| Description |
Existing research in HIV prevention typically focuses on increasing personal agency to overcome risk factors. My research focuses on structural risk factors and policy changes that can help eliminate structural risk factors. I attribute many structural risk factors-like homelessness, poverty and lack of health insurance-to processes described by Sidanius and Pratto in Social Dominance, like aggregated individual discrimination, institutional discrimination and behavioral asymmetry. In examining risk factors in light of Social Dominance Theory, it becomes clear that the source of many risk factors for women and communities of color-for whom HIV remains highly problematic-is inequality. Additionally, I propose thinking about risk factors in terms of gender, space and power. After reviewing literature that outlines the foundations of each concept, I propose the idea that gender, space and power are interdependent many risk factors contain multiple dimensions of each concept. Each risk factor is discussed in terms of the process that creates it and the dimensions of gender, space and power it contains. Housing, which has been considered a protective factor for people at risk for and living with HIV, contains dimensions of gender, space and power. Using existing ethnographies, I demonstrate how housing can contribute to behavioral asymmetry. Some women, for example, who rely on male partners for housing tolerate sexual abuse, cheating and drug use in an effort to preserve the relationship and their housing. However, tolerating the behavior, which meets the definition of behavioral asymmetry, places them at risk for HIV Richard Wilkinson has demonstrated a positive correlation between equality and health. Using his arguments as a foundation, I propose a system for evaluating policies that both eliminate structural risk factors and move society towards equality. A number of existing policies, most from the United States, that deal with homelessness, increasing the proportion of people with health insurance and calculating public entitlements-among others-are presented. Although this is primarily a theoretical work, a number of important conclusions can be drawn. The chief ones are that dominance can be linked to HIV, that social policy that promotes equity may have an impact on the numbers of new HIV cases and that housing should be considered both a potential risk factor and a protective factor. |
