Four main themes were identified as contributing to disparities in HIV rates:

1. Socioeconomic factors: Poverty, unemployment, and lack of education were all found to be associated with higher rates of HIV infection. These factors can make it difficult for people to access healthcare, education, and employment opportunities, which can increase their risk of exposure to HIV.
2. Behavioral factors: Risky sexual behaviors, such as having multiple sexual partners, not using condoms, and injecting drugs, were also found to be associated with higher rates of HIV infection. These behaviors can be influenced by a variety of factors, including social norms, cultural beliefs, and lack of access to information and resources.
3. Structural factors: Laws and policies that discriminate against people with HIV/AIDS can also contribute to disparities in HIV rates. These laws and policies can make it difficult for people with HIV/AIDS to access healthcare, education, and employment opportunities, and they can also create a climate of fear and stigma that can prevent people from getting tested for HIV or seeking treatment.
4. Health system factors: Lack of access to quality healthcare, including HIV testing and treatment, can also contribute to disparities in HIV rates. This can be due to a variety of factors, such as geographic barriers, lack of trained healthcare providers, and high costs of treatment.

The “adults” identified several community characteristics that foster trusting relationships, including:

• A sense of belonging and community: People feel like they belong to a community where they are valued and respected.
• Shared values and beliefs: People share common values and beliefs that provide a foundation for trust.
• Open communication: People feel comfortable communicating with each other openly and honestly.
• Mutual respect: People respect each other’s differences and opinions.
• A sense of shared responsibility: People feel a responsibility to each other and to the community as a whole.

These characteristics were also identified by the youth as important for fostering trusting relationships.

The youth reported that these characteristics can hinder or foster HIV outreach and access to community resources in a number of ways. For example, a lack of trust can make it difficult for people to disclose their HIV status to others, which can prevent them from accessing needed services. Additionally, a lack of trust can make it difficult for people to feel comfortable participating in HIV prevention activities.

On the other hand, trusting relationships can make it easier for people to access HIV services and prevention activities. For example, people who trust their community leaders may be more likely to get tested for HIV or to participate in HIV prevention workshops.

The linking relationships of religious leaders can play a significant role in access to HIV-related services and prevention activities. Religious leaders can provide information about HIV/AIDS, connect people with needed services, and provide emotional support. Additionally, religious leaders can help to reduce stigma and discrimination associated with HIV/AIDS.

Some of the strategies that might be used to address these issues include:

• Building trusting relationships: This can be done through a variety of activities, such as community meetings, workshops, and one-on-one conversations.
• Increasing access to information and resources: This can be done by providing information about HIV/AIDS in a variety of formats, such as brochures, pamphlets, and websites. It is also important to make sure that there is access to affordable HIV testing and treatment.
• Reducing stigma and discrimination: This can be done through education and awareness-raising campaigns. It is also important to create policies and practices that are inclusive of people with HIV/AIDS.
• Empowering communities: This can be done by providing communities with the resources and support they need to address HIV/AIDS in their own way.

Community forces that contributed to the increased HIV rates include:

• Poverty: Poverty can make it difficult for people to access healthcare, education, and employment opportunities, which can increase their risk of exposure to HIV.
• Unemployment: Unemployment can lead to poverty and lack of access to resources, which can also increase risk of exposure to HIV.
• Lack of education: Lack of education can make it difficult for people to understand how to prevent HIV infection, which can increase their risk of exposure.
• Discrimination: Discrimination against people with HIV/AIDS can create a climate of fear and stigma that can prevent people from getting tested for HIV or seeking treatment.
• Violence: Violence can increase risk of exposure to HIV through sexual assault and injection drug use.
• Social norms: Social norms that encourage risky sexual behaviors can increase risk of exposure to HIV.