Social Location and Decision-Making Among Women Living with HIV in the Southern United States: An Intersectional Approach

Courtney Caiola, Marianne R. Choufani, Juliette André, Sadie B. Sommer, Alexander M. Schoemann, Sarah B. Bass and Julie Barroso ()
Additional contact information
Courtney Caiola: College of Nursing, East Carolina University, Greenville, NC 27858, USA
Marianne R. Choufani: College of Nursing, East Carolina University, Greenville, NC 27858, USA
Juliette André: School of Nursing, Vanderbilt University, Nashville, TN 62374, USA
Sadie B. Sommer: School of Nursing, Vanderbilt University, Nashville, TN 62374, USA
Alexander M. Schoemann: Department of Psychology, East Carolina University, Greenville, NC 27858, USA
Sarah B. Bass: Department of Social and Behavioral Sciences, Temple University, Philadelphia, PA 19122, USA
Julie Barroso: School of Nursing, Vanderbilt University, Nashville, TN 62374, USA

IJERPH, 2024, vol. 21, issue 12, 1-16

Abstract: HIV care engagement and antiretroviral therapy (ART) adherence interventions aimed at decreasing viral suppression disparities for women living with HIV (WLWH) in the Southern United States (i.e., the South) are few and seldom consider diverse social locations. These refer broadly and dynamically to contextual factors and the position people occupy in a social hierarchy based on intersecting systems of oppression and social determinants of health like gender, race/ethnic, and class inequities; geographic location; and HIV-related stigma. Using an intersectional approach, we conducted in-depth interviews and used a phased approach to directed content analysis to describe women’s perceptions of their social location and how it impacts their decision-making about HIV care engagement and ART adherence. Participants were recruited to participate from a broad geographic area and represented the diverse social locations occupied by WLWH in the South. Findings from 40 in-depth interviews include descriptions of how geographic context impacts HIV care engagement and medication adherence through access to care, quality of care, and the place-based context of day-to-day experiences of living with HIV. Participants spoke of multilevel power relationships based on their gender and racial identities, and how social determinants and intersecting identities occur simultaneously and vary as a function of one another to impact health and HIV care decision-making. The findings offer a nuanced understanding of how WLWH perceive their contextually specific social locations and make critical decisions about their HIV care engagement and medication adherence.

Keywords: women; HIV; engagement in care; adherence; social location; qualitative (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/21/12/1575/pdf (application/pdf)
https://www.mdpi.com/1660-4601/21/12/1575/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:21:y:2024:i:12:p:1575-:d:1530391

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().