Hope: A new approach to understanding structural factors in HIV acquisition

Barnett, T; Seeley, J; Levin; & Katongole, J Global Public Health: An International Journal for Research, Policy and Practice, 2015; Hope: A new approach to understanding structural factors in HIV acquisition

Can the concept of 'hope' help us understand individual or group susceptibility to infection?

A study explores the concept as a summary of people's experience of the social, economic and cultural world they inhabit. This paper presents the first empirical results of this work.

The authors - from the London School of Hygiene & Tropical Medicine and the MRC/UVRI Uganda Research Unit on AIDS - argue that this variable may contribute to the social epidemiology of HIV/AIDS (or other infectious diseases).

They analysed data from a long-standing General Cohort Study in Uganda (UK Medical REsearch Council and Uganda Virus Research Institute), together with a smaller study of some fishing communities. The hope variable was measured using Snyder's Self-Monitoring Scale.

The paper proposes that measuring hope, using a validated scale, provides access to subtle observations by human actors situated within social structures and historical moments. This measure of hope is, at the individual level, a product of agency and structure. In other terms, it is – for the individual – the site where the intersection of agency and structure is experienced.

Findings show that:

  • the Snyder scale does work in Uganda - it is understood and has meaning when used in a Luganda-speaking population
  • the qualitative data and quantitative data taken together suggest that the variable hope reflects the perceptions and actions of people in the two communities as responses to their different structural situations
  • the differences in their structural situations as reflected in their hope scores are in some way associated with risk factors for STI/HIV acquisition


Some considerations concerning the challenge of incorporating social variables into epidemiological models of infectious disease transmission. This paper discusses conceptual and methodological considerations within such an approach.

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