Individual Action and Community Context: The Health Intervention Project

• Authors: Claire E Sterk, Emory University; Kirk W. Elifson, Georgia State University; Katherine P. Theall, Louisiana State University
• Journal Title: American Journal of Preventive Medicine
• Volume: Volume 32, Number 6S
• Publisher: Elsevier Masson | 2007-06, Pages S177-S181
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1016/j.amepre.2007.02.020
• Subjects: Health Sciences, Public Health; Sociology, Public and Social Welfare

Abstract

Background HIV risk-reduction efforts have traditionally focused on the individual. The need for including the role of the social context and community addition is being recognized. Social capital provides social relationships and potential resources that may hinder or trigger risk or protective health behaviors, especially for individuals with limited economic means. Methods Sixty-five adult inner-city drug using women, who were included in a woman-focused HIV risk reduction intervention trial, participated in in-depth interviews in Atlanta, GA between 2002 and 2004. The interviews focused on the women's individual behavioral change during the six months since completion of the intervention as well as on the impact of community conditions. Topics discussed were sexual and drug use behaviors, social relationships, social capital, and community physical and social infrastructure. The data were analyzed using the constant comparison methods. Results The respondents indicated the poor physical and social infrastructure led to alienation and negatively impacted their behavioral change efforts. Social capital and social support mediated these negative influences. Drug related violence was an especially debilitating in their efforts to reduce HIV risk associated with crack cocaine or injection drug use and associated sexual behavior. Environmental conditions and opportunity structures played salient roles in the women's success. Conclusions Individual actions and community context must be considered simultaneously when facilitating and assessing behavioral interventions.