One Goal, Different Paths: Cultural Models, HIV/AIDS, and Minority Health Outcomes in Urban America

Abstract

HIV, since its emergence in the 1980s, has affected millions of people across the globe. Although the U.S. has seen three decades of research that has increased our knowledge of the virus, created medications to suppress its replication, and improved upon prevention techniques, minority populations continue to be disproportionally affected. The goal of the research reported here is to elucidate the barriers that minority populations encounter while seeking care, and to examine this population’s strategies for healthcare navigation. The construction of cultural models presented here that are based on healthcare decisions of minority persons living with HIV/AIDS will further illuminate the context of healthcare navigation and use, as well as promote understanding of barriers that may impede healthy behaviors. Cultural models theory is a useful tool to establish knowledge that is shared among a group (Strauss and Quinn 1977). In this study I use narratives to investigate two cultural models surrounding the domains of healthcare from a minority group located in Las Vegas, Nevada. Participant observation and in-depth interviews were conducted with twelve providers and forty-seven African-American and Hispanic men and women living with HIV or AIDS during 13-months of fieldwork in 2012-2013. Two specific cultural models that directly affect strategies of tertiary prevention opportunities emerged among people living with HIV/AIDS, 1) the African-American self-advocacy model and 2) the Hispanic ethnic provider model. The former relies on the construction of informal relationships within one’s social network to disseminate information and barriers to healthcare. The latter is reliant upon top-down modes of information dissemination that is delivered within a culturally relevant atmosphere. The investigation of cultural models as a tool to understand local populations has the potential to be part of the elimination of HIV worldwide by providing policy makers, research centers and local programs with important culturally relevant information.