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Between individual agency and structure in HIV prevention: Understanding the middle ground of social practice

Author

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  • Kippax, S.
  • Stephenson, N.
  • Parker, R.G.
  • Aggleton, P.

Abstract

When HIV prevention targets risk and vulnerability, it focuses on individual agency and social structures, ignoring the centrality of community in effective HIV prevention. The neoliberal concept of risk assumes individuals are rational agents who act on information provided to them regarding HIV transmission. This individualistic framework does not recognize the communities in which people act and connect. The concept of vulnerability on the other hand acknowledges the social world, but mainly as social barriers that make it difficult for individuals to act. Neither approach to HIV prevention offers understanding of community practices or collective agency, both central to success in HIV prevention to date. Drawing on examples of the social transformation achieved by community action in Australia and Brazil, this article focuses on this middle ground and its role in effective HIV prevention. © 2013 American Journal of Public Health.

Suggested Citation

  • Kippax, S. & Stephenson, N. & Parker, R.G. & Aggleton, P., 2013. "Between individual agency and structure in HIV prevention: Understanding the middle ground of social practice," American Journal of Public Health, American Public Health Association, vol. 103(8), pages 1367-1375.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2013.301301_2
    DOI: 10.2105/AJPH.2013.301301
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    Cited by:

    1. Kamila A Alexander & Loretta S Jemmott & Anne M Teitelman & Patricia D'Antonio, 2015. "Addressing sexual health behaviour during emerging adulthood: a critical review of the literature," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(1-2), pages 4-18, January.
    2. Christopher J. Burman & Marota Aphane, 2017. "Complex HIV/AIDS Landscapes: Reflections on How ‘Path Creation’ Influenced an Action-Oriented Intervention," Systemic Practice and Action Research, Springer, vol. 30(1), pages 45-66, February.
    3. Maria Letícia Santos Cruz & Claudete A. Araújo Cardoso & Mariana Q. Darmont & Paulo Dickstein & Francisco I. Bastos & Edvaldo Souza & Solange D. Andrade & Marcia D’All Fabbro & Rosana Fonseca & Simone, 2016. "Children and Adolescents with Perinatal HIV-1 Infection: Factors Associated with Adherence to Treatment in the Brazilian Context," IJERPH, MDPI, vol. 13(6), pages 1-12, June.
    4. Stephenson, Niamh & Davis, Mark & Flowers, Paul & MacGregor, Casimir & Waller, Emily, 2014. "Mobilising “vulnerability” in the public health response to pandemic influenza," Social Science & Medicine, Elsevier, vol. 102(C), pages 10-17.
    5. Hirsch, Jennifer S., 2014. "Labor migration, externalities and ethics: Theorizing the meso-level determinants of HIV vulnerability," Social Science & Medicine, Elsevier, vol. 100(C), pages 38-45.
    6. Hatzenbuehler, Mark L. & Prins, Seth J. & Flake, Morgan & Philbin, Morgan & Frazer, M. Somjen & Hagen, Daniel & Hirsch, Jennifer, 2017. "Immigration policies and mental health morbidity among Latinos: A state-level analysis," Social Science & Medicine, Elsevier, vol. 174(C), pages 169-178.
    7. Borsch, Anne Sofie & Verelst, An & Jervelund, Signe Smith & Derluyn, Ilse & Skovdal, Morten, 2023. "Understanding interventions as social practices: How a school-based mental health intervention for migrant adolescents in Denmark interacted with context," Children and Youth Services Review, Elsevier, vol. 153(C).

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