Using photography as a data elicitation technique with African American mothers living with HIV

The strength and vulnerability of African American mothers living with HIV functions at the intersection of gender-, race-, and class-inequality, HIV-related stigma, and motherhood, requiring multidimensional and transdisciplinary approaches to address the complex social and economic conditions of their lives, collectively known as the social determinants of health. Photography offers a means for participants to conceive of, take, and describe visual representations of their social determinants of health, but can also introduce important methodological issues and ethical challenges. This pilot study aims to explore the methodological issues and ethical challenges of using photography as a data elicitation technique with a highly stigmatized social group of women and their children in describing their unique social location as African American mothers living with HIV and the intersection of the social determinants of health they experience. METHODS: Qualitative data collection methods of in-depth interviewing and photo elicitation were used to describe the intersection of the social determinants of health, both positive and negative, experienced by five African American mothers living with HIV. Data collection occurred at three time points over a five week period and participants used disposable cameras to take photographs representing the social and economic circumstances influencing their daily health experiences. RESULTS: Participants captured visual representations of the social complexities of their lives and in conjunction with verbal explanations offered detailed descriptions of the impact of those complexities on health at both the individual and community level. Multiple confidentiality and privacy issues emerged while developing and conducting the pilot study creating ethical challenges in using photography as a data elicitation technique. DISCUSSION: Photography is an effective method for describing social determinants of health but requires keen attention to ethical concerns. Feasibility studies piloting such participatory methods with vulnerable populations are key and research protocols may vary significantly depending on the population and environmental context.