A qualitative study of vulnerability to HIV infection: Places and persons in urban settings of Ethiopia

Abstract

Abstract
Background: HIV continues to differentially affect specific population group and geographic locations in the world. Often individual risk behaviors are associated with vulnerability to HIV infection. However, such notion often overlooks the broader context of social determinants of the infection. Such determinant is broader than personal attributes and includes diverse social factors that contribute to vulnerability to as well as prevention of HIV infection. This study explores the social determinants for HIV infection in urban settings of Ethiopia.
Methods: A qualitative study employing Focus Group Discussions (FGDs) and In-Depth Interviews (IDIs) was conducted in six purposively selected cities of Ethiopia. FGDs and IDIs were tape recorded and fully transcribed. Transcripts were coded, categorized and analyzed using thematic analysis.
Results: Findings show that it is not only people who are vulnerable, but specific places in urban settings where they reside. Vulnerability of places are linked to overcrowding, being hub of in-migrants and transistors, and with limited availability of services and infrastructure for its residents Majority of residents in such places were daily laborers, female sex workers, students who are living away from family, widows, separated and divorced women, those who work in restaurants and engaged in petty trade were found to be relatively more vulnerable group of population. They were also found to have weakened social controls and restraints that facilitate vulnerability.
Conclusion: Every city has settings that are relatively more vulnerable as compared to others and there are population groups that are particularly vulnerable to HIV infection. Mitigating the spread of HIV infection requires mapping vulnerable section of the city and targeting vulnerable group of population makes interventions effective. Moreover, HIV intervention in urban settings calls for a multi-sectoral response. [Ethiop. J. Health Dev. 2016;30(3):105-111]
Key words: HIV, social determinant of health, place, person, JSI