1. The Sojourner Study: The Role of Black Feminist Theory in Evaluation
Sarita Davis, Ph.D.
Georgia State University
November 12, 2010
Some research suggests that using a strictly biomedical framework for designing and evaluating HIV and Substance Abuse programs typically serves to homogenize difference or complexity by, for example, separating race from socioeconomic status and gender as discrete, rather than mutually constitutive, concepts. The Sojourner Study invites us to understand the relational nature of HIV risk and Substance Abuse among dispossessed women in a way that conveys a message about the interaction of gender, race, class and health, as well as dialectic of residence, resilience, and resistance.
American Evaluation Association Annual Conference

2. Overview
The Sojourner Study applies an intersectional theoretical framework to explore how race, class, and gender affects HIV risk and substance abuse among 48 African American women living in high burden areas in metropolitan Atlanta.

3. Background The Parent Study: The Geography Project The Assumptions
Geography, community, and sameness are always risk factors.
Race, class, and gender (RCG) are characteristics of individuals rather than social relations
Interlocking RCG realities have no connection to historical, social and geographic processes.
The Sojourner Study is part of a larger NIH project, The Geography, Networks, and Disease Transmission Project. The Geography Project explores a conceptual model for endemic disease transmission in high-density urban settings. The study postulates that propagation of Human Immunodeficiency Virus (HIV), Sexually Transmitted Infections (STI’s) and Blood-Borne Infections (BBI’s) require multiple exposures delivered through multiple channels (compound risk), a network structure that facilitates transmission, and geographic proximity that increases the probability of partner selection from among persons who are already part of networks at risk.
A team of street ethnographers from the Geography Project interviewed and collected urine and blood sample from over 700 men and women men.
THE ASSUMPTIONS
The parent study assumes that residents use social networks to find resources, establish who to trust, and adapt to the social structures of the street economy. However, according to Schulz and Mullings (2003), a strictly biomedical framework for analysis typically serves to homogenize difference or complexity by, for example, separating race from socioeconomic status and gender as discrete, rather than mutually constitutive, concepts. Often times emphasizing gender, race, and class as characteristics of individuals rather than as social relations, contributing to explanations for sexual decision making them disconnected from the historical, social, and political, and geographic processes from which they emerge (Mullings 2001; Schulz, Freudenberg, and Daniels, 2006; Morgen, 2002). In the context of the parent study, the contribution of the proposed study is to offer an intersectional framework (i.e., black feminist perspective) that will provide an opportunity to explain the sexual decision making and use of mood altering substances among the women in the study in a way that conveys a message about the interaction of race, class, and gender, as well as dialectic of residence, resistance, and resilience.

4. The Purpose of the Sojourner Study
The Sojourner Study provides an opportunity to explain the sexual decision making and use of drugs among the black women in the study in a way that conveys a message about the interaction of race, class, and gender, as well as a dialectic of residence, resistance, and resilience.
Eight years ago, fellow panelist and fellow Cornell alum, Denise Cassaro co-authored a chapter in New Directions for Evaluation entitled Feminist Evaluation- The Inclusion of Difference. Cassaro and Hood highlight the importance of Black Feminist theories in evaluation saying, Black feminist theories direct our attention to the ways racism, misogyny, homophobia, and class discrimination have functioned historically and in the present to subordinate all black people and all women. By addressing the multiple ways in which ideologies of race, gender, class, and sexuality reinforce each other, these theories illustrate the ways in which relations of domination and subordination are produced.

5. The Sojourner Syndrome
What is the Sojourner Syndrome?
Why is this theory useful in examining HIV and Substance Abuse among black women living in high burden communities?
Isabella Baumfree was born into slavery in Ulster County, New York in the late 1790’s. During which time she was sexually abused and physically assaulted. Her children sold into bondage. In 1843 she assumed the name Sojourner Truth and traveled across the county as an abolitionist and preacher promoting the idea of Black freedom and inspired Whites to oppose the legality of slavery.
The Sojourner Syndrome: Truth’s story is symbolic of activism and resistance. Her life conveys a message about the interaction of race, class, and gender, as well as the dialectic of oppression, resilience, and resistance. It offers an interpretive framework designed to provide a broader understanding of why African American women and men die younger compared to whites (Mullings, 2000).
The model is inspired by John Henryism (James, 1994) in that it represents a behavioral strategy which has important health consequences. John Henry was a legendary ‘steel-driving’ man who was known among the late-nineteenth century railroad and tunnel workers for his strength and endurance. In a contest of man against new technology, John Henry and his nine-pound hammer were pitted against a mechanical steam drill. In a close race, John Henry emerged victorious but died moments later from physical and mental exhaustion. John Henryism, a framework developed by Sherman James, describes high-effort coping or a strong behavioral predisposition to cope actively with psychosocial environment stressors. James hypothesizes that this tendency interacts with low socioeconomic status to influence the health of African Americans, particularly the incidence of hypertension.
The Sojourner Syndrome differs in emphasis from John Henryism in two significant ways. While John Henrysim tends to be an individual measure, the Sojourner Syndrome emphasizes structural relationships of race, class, and gender. In addition, the Sojourner Syndrome explicitly incorporates an element of historical patterns of activism and resistance.
The intersectional lens refocuses our perspective on health and illness in several important ways: 1) it invites us to understand race, class, and gender as relational concepts and not merely attributes of people of color; 2) the historical and contemporary processes by which groups are given access to resources; 3) emphasizes the ways in which gender, class, and race are interlocking rather than additive; 4) it seeks to understand how they interrelate at a given historical moment in the study of health disparities, structure vulnerability, and resilience; 5) and it recognizes the many forms of resistance or transformative work that are generated by Black women’s location at the intersection of class, race and gender.

6. The Methodology
All participants were asked the following five questions questions:
What is it like living in your community?
What things in your community cause you stress?
What is it like dating in your community?
How does living in your community affect your use of drugs and alcohol?
What things in your community help your health?
The study used a Phenomenological approach to interviewing African American women who were part of the parent study, the Geography Project. The street ethnographers contacted 48 African-American women via personal contact information to solicit their interest. Once interest was secured, a majority of the women were interviewed in their home, with a few agreeing to on-campus interviews at Georgia State University. All participants were asked the following five questions questions…

7. The Demographics The typical participant
African American female*, single, heterosexual, unemployed, had an 11th grade education, received money from a boy/girlfriend, lived with family/friends, drank alcohol, used crack, and had Herpes 2.
*Four participants were transgender (M2F)

8. The Nexus of the Intersection
HIV RISK
Substance Abuse
Gender
Abuse,
Money
Violence, Environment, Kinship
Race
Education, Environment
Drugs, Kinship
Class
Employment, Environment,
Drugs, Employment, Environment
OVERVIEW
A majority of the women had experienced some type of sexual abuse in their childhood and described their current community as violent. The childhood abuse often times led the women into early promiscuity, perform poorly in school, substance abuse and subsequently, reduced employment options. This pattern influenced many women to use sex or selling drugs as a way to make money.
GENDER, HIV risk *Abuse
I got raped when I was 6 by my father. I had a rough life but I don't talk about it too much where everybody know my business. I've been through some things. I was hard to deal with. I had to go talk to someone because when it was going on it would be time for me to go to school and he would tell my momma I would have to do something to keep me there. He raped me till I was about 12.
GENDER, HIV Risk * Money
The money was good. I went out with a girlfriend of mine and when I left Sears I was making about 600 after they take out on me. And I was with this man and my girlfriend talked me into it and he gave me 800 dollars for 5 minutes. And I said y'all make money like this? She been on the streets. I said aren't you scared of AIDS?- and she said I got to pay my bills and I got to eat. But she been dead for about two years but it was fast money. And the money was good and I would go out again and get 3 or 4 hundred in thirty minutes.
GENDER, Substance Abuse * Violence
Domestic Violence: I saw a lot of abuse. My folks started fighting and my Dad started saying people were coming out the floor and men where in the bed. And that's when him and my older sister started fighting. She started jumping on my Daddy, stabbing him with knives and spraying him with roach spray. She started fighting him.
GENDER, Environment*Substance Abuse: The police come, but no witnesses. Nobody knows. For two years that's all I've witnessed out here is killing. I've seen people get shot off motorcycles. Children playing in broad day light. People just ride up and shoot. I've seen people die out here. Run up into somebody's house rob them and kill them. I've seen them people doing it. I see they face and stuff. I have bad dreams all the time. I dreamed that day before yesterday that I was getting rapped.
GENDER, Substance Abuse * Kinship
I was about 11 then when they took me to a psychiatrist cause I told my mama I wish I was the baby girl because those were his kids and he didn't do the things to his kids that he was doing to me and my other two sisters. Me, Ernestine, and Lisa. We weren't his kids. I wish I was the baby you know. So, I went through a lot of things but I use to suppress it so I’ve learned that when I start using drugs, I didn't need no cocaine when I was 28. And it was introduced to me so I started with crack cocaine off and on of my life-28 to the age that I am now 49. I say that I got myself off that crack. Now I do marijuana and I drank beer, but I don't have sexual intercourse every time they want but naw I ain't wit all that. I'll flirt like I don't know what but I aint finna up nothing because I know its disease out there cause it took my mother from me.
RACE:
RACE, Education * Environment: This is a structural issue. In assessing the impact of race and class on black women, numerous studies have established that the economic return for the same level of education is far lower for black women than white. These historical patterns of race and class discrimination are exacerbated by the flight industry from the inner city. Low-income women in metropolitan Atlanta are subject of a continuum of employment and unemployment that severely affected their income security and access to work-related benefits.
Another woman said: “The guys in my neighborhood are nasty! They done had sex with every girl out there in the neighborhood and even died. I don't want nobody that done already had you. Then you go back behind folks and talk about it, that's not me. You can’t have me for that cause I'm not trash.
RACE, Drugs *Kinship
(see GENDER, Substance Abuse * Kinship)
CLASS: Many of the women are at increased risk of HIV and Substance Abuse due to their low socioeconomic status, which is closely related to their level of education and job skills. This cycle of oppression is reflected in the quality and quantity of community resources available to assist the women.
Money: (see Gender and HIV risk)
CLASS, Drugs* Employment * Environment:
You can get drugs in rehab. You can get more drugs in rehab than you can get in jail. That's pitiful isn't it? They throw it up over the banister over there on Boulevard. They actually through people dope over the banister at Boulevard. So that's just like your living in a place where everyone is suppose to be on the same page of recovery but now you got people that are using and you have to deal with their fickleness back and forth and everything else that go along with you trying to get yourself right. I left after detox. I said I might as well be on the block if it’s going to be like this.

9. Resilience: One coin two sides
Family Function/Dysfunction
Fictive Kin
Fragmentation:
What happens in the streets stays in the streets
I ain’t no outside person
Faith
Resilience:
Despite the salient environmental sources of potential stress many positive aspects of the environment may have served as protective factors and mitigated some of the stressors and strains and became a source of Resilience. These included, Family function/dysfunction, Fictive kin, Fragmentation, and Faith
Family function: While economic conditions were constrained, participants perceived family to be important and involved sacrifice. “I stopped school in the 10th grade because I had to help my momma cause she had so many kids. You have to help your momma cause she's there when nobody else is.”
Family dysfunction: That part right there made me a stronger woman because I look at how my mother went through things and my grandmother and my aunties and uncles and I done watched them use drugs and that really just made me strong cause I see how the drugs effected families so I was like okay, I don’t want to raise my children in a drug family.
Fictive Kin: Well in the community now, I see a lot of black women junkies to tell you the truth. A lot of them on crack. Or if they ain't I see women that's working and just tuned out by they self. That's why I be wanting to get away from this and just go. I don't really be around too many women like that, but I know a lot of strong women out here. My friend mama, I see her she got two jobs and go to church. She don't have time to sleep because she have a lot of folks in her house and a lot of kids… she is so giving. She take anybody in at times. So I know she be stressing because she got all these people in her house everyday and she don't have no time to herself. Her son have tons of folks in there all day everyday smoking and drinking and she never have peace to herself. But she work 24/7, she still take care of her house, making sure everything is right. So that's why I consider her. I look up to her a lot.
Fragmentation:
What happens in the streets stays in the streets: “I don't know. Well with me I deal with a lot of guys out here on the street. As far as bringing a lot of street guys home to where I live at no, I don't do that. I just deal with them in another setting other than where I live.”
-There are a lot of drugs and alcohol where I live and it control a lot of folks out here. I mean, I smoke or whatever, at times I drink every now and then, but other than that, I'm in the house watching kids or cleaning and cooking or something. I don't even go outside like that no more. I ain't no outside person, so I really stay in the house.
Faith: I pray a lot and I talk to my oldest sister a lot. She always gives me good advice, but I pray a lot all the time. I go to God for strength. Another participant said, “Every Sunday and Fridays we be at church because my grandma keep us in church.”

10. Summary and Reflections
The Sojourner Syndrome speaks not only to individual risk but relationships among groups defined by their Race, Class, and Gender hierarchies.
It challenges the notion of individual risk
Public health treatment/evaluation needs to consider the role of risk/protective factors