La protectora (the protectress): A metaphor for HIV(+) Hispanic women

HIV/AIDS can represent an overwhelming disruption for Hispanic women. Beliefs provide a source of comfort when attempting to cope with failure, threats, challenges, and with living in a society with different attitudes, values, and lifestyles. Few researchers have studied the health needs, health status, health beliefs, health-seeking behaviors, or family roles of Hispanic women. No research was found related to cultural influences and folk health practices of women affected by HIV.

The purpose of this exploratory qualitative study was to identify folk health practices of HIV+ Hispanic women. Theoretical sampling was used to identify respondents at an outreach center in a large southwestern city in the United States. Nine respondents were interviewed and audiotaped using a semi-structured interview guide and open-ended questions. Observations were conducted at the outreach center, during support group and alternative therapy sessions, and at the respondents' homes. Data analysis included the constant comparative method consistent with the grounded theory approach.

The core variable of La Protectora (The Protectress) emerged from the findings. Response to the affirmation of HIV+ serostatus becomes a process by which the Hispanic woman chooses to live her life and unfolds into a positive attribute of marianismo, La Protectora. Five main categories emerged that describe how the Hispanic woman deals with life after the revelation of her HIV+ status. They were Revelation of Death, Ofrecer (an offer to change), Living, Revealing, and Duality. Two subcategories emerged from each of the three categories, Living, Revealing, and Duality. Dealing and Surviving emerged from Living. Protecting and Advocating emerged from Revealing. And Intensifying and Actualizing emerged from Duality.

As most of the Hispanic women were pregnant when their serostatus was revealed, their lives had purpose amidst a life sentence of death. The Hispanic woman's purpose was to live for her child and her family. With the infant as the driving force, the Hispanic woman was motivated, sought out, and participated in activities to promote her own well-being. La Protectora emerged as she intensified in her mother role and actualized in her role as a woman with HIV.

The findings have implications for nurses and other healthcare professionals that provide service to Hispanic women, pregnant women, and those affected by HIV/AIDS. HIV+ Hispanic women see themselves as women first. The inequalities they face are recognized as “women issues” rather than cultural issues. How they live their lives, care for their families, and face the prejudice of being HIV+ are based on being women. They assume a pro-active role as they live and take responsibility for their disease.