How do women who face the multiple stigmas associated with drug use, sex work, and HIV-positive status engage as political actors in the wider environment that shapes their lives? This question is at the heart of Workable Sisterhood. Michele Tracy Berger offers one of the first studies of the development of critical consciousness and political participation of women of color who are HIV positive. All of the women she interviewed for her study have also struggled with drug abuse and engaged in sex work, and all have found a way to translate their experiences into a range of political actions designed to empower themselves and other women who face similar challenges. These activities include contesting the stigma associated with HIV-positive status, working “face-to-face” with other HIV-positive women, designing events and cultural projects to educate the wider community about HIV and about those living with HIV and AIDS, and advocating for social and economic changes that would help improve the lives of HIV-positive people (p. 12).

Drawing on the powerful analytic frames of “intersectional stigma” and “life reconstruction,” Berger rightly argues that “the process by which these women have transformed themselves and exerted their rights in a democratic society deserves scholarly attention” (p. 2). She makes powerful use of the construct “life reconstruction” to forge a link between the women's experiences and events that contributed to their development as political actors. She describes a twofold process: first, the development of a “public voice” as an HIV-positive woman, and second, the recognition of resources that could facilitate their political participation (p. 12). These resources rarely included those most associated with political participation, such as professional status, higher education, or access to significant financial assets. In contrast, the women drew on recovery programs, therapeutic work, spirituality, and peer support as resources that fostered their engagement as HIV/AIDS advocates and political activists (p. 4). The women come to view their political work as a “community mandate” that resulted from their efforts to foster change in people's attitudes and treatment of stigmatized women with HIV/AIDS (p. 184).

Berger's study is based on a focused sample of 16 interviewed women who were diagnosed with the HIV/AIDS virus from 1986 to 1996. Through participation in the Street Outreach Program of Females in Trouble, a nonprofit agency that sponsors community development and self-empowerment programs for girls and women in Detroit, Berger formally and informally interviewed a large sample of women who had a problem with crack cocaine. She decided to focus her study on the women who were negotiating the stigma of HIV-positive status, along with the stigmas of drug abuse and sex work, to foreground the complex process of intersectional stigma. As Berger explains, the concept of intersectional stigma helps reveal “why the history and trajectory of their participation looks different when compared to other groups who organized around HIV/AIDS issue” (p. 25). She further explains that “the ‘piling up’ of stigmas does not result just in a negative effect; it changes and transmutes the relationship between other aspects of identity and HIV/AIDS” (p. 30).

The first chapter lays out the analytic framework. Berger links her analysis to scholarship on women's central role as community workers and further argues that the concept of blended and overlapping roles best captures “the ways in which they articulated the work they did in their communities and the meanings they made from it” (p. 5). In Chapter 2, she presents brief “bio-sketches” of the women she interviewed. The bio-sketches are organized around the three overlapping roles of advocate, activist, and helper. It is unclear from the bio-sketches what distinguishes these categories, one from the other. It would have been useful for the reader to have the discussion of the rationale for these different categories included in this chapter, rather than wait until Chapter 7 for an expanded discussion.

Chapter 3 outlines the methodology for the study and includes a thoughtful discussion of the dilemmas the author faced as she carried out her study. Berger's methodology includes close attention to the construction of what she terms “narratives of injustice.” She carefully explores how the women describe their coming to terms with their diagnosis and coming to consciousness about the societal factors that contribute to the marginalization of women like them. Chapter 4 details the narratives of injustice presented by the respondents and highlights the discrimination they faced when they were told about their HIV/AIDS diagnosis. Most of her respondents described experiences with insensitive medical staff who emphasized “an inevitability of death” and did not offer any follow-up support (p. 91). The women reported that they received biased treatment due to their history of drug use. For many, the recognition of the discriminatory treatment served as a catalyst for their political activism.

Chapters 5 and 6 delve into the life reconstruction process and examine how the women drew on nontraditional resources for their political participation. These resources include recovery programs and therapy through which they explored how sexual trauma affected their later life choices. As Berger explains, “therapy around sexual abuse trauma began to provide a language and vocabulary by which women could start to understand the concept of women as a category, and also helped them to see that other women very much like them (women of color, drug users, lower income) also experienced similar phenomena” (p. 111). In Chapter 6, Berger analyzes two main processes that contribute to “reconstructing gender identity”: first, “redirecting HIV stigma related to sex work,” and second, “sexual self (re)education and empowerment,—that is, ways in which women sought to empower themselves around: (1) safe sex and (2) renegotiation of sexual boundaries” (p. 119). Central to these interrelated processes is the “development of a public voice: what it means to be a woman with HIV” (p. 133). Claiming the identity of “a woman with HIV” provided “the bridge to political activity” (p. 133). Chapter 7 focuses on “the multiple expressions of political participation” (p. 143). Berger analyzes the political work of her sample as “black female-centered” and argues that many of the women demonstrate familiarity with the “basic concepts espoused in multiracial feminist or womanist thought,” such as “sharing of power and empowerment issues for women of color” (p. 182).

Berger's study effectively demonstrates the limits of “notions about the route to political socialization and about what is possible for people labeled deviant” (p. 197). Her study is one of the first that I have read that centers on the experiences and political practice of women of color who are HIV-positive and who also face other challenges, such as recovery from drug abuse and sexual trauma. The concepts of “intersectional stigma” and “life reconstruction” have value beyond her study and can provide useful frameworks for researchers working with marginalized populations. Her accessible writing style combined with the rich analytic framework contribute to the value of Workable Sisterhood for multiple audiences.