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Theses Doctoral

The Risk Ecology Framework: A Socioecological Analysis of HIV Risk Perception among Black and Latino Men who have Sex with Men.

Urena, Anthony

This dissertation examines how Black and Latino men who have sex with men (MSM) are making sense of the contemporary HIV/AIDS epidemic and their relation to it. Black and Latino MSM in the United States are disproportionately impacted by HIV. Interdisciplinary scholarship on the matter has conceptualized risk as an intrinsic facet of HIV. However, this research has paid little attention to the process by which Black and Latino MSM form their HIV risk perceptions. In this dissertation, I advance the “risk ecology framework” as a novel socioecological approach for understanding risk perception. This framework conceives of HIV risk perception as emerging from individuals’ relationship to HIV as shaped by the intersecting influences of the broader social environment. I base my analysis on 40 in-depth semi-structured interviews with HIV-negative Black and Latino MSM in New York City, as well as a year of participant-observation with a health advocacy group that serves this community. I find respondents form their risk perceptions by reflecting on HIV vis-à-vis their respective and distinctive social locations. The intersections of race, class, and sexuality come to be associated with HIV risk across the ecological levels of an individual’s lived experience, revealing a risk ecology, or a set of interrelated potential threats posed by HIV. I find this risk ecology to be reflected in Black and Latino MSM’s framing of HIV as a risk to their bodily health and social wellbeing, on the one hand. Or, its framing as personally irrelevant, on the other. Relationships and interactions with family, friends, and romantic/sexual partners inform what Black and Latino MSM understand HIV to potentially threaten. Respondents and the people in their lives draw upon culturally-available discourses, rhetoric, and beliefs concerning HIV that reflect how the institutionalization of racial, social, and sexual inequalities structure risk perception. With respect to health-relevant behaviors, I demonstrate how the analysis of risk perception formation clarifies the ways in which Black and Latino MSM make use of preventative tools and construct meanings about sex. I conclude with a discussion of the broader implications of the risk ecology framework for future health policy and further sociological research. By interrogating what it means to be at-risk, this dissertation lends crucial insight into the persistence of the HIV epidemic at a time when the means to end it are available, and also enriches sociological understandings of risk both within and beyond the public health domain.

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More About This Work

Academic Units
Sociology
Thesis Advisors
Nelson, Alondra
Khan, Shamus
Degree
Ph.D., Columbia University
Published Here
July 31, 2020