31781 - SOCIAL EPIDEMIOLOGY OF HIV: A MEASUREMENT CHALLENGE...

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SOCIAL EPIDEMIOLOGY OF HIV: A MEASUREMENT CHALLENGE FOURTH INTERNATIONAL CONFERENCE ON “ECOLOGY. RADIATION. HEALTH”, SEMEY STATE MEDICAL ACADEMY, KAZAKHSTAN, 28 SEPT. 2007 IRINA CAMPBELL, PhD, MPH US DEPT. OF STATE FULBRIGHT SCHOLAR IN GLOBAL HEALTH [email protected] www.CampbellHealthAssociates.com
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A TRULY GLOBAL PROBLEM REQUIRING GLOBAL COOPERATION, AWARENESS, AND ASSISTANCE
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The Silk Road of Drugs, Migration, HIV
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EVIDENCE-BASED HIV PREVENTION GREATER ACCURACY & PRECISION IN DESCRIBING ROUTES OF TRANSMISSION OF HIV AMONG MOST-AT-RISK GROUPS RATIONALIZES PREVENTION PROGRAMS THIS PRESENTATION WILL TOUCH ONLY ON A BASIC ISSUE IN ESTIMATING HIV PREVALENCE IN KAZAKHSTAN ACCURACY OF ESTIMATES IMPACTS ON DESIGN AND TARGETING OF EFFECTIVE PROGRAMS IN 1994, CDC, USA CENTERS FOR DISEASE CONTROL & PREVENTION, BEGAN RECOMMENDING THAT HIV PREVENTION PLANNING GROUPS APPLY THE PRINCIPLES OF EPIDEMIOLOGY, EVALUATION & BEHAVIORAL SCIENCE THEORIES TO DESIGN PREVENTION PROGRAMS IN ORDER TO GET GRANT FUNDING SCIENTIFIC METHODOLOGIES WHICH ARE MOST RELEVANT TO DEFINING & SOLVING THE HIV EPIDEMIC ARE - EPIDEMIOLOGY & SOCIAL RESEARCH METHODS, BASIC BEHAVIORAL SCIENCE & CHANGE THEORY, EVIDENCE-BASED INTERVENTIONS & EVALUATION METHODS.
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SOCIAL EPIDEMIOLOGY MODELS BRIEFLY, EPIDEMIOLOGY IS THE STUDY OF POPULATION HEALTH THE OCCURRENCE, DISTRIBUTION, NATURAL HISTORY, SOCIAL ETIOLOGY & CAUSAL PATHWAYS OF DISEASE IN A POPULATION WITH MICRO + MACRO MODELS BIOMEDICINE IS THE STUDY OF INDIVIDUAL HEALTH IN THE CLINICAL CONTEXT WITH MICRO MODELS SOCIAL EPIDEMIOLOGY ENCOMPASSES A MULTIDISCIPLINARY, INTERDISCIPLINARY PARADIGM WHICH OVERLAPS ENVIRONMENTAL EPIDEMIOLOGY, ECOLOGY, SMALL AREA ANALYSIS, CHRONIC DISEASE EPIDEMIOLOGY, GEOGRAPHY, & SOCIOLOGICAL CONCEPTS, SUCH AS SOCIAL NETWORKING, SOCIAL COHESION, SOCIAL CAPITAL, & SOCIAL SUPPORT, TO ESTIMATE & PREDICT DISEASE PREVALENCE
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SOCIAL EPIDEMIOLOGY MODELS ESTIMATE INCIDENCE, NEW INFECTIONS OF HIV ESTIMATES PREVALENCE, TOTAL INFECTIONS OF HIV (WHAT) ESTIMATE DISTRIBUTIONS ACROSS PLACES (WHERE) AND GROUPS (WHO) - ECOLOGICAL FACTORS ESTIMATE DISTRIBUTION OF STRUCTURAL (MACRO) BEHAVIORAL (MICRO) RISK FACTORS DETERMINING INCIDENCE & PREVALENCE RATES (WHY) (see FIGURE 1) HEALTHY LIFESTYLES MOVEMENT IN PREVENTIVE MEDICINE & PUBLIC HEALTH IS A RESULT OF THE SCIENTIFIC WORK OF SOCIAL EPIDEMIOLOGISTS
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FIGURE 1: MACRO & MICRO PROPOSITIONS OF GEOGRAPHIC VARIATION IN HEALTH Macro proposition: geographic variation due to Contextual/social causation hypothesis: Micro proposition: geographic variation due to Compositional/individual selection hypothesis: spacial variation in exposure to environmental/structural factors: poverty; pollution, traffic, housing; quality, crime, recreational resources, sanitation, access to material or social resources spacial variation in direct selection: at-risk people moving/staying in area: poor people living in rundown areas; downward SES drift/mobility of sick concentration of sick around
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This note was uploaded on 02/22/2012 for the course HISTORY 308 taught by Professor St. john during the Spring '11 term at Rutgers.

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31781 - SOCIAL EPIDEMIOLOGY OF HIV: A MEASUREMENT CHALLENGE...

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