community identifications and to learn how to activate those memberships for intervention purposes.
Communities exist not only in the minds of their members but are also socially constructed by the views and actions of outsiders. Outsiders constitute an important part of the “we/they feeling” that pervades socially derogated communities. The costs of membership become so high for individuals in some communities that there are strong incentives for them to avoid explicit acknowledgment of their membership if at all possible. For example, many closeted gay and bisexual men and women struggle with the various cultural definitions of sexuality imposed on them and with their membership in both the straight and gay communities.
A wide range of research methods has been employed to study communities: historical research; ecological census research; participant observation; and surveys, including those using targeted sampling. Considerable debate has developed around strategies for developing systematic, multimethod, observational designs that exploit the best of each of the methodologies. Such approaches should increase the thoroughness of our understanding of communities.
As noted above, communities may be defined by their structure, such as their boundaries or the relationships they maintain with other communities, and may also be characterized by processes. Both structure and process are important for understanding communities that are epidemic epicenters. High-risk communities can provide venues for efficient mixing of infected and uninfected populations.
Communities that are at-risk for the spreading of HIV infection are quite diverse and can include college campuses, the military, stable gay neighborhoods, shooting galleries, crack houses, prisons, bathhouses, brothels, and neighborhoods with homeless people. There is a variation in the level of risk within these different types of communities, but when HIV spreads within them, it usually spreads quickly because of the existence of tightly linked networks that are connected through sex and drugs. Such communities can be difficult to study because their members may be highly mobile and are often suspicious and resistant to observation. Three types of high-risk communities will be described here: a gay community organization undergoing changing organizational patterns, a disintegrating inner-city community, and a community undergoing war and low-intensity conflict. These high-risk communities are the contexts for individual lives.