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. 2016 Aug 17;16(1):803.
doi: 10.1186/s12889-016-3364-7.

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

Paula M Frew  1   2   3   4 , Kimberly Parker  5 , Linda Vo  6 , Danielle Haley  7 , Ann O'Leary  8 , Dazon Dixon Diallo  9 , Carol E Golin  10 , Irene Kuo  11 , Lydia Soto-Torres  12 , Jing Wang  13 , Adaora A Adimora  10 , Laura A Randall  6 , Carlos Del Rio  6   14   15 , Sally Hodder  16 ; HIV Prevention Trials Network 064 (HTPN) Study Team
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Socioecological factors influencing women's HIV risk in the United States: qualitative findings from the women's HIV SeroIncidence study (HPTN 064)

Paula M Frew et al. BMC Public Health. .

Abstract

Background: We 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.

Methods: We 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.

Results: The 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.

Conclusions: Multilevel 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 registration: Clinicaltrials.gov, NCT00995176.

Keywords: HIV risk reduction; HIV/AIDS; Minorities; Sexual health; Socioecological model; Women.

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Figures

Fig. 1
Fig. 1
Application of the Bronfrenbrenner ecological model
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References

    1. Centers for Disease Control and Prevention . HIV among women. 2013.
    1. Centers for Disease Control and Prevention Estimated HIV incidence in the United States, 2007–2010. HIV Surveill Suppl Rep. 2012;17:4.
    1. Centers for Disease Control and Prevention (CDC) HIV/AIDS among women fact sheet. CDC fact sheet 2013. 2013.
    1. Des Jarlais DC, Friedman SR. HIV infection among intravenous drug users: epidemiology and risk reduction. AIDS. 1987;1(2):67–76. - PubMed
    1. Moore RD. Epidemiology of HIV infection in the United States: implications for linkage to care. Clin Infect Dis. 2011;52(Suppl 2):S208–13. doi: 10.1093/cid/ciq044. - DOI - PMC - PubMed

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