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Dickson-Gomez J, Krechel S, Katende D, Johnston B, Twaibu W, Glasman L, Ogwal M, Musinguzi G. The Role of Context in Integrating Buprenorphine into a Drop-In Center in Kampala, Uganda, Using the Consolidated Framework for Implementation Research. Int J Environ Res Public Health 2022; 19:10382. [PMID: 36012015 PMCID: PMC9407835 DOI: 10.3390/ijerph191610382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/02/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Although Africa has long borne the brunt of the human immunodeficiency virus (HIV) epidemic, until recently, the continent has been considered largely free of illicit drug use and injection drug use in particular. In Uganda, the number of people who use or inject drugs (PWUD and PWID, respectively) has increased, and PWID are a key population at high risk for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection. However, harm reduction practices, including providing clean injection equipment and medication-assisted treatment (MAT), have only recently been piloted in the country. This project aims to integrate buprenorphine into a harm reduction drop-in center (DIC). METHODS The Consolidated Framework for Implementation Research was used to guide our preparations to integrate buprenorphine into existing practices at a harm reduction DIC. We conducted key informant interviews with members of a community advisory board and DIC staff to document this process, its successes, and its failures. RESULTS Results indicate that criminalization of drug use and stigmatization of PWUD challenged efforts to provide buprenorphine treatment in less regulated community settings. CONCLUSIONS DIC staff and their commitment to harm reduction and advocacy facilitated the process of obtaining necessary approvals.
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Affiliation(s)
- Julia Dickson-Gomez
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Sarah Krechel
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Dan Katende
- Uganda Harm Reduction Network, Kampala 31762, Uganda
| | - Bryan Johnston
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Wamala Twaibu
- Uganda Harm Reduction Network, Kampala 31762, Uganda
| | - Laura Glasman
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Moses Ogwal
- School of Public Health, Makerere University, Kampala 7072, Uganda
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Suro B, Lechuga J, Galletly CL, Glasman L. The influence of perceived immigration context and healthcare utilization immigration law concerns on Latinx immigrants’ HIV testing. Journal of Latinx Psychology 2022; 10:156-167. [PMID: 37034822 PMCID: PMC10081501 DOI: 10.1037/lat0000171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although new HIV infections have remained stable or decreased for most U.S. groups at risk for HIV, incidence among Latinx increased by 6% and among Latinx individuals, immigrants are disproportionately infected. One driver of these infections is low rates of HIV testing. While research shows the chilling effect that restrictive immigration laws can have on immigrants' health care utilization, few studies have examined the influence of perceived immigration context and healthcare utilization immigration law concerns on following a public health recommendation such as HIV testing. The purpose of the study is to test an exploratory model of immigration-related variables and their impact on U.S. Latinx immigrants' yearly HIV testing. U.S.-Latinx immigrants (N=169) completed a cross-sectional survey assessing perceived enforcement of immigration laws, perceptions of law enforcement attitudes towards Latinx and immigrants, fear of deportation, concerns with the consequences of immigration laws for health care utilization, and yearly HIV testing. Path analysis findings indicated that perceived enforcement of immigration laws was related to perceived negative attitudes from law enforcement towards Latinx and immigrants which was associated with fear of deportation. Fear of deportation was associated with concerns with the implications of immigration laws for accessing publicly funded healthcare services and these concerns were negatively related to yearly HIV testing and mediated the association between fear of deportation and yearly HIV testing. Findings point to the need of developing and implementing individual- and policy-level interventions to increase HIV testing among Latinx immigrants in a restrictive immigration law environment. Resumen Aunque nuevas infecciones de VIH se han mantenido estable o han disminuido para la mayoría de los grupos en los Estados Unidos (E.U.) en alto riesgo de contraer VIH, la incidencia de VIH entre Latinx ha aumentado 6% y entre individuos Latinx, los inmigrantes están desproporcionalmente afectados por la epidemia. Uno de los factores que contribuye a la alta tasa de VIH es la baja tasa de pruebas de VIH entre inmigrantes. Aunque la investigación confirma los efectos escalofriantes que las leyes restrictivas de inmigración pueden tener en la utilización de servicios de salud entre los inmigrantes, pocos estudios han examinado la influencia de la percepción del contexto de inmigración y las preocupaciones sobre las implicaciones de las leyes de inmigración si se utilizan servicios de salud públicos en seguir la recomendación de salud pública de hacerse la prueba de VIH regularmente. El propósito del estudio es someter a la prueba un modelo exploratorio de la influencia de variables relacionadas a la inmigración y su impacto en las pruebas anuales de HIV en los inmigrantes Latinx que viven en los E.U. (N=169). Los participantes contestaron un cuestionario transversal que midió la percepción del enforzamiento de las leyes de inmigración, la percepción de las actitudes de los agentes que enforzan las leyes de inmigración hacia Latinx y inmigrantes, el miedo a la deportación, las preocupaciones especificas sobre las consecuencias de las leyes de inmigración para la utilización de servicios de salud, la percepción de la sociedad sobre el estigma de VIH, y si los inmigrantes se hacen la prueba de VIH anualmente. Los resultados de los análisis de trayectoria indicaron que el enforzamiento de las leyes de inmigración esta relacionada con la percepción de que los agentes policiacos que enforzan las leyes tienen actitudes negativas hacia Latinx y inmigrantes lo cual esta asociado con el miedo a la deportación. El miedo a la deportación esta asociado a las preocupaciones sobre las implicaciones de las leyes de inmigración para la utilización de los servicios de salud patrocinados por el gobierno federal y estas preocupaciones fueron negativamente relacionadas con las pruebas anuales de VIH y mediaron la asociación entre el miedo a la deportación y las pruebas anuales de VIH. Los resultados señalan la importancia de desarrollar e implementar intervenciones al nivel individual y al nivel de política para aumentar las pruebas de VIH entre los inmigrantes Latinx en un ambiente de leyes restrictivas de inmigración.
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Sunderrajan A, White B, Durantini M, Sanchez F, Glasman L, Albarracín D. Complex solutions for a complex problem: A meta-analysis of the efficacy of multiple-behavior interventions on change in outcomes related to HIV. Health Psychol 2021; 40:642-653. [PMID: 34435836 DOI: 10.1037/hea0001088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The purpose of this meta-analysis was to examine the success of multiple-behavior interventions and to identify whether the efficacy of such programs depends on the number of recommendations prescribed and the type of outcomes measured. METHOD We conducted a synthesis of 136 research reports (N = 59,330) using a robust variance estimate model (Tanner-Smith et al., 2016) to study change between baseline and the first follow-up across multiple-behavior interventions, single-behavior interventions, and passive controls. RESULTS Multiple-behavior interventions were more efficacious than their single-behavior counterparts (multiple-behaviors: d = .44 [95% confidence interval, CI [.27, .60]); single-behavior: d = .21 [95% CI [.00, .43]), with efficacy varying based on the type of outcomes measured. Publication bias analysis revealed a small asymmetry but controlling for it did not eliminate these effects. There was a strong linear relation between the number of recommendations prescribed by an intervention and intervention efficacy (B = .07, SE = .01, p < .001), with strongest improvements observed for interventions making five or more recommendations. These patterns remained when controlling for other intervention and population characteristics. CONCLUSIONS Multiple-behavior interventions are successful in the HIV domain and increasing the number of recommendations made in the intervention generally maximizes improvements. These findings provide insights that may guide the design and implementation of integrated interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Benjamin White
- Department of Psychology, University of Illinois at Urbana-Champaign
| | - Marta Durantini
- Department of Psychology, University of Illinois at Urbana-Champaign
| | - Flor Sanchez
- Department of Social Psychology and Methodology, Universidad Autónoma de Madrid
| | - Laura Glasman
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin
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Dickson-Gomez J, Tarima S, Glasman L, Cuellar W, de Mendoza LR, Bodnar G. Cumulative Effects of Adding a Small Group Intervention to Social Network Testing on HIV Testing Rates Among Crack Users in San Salvador, El Salvador. AIDS Behav 2021; 25:2316-2323. [PMID: 33515335 PMCID: PMC8165071 DOI: 10.1007/s10461-021-03160-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2021] [Indexed: 11/30/2022]
Abstract
The present study evaluates a combination prevention intervention for crack users in San Salvador, El Salvador that included social network HIV testing, community events and small group interventions. We examined the cumulative effects of the social network HIV testing and small group interventions on rates of HIV testing, beyond the increase that we saw with the introduction of the social network HIV testing intervention alone. HIV test data was converted into the number of daily tests and analyzed the immediate and overtime impact of small group interventions during and in the twelve weeks after the small group intervention. The addition of the small group interventions to the baseline of monthly HIV tests resulted in increased rates of testing lasting 7 days after the small group interventions suggesting a reinforcing effect of small group interventions on testing rates.
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Ko Ko T, Dickson-Gomez J, Yasmeen G, Han WW, Quinn K, Beyer K, Glasman L. Informal workplaces and their comparative effects on the health of street vendors and home-based garment workers in Yangon, Myanmar: a qualitative study. BMC Public Health 2020; 20:524. [PMID: 32306950 PMCID: PMC7168952 DOI: 10.1186/s12889-020-08624-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 03/31/2020] [Indexed: 11/29/2022] Open
Abstract
Background Globally, two billion workers are employed informally but there is limited research on the relationship between informal work and health. Existing studies have focused on informality as an employment condition, with little emphasis on the diversity of physical and social contexts in which informal work takes place. The study considers the diversity of informal workplaces and explores the ways in which this diversity might influence health and well-being of two informal occupational groups in Yangon, the former capital of Myanmar. Methods We conducted 21 field observations and 47 semi-structured interviews with street vendors and home-based garment workers based in Yangon, Myanmar. A constant comparative method was used to identify and compare how the physical characteristics of their informal workplaces affect their health for these two informal subgroups. Results Although both street vendors and home-based garment workers work informally, their exposure to occupational health and income risks are specific to the physical features of their informal workplaces. Street vendors, who work in public spaces with minimal coverage, are more likely to experience the direct effects of outdoor pollution, inclement weather and ergonomic risks from lifting, carrying and transporting heavy merchandise while home-based garment workers, many of whom live and work in unsanitary housing and deprived neighborhoods, are more likely to experience pollution in or near their homes, and ergonomic risks from poor posture. Similarly, although both groups face safety challenges, street vendors face urban violence and abuse during their commute and at vending points whereas home-based garment workers felt unsafe in their home-based workplaces due to the presence of crime and violence in their neighborhoods. Conclusion While informal employment is universally characterized by lack of social protection, exposure to occupational health and income risks for subpopulations of informal workers is determined by the specific physical and social environments of their workplaces. Efforts to improve the health of informal workers should consider the contexts in which informal work takes place to develop tailored interventions for subpopulations of informal workers.
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Affiliation(s)
- Thant Ko Ko
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, USA.
| | - Julia Dickson-Gomez
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, USA
| | - Gisèle Yasmeen
- Institute of Asian Research, School of Public Policy and Global Affairs, University of British Columbia, Vancouver, British Columbia, Canada
| | - Wai Wai Han
- Department of Medical Research, Ministry of Health and Sports, No 5, Ziwaka Road, Dagon Township, Yangon, 11191, Myanmar
| | - Katherine Quinn
- Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kirsten Beyer
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, USA
| | - Laura Glasman
- Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, Milwaukee, WI, USA
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Garcia D, Tarima S, Glasman L, Cassidy LD, Meurer J, Okunseri C. Latino Acculturation and Periodontitis Status Among Mexican-Origin Adults in the United States: NHANES 2009-2012. Fam Community Health 2017; 40:112-120. [PMID: 28207674 PMCID: PMC5321569 DOI: 10.1097/fch.0000000000000142] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study examined the association between Latino acculturation indicators (language and citizenship/nativity status) and periodontitis using data from the National Health and Nutrition Examination Survey (NHANES) 2009-2012. Descriptive statistics and logistic regression analyses were performed and all analyses were adjusted for the complex survey design. Results showed that 63.2% of participants had periodontitis: 9.4% mild, 37.9% moderate, and 16% severe. Language was significantly associated with periodontitis after adjusting for age, educational level, gender, usual source of care, flossing, smoking, and glycohemoglobin level (P = .02). Dental public and private health efforts should implement culturally tailored oral health promotion education efforts for this population.
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Affiliation(s)
- Dina Garcia
- Iowa Institute for Oral Health Research, The University of Iowa
College of Dentistry, Iowa City, IA
| | - Sergey Tarima
- Institute for Health & Society, Medical College of
Wisconsin, Milwaukee, WI
| | - Laura Glasman
- Center for AIDS Intervention Research Department of Psychiatry and
Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Laura D. Cassidy
- Institute for Health & Society, Medical College of
Wisconsin, Milwaukee, WI
| | - John Meurer
- Institute for Health & Society, Medical College of
Wisconsin, Milwaukee, WI
| | - Christopher Okunseri
- Department of Clinical Services, Marquette University School of
Dentistry, Milwaukee, WI
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Abstract
Since the mid-1990 s, many developing countries have introduced and expanded the availability of combination antiretroviral therapy (cART) to persons living with HIV (PLH). However, AIDS-related mortality continues to be high particularly among drug users. In this article, we present results from in-depth interviews with 13 HIV medical providers and 29 crack cocaine and alcohol using PLH in El Salvador. Providers endorsed negative attitudes toward substance using PLH and warned PLH that combining cART with drugs and alcohol would damage their livers and kidneys resulting in death. Upon diagnosis, PLH received little information about HIV treatment and many suffered depression and escalated their drug use. PLH reported suspending cART when they drank or used drugs because of providers' warnings. Substance using PLH were given few strategies and resources to quit using drugs. Messages from medical providers discourage drug users from initiating or adhering to antiretroviral therapy (ART) and may contribute to treatment abandonment.
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Affiliation(s)
| | - Gloria Bodnar
- Fundación Antidrogas de El Salvador, Santa Tecla, El Salvador
| | - Andy Petroll
- Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Kali Johnson
- Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Laura Glasman
- Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Dickson-Gomez J, Lechuga J, Glasman L, Pinkerton S, Bodnar G, Klein P. Prevalence and Incidence of HIV and Sexual Risk Behaviors in Crack Users in the San Salvador Metropolitan Area, El Salvador. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/wja.2013.34046] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Dickson-Gomez J, McAuliffe T, Rivas de Mendoza L, Glasman L, Gaborit M. The relationship between community structural characteristics, the context of crack use, and HIV risk behaviors in San Salvador, El Salvador. Subst Use Misuse 2012; 47:265-77. [PMID: 22217125 PMCID: PMC3263344 DOI: 10.3109/10826084.2011.635325] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This paper explores community structural factors in different low-income communities in the San Salvador, El Salvador, that account for differences in the social context in which crack is used and HIV risk behaviors among crack users. Results suggest that both more distal (type of low-income community, level of violent crime, and poverty) and proximate structural factors (type of site where drugs are used, and whether drugs are used within or outside of community of residence) influence HIV risk behaviors among drug users. Additionally, our results suggest that community structural factors influence the historical and geographic variation in drug use sites.
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Affiliation(s)
- Julia Dickson-Gomez
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwuakee, Wisconsin 53202, USA.
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Bogart LM, Skinner D, Weinhardt LS, Glasman L, Sitzler C, Toefy Y, Kalichman SC. HIV misconceptions associated with condom use among black South Africans: an exploratory study. Afr J AIDS Res 2011; 10:181-187. [PMID: 21804784 PMCID: PMC3144581 DOI: 10.2989/16085906.2011.593384] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In South Africa, approximately 20% of 15-49-year-olds are infected with HIV. Among black South Africans, high levels of HIV/AIDS misconceptions (e.g. HIV is manufactured by whites to reduce the black African population; AIDS is caused by supernatural forces or witchcraft) may be barriers to HIV prevention. We conducted a cross-sectional study of 150 young, black adults (aged 18-26; 56% males) visiting a public clinic for sexually transmitted infections, to investigate whether HIV/AIDS misconceptions were related to low condom use in main partner relationships. We assessed agreement with HIV/AIDS misconceptions relating to the supernatural (e.g. witchcraft as a cause of HIV) and to genocide (e.g. the withholding of a cure). In multivariate models, agreement that 'Witchcraft plays a role in HIV transmission' was significantly related to less positive attitudes about condoms, less belief in condom effectiveness for HIV prevention, and lower intentions to use condoms among men. The belief that 'Vitamins and fresh fruits and vegetables can cure AIDS' was associated with lower intentions among men to use condoms. Women who endorsed the belief linking HIV to witchcraft had a higher likelihood of unprotected sex with a main partner, whereas women who endorsed the belief that a cure for AIDS was being withheld had a lower likelihood of having had unprotected sex. Knowledge about distinct types of HIV/AIDS misconceptions and their correlates can help in the design of culturally appropriate HIV-prevention messages that address such beliefs.
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Affiliation(s)
- Laura M Bogart
- Children’s Hospital Boston/Harvard Medical School, Division of General Pediatrics, 300 Longwood Avenue, Boston, Massachusetts 02115, United States
| | - Donald Skinner
- Stellenbosch University, Faculty of Health Sciences, Health in Research and Society Unit, PO Box 19063, Tygerberg 7505, Cape Town, South Africa
| | - Lance S Weinhardt
- Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, Department of Psychiatry and Behavioral Medicine, 2071 North Summit Avenue, Milwaukee, Wisconsin 53202, United States
| | - Laura Glasman
- Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, Department of Psychiatry and Behavioral Medicine, 2071 North Summit Avenue, Milwaukee, Wisconsin 53202, United States
| | - Cheryl Sitzler
- Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, Department of Psychiatry and Behavioral Medicine, 2071 North Summit Avenue, Milwaukee, Wisconsin 53202, United States
| | - Yoesrie Toefy
- Stellenbosch University, Faculty of Health Sciences, Health in Research and Society Unit, PO Box 19063, Tygerberg 7505, Cape Town, South Africa
| | - Seth C Kalichman
- University of Connecticut, Department of Psychology, 406 Babbidge Road, Unit 1020, Storrs, Connecticut 06269-1020, United States
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Latkin C, Weeks MR, Glasman L, Galletly C, Albarracin D. A dynamic social systems model for considering structural factors in HIV prevention and detection. AIDS Behav 2010. [PMID: 20838871 DOI: 10.1007/s10461-010-9804-y.a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
We present a model for HIV-related behaviors that emphasizes the dynamic and social nature of the structural factors that influence HIV prevention and detection. Key structural dimensions of the model include resources, science and technology, formal social control, informal social influences and control, social interconnectedness, and settings. These six dimensions can be conceptualized on macro, meso, and micro levels. Given the inherent complexity of structural factors and their interrelatedness, HIV prevention interventions may focus on different levels and dimensions. We employ a systems perspective to describe the interconnected and dynamic processes of change among social systems and their components. The topics of HIV testing and safer injection facilities (SIFs) are analyzed using this structural framework. Finally, we discuss methodological issues in the development and evaluation of structural interventions for HIV prevention and detection.
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Affiliation(s)
- Carl Latkin
- Department of Health, Behavior and Society, The Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA.
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