HIV and feminine identity: Exploring the impact of HIV infection on the identity development of African American female adolescents

Background: The majority of female adolescents/young adults living with HIV/AIDS in the U.S. are African American. Much of the literature addressing this population has been framed within the context of risk, with sparse attention to the role of HIV in these young women's healthy growth and development. The present study seeks to explore the ways in which messages received about what it means to be a young woman living with HIV impacts the identity development process of HIV-positive African American female adolescents.

Methods: In-depth qualitative interviews were conducted with twenty African American females between the ages of 18 and 22 with behaviorally acquired HIV infection. Participants were recruited from an urban Midwestern HIV clinic. Analysis utilized a phenomenological approach to uncover themes related to the meaning of being HIV-positive and being a woman.

Results: Thematic analyses revealed that participants' HIV status and the societal messages they receive about living with HIV influenced their identity development in the following three domains: a) motherhood, b) sexuality, and c) romantic relationships. Specifically, participants endorsed feelings of guilt and fear related to motherhood, a muted sense of their sexuality, and feelings of unworthiness regarding romantic relationships.

Conclusions: Receiving an HIV diagnosis can negatively influence the future identity development processes of female African American adolescents. Interventions focused on promoting the healthy growth and development of African American female adolescents living with HIV should assist these young women in developing positive and health-promoting identities, especially related to issues of sexuality, reproduction, and romantic relationships.