Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2010 Dec;55 Suppl 2(0 2):S132-5.
doi: 10.1097/QAI.0b013e3181fbcb38.

Structural interventions for HIV prevention in the United States

Adaora A Adimora  1 , Judith D Auerbach
Affiliations
Review

Structural interventions for HIV prevention in the United States

Adaora A Adimora et al. J Acquir Immune Defic Syndr. 2010 Dec.

Abstract

Background: Structural interventions change the environment in which people act to influence their health behaviors. Most structural interventions research for HIV infection has focused on developing countries, with the United States receiving substantially less attention. This article identifies some social determinants of HIV vulnerability in the United States and structural interventions to address them.

Methods: Review of the medical, public health, and social science literature.

Results: Evidence supports widespread implementation of a number of structural interventions in the United States clearly proximate to HIV, including comprehensive sex education, universal condom availability, expanded syringe access for drug users, health care coverage, and stable housing. Sociological plausibility supports evaluation and implementation of other interventions that target social determinants more distal but of relevance to HIV, such as initiatives to eliminate racial and ethnic disparities in criminal sentencing, to promote early childhood education and to decrease poverty.

Conclusions: Structural interventions that address social determinants of HIV infection may be among the most cost effective methods of preventing HIV infection in the United States over the long term.

PubMed Disclaimer

References

    1. White House Office of National AIDS Policy. National HIV/AIDS Strategy for the United States. Washington, DC: The White House; 2010. [Accessed August 2, 2010]. Available at: http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf.
    1. Commission on Social Determinants of Health. [Accessed March 22, 2010];Social determinants of health [World Health Organization Web site] 2010 Available at: http://www.who.int/social_determinants/en/
    1. Cohen DA, Wu SY, Farley TA. Structural interventions to prevent HIV/sexually transmitted disease: are they cost-effective for women in the southern United States? Sex Transm Dis. 2006 Jul;33(suppl 7):S46–S49. - PubMed
    1. Coates TJ, Richter L, Caceres C. Behavioural strategies to reduce HIV transmission: how to make them work better. Lancet. 2008;372:669–684. - PMC - PubMed
    1. Hecht R, Bollinger L, Stover J, et al. Critical choices in financing the response to the global HIV/AIDS pandemic. Health Aff (Millwood) 2009;28:1591–1605. - PubMed

Publication types

MeSH terms