Volume 12 of Issue 2 | Progress in community health partnerships : research, education, and action
Authors: Chang A, Fiorella KJ, Hickey MD, Salmen CR, Bukusi EA, Cohen CR, Auerswald CL
BACKGROUND
In rural sub-Saharan Africa (SSA), the human immunodeficiency virus (HIV)/AIDS pandemic has exerted effects on nearly every aspect of life. Yet despite the pandemic's near ubiquitous impacts, major barriers to HIV care, treatment, and support persist. Compounding the barriers to care is the incredible complexity and diversity of experience across different sociocultural contexts.
OBJECTIVES
This exploratory community-based participatory study aimed to generate an explanatory model about how geographic and socioeconomic marginalization shape community perception of HIV care, treatment, and support among rural communities of Mfangano Island, Kenya.
METHODS
Twelve focus groups with a total of 105 participants were conducted as a part of a mixed-methods cross-sectional health study.
RESULTS
Study findings are organized within an ecological framework with the following themes: readiness at the individual level, social capital at the household level, and collective efficacy at the community level. Potential solutions were also described within this framework; enabling encouragement at the individual level, enhancing productivity at the household level, and addressing underlying socioeconomic inequities at the community level.
CONCLUSIONS
HIV-related consequences at the individual, household, and community levels have adversely affected how Mfangano communities respond to the HIV/AIDS epidemic. Community-based strategies are needed to address interrelated inequities at multiple levels. Changing community perception may overcome HIV stigma to enable individual readiness to seek care. Access to care and treatment enhances productivity and hence social capital in HIV-affected households. Addressing socioeconomic inequities at the community level increases access to social and instrumental support and, thus, may decrease risk and vulnerability for HIV/AIDS.
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Authors: Daniel F. Marker, Timothy Fitzgerald, Harris A. Gelbard, Irene Kuo, Gregory Phillips, Erin Graves, Laura J. Edwards, Andri Rauch, Jürgen Kurt Rockstroh, Massimiliano Berretta, Paolo De Paoli, Umberto Tirelli, Bruno Cacopardo, Cécile Hérate, Serge Benichou, Marie Lambelé, Brooke E. E. Montgomery, Katharine E. Stewart, Susan Moir, Filippos Porichis, Daniel E. Kaufmann, Srinika Ranasinghe, Bruce Walker, Julie Boucau, Marijana Rucevic, Sylvie Le Gall, Sam M. Mbulaiteye, Sol Aldrete, Vincent C. Marconi, Cathia Soulie, Anne-Geneviève Marcelin, Julie A. Denison, Virginia A. Fonner, Caitlin E. Kennedy, Michael D. Sweat, Guislaine Carcelain, Brigitte Autran, Frank Kirchhoff, Xiong Jiang, David J. Moore, Ronald J. Ellis, Karen Cropsey, C. Brendan Clark, Erin Dehon, Sana Loue, Yannine Estrada, Guillermo Prado, Sana Loue, Sindhu Ravishankar, Felicia A. Browne, Wendee M. Wechsberg, K. Michelle Peavy, Donald A. Calsyn, Keletso Makofane, Theo Sandfort, Nabila El-Bassel, Louisa Gilbert, Stacey A. Shaw, Matthew J. Mimiaga, Elizabeth F. Closson, Amaya Perez-Brumer, Jennifer A. Mitty, Tonya N. Taylor, Stephen Karpiak, Shawnta L. Lloyd, Lauren C. Messina, Anne C. Spaulding, Jae Sevelius, Mallory O. Johnson, Felisa A. Gonzales, Ana María del Río González, María Cecilia Zea, Sean G. Kelly, Babafemi O. Taiwo, Lauren Tompkins, Elena Dukhovlinova, Ronald Swanstrom, Cecilia T. Costiniuk, Mohammad-Ali Jenabian, Abby DiCarlo, Carrigan Parish, Lisa R. Metsch, Kristina Broliden, Andrea Introini, Adam Burgener, Lillian S. Kuo, Eric O. Freed, Barbara Müller, Hans-Georg Kräusslich, Anh Q. Le, Aniqa Shahid, Zabrina L. Brumme, Stephanie M. Dillon, Mario L. Santiago, Cara C. Wilson, Salim S. Abdool Karim, Cheryl Baxter, Meritxell Genescà, Michael B. McChesney, Christopher J. Miller, Bastian Grewe, Klaus Überla, Carolina Herrera, Robin Shattock, Georgios Pollakis, William A. Paxton, Owen Pornillos, Barbie K. Ganser-Pornillos, Neil J. Berry, Nuno Taveira, Ana Cláudia Miranda, Kamal Mansinho, Salma Nowroozalizadeh, Marianne Jansson, Youngjee Choi, David B. Clifford, Geoffrey S. Gottlieb, Nuno Rodrigues Faria, Joakim Esbjörnsson, Philippe Lemey, Phyllis J. Kanki, Souleymane Mboup, Robert Yarchoan, Thomas S. Uldrick, Mark N. Polizzotto, Victor Appay, Anna Lissina, Delphine Sauce, Michele Spina, Rosanna Ciancia, Accursio Augello, Massimiliano Berretta, Umberto Tirelli, Jacques Fellay, Paul McLaren, Diana Hernández, Mallika Bhandarkar, Angela Aidala, Zhi-Ming Zheng
Authors: Anna Cereseto, Yuntao Wu, Jan Davidson-Moncada, Thomas S. Uldrick, Joel Palefsky, Steven A. Yukl, Joseph K. Wong, Shokouh Makvandi-Nejad, Courtney V. Fletcher, Anthony T. Podany, Andrea Calcagno, C. William Wester, Francoise Brun-Vezinet, Sophie Matheron, Diane Descamps, Sima S. Toussi, Michael Rosenberg, Harjot K. Singh, Marshall J. Glesby, Charles Muiruri, Habib R. Omar, John A. Bartlett, Camille Libre, Julien Batisse, Santiago Guerrero, Roland Marquet, Jean-Christophe Paillart, Mark Spear, Yuntao Wu, Christina Karsten, Stefan Pöhlmann, Laure Papin, Coralie F. Daussy, Jamal Alfaisal, Lucile Espert, Fabien P. Blanchet, Julià Blanco, Martine Biard-Piechaczyk
