Abstract
HIV has become an epidemic in African American communities in the Deep South, which poses a major public health crisis. Unfortunately, the lack of attention from health officials has resulted in African Americans experiencing the greatest burden of the disease as compared to any other racial/ethnic group. Thus, this chapter examined social determinants of health that often predicts HIV transmission with an emphasis on African Americans in the Deep South given the legacy of slavery. Social determinants of health are defined as circumstances in which people are born, grow, live, work, and age, which is formed by the distribution of power, wealth, and resources at multiple levels. This chapter employs a quantitative analysis of secondary data from counties and county-equivalents in the Deep South. This chapter also examines interrelationships among major variables of interest and identified empirically relevant correlates of the dependent variable. Multiple regression analysis yielded a set of predictor variables that explained 61% of the variance in HIV rates. The chapter concludes with implications for future research into factors that contribute to the HIV/AIDS epidemic in the Deep South such as stigma, conspiracy theories, and public health policies.
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References
AIDSinfo. (2017). AIDSinfo updates consumer fact sheets on HIV/AIDS-related opportunistic infections and coinfections. Retrieved from https://aidsinfo.nih.gov/e-news/archive/2017/8/25
Anastas, J. W. (2000). Research design for social work and the human services (2nd ed.). Columbia University.
Batelaan, K. (2021). ‘When whites catch a cold, black folks get pneumonia’: A look at racialized poverty, space and HIV/AIDS. Social Identities, 27(2), 262–282.
Bates, D., Maechler, M., Bolker, B. M., & Walker, S. (2015). Fitting linear mixed-effects models using lme4. Journal of Statistical Software, 67(1), 1–48.
Bell, R. (2018). Counterfeit kin: Kidnappers of color, the reverse underground railroad, and the origins of practical abolition. Journal of the Early Republic, 38(2), 199–230.
Bell, R. (2019). Stolen: Five free boys kidnapped into slavery and their astonishing odyssey home. 37 Ink.
Bogart, L. M., Ojikutu, B. O., Tyagi, K., Klein, D. J., Mutchler, M. G., Dong, L., Lawrence, S. J., Thomas, D. R., & Kellman, S. (2021). COVID-19 related medical mistrust, health impacts, and potential vaccine hesitancy among Black Americans living with HIV. Journal of Acquired Immune Deficiency Syndromes (1999), 86(2), 200–207.
Bogart, L. M., Wagner, G., Galvan, F. H., & Banks, D. (2010). Conspiracy beliefs about HIV are related to antiretroviral treatment nonadherence among African American men with HIV. Journal of Acquired Immune Deficiency Syndromes, 53(5), 648–655.
Brewer, R., Daunis, C., Ebaady, S., Wilton, L., Chrestman, S., Mukherjee, S., Moore, M., Corrigan, R., & Schneider, J. (2019). Implementation of a socio-structural demonstration project to improve HIV outcomes among young Black men in the Deep South. Journal of Racial and Ethnic Health Disparities, 6(4), 775–789.
Centers for Disease Control and Prevention. (1982). HIV/AIDS Surveillance Report, p. 1-2. Retrieved from https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-1982.pdf
Centers for Disease Control and Prevention. (2011). Recommended HIV testing definitions and examples HIV testing definitions work group division of HIV/AIDS prevention. Retrieved from https://www.cdc.gov/hiv/pdf/funding/announcements/ps12-1201/CDC-HIV-PS12-1201-Attachment-II.pdf
Centers for Disease Control and Prevention. (2012). Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 U.S. dependent areas—2010. HIV Surveillance Supplemental Report 2012; 17(3), part A. Retrieved from http://www.cdc.gov/hiv/topics/surveillance/resources/reports/.
Centers for Disease Control and Prevention. (2016). CDC issue brief: HIV in the Southern United States. Retrieved from https://www.cdc.gov/hiv/pdf/policies/cdc-hiv-in-the-south-issue-brief.pdf
Centers for Disease Control and Prevention. (2017a). More people with HIV have the virus under control. Available at: https://www.cdc.gov/nchhstp/newsroom/2017/2017-HIV-Continuum-Press-Release.html.
Centers for Disease Control and Prevention. (2017b). NCHHSTP AtlasPlus. Updated 2017. https://www.cdc.gov/nchhstp/atlas/index.htm. Accessed on January 25,2019
Centers for Disease Control and Prevention. (2018). Social determinants of health among adults with diagnosed HIV infection, 2016. Part A: Census tract-level social determinants of health among adults with diagnosed HIV infection—13 states, the District of Columbia, and Puerto Rico. HIV Surveillance Supplemental Report 2018, 23(6). Retrieved from https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2016-vol-23-6.pdf
Centers for Disease Control and Prevention. (2019). HIV in the United States and dependent areas. https://www.cdc.gov/hiv/statistics/overview/ataglance.html. Updated January 29, 2019. Accessed September 11, 2021.
Cobb, T. R. R. (1968). An inquiry into the law of Negro slavery in the United States of America: To which is prefixed, an historical sketch of slavery. University of Georgia Press.
Cohen, J. (1988). Statistical power analysis for the behavior sciences (2nd ed.). West Publishing Company.
Conover, W. J., & Iman, R. L. (1981). Rank transformations as a bridge between parametric and nonparametric statistics. The American Statistician, 35(3), 124–129.
Davis, A., Gardner, B. B., & Gardner, M. R. (2009). Deep South: A social anthropological study of caste and class. University of South Carolina Press.
DeCarlo, L. T. (1997). On the meaning and use of kurtosis. Psychological Methods, 2(3), 292–307.
Department of Health & Human Services. (2014). Office on women’s health. Health Disparities Profiles. Retrieved from http://www.healthstatus2020.com/disparities/images/
Eisinger, R. W., & Fauci, A. S. (2018). Ending the HIV/AIDS pandemic. Emerging infectious diseases, 24(3), 413.
Fauci, A. S., Redfield, R. R., Sigounas, G., Weahkee, M. D., & Giroir, B. P. (2019). Ending the HIV epidemic: A plan for the United States. JAMA, 321(9), 844–845.
Field, A. (2013). Discovering statistics using SPSS (4th ed.). Sage.
Ghasemi, A., & Zahediasl, S. (2012). Normality tests for statistical analysis: A guide for non-statisticians. International Journal of Endocrinology and Metabolism, 10(2), 486–489.
Giroir, B. P. (2020). The time is now to end the HIV epidemic. American Journal of Public Health, 110(1), 22–24.
Granich, R., Williams, B., Montaner, J., & Zuniga, J. M. (2017). 90-90-90 and ending AIDS: Necessary and feasible. The Lancet, 390(10092), 341–343.
Hiers, K. (2020). Implementing the trump administration’s “Ending the HIV Epidemic” plan in the Southern United States. American Journal of Public Health, 110(1), 32–33. https://doi.org/10.2105/AJPH.2019.305452
Humes, K. R., Jones, N. A., & Ramirez, R. R. (2011). Overview of race and hispanic origin: 2010. 2010 Census Briefs. U.S. Department of Commerce. Economics and Statistics Administration. United States Census Bureau. Retrieved from http://www.census.gov/prod/cen2010/briefs/c2010br-06.pdf.
Intellectus Statistics [Online computer software]. (2019). Retrieved from https://analyze.intellectusstatistics.com/
International Federation of Social Workers. (2012). Social work manifesto on HIV and AIDS. Retrieved from http://ifsw.org/resolutions/social-work-manifesto-on-hiv-and-aids/
Kramer, M. R., Black, N. C., Matthews, S. A., & James, S. A. (2017). The legacy of slavery and contemporary declines in heart disease mortality in the US South. SSM-Population Health, 3, 609–617.
Krieger, N., Williams, D. R., & Moss, N. E. (1997). Measuring social class in US public health research: Concepts, methodologies, and guidelines. Annual Review of Public Health, 18(1), 341–378.
Markel, H. (2001). Journals of the plague years: Documenting the history of the AIDS epidemic in the United States. American Journal of Public Health, 91(7), 1025–1028.
Menard, S. (2009). Logistic regression: From introductory to advanced concepts and applications. Sage Publications.
Menefee, A. (2012). The HIV/AIDS epidemic in the Deep South. Clocks and Clouds, 1(1), 1–18.
Mertler, C. A., & Vannatta, R. A. (2016). Advanced and multivariate statistical methods: Practical application and interpretation (5th ed.). Pyrczak.
National Association of Social Workers. (1999). Code of ethics of the National Association of Social Workers. NASW Press.
Nunn, A., Jeffries, W. L., Foster, P., McCoy, K., Sutten-Coats, C., Willie, T. C., Ransome, Y., Lanzi, R. G., Jackson, E., Berkley-Patton, J., Keefer, M., & Coleman, J. D. (2019). Reducing the African American HIV disease burden in the Deep South: Addressing the role of faith and spirituality. AIDS and Behavior, 23(3), 319–330.
O’Connell, H. A. (2012). The impact of slavery on racial inequality in poverty in the contemporary US South. Social Forces, 90(3), 713–734.
Ogunsina, K., Padilla, L. A., Simmons, J. V., & McGwin, G. (2018). Current behavioral, socioeconomic and demographic determinants of lifetime HIV testing among African Americans in the deep south. Journal of Epidemiological Research, 5(1), 28–36.
Osborne, J., & Waters, E. (2002). Four assumptions of multiple regression that researchers should always test. Practical Assessment, Research & Evaluation, 8(2), 1–9.
Reif, S. S., Whetten, K., Wilson, E. R., McAllaster, C., Pence, B. W., Legrand, S., & Gong, W. (2014). HIV/AIDS in the Southern USA: A disproportionate epidemic. AIDS Care, 26(3), 351–359.
Reif, S., Pence, B. W., Hall, I., Hu, X., Whetten, K., & Wilson, E. (2015). HIV diagnoses, prevalence and outcomes in nine southern states. Journal of Community Health, 40(4), 642–651.
Reif, S., Safley, D., McAllaster, C., Wilson, E., & Whetten, K. (2017a). State of HIV in the US Deep South. Journal of Community Health, 1–10.
Reif, S. S., Wilson, E., & McAllaster, C. (2017b). HIV stigma study in the Deep South: Descriptive findings. 1–20. Retrieved from https://southernaids.files.wordpress.com/2017/08/revised-stigma-report-formatted-in-pdf.pdf
Reif, S., Wilson, E., & McAllaster, C. (2018). Perceptions and impact of HIV stigma among high risk populations in the US Deep South. Journal of HIV and AIDS, 4(2), 1–7.
Reif, S., Wilson, E., McAllaster, C., & Pence, B. (2019). The relationship of HIV-related stigma and health care outcomes in the US Deep South. AIDS and Behavior, 23(3), 242–250.
Richardson, J. M. (1969). Florida black codes. The Florida historical quarterly, 47(4), 365–379.
Rubin, A., & Babbie, E. R. (2005). Research methods for social work. Thomson/Brooks/Cole.
Schober, P., Boer, C., & Schwarte, L. A. (2018). Correlation coefficients: Appropriate use and interpretation. Anesthesia & Analgesia, 126(5), 1763–1768.
Shadish, W. R., Cook, T. D., & Campbell, D. T. (Eds.). (2005). Experimental and quasi-experimental designs for generalized causal inference. Wadsworth.
Sprague, C., Brown, S. M., Simon, S. E., McMahan, L. D., & Konkle-Parker, D. (2021). Experience of religion and spirituality among socially marginalized people living with HIV in Mississippi. Culture, Health & Sexuality, 23(8), 1111–1125.
State of Louisiana Department of Health and Hospitals, Office of Public Health, STD/HIV Program. (2016). STD/HIV surveillance report. Available at http://www.ldh.la.gov/assets/oph/HIVSTD/std/STDAnnualReports/2016_STDHIV_SurveillanceReport_Final.pdf. Accessed September 24, 2021.
State of Louisiana Department of Health and Hospitals, Office of Public Health, STD/HIV Program. (2017). Louisiana HIV, AIDS, and early Syphilis surveillance quarterly report 2017. Available at http://ldh.louisiana.gov/assets/oph/HIVSTD/First_Quarter_2017HIV_Syphilis_Report.pdf. Accessed September 28, 2021.
Stevens, J. P. (2009). Applied multivariate statistics for the social sciences (5th ed.). Routledge Academic.
Sutton, M. Y., Gray, S. C., Elmore, K., & Gaul, Z. (2017). Social determinants of HIV disparities in the southern United States and in counties with historically black colleges and universities (HBCUs), 2013–2014. PloS one, 12(1), e0170714.
Tabachnick, B. G., & Fidell, L. S. (2014). Using multivariate statistics (6th ed.). Pearson.
Torrieri, N. (2014). American Community Survey: Design and Methodology (January 2014). Available on-line at: http://www.census.gov/acs/www/Downloads/survey_methodology/acs_design_methodology_report_2014.pdf.
United States Census Bureau. (2017a). American Community Survey (ACS). U.S. Department of Commerce. Economics and Statistics Administration. United States Census Bureau. Retrieved from https://www.census.gov/programs-surveys/acs/about/acs-and-census.html.
United States Census Bureau. (2017b). Measuring poverty: Summary and recommendations Retrieved from https://www.census.gov/content/dam/Census/topics/income/supplemental-poverty-measure/sum.pdf
Walker-DeVose, D. C., Dawson, A., Schueths, A. M., Brimeyer, T., & Freeman, J. Y. (2019). Southern assumptions: Normalizing racialized structures at a university in the Deep South. Race Ethnicity and Education, 22(3), 355–373.
Watson, M., Johnson, S. D., Zhang, T., & Oster, A. M. (2019). Characteristics of and trends in HIV diagnoses in the Deep South region of the United States, 2012–2017. AIDS and Behavior, 23(3), 224–232.
Westfall, P. H., & Henning, K. S. S. (2013). Texts in statistical science: Understanding advanced statistical methods. Taylor & Francis.
White House Office of National AIDS Policy. (2011). National HIV/AIDS Strategy for the United States. Washington, DC: The White House; July 13, 2010. Available at: http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf. Retrieved August 27, 2016.
World Health Organization. (2017). Fact sheet: HIV/AIDS. Retrieved from http://www.who.int/mediacentre/factsheets/fs360/en/.
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Allison, K.D., Chaney, C.D., Tillis, C.M. (2022). Racism and Inequality in the Deep South: The Health and Sociocultural Correlates of HIV/AIDS Among African Americans and the Legacy of Slavery. In: Akande, A. (eds) Handbook of Racism, Xenophobia, and Populism. Springer Handbooks of Political Science and International Relations. Springer, Cham. https://doi.org/10.1007/978-3-031-13559-0_30
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