Influences of Social Determinants of Health on African Americans Living With HIV in the Rural Southeast: A Qualitative Meta-synthesis

J Assoc Nurses AIDS Care. 2015 Jul-Aug;26(4):340-56. doi: 10.1016/j.jana.2015.03.004. Epub 2015 Apr 2.


Social determinants of health influence health outcomes and contribute to health disparities in diverse populations. A meta-synthesis was conducted to provide emic perspectives of the experiences of African Americans living with HIV in the rural southeastern United States. Analysis of qualitative literature revealed patterns among social determinants of health as upstream factors contributing to health care barriers, poor health outcomes, decreased quality of life, and health disparities. The purpose of our meta-synthesis was the illumination and synthesis of themes describing characteristics of social determinants of health in selected qualitative articles. The nine themes that emerged included living in poverty, enduring unemployment, missing work, lacking transportation, sustaining stress, feeling socially excluded, needing social support, battling substance use, and lacking adequate health care.

Keywords: African American; HIV; meta-synthesis; rural; social determinants of health.

Publication types

  • Meta-Analysis

MeSH terms

  • Black or African American / psychology*
  • HIV Infections / psychology*
  • Health Knowledge, Attitudes, Practice
  • Health Status Disparities*
  • Humans
  • Poverty
  • Qualitative Research
  • Quality of Life
  • Residence Characteristics
  • Rural Health*
  • Rural Population*
  • Social Determinants of Health*
  • Social Environment
  • Social Support