Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Dr. Jane M. Georges, Chairperson; Dr. Cynthia D. Connelly; Wilma Wooten, MD, MPH


African Americans, Ethnography, Human Immunodeficiency Virus--HIV, middle aged, nursing, women


Black women, ages 45 and older, are disproportionately affected by the HIV/AIDS epidemic. In 2001, Black women comprised 11% of all older women in the United States; however, they accounted for more than 50% of AIDS cases and more than 65% of HIV cases (Winningham et al., 2004). The literature review reflected little research specifically looking at the reason(s) for the increase in HIV in Black women, ages 45 to 60. Furthermore, few research studies focused on HIV patient health beliefs and their experiences in living with HIV. This study was conducted with an ethnography research method coupled with the American Black feminist theory. The primary purpose of this qualitative study was to examine the reason(s) why the HIV rate is growing at an alarming pace for Black women ages 45 to 60 years old. The research instruments consisted of a demographic form and a six-question interview guide that formed the basis of 60–90 minute interviews meeting the research criteria. Demographic information was collected from a self-administered survey that included age, employment status, income, education level, date of infection, source of infection, date treatment started, whether the participant was currently in treatment or not in treatment, and the reasons for that treatment decision. This was a non-random sample of convenience. This researcher chose not to conduct a random sample because of the parameters of the inclusion and exclusion criteria. The participants consisted of 22 HIV-positive midlife Black women between the ages of 45 and 60 years old who self-selected to participate in the research study; however, two of the participants declined to have their interviews included in the results. Therefore, 20 participant-encounters were included. IRB approval was obtained from the University of San Diego. The participants signed an informed consent that insured their confidentially. The researcher analyzed the qualitative information by hand coding the data because the ethnic, feminist, and culture elements might lead to misinterpretation if qualitative-analysis software was used. Black women, ages 45 to 60 years offered significant reasons why they were infected with the HIV virus (e.g., lack of education about HIV, media influences, aging, unprotected sex, the onset of drug use after age 40). The findings from this study remain pertinent in all nursing research and advance nursing's utilizing of the American Black feminist theory. Finally, the findings may also facilitate further research into the reason(s) for the increase in HIV infections in Black midlife women. In addition, this study may further the body of research which leads to changes in the delivery and policies of health care.

Document Type

Dissertation: Open Access



Included in

Nursing Commons