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Cited by 78HIV/AIDS Research and InterventionsHIV, Drug Use, Sexual RiskCommunity Health and Development

Understanding Social Capital and HIV Risk in Rural African American Communities

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Cené, Crystal W., Akers, Aletha Y., Lloyd, Stacey W., Albritton, Tashuna, Powell Hammond, Wizdom, Corbie-Smith, Giselle·2011·Journal of General Internal Medicine
DOI 10.1007/s11606-011-1646-4PMC PMC3138603
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Abstract

Background African Americans (AA) and rural communities often suffer disproportionately from poorer health. Theory-guided research examining how individual- and community-level factors influence health behaviors and contribute to disparities is needed. Objective To understand how a social network model that captures the interplay between individual and community factors might inform community-based interventions to reduce HIV risk in rural AA communities. Design Qualitative study. Setting and participants Eleven focus groups with 38 AA 16-24 year olds, 42 adults over age 25, and 13 formerly incarcerated individuals held in community settings in two rural, predominantly AA counties in North Carolina. Thirty-seven semi-structured interviews with multiethnic key informants. Approach Semi-structured interviews and focus groups with open-ended questions assessed a) perceptions of multi-level HIV risk determinants from a social network model (individual, interpersonal, social, economic, political and structural) identified through literature review and b) community needs and assets affecting local HIV rates. Qualitative data was analyzed using directive content analysis guided by a social network model. Results We identified four themes regarding the interaction between individuals and their communities that mediate HIV risk: interpersonal processes, community structural environment, social disorder, and civic engagement. Communities were characterized as having a high degree of cohesiveness, tension, and HIV-related stigma. The community structural environment-characterized by neighborhood poverty, lack of skilled jobs, segregation, political disenfranchisement and institutional racism-was felt to reduce the availability and accessibility of resources to combat HIV. Adults noted an inability to combat social problems due to social disorder, which fuels HIV risk behaviors. Civic engagement as a means of identifying community concerns and developing solutions is limited by churches' reluctance to address HIV-related issues. Conclusion To combat HIV-related stigma, physicians should follow recommendations for universal HIV testing. Besides asking about individual health behaviors, physicians should ask about the availability of support and local community resources. Physicians might consider tailoring their treatment recommendations based on available community resources. This strategy may potentially improve patient adherence and clinical outcomes.

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  • In the review, the operationalization of structural racism that most closely aligned with its structural-level conceptualization was the use of the State Racism Index by two studies.

    “In our review, the operationalization of structural racism that most closely aligned with its conceptualization at the structural level was the use of the SRI by two of the studies [21,22].”

    From Structural Racism Conceptualization and Operationalization for Research for the U.S. HIV Epidemic: Findings from a Scoping Review and Implications for Advancing Research for Structural Interventions (2024) · cites this paper as [21]

    The Approach and Analysis sections describe interviews, focus groups, and qualitative content analysis in two rural North Carolina counties. Neither the supplied passages nor searches for “State Racism Index” and “SRI” show this study using that index, so our copy cannot verify its identification as one of the two SRI studies. (LLM, conf=0.74)

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Authors
Cené, C. W., Akers, A. Y., Lloyd, S. W., Albritton, T., Powell Hammond, W., & Corbie-Smith, G.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • Magee-Womens Hospital (US)
  • RTI International (US)
Corresponding author
Cené, Crystal W.
ORCID
Venue
Journal of General Internal Medicine
Publisher
Springer Science and Business Media LLC
Published
2011-02-11
Volume
26
Issue
7
Pages
737-744
ISSN
  • 0884-8734 (ISSN-L)
  • 1525-1497
DOI
10.1007/s11606-011-1646-4
PMC
PMC3138603
OpenAlex
W2056582002
Cited by
78
References
1
Citations by year
2025: 4 · 2024: 2 · 2023: 2 · 2022: 6 · 2021: 5 · 2020: 5 · 2019: 1 · 2018: 9 · 2017: 6 · 2016: 8 · 2015: 10 · 2014: 5 · 2013: 8 · 2012: 5
FWCI
4.12
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Journal of General Internal Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • University of Pittsburgh (KL2 RR024154)
  • Georgia Clinical and Translational Science Alliance
  • National Institutes of Health (UNC/CFAR P30AI50410, AI50410)
  • Center for AIDS Research, University of Washington (P30 AI-50410, AI50410)
  • National Heart, Lung, and Blood Institute (K23HL107614)
  • National Cancer Institute (U01CA114629)
  • National Institute of Allergy and Infectious Diseases (P30 AI50410, P30AI050410)
  • National Center on Minority Health and Health Disparities (1L60 MD002605-01)
  • National Center for Research Resources (KL2RR025746, KL2RR024154, KL2 RR024154-0)
  • National Institute on Minority Health and Health Disparities (L60 MD002605, 1L60MD002605-01, R24MD001671)
  • Center for AIDS Research, University of North Carolina at Chapel Hill (P30 AI‐50410, CFAR P30‐AI50410, UNC CFAR P30 AI50410)
Topics
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
  • Health Sciences › Health Professions › General Health Professions › Community Health and Development
Keywords
HIV risk, social capital, African American community, rural health, social network models, HIV stigma, social disorder, citizen participation, HIV testing, health disparities, formerly incarcerated individuals, community resources, institutional racism
MeSH terms
Adolescent, Adult, Black or African American, Female, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, North Carolina, Risk Factors, Rural Population, Sexual Behavior, Social Support, Socioeconomic Factors, Health Behavior, HIV Infections, Focus Groups, Health Status Disparities, Young Adult

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