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PRECIOUS: Black Women, Neighborhood HIV/AIDS Risk, and Institutional Buffers1

  • Celeste Watkins-Hayes (a1), Courtney J. Patterson (a2) and Amanda R. Armour (a3)

This article posits that the response to the AIDS epidemic among Blacks in the United States must acknowledge structural and institutional realities that render poor Black urban neighborhoods particularly vulnerable to high HIV infection rates. The controversial film Precious: Based on the Novel Push by Sapphire, inspires our analysis, revealing the spatial context of HIV risk and suggesting new potential avenues through which to address the epidemic at the neighborhood level. In the film, we find opportunities for institutions to serve as intermediaries among neighborhoods, families, and individuals, not only to reduce the transmission of HIV, but also to improve health management for HIV-positive inner-city residents. The film points to three potential location-based sites of intervention: (1) mental health services that treat childhood sexual trauma; (2) HIV-related health messaging and services within urban street-level bureaucracies; and (3) neighborhood access to food and dietary resources that mitigate HIV disease progression.

Corresponding author
Celeste Watkins-Hayes, Departments of Sociology and African American Studies, Northwestern University, 1860 Campus Drive, Crowe 5-128 Evanston, IL 60208. E-mail:
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The authors thank Michelle Wright, Mary Pattillo, and anonymous reviewers for their comments and criticisms.

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