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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

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
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

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.

community cohesion, efficacy, inequity, perceived control, social mobility
1608-5906
72-81
Ngwenya, Nothando
c6d79766-a171-4a65-a30a-3dbe8511fc8d
Gumede, Dumile
9b704ca5-ff4b-4ec1-bac7-ce08ab36ff3d
Shahmanesh, Maryam
d88581c9-0ef2-4506-b8d3-d72682936a09
McGrath, Nuala
b75c0232-24ec-443f-93a9-69e9e12dc961
Grant, Alison
0031710c-7e60-4012-b456-51d7cd76f61c
Seeley, Janet
f3106c01-ac91-4ffc-945a-6db3558fd8eb
Ngwenya, Nothando
c6d79766-a171-4a65-a30a-3dbe8511fc8d
Gumede, Dumile
9b704ca5-ff4b-4ec1-bac7-ce08ab36ff3d
Shahmanesh, Maryam
d88581c9-0ef2-4506-b8d3-d72682936a09
McGrath, Nuala
b75c0232-24ec-443f-93a9-69e9e12dc961
Grant, Alison
0031710c-7e60-4012-b456-51d7cd76f61c
Seeley, Janet
f3106c01-ac91-4ffc-945a-6db3558fd8eb

Ngwenya, Nothando, Gumede, Dumile, Shahmanesh, Maryam, McGrath, Nuala, Grant, Alison and Seeley, Janet (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), 72-81. (doi:10.2989/16085906.2017.1415214).

Record type: Article

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.

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Accepted/In Press date: 2 January 2018
e-pub ahead of print date: 4 March 2018
Keywords: community cohesion, efficacy, inequity, perceived control, social mobility

Identifiers

Local EPrints ID: 418776
URI: http://eprints.soton.ac.uk/id/eprint/418776
ISSN: 1608-5906
PURE UUID: bb341be9-abf6-4801-9196-c0baa5e73610
ORCID for Nuala McGrath: ORCID iD orcid.org/0000-0002-1039-0159

Catalogue record

Date deposited: 22 Mar 2018 17:30
Last modified: 17 Dec 2019 05:32

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Contributors

Author: Nothando Ngwenya
Author: Dumile Gumede
Author: Maryam Shahmanesh
Author: Nuala McGrath ORCID iD
Author: Alison Grant
Author: Janet Seeley

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