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AJPH First Look, published online ahead of print Apr 16, 2009
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AJPH.2008.140327v1
99/6/1002    most recent
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June 2009, Vol 99, No. 6 | American Journal of Public Health 1002-1008
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2008.140327

ANALYTIC ESSAY FORUMS

Structural and Social Contexts of HIV Risk Among African Americans

Samuel R. Friedman, PhD, Hannah L. F. Cooper, ScD, SM and Andrew H. Osborne, MSEd, CHES

Samuel R. Friedman and Andrew H. Osborne are with the Center for Drug Use and HIV Research, National Development and Research Institutes, New York, NY. Samuel R. Friedman is also with the Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Hannah L. F. Cooper is with the Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA.

Correspondence: Reprint requests should be sent to Samuel R. Friedman, National Development and Research Institutes, 71 West 23rd Street, 8th Floor, New York, NY 10010 (e-mail: friedman{at}ndri.org).

HIV continues to be transmitted at unacceptably high rates among African Americans, and most HIV-prevention interventions have focused on behavioral change.

To theorize additional approaches to HIV prevention among African Americans, we discuss how sexual networks and drug-injection networks are as important as behavior for HIV transmission. We also describe how higher-order social structures and processes, such as residential racial segregation and racialized policing, may help shape risk networks and behaviors. We then discuss 3 themes in African American culture—survival, propriety, and struggle—that also help shape networks and behaviors.

Finally, we conclude with a discussion of how these perspectives might help reduce HIV transmission among African Americans.






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Copyright © 2009 by the American Public Health Association