From neglect to care: a theory to guide HIV-positive incarcerated women in self-care.

Self-care was investigated in this grounded theory study of 22 HIV-positive women incarcerated in a medium security prison in the southeastern United States. Findings revealed four phases in a social-psychological process of movement from neglect of health to self-care. Phases I and II revealed five social-psychological cofactors that constrained self-care and promoted vulnerability to poor physical and emotional health over time. Phase I, "Recurring Memories of Abuse," focused on the damage of abuse histories; Phase II, "Repeating Harmful Coping Behaviors," described maladaptive coping behaviors that put women at risk for HIV infection and incarceration; Phase III, "Searching for Self-Care," exposed the shock of incarceration and the HIV-positive diagnosis and symbolized a turning point in thinking about health and self-care. During Phase III, women discovered the possibility for better health through self-care. In Phase IV, "Connecting in Caring Relationships," women described their need for relationships that would help them promote and sustain self-care.