Document Type
Article
Publication Date
2016
College/Unit
School of Medicine
Department/Program/Center
Medicine
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 risktaking 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
Digital Commons Citation
Frew, Paula M.; Parker, Kimberly; Vo, Linda; Haley, Danielle; O'Leary, Ann; Diallo, Dazon Dixon; Golin, Carol E.; Kuo, Irene; Soto-Torres, Lydia; Wang, Jing; Adimora, Adaora A.; Randall, Laura A.; del Rio, Carlos; and Hodder, Sally, "Socioecological Factors Influencing Women’s HIV Risk in the United States: Qualitative Findings from the Women’s HIV SeroIncidence Study (HPTN 064)" (2016). Faculty & Staff Scholarship. 1949.
https://researchrepository.wvu.edu/faculty_publications/1949
Source Citation
Frew, P. M., Parker, K., Vo, L., Haley, D., O’Leary, A., Diallo, D. D., Golin, C. E., Kuo, I., Soto-Torres, L., Wang, J., Adimora, A. A., Randall, L. A., del Rio, C., & Hodder, S. (2016). 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, 16(1). https://doi.org/10.1186/s12889-016-3364-7
Comments
© 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.