HIV and African Americans in the southern United States: sexual networks and social context.
BACKGROUND
Heterosexual HIV transmission among African Americans in the rural southern United States has climbed in recent years. Concurrent partnerships and bridge populations have emerged as key elements in the spread of sexually transmitted infections (STIs).


OBJECTIVE
The goal of this study was to examine published empiric data and other literature concerning the extent of these network patterns and their relationship to the socioeconomic context among African Americans in the rural South.


METHODS
The authors conducted a review of public health, medical, and social sciences literature.


RESULTS
In areas of the rural South with high STI rates, there is extensive concurrency with evidence of dense sexual networks and bridging among the general population, core group members, and other high-risk subpopulations. Qualitative research reveals socioeconomic factors that support these network patterns: low ratio of men to women, economic oppression, racial discrimination, and high incarceration rates of black men.


CONCLUSIONS
Concurrency and bridging likely contribute to increased heterosexual HIV transmission among blacks in the South; contextual factors promote these network patterns in this population.
Adimora
Adaora A
AA
Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7030, USA. adimora@med.unc.edu
Schoenbach
Victor J
VJ
Doherty
Irene A
IA
D044383:Black People / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D012307:Risk Factors; D012424:Rural Population; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control; D012944:Social Support; D012959:Socioeconomic Factors; D015144:Southeastern United States / Q000453:epidemiology; D001741:Black or African American