Ngwenya, N;
Gumede, D;
Shahmanesh, M;
McGrath, N;
Grant, A;
Seeley, J;
(2018)
Community perceptions of the socio-economic structural context influencing HIV and TB risk, prevention and treatment in a high prevalence area in the era of antiretroviral therapy.
African Journal of AIDS Research
, 17
(1)
pp. 72-81.
10.2989/16085906.2017.1415214.
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Abstract
Following calls for targeted HIV prevention interventions in so-called “hotspots”, we explored subjective perceptions of community members in places considered to be high HIV and tuberculosis (TB) transmission areas and those with low prevalence. Although more people now have access to antiretroviral therapy (ART), some areas are still experiencing high HIV transmission rates, presenting a barrier to the elimination of HIV. A rapid qualitative assessment approach was used to access a sample of 230 people who contributed narratives of their experiences and perceptions of transmission, treatment and prevention of HIV and TB in their communities. Theoretical propositions case study strategy was used to inform and guide the thematic analysis of the data with Research Department of Epidemiology & Public Health, University College London, London, UK. Our results support the concept of linking perceived control to health through the identification of structural factors that increase communities’ sense of agency. People in these communities did not feel they had the efficacy to effect change in their milieu. The few socio-economic opportunities promote social mobility in search of better prospects which may have a negative impact on community cohesion and prevention strategies. Communities were more concerned with improving their immediate social and economic situations and prioritised this above the prevention messages. Therefore approaches that focus on changing the structural and environmental barriers to prevention may increase people’s perceived control. Multifaceted strategies that address the identified constructs of perceived control may influence the social change necessary to make structural interventions successful.
| Type: | Article |
|---|---|
| Title: | Community perceptions of the socio-economic structural context influencing HIV and TB risk, prevention and treatment in a high prevalence area in the era of antiretroviral therapy |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.2989/16085906.2017.1415214 |
| Publisher version: | https://doi.org/10.2989/16085906.2017.1415214 |
| Language: | English |
| Additional information: | Copyright © The Authors 2018. Open Access article distributed in terms of the Creative Commons Attribution License [CC BY 4.0] (http://creativecommons.org/licenses/by/4.0). |
| Keywords: | community cohesion, efficacy, inequity, perceived control, social mobility |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10046689 |
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