The Social Determinants of Health and the Influence on the Incidence and Prevalence of HIV/Syphilis Co-Infections in Dougherty County, GA Pubblico

Knight, Torrey Romell (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/7h149q44w?locale=it
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Abstract

Background/Introduction: Located in the Southwest region of the State of Georgia, Dougherty County is the county seat for the metropolitan City of Albany. With a population of 92, 407 (US Census Bureau, 2014), this rural community is most noted for its agricultural abundances and its aquatic attractions. The rates of HIV and syphilis in Dougherty County have been on a consistent rise. In 2014, there were 48 new HIV cases diagnosed in Dougherty County. The county has the second highest rate of HIV diagnosis (63.8 per 100,000) in the state. There were 62 new cases of syphilis, at a rate of 60.6 per 100,00. Eighty-seven percent of syphilis cases and HIV cases in the county are among young black men.

Methods: This study consisted of fifteen randomly selected participants who are patients of the Dougherty County Health Department Sexually Transmitted Infection Clinic. To be considered eligible for the study, each participant must be a resident of Dougherty County. Also, each participant must have a confirmed positive lab result for syphilis, HIV, or both on file at the Dougherty County Health Department. The data collected via survey was manually coded and analyzed using SPSS and qualitative methods. Coding the text was completed to identify themes in participant knowledge, attitude, and perceptions of the relationships between social determinants of health and STDs/HIV co-infections.

Results: From 2015 to 2016, fifteen surveys were administered to patients at the Dougherty County Health Department STD Clinic. All participants were African American. The survey population consisted of ten males (66.7%) and five females (33.3%) who previously tested positive for HIV, Syphilis or were co-infected with both HIV and syphilis. Sixty percent of those interviewed were unemployed with a median household income of $12,000. Eighty-seven percent of those interviewed held a high school diploma and 10 (67%) reported having had some college education. Sixty percent reported having a fair financial status, while only 20% described their finances as poor. Participants were asked to express their views on what could be contributing factors towards the increase in HIV and syphilis co-infections in Dougherty County. Responses fell within three categories: 1) sexual risk taking behaviors, 2) stigmatizing attitudes and discrimination, and 3) lack of HIV/STD transmission-related education that target the social reality of young MSM populations.

Conclusion: Health is affected by where and how we live, work, play, and learn. These social determinants of health were shown to have an influence on the incidence and prevalence of HIV and syphilis co-infections in Dougherty County, GA. Particularly, the general stigma associated with HIV/STD in rural communities, the frequent repression of discussion about sexuality, and extreme pockets of poverty has proven to negatively impact health outcomes. To address HIV/STD outcomes in Dougherty County it will be important to work toward unfettered access to quality sexual health information and addressing the association of health outcomes with the unique history and culture of the deep south, particularly among people of color, gay and bisexual men, and transgender people.

Table of Contents

I. Background/ Introduction …………………………………………….........pg. 1

II. Overview of Literature/Literature Review ……………………………....pg. 5

III. Methodology ………………………………………………………………….pg. 14

IV. Results/Analysis ……………………………………………………………..pg. 20

V. Conclusion ……………………………………………………………………..pg. 26

VI. References …………………………………………………………………….pg. 30

VII. Appendix …………………………………………………………………….pg. 33

Figure 1: Map of Census Tract II in Dougherty County, GA …………...pg. 34

Figure 2. Table of Participant Views on HIV/Syphilis …………………..pg. 35

Participant Survey ……………………………………………………………...pg. 36

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