Surviving HIV/AIDS in the Inner City: How Resourceful Latinas Beat the Odds by Sabrina Marie Chase (review)

In Surviving HIV/AIDS in the Inner City: How Resourceful Latinas Beat the Odds, Sabrina Marie Chase examines the experiences of 17 Puerto Rican women faced with the burden of living with HIV/AIDS. These women resided in the greater Newark, New Jersey area; half had acquired the virus from their husbands or partners, while the others had contracted it from intravenous drug use or drug-related sex work. Surviving HIV/AIDS provides an in-depth analysis of these women’s successes and the challenges they faced in attempting to obtain the health care and assistance needed for their survival. Chase attempts to answer the following four questions in her book: Given the limited resources of the participants, how did they manage an illness as serious as HIV/AIDS? Did they seek out alternatives to conventional medical treatments, and if so what kind? Did the magnitude of the challenges they faced deprive them of agency, or could they act effectively on their own behalf and on behalf of others? If so, how did their agency operate? And what can we, as a greater society, learn from this?^[p.7]

Chase draws on French sociologist Pierrre Bourdieu’s concepts of cultural capital, habitus, and social capital to explain why some of these women thrived while others faltered when faced with structural violence and the challenges of dealing with professionals in the health care system and government agencies. Cultural capital is defined here as a group of important resources individuals acquire from the families who raise them and socialize them into adulthood. Each group’s cultural capital is expressed as its habitus, the class and sub-culture specific worldview that prizes one set of preferences and activities over others. The author also stresses the importance of social capital, defined as benefits that emerge from relationships built on trust and reciprocity, in order to demonstrate why institutions such as hospitals and clinics are easier to navigate for people whose habitus has been shaped by middle-and upper-class privilege.

Although Chase starts out by describing the poverty, prejudice, health disparities, and drug-related problems that placed these women at risk of becoming infected with HIV, the goal of the book is not simply to highlight the challenges they faced, but rather to emphasize their agency and the meanings they constructed from their experience; she also sought to show how their habitus affected their experience with the health care system. To illuminate the effects of the women’s background on their experience with the health care system, Chase created three categories: women with broad cultural and social capital, women with average cultural and social capital, and women whose cultural and social capital fell somewhere in the middle. Chase asserts that one of the main differences between women with broad cultural capital and those with average capital is that broad capital women expressed both a greater desire and ability to cross from one habitus to another, while average capital women preferred to remain in their own habitus. As a result, broad capital women were better able than average capital women to interact successfully with a variety of professional institutions which helped them to expand their social capital while receiving the necessary resources needed for their survival. Chase uses these categories throughout the book to further demonstrate the impact of cultural and social capital on the type and quality of health care women received and on their outlook on life and on the strategies they developed to deal with HIV as well as their overall health.

The major strength of this volume, in my view, is the amount of time the author spent following and developing trusting relationships with the women in her study; these relationships enabled her to learn women’s stories and portray their experience in a manner easily accessible to the reader. Chase used snowball sampling to conduct extensive fieldwork from 1998 – 2000 in three...