RESUMO
Community-based organizations (CBOs) are integral to achieving the goal of Ending the HIV epidemic (EHE). Their familiarity with and proximity to communities position them to effectively implement strategies necessary to address determinants of health through their formal and informal medical and social services. However, structural inequities have contributed to the demise of many organizations that were instrumental in early responses to the HIV epidemic. We define structural inequities for HIV CBOs as systems in which policies, institutional practices, organizational (mis)representations, and other norms work to produce and maintain inequities that affect CBOs' ability to survive and thrive. In this discussion, we describe the organizational threats to grassroots HIV CBOs and the risks to livelihood and longevity, including examples. The invaluable role of HIV CBOs in EHE and their role in responding to existing and novel infectious diseases like COVID-19 should not be overlooked. Recommendations to promote structural equity are offered. (Am J Public Health. 2022;112(3):417-425. https://doi.org/10.2105/AJPH.2021.306688).
Assuntos
Redes Comunitárias/organização & administração , Infecções por HIV/epidemiologia , Organizações sem Fins Lucrativos/organização & administração , Epidemias , Humanos , Organizações sem Fins Lucrativos/economiaRESUMO
As the South is disproportionately affected by HIV/AIDS compared to other U.S. regions, Southerners are more likely to contract HIV and, given barriers to care, are at increased risk for morbidity and mortality. As part of a multistate interdisciplinary university-community HIV/AIDS partnership, community stakeholders described historical perspectives and traditions of the South contributing to disproportionate HIV/AIDS disease burden and unique regional challenges to HIV testing, linkage, and retention in HIV care. This article addressed the question, "Why are community stakeholder pressing for a call to action to curtail the HIV/AIDS epidemic in the South?" to highlight social, cultural, and faith traditions of the South that may pose barriers to HIV testing and promote HIV-related stigma. A call to action is presented to the social work profession to implement a strengths-based, socioecological approach to HIV/AIDS service provision that integrates prevention, intervention, community engagement, social action, and policy advocacy to assist in alleviating the disproportionate disease burden among Southerners. Next steps for the authors' interdisciplinary university-community HIV/AIDS partnership to increase social awareness and health literacy in the South are also discussed.