Social Location and Decision-Making Among Women Living with HIV in the Southern United States

An Intersectional Approach

Bibliographic Data

ID15463299
AuthorsCourtney Caiola (0000-0001-5267-2245, East Carolina University), Marianne R Choufani (0009-0005-7102-4370, East Carolina University), Josette André (Vanderbilt University), Sadie B Sommer (0009-0007-7819-8909, Vanderbilt University), Alexander M Schoemann (0000-0002-8479-8798, East Carolina University), Sarah Bauerle Ba (0000-0003-2742-1609, Temple University), J Falcón Barroso (0000-0003-0107-1268, Vanderbilt University, corresponding author)
Year2024
Volume21
Issue12
Pages1575-1575
Publication date2024-11-27
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueInternational Journal of Environmental Research and Public Health (JOURNAL)
Journal identifiersISSN: 1661-7827 • E-ISSN: 1660-4601
PublisherMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/ijerph21121575
PMID39767417
OpenAlexW4404767386
LanguageEN
Citations received2
References cited22

HIV care engagement and antiretroviral therapy (ART) adherence interventions aimed at decreasing viral suppression disparities for women living with HIV (WLWH) in the Southern United States (i.e., the South) are few and seldom consider diverse social locations. These refer broadly and dynamically to contextual factors and the position people occupy in a social hierarchy based on intersecting systems of oppression and social determinants of health like gender, race/ethnic, and class inequities; geographic location; and HIV-related stigma. Using an intersectional approach, we conducted in-depth interviews and used a phased approach to directed content analysis to describe women's perceptions of their social location and how it impacts their decision-making about HIV care engagement and ART adherence. Participants were recruited to participate from a broad geographic area and represented the diverse social locations occupied by WLWH in the South. Findings from 40 in-depth interviews include descriptions of how geographic context impacts HIV care engagement and medication adherence through access to care, quality of care, and the place-based context of day-to-day experiences of living with HIV. Participants spoke of multilevel power relationships based on their gender and racial identities, and how social determinants and intersecting identities occur simultaneously and vary as a function of one another to impact health and HIV care decision-making. The findings offer a nuanced understanding of how WLWH perceive their contextually specific social locations and make critical decisions about their HIV care engagement and medication adherence

Context (archaeology · Ethnic group · Family medicine · Geography · Health care · Human immunodeficiency virus (HIV · Intersectionality · Men who have sex with men · Political science · Psychological intervention · Sociology · Gender Studies · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · LGBTQ Health, Identity, and Policy · Medicine · Nursing · Psychology · Social Psychology · Gerontology

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