?url_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&rft.relation=http%3A%2F%2Fd-scholarship-dev.library.pitt.edu%2F7985%2F&rft.title=%22This+is+Tobago%22Social+and+Cultural+'Influencers'+of+HIV+Infections+in+Tobago&rft.creator=Brebnor%2C+Faith&rft.description=INTRO%3A+In+Tobago%2C+HIV+rates+continue+to+increase+(prevalence+rate+%3D5%25).+Women+and+youth+are+increasingly+being+infected%2C+and+heterosexual+transmission+accounts+for+most+HIV+infections.+If+these+trends+continue%2C+Tobago's+economic+and+social+structure+will+be+in+jeopardy.+This+study+has+public+health+significance+because+it+identifies+and+makes+recommendations+for+incorporating+relevant+social+and+cultural+factors+into+HIV+prevention+programs+in+Tobago.+METHODS%3A+Qualitative+methods+(participant+observations%2C+ethnographic+and+in-depth+interviews)+were+utilized+to+unearth+(a)+pre-+and+post-HIV+infection+experiences+of+People+Living+With+HIV%2FAIDS+(PLWHAs)%2C+(b)+relevant+cultural+and+social+'influencer'+of+HIV%2FAIDS+rates%2C+(c)+how+these+factors+influence+community+norms+and+individual+behavior%2C+and+(d)+appropriate+methods%2Fmodel+for+incorporating+relevant+factors+into+HIV%2FAIDS+prevention+programs.+PLWHAs%2C+health+professionals%2C+community+members+and+leaders+were+interviewed.+RESULTS%3A+14+PLWHAs%2C+10+health+professionals%2C+15+community+leaders+and+25+community+members+were+interviewed.+Participant+observations+occurred+in+homes%2C+businesses%2C+entertainment+events%2C+HIV-related+organizations+and+health+facilities.+206+PLWHAs+are+currently+being+treated+in+Tobago+(HIV-related+medications+free+to+Trinidad+and+Tobago+citizens).+Infidelity%2C+sex-in-exchange+for+resources%2C+abuse+and+economic+need+increased+PLWHAs'+HIV+risk.+Lack+of+confidentiality+is+an+issue%2C+and+stigma+and+discrimination+are+prevalent.+There+is+lack+of+information+about+the+causes%2C+prevention+and+treatment+of+HIV+in+the+general+population.+Sex+is+not+openly+discussed%2C+however+youth+sexual+behavior+is+common.+Serial+monogamy+coupled+with+multiple+sexual+partnering+increases+general+community+risk.+Consistent+and+correct+condom+use+is+not+common%2C+and+purchasing+or+requesting+condom+use+is+difficult+for+women%2C+youth%2C+and+married+individuals.+HIV+testing+is+not+common%2C+and+pre-+and+post-test+counseling+is+inadequate.+Current+HIV+prevention+programs+focus+on+abstaining%2C+being+faithful+and+using+condoms%2C+which+do+not+take+into+account+the+complexities+surrounding+sexual+decision+making.+There+is+a+need+for+comprehensive+HIV+prevention+programs.+RECOMMENDATIONS%3A+A+client-centered%2C+risk-reduction+model+of+HIV+prevention+is+recommended.+Using+the+socio-cultural+theory+of+learning%2C+this+study+highlights+the+zone+of+proximal+development%2C+the+knowledge-in-waiting%2C+knowledge-in-use%2C+agents+of+change%2C+needed+resources%2C+and+social+environment+needed+to+improve+HIV+prevention+strategies+in+Tobago.&rft.date=2007-09-27&rft.type=University+of+Pittsburgh+ETD&rft.type=PeerReviewed&rft.format=application%2Fpdf&rft.language=en&rft.identifier=http%3A%2F%2Fd-scholarship-dev.library.pitt.edu%2F7985%2F1%2FBrebnorF_etdPitt2007.pdf&rft.identifier=++Brebnor%2C+Faith++(2007)+%22This+is+Tobago%22Social+and+Cultural+'Influencers'+of+HIV+Infections+in+Tobago.++Doctoral+Dissertation%2C+University+of+Pittsburgh.++++(Unpublished)++