Background: Young black gay, bisexual, and other men who have sex with men (YB-GBMSM) are disproportionately impacted by HIV. Structural influences on these disparities, including characteristics of the various organizations that serve YB-GBMSM, are understudied to date. To gain insight into quality of services provided by organizations in Atlanta, we drew on Weick’s model of organizing, which defines “enactment” as the process by which organizations define problems and determine appropriate solutions.
Methods: We conducted qualitative interviews with 28 HIV service providers (representing 20 healthcare and community-based organizations) in Atlanta. Participants responded to questions regarding their organizations’ strategies for meeting the needs of YB-GBMSM. Interview transcripts were coded thematically, grouped by type of enactment, and analyzed using a constant comparison approach.
Results: Organizations’ enactment of HIV service provision could be described as following either simplified “rules”, or more nuanced “communication behavior cycles” (CBCs). Examples of rules included emphasis on patient quotas, one-time staff trainings, and limited hours of operation. Rules were often viewed as rigid, out-of-touch, and direct inhibitors of engagement with YB-GBMSM. Examples of CBCs included relationship-building, patient-feedback loops and rejection of traditional hierarchical structures. CBCs fostered a broader definition of HIV care, creative insights to combating the epidemic, and increased levels of cultural awareness and community buy-in.
Conclusion: HIV in YB-GBMSM is a multifaceted epidemic that requires an equally complex response. Organizations should strive to enact CBCs, to cultivate culturally conscious and innovative definitions of HIV care and foster new approaches to prevention and engagement by YB-GBMSM.
Table of Contents
Background and Rationale 1
Problem statement 1
Weick’s Model of Organizing 2
Purpose statement 3
Research question 3
Significance statement 3
Definition of terms 3
Literature Review 5
HIV in YB-GBMSM 5
Socio-contextual Determinants of HIV Incidence Among YB-GBMSM 7
Weick’s Theory of Organizing in Practice 8
Study Context 11
Participant Recruitment 11
Data Collection 12
Data Analysis 12
Ethical Considerations 13
Communication Behavior Cycles 21
Public Health Implications 33
About this Master's Thesis
|Committee Chair / Thesis Advisor
|Examining HIV Organizational Structures and their Influence on Engagement with Young Black Gay, Bisexual, and other Men who have Sex with Men in Atlanta ()
|2019-04-23 00:33:25 -0400