Social organization of sexual‐economic networks and the persistence of HIV in a rural area in the USA

Abstract

In order to determine why high rates of HIV transmission have persisted in a rural area despite community-wide HIV prevention since the mid-1980s, qualitative information was collected about the contexts and social organization of risk behaviour for HIV transmission from residents of a southern Florida community with high HIV prevalence. Original data were collected during 1995-1997 using individual interviews, observations, focus groups, and print media. The research findings were recently reviewed by community members, and the relevance of the data in the present day context was confirmed. We identified risk behaviours including multiple sex partners within heterosexual networks that cross socioeconomic strata and include adults and young people, sex workers, men who have sex with men, prison inmates, truckers, and migrant workers. Crack cocaine was an important feature of some networks. Financial support from multiple male or female sex partners was often part of a personal economic strategy and overlaid traditional social support networks. This type of relationship appears to be historically integrated into the economic fabric of the community and is not likely to receive social censure. Sexual reciprocity may explain, in part, why HIV transmission is rising among women in rural southern communities that have depressed economies.

Mapping U.S. long-haul truck drivers’ multiplex networks and risk topography in inner-city neighborhoods

“…Empirical evidence from diverse trucking settings indicates that some North American regional and long-haul truckers engage in risk-laden sexual encounters with women and men that are often combined with illicit substances (Apostolopoulos et al, 2012, Stratford et al, 2007). Although the number of truckers who engage in these behaviors might be proportionally small, their interstate perpetual mobility and engagement in risky sexual behaviors pose risks to others.…”

A Qualitative Study of Barriers to the Utilization of HIV Testing Services Among Rural African American Cocaine Users

“…Substance use, especially noninjecting cocaine use, is prevalent among African Americans in the rural South, putting rural African American substance users at even greater risk (Booth, Leukefeld, Falck, Wang, & Carlson, 2006; Chu & Selwyn, 2008; Farley, 2006; Fleming, Lansky, Lee, & Nakashima, 2006; Wright et al, 2007). HIV risk behaviors associated with cocaine use include having unprotected sex, using condoms inconsistently, having multiple concurrent sexual partners, having sex when using drugs, and trading sex for drugs or for survival needs (Adimora, Schoenbach, & Doherty, 2006; Fleming et al, 2006; Reif, Geonnotti, & Whetten, 2006; Stratford, Ellerbrock, & Chamblee, 2007; Wright et al, 2007). …”

Male Labor Migrants in Russia: HIV Risk Behavior Levels, Contextual Factors, and Prevention Needs

“…Prior research in multiple world regions has shown that migrants often have limited HIV knowledge (4,5) and low perceptions of risk (6). Labor migrants may have multiple sexual partners (4,7,8), inconsistently use condoms, and have sex with commercial sex workers (6,9,10). Sexual harassment, abuse, or rape are commonly reported by female labor migrants (5,11).…”

“…Social factors that contribute to vulnerability include stresses associated with being away from spouses and other emotionally important persons in one’s home country for extended periods, as well as with lack of acculturation and assimilation in a destination country. Alcohol and drug use, unofficial status that prevents access to services, and absence of legal rights are common among labor migrants (7,9,10,14–16). …”