1
|
Robillard AG, Julious CH, Smallwood SW, Douglas M, Gaddist BW, Singleton T. Structural Inequities, HIV Community-Based Organizations, and the End of the HIV Epidemic. Am J Public Health 2022; 112:417-425. [PMID: 35196039 PMCID: PMC8887177 DOI: 10.2105/ajph.2021.306688] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2021] [Indexed: 11/04/2022]
Abstract
Community-based organizations (CBOs) are integral to achieving the goal of Ending the HIV epidemic (EHE). Their familiarity with and proximity to communities position them to effectively implement strategies necessary to address determinants of health through their formal and informal medical and social services. However, structural inequities have contributed to the demise of many organizations that were instrumental in early responses to the HIV epidemic. We define structural inequities for HIV CBOs as systems in which policies, institutional practices, organizational (mis)representations, and other norms work to produce and maintain inequities that affect CBOs' ability to survive and thrive. In this discussion, we describe the organizational threats to grassroots HIV CBOs and the risks to livelihood and longevity, including examples. The invaluable role of HIV CBOs in EHE and their role in responding to existing and novel infectious diseases like COVID-19 should not be overlooked. Recommendations to promote structural equity are offered. (Am J Public Health. 2022;112(3):417-425. https://doi.org/10.2105/AJPH.2021.306688).
Collapse
Affiliation(s)
- Alyssa G Robillard
- At the time of the writing of this essay, Alyssa G. Robillard was with the Institute for Families in Society, University of South Carolina, and Palmetto AIDS Life Support Services, Columbia, SC. Carmen H. Julious is with Palmetto AIDS Life Support Services. Stacy W. Smallwood is with the Department of Health Policy & Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Mark Douglas was with My Brothaz HOME Inc, Savannah, GA. Bambi W. Gaddist was with South Carolina HIV Council doing business as Wright Wellness Center, Columbia. Tyler Singleton was with the University of South Carolina School of Medicine, Columbia
| | - Carmen H Julious
- At the time of the writing of this essay, Alyssa G. Robillard was with the Institute for Families in Society, University of South Carolina, and Palmetto AIDS Life Support Services, Columbia, SC. Carmen H. Julious is with Palmetto AIDS Life Support Services. Stacy W. Smallwood is with the Department of Health Policy & Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Mark Douglas was with My Brothaz HOME Inc, Savannah, GA. Bambi W. Gaddist was with South Carolina HIV Council doing business as Wright Wellness Center, Columbia. Tyler Singleton was with the University of South Carolina School of Medicine, Columbia
| | - Stacy W Smallwood
- At the time of the writing of this essay, Alyssa G. Robillard was with the Institute for Families in Society, University of South Carolina, and Palmetto AIDS Life Support Services, Columbia, SC. Carmen H. Julious is with Palmetto AIDS Life Support Services. Stacy W. Smallwood is with the Department of Health Policy & Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Mark Douglas was with My Brothaz HOME Inc, Savannah, GA. Bambi W. Gaddist was with South Carolina HIV Council doing business as Wright Wellness Center, Columbia. Tyler Singleton was with the University of South Carolina School of Medicine, Columbia
| | - Mark Douglas
- At the time of the writing of this essay, Alyssa G. Robillard was with the Institute for Families in Society, University of South Carolina, and Palmetto AIDS Life Support Services, Columbia, SC. Carmen H. Julious is with Palmetto AIDS Life Support Services. Stacy W. Smallwood is with the Department of Health Policy & Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Mark Douglas was with My Brothaz HOME Inc, Savannah, GA. Bambi W. Gaddist was with South Carolina HIV Council doing business as Wright Wellness Center, Columbia. Tyler Singleton was with the University of South Carolina School of Medicine, Columbia
| | - Bambi W Gaddist
- At the time of the writing of this essay, Alyssa G. Robillard was with the Institute for Families in Society, University of South Carolina, and Palmetto AIDS Life Support Services, Columbia, SC. Carmen H. Julious is with Palmetto AIDS Life Support Services. Stacy W. Smallwood is with the Department of Health Policy & Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Mark Douglas was with My Brothaz HOME Inc, Savannah, GA. Bambi W. Gaddist was with South Carolina HIV Council doing business as Wright Wellness Center, Columbia. Tyler Singleton was with the University of South Carolina School of Medicine, Columbia
| | - Tyler Singleton
- At the time of the writing of this essay, Alyssa G. Robillard was with the Institute for Families in Society, University of South Carolina, and Palmetto AIDS Life Support Services, Columbia, SC. Carmen H. Julious is with Palmetto AIDS Life Support Services. Stacy W. Smallwood is with the Department of Health Policy & Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Mark Douglas was with My Brothaz HOME Inc, Savannah, GA. Bambi W. Gaddist was with South Carolina HIV Council doing business as Wright Wellness Center, Columbia. Tyler Singleton was with the University of South Carolina School of Medicine, Columbia
| |
Collapse
|
2
|
Abstract
[Figure: see text].
Collapse
Affiliation(s)
- Yudit Namer
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany, and Research Institute Social Cohesion, Bielefeld, Germany
| | - Oliver Razum
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany, and Research Institute Social Cohesion, Bielefeld, Germany
| |
Collapse
|
4
|
Abstract
COVID-19 has caused devastating health consequences and social inequities globally and in the United States. Unfortunately, the US has not developed a comprehensive National COVID-19 Strategy. In this editorial, we briefly review lessons about the development, structure, implementation and evaluation of the National HIV/AIDS Strategy (NHAS) for the US, and use these lessons to inform an initial proposal for a timely, dynamic, evidence-based, participatory, comprehensive and impactful National COVID-19 Strategy. Without such a strategy, the national response to the COVID-19 pandemic will remain uneven across jurisdictions and less than optimally impactful on disease-related mortality, short- and long-term morbidity, and health and social inequities.
Collapse
|