Aside from individual perceptions and resources available to the individual and the community, interventions aimed at reducing and mitigating the spread of HIV infections must take into account the existence of social support systems in the community and society where individuals are located. For one, the availability of support either from friends, family, or community community influences an individual’s decision to adopt or change his or her lifestyle to mirror the objectives of health promotion programs.
At the same time, the behaviors and lifestyles of an individual’s friends, family, or community itself may be promoting values and norms that contribute to HIV risk factors. The experiences of the HIV Prevention Planning Council of the San Francisco Health Department (2004) point to the presence of three negative influences that prevent HIV- affected individuals from seeking counselling and treatment and at the same time facilitate the continued transmission of the disease to the general populace.
The first among these factors is the prevalence of drug use (p. 14), which promotes both the acceptability of substance abuse as a form of recreation and risky sexual behavior. These values are particularly dominant among San Francisco’s gay communities, whose population unsurprisingly have the biggest number of HIV infections. A second factor is San Francisco’s liberal culture (p. 13), which means that society may be more permissive of and may condone risky sexual behavior that would be deemed unacceptable in other places.
The growing acceptability of risky sexual behavior and the decreasing popularity of condom use becomes a motivation for individuals to engage in activities that expose them to possible HIV infection. Moreover, the liberal culture within San Francisco’s communities may be reinforcing the acceptability of drug use, especially among poorer neighborhoods. Zierler and Krieger (1997, p. 405) note that poor communities may find substance abuse appealing, or at least find it inoffensive, since it serves both as a source of livelihood and as a source of recreation and stimulation.
On the other hand, the ironic existence of racist and discriminatory attitudes within liberal San Francisco (San Francisco Health Department, 2004, p. 8) may discourage people of color, gay, and male-to-female transgendered individuals from seeking help when they become infected by HIV due to the fear that they will be doubly stigmatized by carrying the disease. Although San Francisco’s liberal values and attitudes may have negative effects on efforts to curb the HIV epidemic, these same values also provide a positive influence in combatting HIV.
For one, San Francisco’s “progressive thinking and liberal policies” (San Francisco Health Department, 2004, p. 13) also enables individuals infected with HIV to easily gain the support of their friends, families, and communities, which could provide enough encouragement for them to adopt healthier lifestyles. San Francisco’s openness and diversity also allow individuals to create and live their own lifestyles with minimal pressure to conform to dominant beliefs and values which could help individuals avoid popular but negative influences on lifestyle choices.
Likewise, the liberal culture within many communities enables individuals to seek support from peers such as the gay community when one’s own family displays reluctance to provide support to the individual affected by HIV. Clearly, HIV intervention programs could utilize the existence of positive social support structures in a society in order to successfully combat HIV.
At the same time, these programs must be able to address and mitigate the negative influence of an individual’s social support network, including the values and attitudes of friends or family members which discourage an individual from changing his or her lifestyle to reduce HIV risk and exposure. Works Cited: San Francisco Department of Public Health. (2004). 2004 San Francisco HIV prevention plan. Retrieved February 5, 2009, from http://sfhiv. org/documents/Complete2004SanFranciscoHIVPreventionPlan. pdf Zierler, S. & Krieger, (1997). Reframing women’s risk: social inequalities and HIV infection. Annual Review of Public Health 18:401–36.
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