Faculty Collaboration Database

Resources and obstacles to developing and implementing a structural intervention to prevent HIV in San Salvador, El Salvador. Soc Sci Med 2010 Feb;70(3):351-359

Date

11/17/2009

Pubmed ID

19910099

Pubmed Central ID

PMC2815075

DOI

10.1016/j.socscimed.2009.10.029

Scopus ID

2-s2.0-73149110108 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

HIV prevention researchers have increasingly advocated structural interventions that address factors in the social, political and economic context to reduce disparities of HIV/AIDS among disadvantaged populations. This paper draws on data collected in three different types of low-income communities (n=6) in the San Salvador metropolitan area in El Salvador. Nine focus group discussions were conducted between January 2006 and July 2007, 6 with community leaders, and 3 with crack cocaine users, as well as in-depth interviews with 20 crack users and crack dealers. We explore opportunities and barriers to the implementation of a community-level, structural intervention. We first analyze the different forms of leadership, and other community resources including existing HIV prevention activities that could potentially be used to address the related problems of crack use and HIV in the communities, and the structural factors that may act as barriers to capitalizing on communities' strengths in interventions. Each of the communities studied demonstrated different resources that stem from each community's unique history and geographic location. HIV testing and prevention resources varied widely among the communities, with resources concentrated in one Older Central community despite a strong need in all communities. In many communities, fear of gang violence and non-responsiveness by government agencies to communities' needs have discouraged community organizing. In the discussion, we offer concrete suggestions for developing and implementing structural interventions to reduce HIV risks that use communities' different but complementary resources.

Author List

Dickson-Gomez J, Corbett AM, Bodnar G, Rodriguez K, Guevara CE

Author

Julia Dickson-Gomez PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Cocaine-Related Disorders
Community Health Services
Crack Cocaine
El Salvador
Female
Focus Groups
HIV Infections
Health Care Rationing
Health Resources
Health Status Disparities
Humans
Interviews as Topic
Male
Needs Assessment
Program Development
Residence Characteristics
Socioeconomic Factors