THE LIVED EXPERIENCE OF RESILIENCE IN AFRICAN-BORN BLACK WOMEN LIVING WITH HIV AND ENGAGED IN CARE THROUGH COMMUNITY-BASED ORGANIZATIONS IN THE UNITED STATES: A CRITICAL INTERPRETIVE PHENOMENOLOGICAL ETHNOGRAPHY

Abstract

African-born Black women living with HIV (ABWLWH) represent a growing yet understudied population in the U.S. Despite often presenting for HIV care at later and more advanced stages of the illness, ABWLWH have higher survival rates than other demographic groups. However, no U.S.-based studies to date have examined the resilience factors that contribute to these outcomes. Existing research typically adopts deprivation-based frameworks, which overlook the strengths and resources that support resilience in this population. This dissertation employs a strengths-based approach, integrating critical interpretive phenomenology and ethnography to explore the lived experiences and meaning of resilience among ABWLWH in the U.S. engaged in care through community-based organizations (CBOs).

The study situates resilience within the intersecting contexts of participants' identities as Black African immigrant women and as individuals living with HIV. Over the course of sixteen months in the field, I volunteered at a CBO that served as the study’s primary research site and conducted direct ethnographic observations. I engaged in participant observations at support group meetings with participants and conducted in-depth interviews and informal conversations with eight ABWLWH who were receiving support and services through the CBO.

This study offers a nuanced understanding of how ABWLWH develop, maintain, and interpret their experiences of resilience amidst intersecting challenges related to migration, stigma, economic instability, and structural barriers. The findings contribute to a deeper understanding of resilience as a dynamic, socially embedded process and offer insights to inform more equitable, culturally grounded support systems and interventions for ABWLWH.