“Picturing New Possibilities:” Photovoice as a means of Critical Dialogue, Action, and Participation among Women Living with HIV/AIDS

Background: Health promotion and prevention strategies for women living with HIV/AIDS (WLH/A) are critical to improve women's quality of life and prevent HIV transmission. Opportunities for WLH/A to define and express their health priorities are often not considered, yet knowing WLH/A's perspective is essential to effective service provisions. We conducted a photovoice project to engage WLH/A about their health experiences, and harness the power of women's photo-narratives to inform participant-driven health promotion and prevention strategies for WLH/A.

Methods: We recruited WLH/A from two AIDS service agencies in St. Louis, Missouri. Participants (N=13) photographed their experiences and health and prevention needs; and attended a training session, two photo discussion sessions, and a community exhibit of their photos. We analyzed transcripts of discussion sessions for key themes and narratives.

Results: The participants were African American (92%). Their mean age was 42 years. Our analysis revealed that women's photo-narratives served six key functions: document health/social challenges; process trauma; depict visually the journey from sickness to living healthily with HIV/AIDS; express hopefulness; acknowledge social support; and promote action and advocacy to solve problems.

Conclusions: Photovoice is a powerful strategy to motivate dialogue among WLH/A, and to identify women's needs. Photo-narratives have implications for health promotion and prevention strategies. The findings suggest that services for WLH/A should focus holistically on women's lives and needs, not just on HIV/AIDS; help women recover from trauma; acknowledge women's ability to transform from despair to health; build and nurture social support; and recognize WLH/A as healthy, powerful, and capable.