Structural Dynamics of HIV

1. Front Matter

   Pages i-xxx

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2. Risk

   1. Front Matter

      Pages 1-1

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   2. Understanding HIV Disparities Among Transgender Women in Guatemala: Linking Social and Structural Factors to HIV Vulnerability

      • Clare Barrington, César Galindo Arandi, José Manuel Aguilar-Martínez, William M. Miller

      Pages 3-17

   3. From Structural Analysis to Pragmatic Action: The Meso-level Modifiable Social Determinants of HIV Vulnerability for Labor Migrants

      • Jennifer S. Hirsch, Morgan M. Philbin, Daniel Jordan Smith, Richard G. Parker

      Pages 19-43

   4. Addressing the Micro- and Macro-Environmental Vulnerabilities to HIV of People Who Inject Drugs in Tanzania: A Case Study of the Muhimbili Medication-Assisted Treatment Clinic

      • Jessie Mbwambo, Haneefa T. Saleem, Pamela Kaduri, Barrot H. Lambdin, Sheryl A. McCurdy

      Pages 45-63

3. Resilience

   1. Front Matter

      Pages 65-65

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   2. No-One-Size-Fits-All: Addressing the Social and Structural Dimensions of Sex Worker Vulnerability to HIV Through Community Mobilization in Avahan

      • Nimesh Dhungana, Kim M. Blankenship, Monica R. Biradavolu, Nehanda Tankasala, Annie George

      Pages 67-96

   3. Abriendo Puertas: A Multi-level Intervention to Improve HIV Outcomes by Addressing Stigma and Discrimination Among Female Sex Workers in the Dominican Republic

      • Deanna Kerrigan, Clare Barrington, Maria Carrasco, Andrea Mantsios, Martha Perez, Hoisex Gomez et al.

      Pages 97-114

   4. Multi-level Responses to Multi-level Vulnerabilities: Creating an Enabling Environment for HIV Prevention for Girls in Botswana, Malawi, and Mozambique

      • Carol Underwood, Jane Brown, Hilary Schwandt

      Pages 115-130

4. Response

   1. Front Matter

      Pages 131-131

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   2. Sustaining a Rights-Based Response to HIV in Brazil

      • Laura Murray, Deanna Kerrigan, Vera Paiva

      Pages 133-155

   3. Structural Approaches Are Building Power: South Africa’s National HIV Response Among Female Sex Workers (1990–2016)

      • Daniel M. Woznica, Anna M. Leddy, Tim Lane

      Pages 157-171

   4. Structural Factors and the National HIV/AIDS Strategy of the USA

      • Ronald O. Valdiserri, Catherine H. Maulsby, David R. Holtgrave

      Pages 173-194

   5. Finding and Reforming the (In)visible State: Nongovernmental Organizations and the Response to HIV in Ukraine

      • Jill Owczarzak, Sarah D. Phillips, Olga Filippova

      Pages 195-211

This book examines the structural dynamics of HIV among populations at heightened vulnerability to infection as the result of stigma, discrimination and marginalization. It first examines how the socio-structural context shapes HIV risk and how affected populations and national governments and programs have responded to these structural constraints.  Chapters focus on structural determinants of HIV risk among transgender women in Guatemala, migrant workers in Mexico, Nigeria and Vietnam, and people who inject drugs in Tanzania. Next, the book examines resilience and community empowerment and mobilization among key populations such as female sex workers in the Dominican Republic and India, and young women and girls in Botswana, Malawi and Mozambique. A third set of chapters explores how national responses to HIV have addressed the role of structural factors in diverse political, geographic and epidemic settings including: Brazil, South Africa, Ukraine and the USA. Ultimately, effectiveand sustainable responses to HIV among marginalized groups must be grounded in an in-depth understanding of the factors that create vulnerability and risk and impede access to services. Throughout, this book brings together a rigorous social science research perspective with a strong rights-based approach to inform improvements in HIV programs and policies. It offers new insights into how to better address HIV and the health and human rights of historically excluded communities and groups.

• Structural factors
• HIV and AIDS
• Key populations
• Human rights
• Social context

• Johns Hopkins Bloomberg School of Public Health, Baltimore, USA

  Deanna Kerrigan

• University of North Carolina (UNC) Gillings School of Global Public Health, Chapel Hill, USA

  Clare Barrington

Deanna Kerrigan, PhD, MPH is an Associate Professor at the Johns Hopkins Bloomberg School of Public Health. She has been engaged in public health intervention research with a focus on the study of social and structural factors influencing the adoption of health-promoting behaviors related to HIV prevention and care since 1995. A significant portion of her research has focused on evaluating the role and impact of environmental-structural factors related to HIV outcomes among marginalized groups, including female sex workers, people living with HIV and disadvantaged youth. She recently directed a large-scale, global HIV prevention operations research portfolio funded by USAID, Project Search: Research to Prevention (R2P). She is the Co-Director of the Prevention Core of the Johns Hopkins Center for AIDS Research (CFAR). Her current work focuses on Tanzania, the Dominican Republic, Brazil and Baltimore. She previously served as a Program Officer in the area of Sexuality, Reproductive Health and Rights for the Ford Foundation in Brazil.

Clare Barrington, PhD, MPH is an Associate Professor in the Department of Health Behavior at the University of North Carolina (UNC) Gillings School of Global Public Health. She is also the Latin American Projects Director for the UNC Institute for Global Health and Infectious Diseases and a fellow at the Carolina Population Center. Dr. Barrington conducts mixed-methods research to examine social network and structural influences on health and health behaviors, with a focus on HIV prevention and care among female sex workers and their male partners, men who have sex with men, and transgender women in Latin America. She has worked in the Dominican Republic since the mid-1990s and also has current projects in Central America and with Latinos in North Carolina. Dr. Barrington also leads the qualitative component of several mixed-methods HIV studies and impact evaluations of social cash transfer programs. She teaches graduate-levelcourses in qualitative data analysis and writing and global health. 

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