Ariel Rankin Final Dissertation Package May 26 2015 AMR-AN

169 Pages·2015·1.47 MB·English

by  Ariel Rankin

UCLA
UCLA Electronic Theses and Dissertations
Title
Repurposing a Legacy: The Experiences of African American Women Receiving a Human
Immunodeficiency Virus Diagnosis at the Age of 50 or Older
Permalink
https://escholarship.org/uc/item/0rw634d8
Author
Rankin, Ariel Marcia
Publication Date
2015

Peer reviewed|Thesis/dissertation
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University of California
UNIVERSITY OF CALIFORNIA
Los Angeles

Repurposing a Legacy: The Experiences of African American Women Receiving a Human
Immunodeficiency Virus Diagnosis at the Age of 50 or Older

A dissertation submitted in partial satisfaction of the requirements for the degree of Doctor of
Philosophy in Nursing

by

Ariel Rankin

2015
© Copyright by
Ariel Rankin
2015
ABSTRACT OF THE DISSERTATION

Repurposing a Legacy: The Experiences of African American Women Receiving a Human
Immunodeficiency Virus Diagnosis at the Age of 50 or Older
by

Ariel Rankin
Doctor of Philosophy in Nursing
University of California, Los Angeles, 2015
Professor Adeline Nyamathi, Chair

By the end of 2015, over half of all HIV/AIDS cases will be in adults aged 50 and older.
One of the fastest growing older adult sub groups afflicted by the HIV epidemic is older African
American women. At present, no studies have explored the unique experiences of older African
American women who have received an HIV diagnosis at the age 50 and older.
A descriptive qualitative study employing constructivist grounded theory methodology
was used to gain insights into the experience of African American women diagnosed with HIV at
age 50 and older. In taking the constructivist approach, analysis stemmed from shared
experiences and relationships with participants. Semi-structured interviews were conducted,
audio-recorded and transcribed. A total of 16 interviews were used. Open-ended, non-leading
questions and probes were developed from a literature review and community members’
suggestions. Coding, mapping, analytic strategy usage, and memoing all assisted in creation of
the grounded theory.
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The results of this study demonstrated how older African American women utilized
various strategies to repurpose a legacy, after an HIV diagnosis. The strategies used by the
women included re-evaluating perceptions of HIV risk, learning lessons from tumultuous times,
and reconciling past and present events. The women’s lack of HIV risk perceptions and their
provider’s failure to assess risky behaviors resulted in delayed HIV testing. After being tested,
the women embarked on a journey to resolve newfound issues, and in the process, learned
various life lessons. This process allowed the women to make meaning of their HIV diagnosis
and set out on a path to self-discovery. The results of this study can shape forthcoming research
on the HIV trajectory of older African American women living with HIV/AIDS and at risk for
HIV/AIDS.

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The dissertation of Ariel Rankin is approved.

Linda R. Phillips
Carol L. Pavlish
Sally Louise Maliski
Donald E. Morisky
Adeline M. Nyamathi, Committee Chair

University of California, Los Angeles
2015

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Dedication

To the 16 African American/Black women whose powerful stories made this study possible.
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Table of Contents
Chapter One: Introduction
Introduction 1
Background 3
Purpose of the Study 7
Organization of the Study 8
Chapter Summary 9

Chapter Two: Literature 10
Review
HIV Risk Influences 11
Perception of HIV Risk 16
Social Support 18
Healthcare Needs and Linkage to HIV Care 22
Chapter Summary 27

Chapter Three: Theoretical 29
Orientation and
Philosophical
Underpinnings
The Cognitive Theory of Stress, Appraisal and 29
Coping
The Behavioral Model of Health Services Use 37
Symbolic Interactionism 43
Chapter Summary 52

Chapter Four: Methodology 54
and Design
Research Approach 54
Qualitative Data Collection Procedure 58
Data Analysis Procedure 61
Chapter Summary 68

Chapter Five: Results 69
Socio-demographic Characteristics 69
Repurposing a Legacy 70
Lack of Perceptions of HIV Risk 71
Initiation of HIV Testing 77
Finding and Creating a New Identity 81
Building a Legacy- Finding my Purpose 103

Summary 109

Chapter Six: Discussion 111
Pre-HIV Diagnosis 111
Post-HIV Diagnosis- Finding and Creating a New 114
Identity
Conclusion 117
Summary 122

Appendices 123
Appendix A: Flyer 123
Appendix B: Pre-Eligibility Screening Guide 124
Appendix C: Interview Guide 126
Appendix D: Consent Form 129
Appendix E: Demographic Data Form 132
Appendix F: Results Dissemination Guide 134
Appendix G: Table 1.1: Participant 135
Characteristics
Appendix H: Table 1.2: Participant 136
Characteristics
Appendix I: Figure 1.1: “Repurposing a Legacy” 137

References 138

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Acknowledgments
“It takes a village…” There are far too many people to thank but I offer a heartfelt thank
you to my dissertation committee, classmates, family and friends for your prayers and support
during this process. I thank God for His grace and mercy.
A special acknowledgment goes to my parents, Morsin and Launcelot Rankin. Thank you
mom for encouraging an appreciation and love for learning. You would always say, “If I could
come to this country and succeed, I know you can out shine me.” I will continue to make you
proud. Also, I would like to acknowledge my best friend, Tyrone McDonald for being my
sounding board and “my rock.”
I would like to express my deepest gratitude to my chair Dr. Adeline Nyamathi for seeing
my potential and helping me to grow as a researcher. Thank you for volunteering countless hours
to guide me in this dissertation writing process. Thank you Dr. Maliski for guiding me through
this qualitative research experience. Your expertise and nurturing spirit helped me to create a
grounded theory that the women, of my study, would be proud of. Thank you Dr. Phillips for
your consistent mentorship from the MECN program to the PhD program. I have a greater
knowledge and appreciation for gerontology because of you. Thank you Dr. Morisky and Dr.
Pavlish for offering your time and expertise. Your insights into this dissertation were essential. I
would like to acknowledge my colleagues Lindsay Williams, Rhonda Flenoy-Younger and Kia
Skrine-Jeffers for your support and advice throughout this dissertation.
Lastly, I want to acknowledge the financial support for this research, which was provided
by the National Institutes of Nursing Research, T32 NR007077 Vulnerable Populations/ Health
Disparities pre-doctoral fellowship.

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