Department of Sociology, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016-4072, USA.
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA.
AIDS Behav. 2021 Nov;25(Suppl 2):190-201. doi: 10.1007/s10461-021-03238-4. Epub 2021 Apr 1.
We contrast a typical "social determinants of health" framing with a more dynamic and complex "social determination of health" framing to analyze HIV-related sexual risk among women in low-income, segregated neighborhoods in New Haven, CT. Using an abductive approach, we analyze repeated, longitudinal qualitative interviews conducted over a 2-year period with a sample of 14 HIV-negative women who engaged in sex with men during the study period. Three case studies are presented to demonstrate how behaviors and sexual practices typically described as HIV "risks" can be understood as part of the work of establishing and maintaining monogamous committed relationships, which we call "relationship work," shaped in a context characterized by housing vulnerabilities and the many manifestations of mass incarceration and the surveillance state. We conclude by suggesting that for these women, their relationship work is the work of HIV prevention and life in low-income segregated neighborhoods is their HIV-related risk.
我们将典型的“健康的社会决定因素”框架与更具动态和复杂性的“健康的社会决定”框架进行对比,以分析康涅狄格州纽黑文低收入隔离社区中与艾滋病毒相关的女性性行为风险。我们采用溯因方法,对在研究期间与 14 名与男性发生性关系的 HIV 阴性女性进行了为期两年的重复纵向定性访谈,对其进行了分析。呈现了三个案例研究,以展示通常被描述为 HIV“风险”的行为和性行为如何被理解为建立和维持一夫一妻制承诺关系的工作的一部分,我们称之为“关系工作”,这种关系工作是在住房脆弱性以及大规模监禁和监视国家的多种表现形式的背景下形成的。我们的结论是,对于这些女性来说,她们的关系工作是 HIV 预防的工作,而生活在低收入隔离社区是她们与 HIV 相关的风险。