Employment as a Social Determinant of Health: An Urban Partnership’s Experience with HIV Intervention Development and Implementation Using Community-Based Participatory Research (CBPR)

Abstract

The introduction of antiretroviral therapy has led to profound declines in AIDS-related mortality. As persons with HIV live longer, serious non-AIDS-defining illnesses have replaced HIV-related opportunistic infections as the leading causes of death. In this chapter, we outline the development of an urban community-academic partnership and how it applied community-based participatory research (CBPR) principles to build trust, expand networks, and establish a partnership to identify and meet the needs and priorities of persons with HIV in general and gay men with HIV in specific. Members of our CBPR partnership wanted to explore and better understand these needs and priorities to inform action, including intervention and programming, to positively affect the health and well-being of this vulnerable population. We chose CBPR as an approach to research to ensure authentic community engagement and full participation of community members, organizational representatives, and academic researchers in all aspects of the research process. We describe how members of our partnership came to identify employment as a social determinant of health among persons with HIV on which to explore and intervene. We outline our action-oriented intervention research using self-management concepts and constructs from hope theory. We also present lessons learned throughout our decade-long history with CBPR in Washington, DC.