Social determinants of HIV/AIDS and intimate partner violence: interrogating the role of race, ethnicity and skin color

Abstract

Intimate partner violence (IPV) and HIV/AIDS affect the lives of millions of women across the globe, limiting life expectancy and quality of life. One in three women are affected by IPV. In 2018, worldwide, almost 40 million people were living with HIV. IPV experiences exacerbate risks for HIV/AIDS because people have limited ability to negotiate safe sex, are less likely to use condoms, and are often partnered with people who are engaged in risky behaviors such as drug use and condom-less sexual activity with partners that overlap in time (1). People who are living with HIV (LWH) can experience accelerated disease progression if exposed to IPV, particularly if their partner uses control to interfere with taking life-saving HIV medications or forces sexual activity (2). Unfortunately, IPV and HIV/ AIDS disproportionately affect people of the global majority (PGM; also known as people of color) and persons living in poverty. People with greatest vulnerabilities to IPV and HIV/AIDS are often described by their race, ethnicity, and skin color, perhaps perpetuating false biological or physiological links to disease outcomes. Alternatively, social determinants of health, the conditions in which PGM develop and sustain romantic and sexual relationships, heavily influence transmission of HIV/AIDS and exposure to IPV (3). In this editorial, I offer comments on ways in which two social determinants of health-poverty and diminished gender power are complex constructs through which to interrogate our use of race and gender as intersectional variables in research about these intersecting health epidemics. As an exemplar, I will discuss the impact of HIV/AIDS and IPV on the health of Black women in the U.S. Despite recent successes in curbing new HIV infections, Black women in the U.S. continue to experience disproportionate effects to health. Almost one-fifth of new HIV infections are Black women and about one in

Mapping of nursing interventions for elderly women with vulnerability related to HIV/AIDS

“…As for social vulnerability , the importance of recognizing organized civil society as capable of influencing the construction and implementation of public policies to fight the HIV/AIDS epidemic is observed. The social effects of epidemics can be mitigated or faced through the rupture of cultural and programmatic barriers that is allowed through the access of PLWHA to health services in general ( 23 ) .…”

“…In the context of programmatic vulnerability , not coincidentally, the highest frequency of interventions is found in the WC system , where it is restricted to the nurse/multiprofessional health team to act in a given situation so that it directs itself to effective solutions ( 2 ) . Considering panoramas of understanding the vulnerable context of some populations, in addition to individual accountability in prevention, coping and treatment, it is appropriate to approach social and institutional determinants, such as access to services and the professional look at sociocultural aspects as emancipatory mechanisms towards epidemics ( 23 ) . In this context, the theoretical categorization allows us to perceive the impossibility of outsourcing responsibility for the NIs, which should be assumed as the role of the nurse in the face of the demands of programmatic vulnerability, either through the SE system or through the WC system.…”

Epidemiological and Metabolic Profile of Women Living With HIV/AIDS in Campos Gerais: 2008-2017

“…There are reports of significant associations between the risk of HIV infection and underlying factors, including demographic (e.g., gender, age, marital status, mobility and residence), socioeconomic (e.g., income, education, and occupation), and sociocultural characteristics (e.g., religion and ethnicity) of individuals. Thus, the number and type of sexual contacts, lack of condom use or the presence of simultaneous STDs are also considered important risk factors [5].…”

Acceptability of a feasibility randomized clinical trial of a microenterprise intervention to reduce sexual risk behaviors and increase employment and HIV preventive practices (EMERGE) in young adults: a mixed methods assessment

“…African-Americans, who make-up a substantial proportion of the urban homeless and unemployed [20], have a rate of new HIV infections that is 8.3 times higher than that of non-Hispanic whites [20]. In fact, health disparities by race in the U.S., including HIV, are welldocumented [19][20][21][22][23][24]. These disparities are, in part, driven by the overlapping factors of economic deprivation and racism [20,22,[25][26][27].…”