A Multilevel Understanding of HIV/AIDS Disease Burden among African American Women

Disproportionate HIV/AIDS rates among African American women have been examined extensively—primarily from an individually-centered focus. Beyond individual behaviors, factors such as the hyper-incarceration of African American men and geographically concentrated disadvantage may better explain inequitable disease burden. This paper proposes a conceptual model of individual, social, and structural factors that influence HIV transmission among African American women. The model can be used to develop comprehensive assessments and guide prevention programs in African American communities.

…Limited educational attainment, poverty, and imbalanced male-female sex ratios all fuel the HIV epidemic among African American populations (Dean & Fenton, 2010). Thus, structural interventions should continue to be incorporated in our HIV prevention dialogue, especially since they have proven to be efficacious (Adimora & Auerbach, 2010). Similar to others, this author argues that HIV is an individual, social and structural concern, requiring community engagement and mobilization toward its eradication. Although a universal “test-and-treat” model could potentially eliminate new HIV infections over time, social and structural barriers exist to widespread implementation and sustainability (Kulkarni, Shah, Sarma, & Mahajan, 2013). Neither a biomedical nor behavioral approach to HIV prevention can be sustained in the absence of considering the broader contexts. It is important to note, however, that there are substantial challenges associated with the implementation of structural interventions so as not to minimize the arduous nature in which they are executed (Auerbach et al., 2011). This becomes particularly difficult when opposing entrenched systems and interests that continue to marginalize and oppress certain groups (Miller, Reed, Francisco, & Ellen, 2012), such as African American women…

Below:  A Conceptual Model (with Presumed Pathways [P_x]) for Understanding Geobehavioral Vulnerability to HIV among African Americans

Full article at:   http://goo.gl/hIrFc9

By:  Bridgette M. Brawner, PhD, APRN, Assistant Professor of Nursing

Bridgette M. Brawner, Center for Health Equity Research, Center for Global Women's Health, University of Pennsylvania School of Nursing, 418 Curie Blvd., 4th Floor, Room 419, Philadelphia, PA 19104-4217, 215-898-0715 (office), 215-746-3374 (fax),

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