Socioecological factors influencing women’s HIV risk in the United States: qualitative findings from the women’s HIV SeroIncidence study (HPTN 064)

BMC Public Health

Research Article

Danielle Haley¹  Kimberly Parker²  Laura A. Randall³  Linda Vo³  Paula M. Frew⁴  Carlos del Rio⁵  Adaora A. Adimora⁶  Carol E. Golin⁶  Ann O’Leary⁷  Irene Kuo⁸  Lydia Soto-Torres⁹  Dazon Dixon Diallo^1,10  Jing Wang^1,11  Sally Hodder^1,12 

[1] Department of Behavioral Sciences and Health Education, Emory Rollins School of Public Health, 1518 Clifton Road NE, 30322, Atlanta, GA, USA;Department of Health Studies, Texas Woman’s University, PO Box 425499, CFO Bldg – 1007, 76204, Denton, TX, USA;Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, 1760 Haygood Road, Suite 300, 30322, Atlanta, GA, USA;Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, 1760 Haygood Road, Suite 300, 30322, Atlanta, GA, USA;Department of Behavioral Sciences and Health Education, Emory Rollins School of Public Health, 1518 Clifton Road NE, 30322, Atlanta, GA, USA;Hubert Department of Global Health, Emory Rollins School of Public Health, 30329, 1518 Clifton Road NE, Atlanta, GA, USA;Emory Center for AIDS Research, Emory University, 1518 Clifton Road NE, Suite 8050, 30322, Atlanta, GA, USA;Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, 1760 Haygood Road, Suite 300, 30322, Atlanta, GA, USA;Hubert Department of Global Health, Emory Rollins School of Public Health, 30329, 1518 Clifton Road NE, Atlanta, GA, USA;Emory Center for AIDS Research, Emory University, 1518 Clifton Road NE, Suite 8050, 30322, Atlanta, GA, USA;Department of Medicine, UNC School of Medicine, University of North Carolina Chapel Hill, 130 Mason Farm Rd, 27599, Chapel Hill, NC, USA;Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, 30333, Atlanta, GA, USA;George Washington University Milken Institute School of Public Health, 950 New Hampshire Avenue NW, Suite 500, 20052, Washington, DC, USA;National Institute of Allergy and Infectious Diseases, Washington, DC, USA;SisterLove, Inc, 3709 Bakers Ferry Rd, SW, 30331, Atlanta, GA, USA;Statistical Center for HIV/AIDS Research and Prevention (SCHARP), Fred Hutchinson Cancer Research Center, Seattle, WA, USA;West Virginia University School of Medicine, One Medical Center Drive, HSC-South 2244, 26506, Morgantown, WV, USA;

关键词: HIV/AIDS;    Sexual health;    Socioecological model;    Women;    Minorities;    HIV risk reduction;   

DOI  :  10.1186/s12889-016-3364-7

 received in 2015-12-06, accepted in 2016-07-23,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundWe sought to understand the multilevel syndemic factors that are concurrently contributing to the HIV epidemic among women living in the US. We specifically examined community, network, dyadic, and individual factors to explain HIV vulnerability within a socioecological framework.MethodsWe gathered qualitative data (120 interviews and 31 focus groups) from a subset of women ages 18–44 years (N = 2,099) enrolled in the HPTN 064 HIV seroincidence estimation study across 10 US communities. We analyzed data from 4 diverse locations: Atlanta, New York City (the Bronx), Raleigh, and Washington, DC. Data were thematically coded using grounded theory methodology. Intercoder reliability was assessed to evaluate consistency of team-based coding practices.ResultsThe following themes were identified at 4 levels including 1) exosystem (community): poverty prevalence, discrimination, gender imbalances, community violence, and housing challenges; 2) mesosystem (network): organizational social support and sexual concurrency; 3) microsystem (dyadic): sex exchange, interpersonal social support, intimate partner violence; and 4) individual: HIV/STI awareness, risk taking, and substance use. A strong theme emerged with over 80 % of responses linked to the fundamental role of financial insecurity underlying risk-taking behavioral pathways.ConclusionsMultilevel syndemic factors contribute to women’s vulnerability to HIV in the US. Financial insecurity is a predominant theme, suggesting the need for tailored programming for women to reduce HIV risk.Trial registrationClinicaltrials.gov, NCT00995176

【 授权许可】

CC BY   
© The Author(s). 2016