摘要：HIV continues to be transmitted at unacceptably high rates among African Americans, and most HIV-prevention interventions have focused on behavioral change. To theorize additional approaches to HIV prevention among African Americans, we discuss how sexual networks and drug-injection networks are as important as behavior for HIV transmission. We also describe how higher-order social structures and processes, such as residential racial segregation and racialized policing, may help shape risk networks and behaviors. We then discuss 3 themes in African American culture—survival, propriety, and struggle—that also help shape networks and behaviors. Finally, we conclude with a discussion of how these perspectives might help reduce HIV transmission among African Americans. HIV is spreading faster among African Americans than it is among other US populations. Specific understanding of the dynamics of HIV transmission and of social structures and processes within and affecting African American communities may help us develop effective HIV prevention methods. To develop more effective HIV transmission among African Americans, we must develop a specific understanding of the dynamics of HIV transmission. In this essay, we present ideas about causal pathways that have received relatively little attention in the HIV/AIDS literature but that might contribute to African American's elevated HIV risk. These pathways suggest areas for future research and action.
