Social Determinants of Health for African American HIV-infected Mothers

非洲裔美国艾滋病毒感染母亲健康的社会决定因素

• 批准号: 8602619
• 负责人: Courtney Ellis Caiola
• 金额: $ 4.22万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8602619
• 关键词: AIDS/HIV problem; Academic Medical Centers; Acquired Immunodeficiency Syndrome; Address; Affect; African American; Child; Clinic; Communicable Diseases; Complex; County; Early Intervention; Economic Conditions; Economics; Gender; Goals; HIV; HIV Infections; Health; Health behavior; Healthcare; Hospitals; Individual; Inequality; Infection; Intervention; Intervention Studies; Interview; Life; Link; Location; Measures; Mental Health; Methods; Mothers; North Carolina; Outcome; Participant; Persons; Photography; Population; Poverty; Precipitating Factors; Predisposition; Prevention; Provider; Qualitative Methods; Race; Recruitment Activity; Reporting; Research Methodology; Risk Behaviors; Role; Services; Shapes; Social Conditions; Social Identification; Stress; Time; Universities; Vulnerable Populations; Woman; Women' s Health; Work; World Health Organization; design; experience; girls; improved; innovation; motherhood; physical conditioning; public health relevance; response; social; social health determinants; social implication; social stigma; socioeconomics; transmission process; violence against women

DESCRIPTION (provided by applicant): Significance: The vulnerability of African American HIV-infected mothers functions at the intersection of gender-, race-, and class-inequality; HIV-related stigma; and motherhood, requiring multidimensional and transdisciplinary approaches to address the complex social and economic conditions of their lives, collectively known as the social determinants of health. African American (AA) women suffer significantly higher HIV infection rates and tend to die earlier from their infection than their White counterparts. Poverty is a significant precipitating factor for HIV infection and AA women are disproportionately poorer than other subpopulations in the US. HIV-related stigma is linked to poorer mental and physical health outcomes across a broad range of demographic profiles. Being a mother adds an extra layer of social complexity to the lives of HIV-infected women. This descriptive study of AA HIV-infected mothers' unique social location and the intersection of the social determinants of health they experience is an essential step in understanding and addressing the disparity in their health outcomes. Purpose: This study aims to describe the intersection of gender-, race-, and class-inequality; HIV-related stigma; and motherhood specific to AA HIV-infected mothers and to describe how their unique social identity influences their health-related experiences. Methods: In this qualitative descriptive study I will identify 20-30 AA HIV-infected mothers and use participant- initiated photography in conjunction with in-depth qualitative interviewing to explore the intersection of the social determinants of health they experience. Participants will be recruited from the Infectious Diseases Clinics at Duke University Medical Center; the Durham County Health Department Early Intervention Clinic; the Wake County Health Department; the Infectious Diseases Clinic at the University of North Carolina Hospitals; and the Alliance of AIDS Services - Carolinas, Inc., using provider referral and recruitment flyers for self- referral. Summary: This study will help to generate hypotheses about how the described intersection operates to shape health behaviors and produce health outcomes for AA HIV-infected mothers and will identify what aspects of the problem might be measured, are amenable to change, and can be meaningfully addressed by intervention.

描述（由申请人提供）：意义：非裔美国人艾滋病毒感染的母亲在性别，种族和阶级运动的交集中的脆弱性；与HIV相关的污名；和母性，需要多维和跨学科的方法来解决其生活中复杂的社会和经济状况，共同被称为健康的社会决定因素。非裔美国人（AA）妇女的艾滋病毒感染率明显更高，并且比白人同龄人更早死于感染。贫困 是艾滋病毒感染的重要沉淀因子，而AA妇女比美国其他亚群体差的差异不成比例。与艾滋病毒相关的污名与广泛的人口统计学概况的精神和身体健康结果较差有关。作为母亲，为感染了艾滋病毒的妇女的生活增添了社会复杂性。这项描述性研究对AA HIV感染的母亲的独特社会位置以及他们所经历的健康决定因素的交汇处是理解和解决其健康成果差异的重要步骤。目的：本研究旨在描述性别，种族和阶级质量的交集；与HIV相关的污名；以及针对AA HIV感染的母亲的母性，并描述其独特的社会身份如何影响与健康相关的经历。方法：在这项定性的描述性研究中，我将确定20-30 AA感染HIV的母亲，并将参与者发起的摄影与深入的定性访谈结合在一起探索 他们经历的健康决定因素的交集。参与者将从杜克大学医学中心的传染病诊所招募；达勒姆县卫生部早期干预诊所；韦克县卫生部门；北卡罗来纳大学医院的传染病诊所；以及艾滋病服务联盟-Carolinas，Inc。，使用提供商推荐和招聘传单进行自我推荐。摘要：这项研究将有助于产生有关描述的交叉路口如何运作以塑造健康行为并为AA HIV感染的母亲产生健康结果的假设，并将确定可以衡量问题的哪些方面，可以改变，并且可以通过干预来有意义地解决。