Abused African American women's processes of staying healthy.

Fifteen African American women with a history of intimate partner violence (IPV) were interviewed to examine (a) the ways in which poor, urban African American women stay healthy, and particularly how they protected themselves from sexually transmitted diseases and HIV while in abusive relationships; and (b) the roles of intersecting contextual factors such as lifetime experiences of violence, mental health symptoms, and substance use in women's processes of maintaining their health. Data were analyzed using a qualitative descriptive approach. Women were managing numerous, complex problems as they actively worked to maintain their mental and physical health and that of their children. The turning point at which women made substantial changes came when women were "tired" and believed that a new beginning was needed. Racism, poverty, multiple experiences of violence, and health and mental health problems influenced women's health care decisions. Women's health maintenance strategies were often not visible to health care providers and included some behaviors that may place women at greater risk of violence or disease from the point of view of the health care provider.