice. In general, both voice and perceived support for voice were higher in settings with minimal power differentials (i.e., with female and Asian peers vs. with authority figures). In two of the social contexts of interest (i.e., non-Asian peers and male authority figures), racism-related stress was significantly associated with lower levels of voice. Self-construal, which was used as an indicator of cultural tendencies, was also significantly associated with voice; individuals with an independent style had more voice, and those with an interdependent style had less voice. Higher levels of voice were associated with higher perceived support for voice. And ultimately, higher voice was linked with better psychological outcomes. Implications for research, work/school settings, and clinical practice were discussed, as well as limitations and suggestions for future research. / Thesis (PhD) — Boston College, 2014. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental and Educational Psychology.

Thesis advisor: Ruth McRoy / Historically, many midlife African American women have served as kinship care providers for children in the family. These parenting responsibilities present even greater challenges for the increasing and 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, HIV is the fourth leading cause of death among midlife African American women. Despite the existing 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 has not been conducted. To fill this gap, using a resiliency model as a conceptual framework, the researcher conducted semi-structured in-depth interviews with a convenience sample of 24 middle-aged African American women with HIV/AIDS who are providing informal kinship care. Implications for policy, research, and practice are provided and suggestions for health care providers and child welfare professionals regarding how to support these women and children through enhanced services and other interventions. / Thesis (PhD) — Boston College, 2012. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

Thesis advisor: Joellen W. Hawkins / African American women represent a unique group of women in the United States and have a long history of lack of reproductive freedom. Slavery and forced procreation, sterilization abuses, the Eugenics movement, and federally mandated contraception have all impacted on African American women’s independence in contraceptive decision-making. Given this population’s history, it is important for healthcare providers to understand African American women’s contraceptive decision-making, as women often seek their guidance. The purpose of this dissertation research was to discover the intergenerational influences on African American women’s contraceptive decision-making. The specific aims of this study were to: 1) develop an understanding of African American women’s contraceptive decision-making process; 2) identify the factors that influence their decision-making; and 3) develop knowledge that can be used to influence nursing practice. Included in this exploration were questions on the role of mothers and grandmothers in adolescents’ decision-making, familial beliefs about contraceptive choices and whether societal and social factors continue to influence contraceptive decisionmaking in the 21st Century. For this work, I used a qualitative descriptive approach to develop an understanding of the phenomenon from the participants’ worldview. I recruited a purposive sample of 7 triads from a metropolitan community in the northeast United States. I conducted an individual interview, using a semi-structured guide, with each participant. Six themes emerged from the data: 1) southern influences; 2) a worldview of relationships; 3) communication: key to preparedness; 4) seeking information from Mom; 5) "I got caught up in the game"; and 6) contraceptive use and beliefs. African American women's contraceptive decision making is influenced by a variety of factors including familial beliefs, attitudes, culture, and ethnicity. These patterns are transferred to each succeeding generation. Nurses have a significant role to play in providing appropriate contraceptive information and education in a culturally competent context that will meet the needs of these women and their families. / Thesis (PhD) — Boston College, 2008. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

Thesis advisor: Maureen E. Kenny / Recent research suggests that eating disorders exist across genders, races and ethnicities (e.g., Smolak & Striegel-Moore, 2001; Striegel-Moore & Smolak, 2000; Talleyrand, 2002, 2006; Taylor, Caldwell, Baser, Faison, & Jackson, 2007; Thompson, 1994, 1996), but most findings and frameworks within the eating disorders literature are based on research with White women who engage in restrictive eating patterns. Given the rapid rise in rates of obesity and related illnesses in the United States — particularly among Black American women (e.g., Hedley et al., 2004), an understanding of overeating that accounts for race-related factors is needed. By exploring the relationship between perceived racism, racial socialization, perceived stress, and overeating patterns among Black American women, the current study sought to develop a model of disordered eating that accounts for the unique contextual, emotional, and behavioral factors in the lives of Black American women. Using a sample of Black American women (N = 201), the results of the data analysis revealed that perceived racism was related to overeating by way of perceived stress. This finding supports theories that race–related factors underlie the development of eating disorder symptoms (e.g., Harris & Kuba, 1997) and that perceived racism may be a significant etiological factor in the development of eating disturbances among Black American women (Mastria, 2002; Root, 1990; Smolak & Striegel-Moore, 2001; Thompson, 1994, 1996; Talleyrand, 2006). This finding also adds to the larger body of literature, which links perceived racism to a range of negative psychological, behavioral, and physical outcomes (e.g., Mays et al., 2007). Racial socialization was not found to have a significant moderating effect in the relationship between perceived racism and overeating, but was unexpectedly found to be related to disinhibition around food. Although the explanation for this finding is unclear, it is consistent with some evidence that that identification with Black American culture may promote greater levels of comfort regarding food (Talleyrand, 2006; Villarosa, 1994). / Thesis (PhD) — Boston College, 2011. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental, and Educational Psychology.

Thesis (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 1982. / MICROFICHE COPY AVAILABLE IN ARCHIVES AND ROTCH / Bibliography: [unnumbered leaves 13-19] / by Amy Ellen Weisman. / M.C.P.

The world has suffered immensely and disproportionately from the ravages of HIV and AIDS. Oral PrEP is a single pill taken once daily that can reduce the risk of sexually transmitted HIV infection by up to 92% (CDC, 2014a). This study describes African American females’ awareness, beliefs, and perception of PrEP and identifies factors that may motivate women to either accept or reject PrEP. This cross-sectional study occurred over a 3-month period from November 2017 to January 2018, following from a previous pilot study. The sample comprised African American women aged 18 and over receiving STD or HIV screening services at a FQHC in Brooklyn, New York. Women were interviewed using the five characteristics of the Diffusion of Innovation theory and also completed a risk assessment for HIV using CDC recommended guidelines for screening heterosexual women for PrEP. Awareness of PrEP remained extremely low among the 72 African American women interviewed in the study. Using the CDC guidelines, all women reported one or more risk factors for PrEP indication. Awareness about PrEP, negative reactions from partners and shared experiences from female PrEP users were cited as factors that may predict and motivate African American women to use PrEP. Additionally, skills in pill-taking, cost and insurance, and maintaining privacy while using PrEP were strong enabling factors to support PrEP use. Factors such as initiating couple’s PrEP use as an intervention, medical doctors overtly directing PrEP for women, and the role of older women in promoting PrEP use were persuasive factors in reinforcing the utilization of PrEP among African American women in the study. Creative programming within high burden communities is critically important to penetrate with messages of new innovations and best practices. The results of the current research speak volumes to the continued work needed to educate communities with prevention messages.

Within the United States, African Americans account for 13% of the entire population, making them the second largest minority group. A notable concern is the rate at which African Americans fail to utilize both medical and mental health services. Researchers have long examined possible factors, such as stigmas, barriers, and accessibility, as reasons why African Americans underutilize psychological help. Overlooked is the potential influence of adverse childhood experiences (ACE). The term ACE encompasses ten major domains, ranging from emotional abuse to parental divorce/separation, all of which have been found to negatively influence individuals’ well-being. As such, this study examined the association between African American women’s adverse childhood experiences and help seeking attitudes. Data for this study were gathered from 64 African American female college students. Adverse childhood experiences were measured with the Traumatic Experiences Checklist (TEC) and help seeking attitudes were assessed with the Attitudes Toward Seeking Professional Psychological Help-Short Form (ATSPPH-SF). Results demonstrated scores reflecting childhood traumatic events for violence, death, and legal involvement were negatively related to attitudes toward help seeking. The results of this study highlight the need for continued research regarding ACE for African American women in college settings. Specific implications for this study include outreach development in university counseling centers focused on the association between childhood trauma, violence/legal involvement, and intersectionality. Programming of this nature may provide a critical link to increase this population’s utilization of mental health services. Keywords: African American women, ACE, help seeking