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. 2017 Sep;19(9):948-963.
doi: 10.1080/13691058.2016.1274428. Epub 2017 Jan 30.

Stakeholder conceptualisation of multi-level HIV and AIDS determinants in a Black epicentre

Bridgette M Brawner  1 , Janaiya L Reason  1 , Kelsey Hanlon  1 , Barbara Guthrie  2 , Jean J Schensul  3
Affiliations

Stakeholder conceptualisation of multi-level HIV and AIDS determinants in a Black epicentre

Bridgette M Brawner et al. Cult Health Sex. 2017 Sep.

Abstract

HIV has reached epidemic proportions among African Americans in the USA but certain urban contexts appear to experience a disproportionate disease burden. Geographic information systems mapping in Philadelphia indicates increased HIV incidence and prevalence in predominantly Black census tracts, with major differences across adjacent communities. What factors shape these geographic HIV disparities among Black Philadelphians? This descriptive study was designed to refine and validate a conceptual model developed to better understand multi-level determinants of HIV-related risk among Black Philadelphians. We used an expanded ecological approach to elicit reflective perceptions from administrators, direct service providers and community members about individual, social and structural factors that interact to protect against or increase the risk for acquiring HIV within their community. Gender equity, social capital and positive cultural mores (e.g., monogamy, abstinence) were seen as the main protective factors. Historical negative contributory influences of racial residential segregation, poverty and incarceration were among the most salient risk factors. This study was a critical next step toward initiating theory-based, multi-level community-based HIV prevention initiatives.

Keywords: AIDS; African Americans; Black; HIV; USA; epidemic determinants; structural factors.

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Figures

Figure 1.
Figure 1.
Multi-level conceptual model of HIV among Black Philadelphians
Figure 2.
Figure 2.
Focus group themes.
See this image and copyright information in PMC

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