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Jhjj 1. In Mental illness some contexts these include having a mental illness, being a member of an ethnic minority Stigma group, being an immigrant, being poor, and being a woman who does not live up to gen- Sexuality dered expectations.

However, the participants fall short of their gender ideals and engage in sexual relationships that they experience as disempowering and unsatisfying.

The effects of their multiple identities as poor Latina women living with severe mental illness in an urban ethnic minority community are not always additive, but the interlocking effects can facilitate increased HIV risks.

All rights reserved. Introduction SMI exemplify one such group. High rates of coercive sexual encounters, un- racism, and stigma carry the greatest burden of disease and protected sex with high risk partners, and exchange sex death Farmer, A focus on individual characteristics alone has not successfully curtailed the epidemic in vulnerable women.

E-mail addresses: pyc1 columbia. Collins , unger wzb. Collins et al. Conceptualiza- practices that prioritize reproductive control over HIV pre- tions of stigma and intersectionality both would suggest vention Collins, ; Stern, These might tion of stigma related to mental illness can also have include laws that determine access to welfare, Medicaid, grave social consequences.

We recruited women aged 18 and older from two community mental health clinics in New York City to Stigma, intersectionality, and contextual risk participate in Project Wisdom, a study of HIV prevention for women with SMI.

We later met with women receiving services Feminist theorists have explored the ways in which sys- to describe the study during community meetings.

Lorde, The concept presumes that systems qualitative interviews in English and Spanish. Women were interviewed when they expressed Collins, Ethnic minority women are further subject interest in the study and had the capacity to give informed to sexualized stereotypes, a phenomenon described as consent.

The majority of women 3. All inter- physical or sexual abuse by their partners or family mem- views were audio-taped and transcribed.

The transcripts Social context were read multiple times. We then conducted a de- mental health clinics located in urban neighborhoods tailed indexing of the interviews, organizing them accord- with large Latino populations.

Men and women with men- ing to major topical areas. Many of minority membership and sexuality. We then conducted the study participants had attended the clinics for several open line-by-line coding, accompanied by memo writing years and viewed the clinic staff and other patients as on emergent themes.

We grouped themes into categories important members of their support system and social net- during discussions among the research team members.

Some women attended the clinics multiple times per The data were also subjected to the constant comparative week to participate in day treatment programs, whereas method both as a method of analysis and to increase the others attended monthly for prescription renewal and sup- validity of the study results Charmaz, Additional portive therapy.

AIDS is conclusions are based on, but also of discrepant data and the third most common cause of death after cancer and deviations from the main story lines Maxwell, Nearly one-third of the res- From this process we arrived at conclusions about how idents live in poverty.

Spanish is widely spoken on the stigmatization experiences relating to mental illness and street and in shops. Three of the main themes ties that took them outside.

Participants or their families came from the Dominican Republic, Puerto Rico, and other Span- Results ish speaking countries. Most had lived in poverty with lim- ited opportunities for education.

They were employed in Demographics factories or private homes as domestic workers. Others, with greater means had operated small businesses.

For The women ranged in age from 24 to 64 years, with several women parenthood at a young age had led them a mean age of Among the 24 Latinas, 15 were into deeper poverty; some formed partnerships with men Dominican, 7 were Puerto Rican, 1 was South American, because they offered an opportunity to emigrate.

Many and 1 of mixed ancestry. An older woman ily spoke Spanish. The remaining were born to im migrant lamented the loss of community and the sense of being parents.

But the US brought advantages, bers or male partners, three lived alone in apartments or also. Five worked part-time in mental Among the resources women encountered in New York health programs.

Symptoms of mental illness time of the interview. Of those not currently in a relation- kept many women out of the job market, locking them into ship, 9 out of 13 had been previously partnered or in dating poverty.

When unable to continue working, they obtained relationships. Yet, for those women boyfriends; unintended pregnancy; the stress of life in whose dreams of a better life in the United States were the United States lack of money and work, social isolation ; derailed by the onset of psychiatric illness, the inability to the stress of im migration; and traumatic childhood work and earn money added to the pain of living with events being orphaned, unstable family environment.

Others had been told by their doctors that the mental For many of the migrants and immigrants, arrival to illness was hereditary or linked to a childhood illness.

New York also brought a new status as an ethnic minority. When sent to a hospital outside the response. Another visits a church outside of her The work of making sense of the illness often occurred neighborhood and takes care that her own behavior is tact- in the context of treatment.

In contrast, they described themselves as laws of the United States. People know mental illness in its extreme. Mental illness A loco can shoot someone on the train.

Susana and major depression 2 with psychotic features 2. The onset of illness frightened and perplexed most women. Women who were already in re- chose partners who also lived with a mental illness.

Some men were clinic. Her own lack of a job makes her feel vulnerable to supportive and made sure their wives adhered to their criticism and judgment by people without mental illness.

During periods of acute illness they accompa- Ultimately, her approach to her relationship with her part- nied them to the hospital and visited them regularly.

Neither Rosalie nor Many who were not in committed relationships, but her partner likes to use condoms given his already actively dating, believed that disclosing their illness would impaired sexual functioning a consequence of his lead to abandonment.

Linda, a year-old immigrant medication. She agrees with living with a mental illness. Renee re- sex outside the relationship, which presents a possible veals that she has recently started a relationship with HIV risk.

Because many of the women struggle with low a man, but has kept her illness a secret due to fears that he self-esteem, they are hurt by the rejection they experience.

Then they would leave for one gether while others settle for a partner who will stay thing or another. In other cases, medica- tions took away sexual desire.

I felt nothing, nothing, nothing. She remarks that them. I believe this was the most serious. Cati, a middle-aged impact of stigma at the intersection of gender, class and woman, implies that her symptoms contribute to her hus- ethnicity.

One of the experience of their relationships and forces them to recog- things that led to my emotional state, to going to the doctor nize how others viewed them often unfavorably , they more, was that.

Most participants describe en. I knew he was going around with women and I suf- being raised in settings where traditional gender roles pre- fered from that.

Women could either meet their out, it should work out. It takes sometimes a while to see because search of women. It is a man. If there is a woman who gives him the opportu- takes a while to realize that.

You feel disturbed and nity, the man takes it. You have to go back with partners they believed to be unfaithful. Women also to the doctor, pray, do something.

As a result, they of- the way she would like. She expresses deep regret for the ten have sexual experiences, but are rarely treated with re- loss of dignity that follows.

Another woman secretly of pain and disempowerment for many. Mental illness seeks and maintains a sexual relationship outside of her placed them at risk of rejection or derision.

Patricia, a participant from women or others striving toward the ideal seems partic- the Dominican Republic, is highly critical of the gender ularly relevant for women with SMI.

It serves to maintain system and refuses to play a part in it: dignity and counteract the stereotypes of promiscuity as- sociated with the loca.

Dominican men are always in the street. And where which she feels disrespected. Her partner is a younger are the women?. In the house watching soap operas.

Democratic Republic of the Congo. WIR euro complementary currency. WIR franc complementary currency. Chinese yuan [8]. Costa Rican colon.

Costa Rica. Cuban convertible peso. Cabo Verde. Czechia [10]. Dominican Republic. Falkland Islands pound. Falkland Islands pegged to GBP Gibraltar pegged to GBP Hong Kong.

North Korea. South Korea. Cayman Islands. Sri Lanka. North Macedonia. Papua New Guinean kina. Papua New Guinea. Philippine peso [12]. Saudi Arabia.

Solomon Islands dollar. Solomon Islands. Seychelles rupee. Sierra Leone. South Sudan. El Salvador. Eswatini [12]. Trinidad and Tobago dollar.

Trinidad and Tobago. United States. Unidad previsional [14]. Silver one troy ounce. Gold one troy ounce. European Monetary Unit E.

European Unit of Account 9 E. European Unit of Account 17 E. East Caribbean dollar. Special drawing rights. International Monetary Fund. Palladium one troy ounce.

Platinum one troy ounce. African Development Bank [16]. Chinese yuan offshore. The code CNT is used to represent the Chinese yuan aka Renminbi in offshore trading, especially offshore trading involving T aiwan.

See Other markets. GGP [21]. IMP [21]. Isle of Man pound. JEP [21]. KID [22]. TVD [21]. ZWB [24]. De facto currency used until January , when it was replaced by the euro EUR.

MAF [ citation needed ]. Used until January , when it was replaced by the euro EUR. Used from January through , when it was replaced by the second denar MKD.

San Marinese lira. Re-denomination used in January [25] until it was replaced by the novi dinar YUM. Yugoslavia [d]. Angolan kwanza.

Angolan novo kwanza. Angolan kwanza reajustado. Argentine peso argentino. Bosnia and Herzegovina dinar. Brazilian cruzado novo.

Brazilian cruzeiro real. Belarusian ruble. Ecuador Unidad de Valor Constante funds code. Equatorial Guinean ekwele.

Lithuanian talonas [38]. Luxembourg convertible franc funds code. Luxembourg financial franc funds code. Latvian ruble [39]. Peruvian old sol.

Peruvian sol. Turkmenistani manat. Portuguese Timorese escudo.

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