Social Determinants of Health for African American HIV-infected Mothers

描述（由申请人提供）：意义：非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起作用；与艾滋病毒相关的耻辱;以及母性，需要采取多层面和跨学科的办法来处理她们生活中复杂的社会和经济条件，这些条件统称为健康的社会决定因素。非裔美国妇女的艾滋病毒感染率明显高于白人妇女，而且往往比白人妇女更早死于感染。贫困

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.