Vulnerability and Empowerment: At the International AIDS Conference, an Examination of Sexual Abuse and Violence Against Women -- and Men

Critical Consciousness

Doctoral psychology student Gwendolyn Kelso of Boston University presented on the concept of critical consciousness, the "capacity to critically reflect and act upon one's sociopolitical environment." She reported specifically on African American women in the Chicago WIHS unit.

She and her colleagues surveyed 73 HIV-positive and 25 HIV-negative women. They found that the HIV-positive women with higher levels of critical consciousness had higher CD4+ T-cell counts and lower viral loads.

According to the presentation, African American women's vulnerability to the virus is shown in racial disparities in HIV and mortality; in structural factors creating vulnerability, namely racial and gender discrimination related to illicit drug use and depression; and in illicit drug use, depression, race, and HIV-related outcomes.

The flip side to vulnerability is empowerment, namely, critical consciousness and its capacity to empower an individual by enabling them to think critically about their place in their world and act upon the realities of their sociopolitical environment by identifying areas where change is desirable and working towards that change. Empowerment is both personal, with individual coping and resilience, and political, with an aim to social change. Empowerment has been shown to be related to higher levels of education, decreased likelihood of cigarette smoking, longevity, physical and mental well-being, and commitment to a career and a future. Social change could be as simple as registering to vote and going to the polls, but in this concept, is connected to people uniting as a group to effect positive change in their lives (for example, coming together to advocate for better working conditions or to lobby legislators).

In short, if people can understand the social forces working against them, they're in a better position to deal with those forces effectively. This study affirmed other research showing that awareness of racism can improve a person's health outcomes (see the link to her slides below for references).

Read an interview with Gwendolyn Kelso, M.A., here.
See the abstract and study slides on "Critical Consciousness, Perceived Racial Discrimination, and Perceived Gender Discrimination in Relation to Demographics and HIV Status in African-American Women."

Read the full-text study, "Medically Eligible Women Who Do Not Use HAART: The Importance of Abuse, Drug Use, and Race."

The full-text study, "Causes of Death among Women with Human Immunodeficiency Virus Infection in the Era of Combination Antiretroviral Therapy," is available here.

See the abstract on "Perceived Racism and Self and System Blame Attribution: Consequences for Longevity."

Men, Women and Gender

Kristin Dunkle, M.P.H., Ph.D. of Emory University noted that while research has found a link between sexual abuse of women and of men who have sex with men (MSM) and a higher risk of HIV infection, there is much less data on the connection for other populations of men and almost none from developing countries. She and her colleagues found increased HIV risk for both male victims and perpetrators in South Africa. See their and other abstracts for presentations in this session.