Research and Theory for Nursing Practice: An International Journal, Vol. 27, No. 4, 2013
240 © 2013 Springer Publishing Company
http://dx.doi.org/10.1891/1541-6577.27.4.240
Rethinking the Experience of
HIV-Positive Refugee Women in
the Context of Pregnancy: Using an
Intersectional Approach in Nursing
Teresa Chulach, RN, NP, MN, PhD(c)
Marilou Gagnon, RN, ACRN, PhD
University of Ottawa, Ontario, Canada
When providing care to HIV-positive refugee women in the context of pregnancy,
nurses must be able to move beyond the individual experiences of health and illness
and acquire a more meaningful understanding of the historical, social, cultural,
political, and structural influences that shape women’s health and women’s lives.
Intersectionality is a framework that focuses on various dimensions of a refugee
woman’s social identity such as race, class, gender, as well as education, citizenships,
and geographic location and how these dimensions intersect to influence the experi-
ences of health and illness. In this article, we present a brief overview of the origins
and evolution of intersectionality. From there we describe three distinct levels of
analysis: (a) micro-level analysis to examine the influences that impact the social
identity and social location of women; (b) meso-level analysis to explore informal
and formal support systems; and (c) macro-level analysis to interrogate historical,
social, cultural, political, and structural influences that shape health outcomes.
Finally, we will examine how this framework may be useful for nursing practice,
research, and knowledge development. We hope to illustrate how intersectionality
is a useful framework to understand the experiences of HIV-positive refugee women
in the context of pregnancy.
Keywords: health; HIV; intersectionality; pregnancy; refugee; women
B
iomedical conceptualizations of health, illness, and life transitions (such as
pregnancy) have proved inadequate to understand the experiences of refugee
women because they fail to bear in mind, or only minimally consider, the social
structures, the social contexts, and the social identities that shape these experiences
(Rusek, Olesen, & Clarke, 1997). From this perspective, the focus of attention is the
individual body and the pathological (or potentially pathological) processes that take