On the margin: Power and women's HIV risk reduction strategies

HIV risk and prevention research has failed to investigate adequately the e ffects of gender-related factors such as relationship power sexual communic ation, abuse, and gender roles on women's abilities to engage in protective actions. We propose that women's HN risk from heterosexual transmission is embedded in the context of gender, race/ethnicity, and class oppression. T his context has central implications for interpersonal relationship factors relevant to women's HIV risk. We suggest a framework for understanding wom en's HIV risk within the context of oppression and the role of power in int imate sexual relationships Three common dynamics of oppression are consider ed: (1) Silencing, (2) Violence and Fear of Violence and (3) internalized O ppression. These dynamics are based on characteristics of oppression discus sed in the work of Jean Baker Miller on gender, Hussain Bulhan on race, and Paulo Freire on class. These dynamics are discussed in the context of find ings reported in this journal issue and those of other authors. Finally, th e discussion identifies common patterns across studies, as well as areas of disagreement and directions for future research and public health preventi on efforts.