Washington D.C., USA, July 2012www.aids2012.org 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, MA 1, Ruth C. Cruise, MA 1, Sannisha Dale, MA, EdM, 1 Kathleen Weber, RN, BSN, 2 Mardge Cohen, MD 2, Leslie R. Brody, PhD 1 1 Boston University Psychology Department, Boston, MA 2 Cook County Health & Hospital Systems, Chicago, IL

Washington D.C., USA, July 2012www.aids2012.org Critical Consciousness Capacity to critically reflect and act upon one’s sociopolitical environment 1

Washington D.C., USA, July 2012www.aids2012.org African American Women: Vulnerability Racial disparities in HIV infection and mortality 2, 3 Structural factors create vulnerability 4 - Racial and gender discrimination relate to illicit drug use and depression 5-7 Illicit drug use, depression, race and HIV- related health outcomes 8-10

Washington D.C., USA, July 2012www.aids2012.org African American Women: Empowerment Critical Consciousness: capacity to critically reflect and act upon sociopolitical environment 1 - Empowerment - Individual coping 11 - Social change Related to: - Education 12, 13 - Decreased likelihood of smoking cigarettes 12 - Longevity 14 - Physical and mental well-being 15 - Commitment to career and future 16

Washington D.C., USA, July 2012www.aids2012.org 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?

Washington D.C., USA, July 2012www.aids2012.org 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, ,000 21% employed

Washington D.C., USA, July 2012www.aids2012.org Modified Detroit Area Study - Discrimination Scale 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?”

Washington D.C., USA, July 2012www.aids2012.org Critical Consciousness 13 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?”

Washington D.C., USA, July 2012www.aids2012.org AGEEDUCATIONEMPLOYMENTINCOMEPGDPRD CRITICAL CONSCIOUSNESS.17 †.29**.25*.08.30**.36** PERCEIVED GENDER DISCRIMINATION (PGD).23* PERCEIVED RACIAL DISCRIMINATION (PRD).22* † p <.10, *p <.05, **p <.01. Results 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

Washington D.C., USA, July 2012www.aids2012.org 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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