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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

基本信息

批准号：
8712218
负责人：
Courtney Ellis Caiola
金额：
$ 3.28万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
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/8712218
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&apos 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

项目摘要

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：非洲裔美国人感染艾滋病毒的母亲的脆弱性在性别，种族和阶级不平等的交叉点上发挥作用;艾滋病毒相关的耻辱;和母性，需要多层面和跨学科的方法来解决他们生活中复杂的社会和经济条件，统称为健康的社会决定因素。非洲裔美国妇女的艾滋病毒感染率明显高于白色妇女，而且往往死于感染的时间更早。贫困是艾滋病毒感染的一个重要诱因，AA妇女比美国其他亚群更穷。与艾滋病毒有关的耻辱感与广泛的人口概况中较差的心理和身体健康结果有关。成为母亲给感染艾滋病毒的妇女的生活增加了一层额外的社会复杂性。这种描述性研究AA艾滋病毒感染的母亲的独特的社会位置和健康的社会决定因素的交集，他们的经验是理解和解决其健康结果的差异的重要一步。目的：本研究旨在描述性别，种族和阶级不平等的交叉点;艾滋病毒相关的耻辱;和特定的AA艾滋病毒感染的母亲的母性，并描述他们独特的社会身份如何影响他们的健康相关的经验。研究方法：在这项定性描述性研究中，我将确定20-30位AA HIV感染母亲，并使用参与者发起的摄影结合深入的定性访谈来探索他们所经历的健康的社会决定因素的交叉点。参与者将从杜克大学医学中心的传染病诊所、达勒姆县卫生部早期干预诊所、威克县卫生部、北卡罗来纳州大学医院的传染病诊所和艾滋病服务联盟招募。利用提供者推荐和招聘传单进行自我推荐。总结：这项研究将有助于产生假设所描述的交叉口如何运作，以塑造健康行为和AA艾滋病毒感染的母亲产生的健康结果，并将确定哪些方面的问题可能会被测量，易于改变，并可以有意义地解决干预。