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Structural Violence and Structural Vulnerability Within the Risk Environment: Theoretical and Methodological Perspectives for a Social Epidemiology of HIV Risk Among Injection Drug Users and Sex Workers

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Rethinking Social Epidemiology

Abstract

The transmission of HIV is shaped by individual-environment inter­actions. Social epidemiologic approaches thus seek to capture the dynamic and reciprocal relationships of individual-environment interactions in the production and reduction of risk. This presents considerable methodological, theoretical and disciplinary challenges. Drawing upon four research case studies, we consider how methods and concepts in the social and epidemiologic sciences might be brought together towards understanding HIV risk as an effect of social, cultural and political condition. The case studies draw upon different combinations of methods (qualitative, ethnographic and quantitative) and disciplines (sociology, anthropology and epidemiology) in different social contexts of HIV vulnerability (street settings in Russia, Serbia and North America and a cross-border setting in Mexico) among a range of marginalised high-risk populations (injection drug users and female and transvestite sex workers). These case studies illustrate the relevance of the social science concepts of “structural violence” and “structural vulnerability” for a social epidemiology of HIV risk. They also explore how social epidemiologic work can benefit from the mixing of social science methods and theories. We contend that social epidemiology cannot advance in its understanding of structural vulnerability without embracing and relying upon ethnographic and qualitative approaches. We put ­forward the linked concepts of “structural violence,” “structural vulnerability” and “risk environment” as building blocks for a theory-informed social epidemiology of HIV risk among marginalised populations.

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Abbreviations

GIS:

Geographic Information Systems

HCV:

Hepatitis C virus

IDU:

injection drug user

SRO:

single room occupancy

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Author information

Authors and Affiliations

  1. London School of Tropical Medicine and Hygiene, 15-17 Tavistock Place, London, WC1H 9SH, UK

    Tim Rhodes

  2. Division of Global Public Health, Department of Medicine, UC San Diego, San Diego, California, USA

    Karla Wagner, Steffanie A. Strathdee & Peter Davidson

  3. Department of Medicine, University of British Columbia and BC Centre for Excellence in HIV/AIDS, Vancouver, Canada

    Kate Shannon

  4. Department of Anthropology, University of Pennsylvania, Philadelphia, USA

    Philippe Bourgois

Authors
  1. Tim Rhodes
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  2. Karla Wagner
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  3. Steffanie A. Strathdee
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  4. Kate Shannon
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  5. Peter Davidson
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  6. Philippe Bourgois
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Corresponding author

Correspondence to Tim Rhodes .

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Editors and Affiliations

  1. St. Michael’s Hospital, Bond Street 30, Toronto, M5B 1W8, Ontario, Canada

    Patricia O’Campo

  2. , McMaster University, Department of Health, Aging and Society, Main Street West 1280, Hamilton, L8S 4L8, Ontario, Canada

    James R. Dunn

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Rhodes, T., Wagner, K., Strathdee, S.A., Shannon, K., Davidson, P., Bourgois, P. (2012). Structural Violence and Structural Vulnerability Within the Risk Environment: Theoretical and Methodological Perspectives for a Social Epidemiology of HIV Risk Among Injection Drug Users and Sex Workers. In: O’Campo, P., Dunn, J. (eds) Rethinking Social Epidemiology. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2138-8_10

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