“Let’s Talk About HIV”: Middle Class Black Women’s Self-Advocacy in Patient-Provider Communication

Allison Mathews, our guest blogger, is a doctoral candidate in the Department of Sociology and Humphreys Fellow with the Graduate School at UNC-Chapel Hill. Her dissertation research focuses on the role that Black and gay identity play in Black gay men’s religious choice and participation. Her research interests include race and ethnicity, masculinity and sexuality, religion, and health disparities.

A recent article in The New Yorker entitled, “HIV’s Grip on the American South,” highlighted the devastating and long-term effects that high rates of HIV prevalence have on the American south, and specifically Black Americans. Despite recent findings in HIV/AIDS research that boast medical advances leading to a possible cure, the risk for contracting and dying from the disease is still a heavy burden for Black southerners to bear. In their recent presentation for the IAAR spring 2014 talk series, Kia Lilly Caldwell (Associate Professor, Dept of African, African American and Diaspora Studies, UNC-Chapel Hill) and Niasha Fray (doctoral student, Dept of Health Behavior, UNC-Chapel Hill) take on a new and refreshing perspective to this public health issue by examining the experiences of middle class Black women, who are an often understudied population. They seek to understand how the experiences of middle class Black women living in the southeastern United States engage in conversations with their health care providers around risk and preventive methods for contracting HIV/AIDS. Caldwell and Fray find that participants’ perceptions of their need to self-advocate for HIV/AIDS and STD testing in patient-provider interactions served as a potential pathway to increase testing. However, patients’ self-advocacy was also a reaction to the providers’ hesitance in offering the test. Participants in the study had a perception that their healthcare providers assumed they were not at risk for contracting HIV/AIDS or other STDs because of their middle class status. Thus, they believed health care providers were not as willing to offer Black middle class women HIV/AIDS or STD tests. Importantly, all participants in the study had been tested at one point in their lives and most were likely to get tested while visiting a healthcare provider.

Attendees to the brown-bag presentation actively engaged both speakers after the presentation with questions that extended the discussion. One attendee asked, “Are assumptions of low risk for contracting HIV/AIDS among middle class patients affecting patient-provider communication across the board or is this pattern unique to Blacks?” Caldwell and Fray responded that in general, providers are more likely to assume that middle class patients are not at high risk for contracting HIV/AIDS; however, there is little research to substantiate these assumptions because few statistics examine class differences for HIV/AIDS rates. Additionally, Black Americans are disproportionately affected by the disease, have less access to health care, and often are provided with less effective treatment due to both patient mistrust and provider bias. Thus, it is important to try to find ways to improve patient-provider communication for those disproportionately impacted by the disease, including Black middle class women. Needless to say, the research presented was timely and important for understanding factors that affect patient-provider communication around HIV/AIDS and ways to improve such communication.

Centralizing the Griot in Space and Time: The Practice of Spatial Literacy

Tanya Shields, our featured IAAR blogger, is an assistant professor in UNC’s Department of Women’s and Gender Studies.  Dr. Shields’s first book, Bodies and Bones: Feminist Rehearsal and Imagining Caribbean Belonging, is forthcoming with the University of Virginia Press and examines the ways in which rehearsing historical events and archetypal characters shapes belonging to the Caribbean region.  Dr. Shields has been working with several Caribbean artists in an effort to engage in “real time” conversations on change and rehearsal. She teaches classes on Caribbean women, the arts of activism, growing up as a girl globally, and the continuing influence of plantation economics and politics. 

Folashade Alao’s recent IAAR talk, “‘I Remember, I Believe:’ Griots, Migrants, and the Textures of Southern Space,” uses Lizz Wright’s version of Sweet Honey’s “I Remember, I Believe” as a structuring device to illuminate not only the griot tradition, but also the import of space in helping us “read a black diasporic past that we cannot see.”

Alao characterizes the griot as not only a storyteller, but more importantly as a guide who “radically and fundamentally transform[s] the very ways in which…readers [and] viewers interact with physical and natural spaces.” Artists serve as griot guides who show the reader and/or viewer the significance of space on our consciousness. Using the concept of spatial literacy, which she defines as “the ability to read physical geography as a critical text that is constructed and shaped through social processes, events, and individuals at different moments across time,” Aloa allows us to see the past as dynamic. To demonstrate the doing of spatial literacy Alao applies it to three texts: “1960 Who: Atlanta Student Movement and Freedom Riders,” Sheila Pree Bright’s interactive photo installation; the collective family memoir, Lemon Swamp, by Mamie Garvin Fields and Karen Fields; and Triangular Road, Paule Marshall’s spatially-inflected memoir.

This talk and Alao’s book manuscript, “I Hear Echoes Still” is attentive to the various registers of southern space and the construction of the south as a place.  Her work begs the question: what is the south? Our collective imagination is replete with Southern imaginaries that have been shaped by history and culture: big oaks (gallant trees), magnolia, slavery, Jim Crow segregation, violence, horror, victimization, family, fried chicken, and sweet potato, etc. Or if we expand our definition to include the global South: it could include palm trees, sapodilla, hibiscus, slavery, colonialism, family, the Caribbean Sea, the Atlantic Ocean, Santeria, rum, plantains, yams, pan music, rumba, and reggae. But in this globalized world, what makes the South different from other spaces? A more rigorous definition of what encompasses the region would be instructive in illuminating Alao’s point that the south is not static, but a site that is shifting and reconstituting itself like every other place. Indeed, the U.S. South today has significant Latina/o and Asian populations in addition to its historical black and white ones. And as the cotton fields to skyscrapers exhibit at the Levine Museum of the New South indicates, southern landscapes have evolved. Alao points to a nuanced engagement with cultural geography that allows us to experience the history hidden in the overgrowth of a reclaiming nature or demolished by a gentrification (see the film, My Brooklyn), all of which challenge our notions of the south.  Additionally, as with Marshall’s memoir, Alao has the opportunity to investigate a global south.  While this may be beyond the purview of her project, I am struck by the way the griot guides resonate, mimic, and flow into each other. For instance, here are two examples: Jabulile, a Gullah storyteller/guide and Miss Lou, the famed Jamaican poet and cultural keeper.

Dr. Folashadé Alao in her lecture "I Remember, I believe."

Dr. Folashadé Alao in her lecture “I Remember, I believe.”

Alao’s presentation is particularly compelling when she reminds us of the tensions between memory and forgetting. To do this, she invokes Toni Morrison’s 1989 acceptance speech for the Frederic G. Melcher Book Award. In this piece, Morrison decries the lack of “suitable memorials” for slaves and “the ones who made the journey and of those who did make it.” And because these memorials do not exist, “the book [Beloved] had to” and thus, Alao’s interweaves visual texts and memoirs to show how space evolves based on the confluence of history, culture and environment. The interaction of these texts indicate the bodily and sensory potential of spatial literacy (While Lizz Wright framed the talk, Alao used Gregory Porter’s “1960 What?” to frame Bright’s exhibition, “1960 Who?”) and complements the analysis in the talk. Her critical work reminds me of two novels, Gloria Naylor’s Mama Day and Merle Collins’s The Colour of Forgetting. In these novels, characters “assemble different aspects of space” to bring various fragments of themselves into some semblance of a whole. The process of developing a holistic subjectivity or a less fragmented one means coming to terms with the past. “I Remember, I Believe” maps the ways in which layers of space, self, and community are made visible. The bleeding through of story from one generation to the next is at the very heart of spatial literacy as a practice of re-writing that centers the griot as a guide.

African American English and Embracing Linguistic Diversity in the Classroom

Jen Griffin, our featured guest blogger for February, is a doctoral candidate in the Linguistics Department at UNC.

Her research interests include the documentation of dialect variation and evaluating models of variation. Her dissertation project seeks to document the various dialects of Sgaw Karen, which is an understudied language spoken by members of the Karen refugee community here in Chapel Hill.

In recent years, universities and other academic institutions nationwide have sought to promote diversity. In faculty training, course syllabi, and university policies, tolerance of diversity is emphasized in regards to race, gender, nationality, religion, and sexual orientation. However, as sociolinguist Walt Wolfram of North Carolina State University noted at the recent IAAR panel on African American English, one type of diversity that has largely been ignored is linguistic diversity. Little attention has been given to increasing tolerance for or understanding of the many distinct dialects of English that are spoken throughout the nation. Continue reading

Mentorship and Professional Development for Researchers of African Americans and the African Diaspora

No one disputes that mentorship and network-building are the stuff of professional development for young scholars and students. Arguably, mentoring is especially important in interdisciplinary fields such as African American and African diaspora studies, an area of scholarship that some consider less legitimate than “traditional” disciplines (see Robin Kelley’s recent article on this) and that others discredit as yet another “studies” field. Creating structures and opportunities for students and emerging scholars, then, becomes critical for their ability to find and build community and support for their scholarly interests and production as well as gain and acquire access to vital knowledge and strategies for navigating the profession successfully and productively.  Continue reading

Audio: Infant Feeding and African American Mothers

Listen to Profesor Margaret Bentley (UNC-CH, Gillings School of Global Public Health) January 23rd talk on “Infant Feeding, Care and Risk of Pediatric Obesity among African American Mothers in North Carolina.” She was joined by Dr. Heather Wasser (UNC-CH, Center for Women’s Health Research) and Dr. Amanda Thompson (UNC,-CH, Dept of Anthropology).

Click here to listen to the talk at SoundCloud →

Fat Babies

Our featured guest blogger today is Taylor Livingston, a doctoral candidate in the Department of Anthropology at UNC-CH. Taylor’s dissertation project examines whether, how and why African-American women choose to breastfeed. She is particularly interested in the ways that public health discourses and the legacy of slavery and racism in the South shape African-American women’s infant caregiving decisions and practices.

On Thursday afternoon, Dr. Margaret (Peggy) Bentley kicked off IAAR’s Spring semester talks. Dr. Bentley discussed the importance of maternal beliefs and perceptions for understanding infant feeding practices. Dr. Bentley presented the findings from the “Infant Care” study conducted with her colleagues, Dr. Amanda Thompson, Dr. Heather Wasser, and Ms. Kenitra Williams. “Infant Care,” a longitudinal study from 2003-2010, is a descriptive project undertaken with African-American first-time mothers in North Carolina to understand infant feeding. The main focus of the study was to assess if there is a connection between early infant feeding practices and childhood obesity. Continue reading

Warm up with the IAAR Spring Events

As you try to wrap your mind around how the temperatures can go from 10 to 70 degrees all in the first week of classes, take a look at the more comprehensible and balanced roster of events that we have lined up for spring 2014. Our focus continues to be currency in research on African Americans and the African diaspora. Three of our spring talks draw on big or emerging questions for studies of Black American women in different fields. Anthropologist and Global Nutrition professor, Margaret Bentley will discuss mothering and child health. Literature scholar, Folashadé Alao (University of South Carolina), will talk about themes of spatial literacy and diaspora among African American women writers in the post-1970s period. And, Kia Caldwell, UNC associate professor of African, African American and African Diaspora Studies, will present with Niasha Fray (doctoral candidate, Dept of Health Behavior) to address self-advocacy among middle class black women undergoing HIV testing. Continue reading

Research Insights, Emotions and the Case of Trayvon Martin

When I pulled together a panel of speakers to discuss the case of Trayvon Martin for IAAR’s second fall program, I hadn’t banked on the event being as intense and rich as it turned out to be. I wanted scholars who may never have written analytically on Martin to bring their research insights on a variety of substantive issues and theoretical questions to bear on the case. But, the take away was that research insights are not decoupled from visceral reaction and emotion. As a cultural anthropologist I knew this truism all too well thanks to work by people like Ruth Behar who talks of an anthropology that “breaks your heart.” But, I had never seen that truism play out in an event space, certainly not as intensively as it did on this particular Thursday evening. And so, as we heard about and discussed complex theoretical categories like social structure, historical process, constructions of race and discrimination, it became clear that the panelists and audience members in the room (students and faculty alike) felt the weightiness of applying those categories to the fraught case of Trayvon Martin’s death. Performing the analytical work and critical thinking together – in what a friend termed an “honest space” – was arduous, productive and riveting. Continue reading

Andrews, Crayton and Unah Speak at IAAR Opening Event


The IAAR is pleased to have three UNC faculty speak at its opening event, Voting Rights, Racial Justice and Moral Mondays: Examining Civil Rights in the 21st Century. Professors Kareem Crayton, Isaac Unah, and Kenneth (Andy) Andrews will examine recent national rulings and state legislative changes in the context of civil rights concerns past and present. Focus will be specifically on developments regarding the Voting Rights Act, the Racial Justice Act, and the Moral Monday protests placed in the context of the Civil Rights Movement. Information on these three accomplished professors can be found below.

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