Interventions to reduce African-American HIV risk should target factors outside health system

Dr. Wizdom Powell Hammond

The study, “Understanding Social Capital and HIV Risk in Rural African-American Communities,” was co-authored by Wizdom Powell Hammond, PhD, assistant professor of health behavior and health education at UNC Gillings School of Global Public Health and published online Feb. 11 in the Journal of General Internal Medicine.

The qualitative study was a collaborative effort between physician-researchers at UNC and community partners in two rural counties in northeastern North Carolina. The researchers conducted 11 focus groups with three populations of African-American participants considered to be at high risk for HIV – youth and young adults ages 16 to 24, formerly incarcerated individuals and adults over age 25. The researchers also conducted interviews with 37 adults considered to be influential “key informants” within these communities.

Findings of the study include:

• Adults believed their communities had a high degree of cohesiveness between individuals while youths and formerly incarcerated persons perceived significant tension between various groups. All participants felt that intense HIV-related stigma adversely affected HIV outreach and prevention efforts.
• The community environment in these counties was characterized by neighborhood poverty, lack of skilled jobs, segregation by race and social class, political disenfranchisement of African-Americans and institutional racism. All of these factors reduced the availability and accessibility of resources needed to combat HIV.
• Participants felt there was a collective inability to combat social problems such as crime and violence due to community disorder and a lack of police protection. As a result, it was easier and more acceptable for individuals to engage in behaviors that increased HIV risk.
• African-American churches are not good sources of support for HIV prevention because of members’ reluctance to discuss HIV/AIDS or participate in HIV-related activities.

“This study highlights the need for clinicians to look beyond individual-level behaviors when trying to prevent HIV and address HIV-related disparities,” Cené said. “The communities in which people live and the social and material resources available within those communities are equally as important.”

Other study authors are Aletha Y. Akers, MD, MPH, of Magee-Women’s Hospital in Pittsburgh, Penn., Stacey W. Lloyd, MPH, of RTI International, in Research Triangle Park, N.C.; Tashuna Albritton, MSW, UNC doctoral student in social work; and Giselle Corbie-Smith, MD, associate professor of social medicine at UNC.

UNC Gillings School of Global Public Health contact: Ramona DuBose, director of communications, (919) 966-7467 or ramona_dubose@unc.edu.