1
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Ransome Y, Taggart T, Huang AS, Vermund SH, Mayer KH, Nunn AS. Increasing Spiritual Beliefs are Associated With Lower HIV Incidence Among Black Men Who Have Sex With Men: Results From HPTN 061 Longitudinal Study. J Acquir Immune Defic Syndr 2023; 94:196-202. [PMID: 37850978 DOI: 10.1097/qai.0000000000003278] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 07/17/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND There is a limited understanding about the impact of spiritual beliefs and activities on HIV seroconversion among black men who have sex with men (BMSM), which we investigate in this study. SETTING United States. METHODS The HIV Prevention Trials Network Study 061 collected demographic and biomedical assessments among BMSM across 6 United States cities for longitudinal analysis. Spiritual beliefs and spiritual activities are constructed composite scales. Bivariate analyses among 894 who provided data at 12-month follow-up compared men who seroconverted to HIV between baseline and 6 months with those who remained uninfected with HIV at 12 months. Cox proportional hazard regression among 944 men tested spiritual beliefs and activities on the longitudinal risk of HIV seroconversion adjusting for age and any sexually transmitted infection (STI). RESULTS Among this sample, HIV incidence between baseline and 6 months was 1.69%, (95% confidence intervals [CI]: 1.04 to 2.77). Men who seroconverted to HIV were significantly younger than those who remained uninfected at the 12-month follow-up: (mean age 27, SD = 11 vs 37, SD = 12) and a higher proportion reported any STI (46.67% vs 11.39%, P < 0.01). A one-unit increase in spiritual beliefs was associated with lower hazard rate of seroconverting to HIV at follow-up [adjusted hazard ratio (aHR) = 0.37, 95% CI: = (0.16 to 0.87)]. Religious service attendance and spiritual activities were unrelated to seroconverting. CONCLUSIONS Spirituality is important in the lives of BMSM. Biomedical and behavioral HIV prevention interventions should consider assessing spiritual beliefs in HIV care among BMSM.
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Affiliation(s)
- Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Heaven, CT
| | - Tamara Taggart
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Heaven, CT
- Department of Prevention and Community Health, The George Washington University Milken Institute, School of Public Health, Washington, DC
| | - Amber Shu Huang
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy University of Florida, Gainsville, FL
| | - Sten H Vermund
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, MA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
- Harvard Medical School, Boston, MA
| | - Amy S Nunn
- Department of Social and Behavioral Sciences, Brown University School of Public Health, Providence, RI; and
- Rhode Island Public Health Institute, Providence, RI
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2
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Lefevor GT, Etengoff C, Davis EB, Skidmore SJ, Rodriguez EM, McGraw JS, Rostosky SS. Religion/Spirituality, Stress, and Resilience Among Sexual and Gender Minorities: The Religious/Spiritual Stress and Resilience Model. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:1537-1561. [PMID: 37369080 DOI: 10.1177/17456916231179137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Although many sexual and gender minorities (SGMs) consider themselves religious or spiritual, the impact of this religiousness or spirituality (RS) on their health is poorly understood. We introduce the religious/spiritual stress and resilience model (RSSR) to provide a robust framework for understanding the variegated ways that RS influences the health of SGMs. The RSSR bridges existing theorizing on minority stress, structural stigma, and RS-health pathways to articulate the circumstances under which SGMs likely experience RS as health promoting or health damaging. The RSSR makes five key propositions: (a) Minority stress and resilience processes influence health; (b) RS influences general resilience processes; (c) RS influences minority-specific stress and resilience processes; (d) these relationships are moderated by a number of variables uniquely relevant to RS among SGMs, such as congregational stances on same-sex sexual behavior and gender expression or an individual's degree of SGM and RS identity integration; and (e) relationships between minority stress and resilience, RS, and health are bidirectional. In this manuscript, we describe the empirical basis for each of the five propositions focusing on research examining the relationship between RS and health among SGMs. We conclude by describing how the RSSR may inform future research on RS and health among SGMs.
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Affiliation(s)
| | | | - Edward B Davis
- School of Psychology, Counseling, and Family Therapy, Wheaton College
| | | | - Eric M Rodriguez
- Social Science Department, New York City College of Technology, City University of New York
| | - James S McGraw
- Department of Psychology, Bowling Green State University
| | - Sharon S Rostosky
- Department of Educational, School, and Counseling Psychology, University of Kentucky
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3
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Huang FF, Chen WT, Shiu C, Yang JP, Zhao H. Relationships between spirituality and mental stress in people living with HIV in China: A cross-sectional study. Ment Health Relig Cult 2023; 26:276-289. [PMID: 37974904 PMCID: PMC10651058 DOI: 10.1080/13674676.2023.2219620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 05/24/2023] [Indexed: 11/19/2023]
Abstract
There are limited reports on the relationship between spirituality and mental stress in PLWH in China, who may be subject to anti-religious pressures from the government. In this study, we aimed to understand whether spirituality influences Chinese PLWH's mental stress and, if so, at what level. We recruited 200 PLWHs from Beijing's Ditan Hospital to complete a cross-sectional survey inquiring about their practice of spirituality as well as their level of mental stress. The study found that PLWH who presented with a mid-level of spirituality have the highest mental stress when compared to those who have a low level of spiritual beliefs or a high level of spiritual beliefs. This study points to the utility of healthcare providers taking PLWH's potential spirituality into consideration, perhaps in particular for those with a moderate level of spirituality, in order to provide the most comprehensive care possible.
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Affiliation(s)
- Fei Fei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
| | - Chengshi Shiu
- National Taiwan University, Department of Social Work, Taipei, Taiwan
| | - Joyce P. Yang
- Department of Psychology, University of San Francisco, San Francisco, CA, USA
| | - Hongxin Zhao
- Beijing Ditan Hospital, Capital Medical University, Beijing, China
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4
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Eden TM, Smallwood SW, Matthews DD. Using a Measurement Model to Reconceptualize the Church Experiences of Black Men who have Sex with Men. JOURNAL OF RELIGION AND HEALTH 2023; 62:2213-2225. [PMID: 36260262 PMCID: PMC10113399 DOI: 10.1007/s10943-022-01671-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
Religious spaces have proven to be effective sites of health intervention among Black Americans. Less is known about how religious environments impact the health of subgroups of Black Americans, specifically Black men who have sex with men (MSM). Using data from the Promoting Our Worth, Equality, and Resilience study, we explored the factor structure of a 10-item religious environment scale among Black MSM (N = 2,482). Exploratory factor analysis revealed three distinct factors: (1) visibility of MSM, (2) structural support, and (3) structural homonegativity. The relationship between Black MSM and their religious environments is complex and should be investigated using measures that accurately reflect their lived experiences.
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Affiliation(s)
- Tiffany M Eden
- Department of Health Behavior, University of North Carolina at Chapel Hill, 135 Dauer Drive, Campus Box 7440, Chapel Hill, NC, 27599-7440, USA.
| | - Stacy W Smallwood
- Department of Health Policy & Community Health, Georgia Southern University, Statesboro, GA, USA
| | - Derrick D Matthews
- Department of Health Behavior, University of North Carolina at Chapel Hill, 135 Dauer Drive, Campus Box 7440, Chapel Hill, NC, 27599-7440, USA
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5
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Pan SW, Fairley CK, Chow EPF, Zhang Y, Tieosapjaroen W, Lee D, Ong JJ. Supernatural beliefs, religious affiliations, and HIV testing among recently arrived Asian-born men who have sex with men in Australia. AIDS Care 2023:1-6. [PMID: 36821649 DOI: 10.1080/09540121.2023.2179012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
HIV testing rates among recently arrived (≤5 years) Asian-born men who have sex with men (MSM) in Australia remain suboptimal. Research indicates that belief in supernatural determinants of health (supernatural beliefs) may be an important barrier to greater HIV test uptake. We examined potential associations between supernatural beliefs and HIV testing among recently arrived Asian-born MSM in Australia. In 2019, an online survey was completed by 186 self-identified MSM born in Asia, and who arrived in Australia within the past five years and were never diagnosed with HIV. Supernatural belief was measured as the extent to which one felt that health was influenced by supernatural forces. Measures of association were estimated with multiple logistic regression. Participants with supernatural beliefs were significantly less likely to have tested for HIV in the past year. The adjusted predicted probability of not testing for HIV in the past year was 44.8% among those who held supernatural beliefs (95% CI: 30.5-59.2%), but only 5.2% among those who did not hold supernatural beliefs (95% CI: 1.9-8.6%). Religious affiliation was not significantly associated with testing for HIV. Supernatural beliefs may be an important but underappreciated barrier to HIV testing among recently arrived Asian-born MSM in Australia.
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Affiliation(s)
- Stephen W Pan
- Department of Public Health, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Christopher K Fairley
- Central Clinical School, Monash University, Melbourne, Australia.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
| | - Eric P F Chow
- Central Clinical School, Monash University, Melbourne, Australia.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | | | - Warittha Tieosapjaroen
- Central Clinical School, Monash University, Melbourne, Australia.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
| | - David Lee
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
| | - Jason J Ong
- Central Clinical School, Monash University, Melbourne, Australia.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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6
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Hickson DA, He Y, Odusanya A, Smith AE, Ogunbajo A, Smallwood SW. Psychometric Testing of the Daily Spiritual Experiences Scale (DSES) Among Black Gay, Bisexual, and Other Sexual Minority Men (SMM) and Black Transwomen in the Deep South: The MARI Study. JOURNAL OF RELIGION AND HEALTH 2022; 61:3507-3524. [PMID: 35147863 DOI: 10.1007/s10943-022-01516-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/22/2022] [Indexed: 06/14/2023]
Abstract
Spirituality is a well-established protective psychosocial determinant of health. The current study examined the psychometric properties of the Daily Spiritual Experiences Scale (DSES) among Black gay, bisexual and other sexual minority men (SMM) and Black transwomen (TW) in the Deep South. Data were collected via self-interview technology and analyzed using factor analyses and correlation coefficients. We demonstrated a single-factor structure of the DSES with high internal consistency (Cronbach's α = 0.96). DSES was positively and significantly associated with multiple dimensions of religion, resilience, optimism and social support and not significantly associated with cynicism and anger expressions. Spirituality should be included in HIV prevention, treatment and care strategies focused on Black SMM and Black TW, especially those residing in the Deep South, USA.
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Affiliation(s)
- DeMarc A Hickson
- Us Helping Us, People Into Living Inc., 3636 George Ave NW, Washington, DC, 20010, USA.
| | - Ying He
- Center for Research, Evaluation and Environmental and Policy Change, My Brother's Keeper, Inc., Jackson, MS, USA
| | - Anne Odusanya
- Department of Community Health Behavior and Education, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Adam E Smith
- Department of Mathematics, Tougaloo College, Tougaloo, MS, USA
| | - Adedotun Ogunbajo
- Us Helping Us, People Into Living Inc., 3636 George Ave NW, Washington, DC, 20010, USA
| | - Stacy W Smallwood
- Department of Community Health Behavior and Education, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
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7
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Ogunbajo A, Oke T, Okanlawon K, Abubakari GM, Oginni O. Religiosity and Conversion Therapy is Associated with Psychosocial Health Problems among Sexual Minority Men (SMM) in Nigeria. JOURNAL OF RELIGION AND HEALTH 2022; 61:3098-3128. [PMID: 34455514 DOI: 10.1007/s10943-021-01400-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 05/25/2023]
Abstract
We investigated the associations between social marginalization, psychosocial health, and religiosity among sexual minority men (SMM) in Nigeria (N = 406). We conducted bivariate and multivariable logistic regression. Factors associated with reporting a history of conversion therapy at a religious institution were: being HIV positive, having depressive symptoms, reporting suicide thoughts, and reporting inability to access medical care. Factors associated with increased odds of agreeing that sex between two men was a sin were: residing in Plateau, being Muslim, and higher levels of internalized homophobia. Our findings support the need for LGBT-affirming religious doctrine, which has implications for the health of LGBT communities.
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Affiliation(s)
- Adedotun Ogunbajo
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
| | - Temitope Oke
- School of Social Work, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Kehinde Okanlawon
- Institute of Social Studies, Erasmus University, The Hague, Netherlands
| | | | - Olakunle Oginni
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Osun, Nigeria
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8
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Ouafik MR, Buret L, Scholtes B. Mapping the current knowledge in syndemic research applied to men who have sex with men: A scoping review. Soc Sci Med 2022; 306:115162. [PMID: 35779501 DOI: 10.1016/j.socscimed.2022.115162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/17/2022] [Accepted: 06/18/2022] [Indexed: 11/25/2022]
Abstract
Men who have sex with Men (MSM) represent a population affected by numerous health conditions. Syndemic theory has been used as a framework to study the health of MSM for nearly 20 years. However, the literature is plagued by a lack of consensus regarding what constitutes a synergy in a syndemic and recent reviews have shown that most of the papers published thus far have failed to demonstrate a synergy nor describe the bio-social interaction needed to account for a true syndemic. Moreover, to our knowledge, none of the existing reviews have focused specifically on MSM. This scoping review aims to fill this gap by mapping in detail how syndemic research on MSM has been conducted. A systematic database search was conducted between 2020 and 2021 and 115 studies were included. Our findings showed a lack of diversity regarding the location, design, subpopulation, and outcomes studied. In addition, the syndemic conditions, as well as their measurement, were not focused enough to ensure the robustness and reproducibility of the findings. Furthermore, our results support previous reviews showing a lack of empirical data to support disease interaction in syndemic research applied to MSM. Our review offers some important recommendations to help move the field forward in future work and describes some promising methodological advances.
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Affiliation(s)
- Maxence R Ouafik
- Research Unit of Primary Care and Health, General Practice Department, University of Liège, Quartier Hôpital B23, Avenue Hippocrate 13, 4000, Liège, Belgium.
| | - Laetitia Buret
- Research Unit of Primary Care and Health, General Practice Department, University of Liège, Quartier Hôpital B23, Avenue Hippocrate 13, 4000, Liège, Belgium.
| | - Beatrice Scholtes
- Research Unit of Primary Care and Health, General Practice Department, University of Liège, Quartier Hôpital B23, Avenue Hippocrate 13, 4000, Liège, Belgium.
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9
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Anderson-Carpenter KD. Do Spirituality, Rurality, and LGBTQ Support Increase Outness and Quality of Health in Gay and Bisexual Men? JOURNAL OF HOMOSEXUALITY 2022; 69:1081-1096. [PMID: 34292137 DOI: 10.1080/00918369.2021.1905382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Although the existing research suggests that spirituality may positively affect health outcomes for gay and bisexual men, it is unclear to what extent it improves the quality of health over and above sociodemographic factors. Furthermore, there remains conflicting evidence regarding the role of residential location on levels of outness for gay and bisexual men. To that end, the present study used hierarchical linear regression analyses to examine the role of spirituality, rurality, and LGBTQ connectedness in outness and quality of health. The sample comprised 2,202 self-identified gay and bisexual men aged 18 and older who responded to the Social Justice Sexuality Project survey; participants represented all 50 states and Puerto Rico. The results indicate that whereas spirituality was positively associated with a greater quality of life, there was no significant difference in outness between rural versus nonrural participants. Moreover, bisexual men endorsed significantly lower levels of outness compared to their gay counterparts. Implications for future research regarding the role of spirituality and rurality in sexual minority health are discussed.
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10
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Sprague C, Brown SM, Simon SE, McMahan LD, Konkle-Parker D. Experience of religion and spirituality among socially marginalised people living with HIV in Mississippi. CULTURE, HEALTH & SEXUALITY 2021; 23:1111-1125. [PMID: 32631148 DOI: 10.1080/13691058.2020.1758345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/16/2020] [Indexed: 06/11/2023]
Abstract
African Americans in Mississippi have the highest HIV-related mortality and poverty rates in the USA, and they tend to be religious. Attitudes toward gender and sexuality are changing, yet few studies have investigated religion and spirituality among special populations living with HIV. Using grounded theory and qualitative methods, we investigated the experience of health and illness of a low-income, socially marginalised population living with HIV in two locations of Mississippi in 2015. In a context of high stigma and HIV-related health disparities, individuals turned, or returned, to religion, church and spirituality as sources of community and strength, which also motivated safer health behaviours. Findings underscore how religion and spirituality are enabling social determinants of health that are under-explored, untapped, potentially culturally acceptable, sustainable interventions at the community-level. We posit, given diminished funding for community-based services, the most significant influence churches could exert is in decreasing HIV stigma. Given the current US plan to end HIV by 2030, with appropriate stakeholder participation, the role of religion, spirituality and clergy could be further amplified via linkage to care providers and the 'normalisation' of the HIV discourse, to address disparities and improve the health of African Americans.
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Affiliation(s)
- Courtenay Sprague
- Department of Conflict Resolution, Human Security & Global Governance, McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, Boston, MA, USA
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Shelley M Brown
- Department of Health Sciences, Sargent College, Boston University, Boston, MA, USA
| | - Sara E Simon
- Department of Conflict Resolution, Human Security & Global Governance, McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, Boston, MA, USA
| | - Lyndsey D McMahan
- Department of Conflict Resolution, Human Security & Global Governance, McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, Boston, MA, USA
| | - Deborah Konkle-Parker
- Department of Medicine, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, MS, USA
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11
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Duncan DT, Ransome Y, Park SH, Jackson SD, Kawachi I, Branas CC, Knox J, Al-Ajlouni YA, Mountcastle H, Miles CH, Hickson DA. Neighborhood social cohesion, religious participation and sexual risk behaviors among cisgender black sexual minority men in the southern United States. Soc Sci Med 2021; 279:113913. [PMID: 33991789 PMCID: PMC8336607 DOI: 10.1016/j.socscimed.2021.113913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/09/2021] [Accepted: 04/05/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Few studies have examined associations between neighborhood social cohesion and sexual risk behaviors among gay, bisexual, and other sexual minority men (SMM), and none have among Black SMM in the southern U.S. The purpose of the current study is to examine associations between neighborhood social cohesion and sexual risk behaviors among Black SMM in the southern U.S., a population heavily impacted by HIV. We also examined whether these relationships are modified by religious participation for Black SMM in the southern U.S. METHODS Data was obtained from the MARI Study, a sample of Black SMM ages 18-66 years, recruited from the Jackson, MS and Atlanta, GA metropolitan areas (n = 354). Neighborhood social cohesion was assessed with a validated 5-item scale. We conducted multivariable regression analyses to examine the association between neighborhood social cohesion with each of the sexual risk behaviors (e.g., condomless sex and drug use before or during sex), controlling for key confounders. We then performed moderation analysis by religious participation (religious attendance and private religiosity). RESULTS Compared to Black SMM with higher perceived neighborhood social cohesion, Black SMM with lower neighborhood social cohesion had increased odds of alcohol use before or during sex (aPR = 1.56; 95% CI = 1.16-2.11) and condomless anal sex with casual partners (aPR = 1.55; 1.03-2.32). However, the magnitude of these associations varied by religious attendance and private religiosity. Black SMM with low religious service attendance had higher risk of alcohol use in the context of sex when perceived neighborhood social cohesion was low; those with high private religiosity had elevated alcohol use in the context of sex when perceived neighborhood social cohesion was low. DISCUSSION Interventions that target connectedness among neighborhood members through community education or mobilization efforts, including the involvement of religious organizations, should be considered for HIV prevention focused on alcohol and condomless sex among Black SMM.
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Affiliation(s)
- Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Su Hyun Park
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Skyler D Jackson
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Charles C Branas
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Justin Knox
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Yazan A Al-Ajlouni
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Hayden Mountcastle
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Caleb H Miles
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
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12
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Taggart T, Mayer KH, Vermund SH, Huang S, Hayashi K, Ransome Y. Interaction of Religion/Spirituality With Internalized HIV Stigma, Depression, Alcohol Use, and Sexual Risk Among Black Men Who Have Sex With Men: The 6 City HPTN 061 Study. J Acquir Immune Defic Syndr 2021; 87:e188-e197. [PMID: 33633033 PMCID: PMC8131231 DOI: 10.1097/qai.0000000000002667] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/16/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Black men who have sex with men (BMSM) remain at highest risk for HIV in the United States. Internalized HIV stigma and depression contribute to substance use and condomless anal intercourse (CAI). Religion and spirituality (R/S) are associated with decreased HIV-related risk behaviors for some groups, but their impact among BMSM is uncertain. We investigated the main and moderating roles of R/S on pathways from internalized HIV stigma to CAI while under the influence of drugs. METHODS We used baseline data from 1511 BMSM from the HIV Prevention Trials Network (HPTN) 061 study to examine the associations between internalized HIV stigma, depressive symptoms, alcohol use, and CAI while under the influence of drugs, adjusting for covariates in generalized structural equation models. We then tested whether R/S moderated the association between (1) internalized HIV stigma and depressive symptoms, (2) depressive symptoms and alcohol use, and (3) alcohol use and CAI while under the influence of drugs. RESULTS Spiritual beliefs [F(1,2) = 9.99, P < 0.001], spiritual activities [F(1,2) = 9.99, P < 0.001], and religious attendance [F(1,2) = 9.99, P < 0.001] moderated the pathway between internalized HIV stigma and depressive symptoms. As internalized HIV stigma increased, those with lower spiritual activity scores experienced significantly higher increases in depressive symptoms compared with those with higher spiritual activity scores whose depressive symptom scores remained unchanged [stigma × spiritual activities B = -0.18 (SE = 0.07), P < 0.001]. CONCLUSIONS Religion and spirituality were protective against CAI among BMSM. Future intervention research should explore ways to incorporate religious and/or spiritual activities to reduce internalized HIV stigma as one way to reduce depressive symptoms among BMSM.
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Affiliation(s)
- Tamara Taggart
- Department of Prevention and Community Health, George Washington University, Milken Institute School of Public Health
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Kenneth H. Mayer
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | - Shu Huang
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Kamden Hayashi
- Department of Health Behavior, University of North Carolina, Chapel Hill, NC, USA
| | - Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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13
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Rahim NK, Waluyo A, Yona S. The relationship between self-efficacy and spirituality in condom use behaviour among MSM-PLWHA in Bandung, indonesia. J Public Health Res 2021; 10. [PMID: 34060743 PMCID: PMC9309638 DOI: 10.4081/jphr.2021.2339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 11/23/2022] Open
Abstract
Background The prevalence of HIV/AIDS, especially among Men Who Have Sex With Men (MSM),
is increasing. Disease transmission occurs because of the low use of
condoms. This study aimed to identify the relationship between condom
self-efficacy and spirituality in condom use behavior. Design and Methods This study used a cross-sectional design with consecutive sampling
techniques. It involved 251 people living with HIV & AIDS (PLWH) MSM.
Chi-square test was used in bivariate analysis and then continued with the
logistic regression analysis for multivariate analysis. Results The results show that there was a significant relationship between condom
self-efficacy and condom use behavior with p value <0.05 (OR = 11.298;
95% CI: 4.35-20.1, p value=0.000) and spirituality towards condom use
behavior p-value < 0.05 (OR = 3.405; 95% CI : 0.85-3.21, p value : 0.00).
In multivariate analysis of multiple logistic regression, condom
self-efficacy is the factor that predominantlyinfluences condom use
behaviour. Conclusions To improve the consistency of condom use, nurses need to prioritize
interventions such as counselling activities that focus on increasing
self-confidence (self-efficacy).
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Affiliation(s)
| | - Agung Waluyo
- Department of Medical surgical Nursing Faculty of Nursing, Universitas Indonesia, Depok, West Java.
| | - Sri Yona
- Department of Medical surgical Nursing Faculty of Nursing, Universitas Indonesia, Depok, West Java.
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Okafor CN, Li MJ, Hucks-Ortiz C, Mayer KH, Shoptaw S. Disclosure of HIV Status and HIV Sexual Transmission Behaviors among HIV-Positive Black Men Who Have Sex with Men in the BROTHERS (HPTN 061) Study. J Urban Health 2020; 97:692-703. [PMID: 32020466 PMCID: PMC7560677 DOI: 10.1007/s11524-020-00419-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
We assessed whether disclosure of HIV status is significantly associated with reported HIV sexual risk behaviors among HIV positive Black/African American men who have sex with men (MSM) (Black MSM) in six cities in the USA. Participants from the BROTHERS (HIV Prevention Trials Network [HPTN 061]) study focused on assessing the feasibility and acceptability of a multifaceted HIV prevention intervention to reduce HIV infections among Black MSM enrolled between July 2009 and October 2010. All participants completed a behavioral assessment using an audio computer-assisted self-interview that included questions about HIV status disclosure, HIV sexual risk behaviors, and other behaviors. Biological samples were also collected. This analysis focused on baseline data of HIV-positive Black MSM in the HPTN 061 study. Of the 143 HIV-positive Black MSM (majority ≥ 35 years of age) included in this analysis, 58% reported disclosing their HIV status to their last male anal sex partner. Forty-three percent and 42% reported condomless insertive and receptive anal intercourse respectively with their last male partner; whereas, 17% and 18% of the sample engaged in condomless insertive and receptive anal intercourse with a serodiscordant/unknown status partner, respectively. In multivariable logistic regression models, there was no statistically significant association between HIV status disclosure and condomless insertive anal intercourse (aOR = 0.35, 95% CI 0.11, 1.08; p = 0.30), condomless receptive anal intercourse (aOR = 2.48, 95% CI 0.94, 6.52; p = 0.20), or condomless receptive anal intercourse with a serodiscordant/unknown status partner (aOR = 0.55, 95% CI 0.20, 1.49; p = 0.45). However, HIV status disclosure was significantly associated with lower odds of reporting condomless insertive anal intercourse with a serodiscordant/unknown status partner (aOR = 0.19, 95% CI 0.06, 0.68; p ≤ 0.01). Among this multi-city sample of HIV-positive Black MSM, disclosure of HIV status was common and associated with lower HIV sexual risk behaviors. These findings should motivate and guide research to develop prevention messages to increase HIV status disclosures.
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Affiliation(s)
- Chukwuemeka N Okafor
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, USA.
- Center for Behavioral and Addiction Medicine, Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, USA.
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, USA.
| | - Michael J Li
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, USA
- Center for Behavioral and Addiction Medicine, Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, USA
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Christopher Hucks-Ortiz
- CommonSpirit Health, Dignity Health, CARE Clinic, St. Mary Medical Center, Long Beach, CA, USA
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Division of Infectious Disease, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Steve Shoptaw
- Center for Behavioral and Addiction Medicine, Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, USA
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, USA
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15
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Grieb SM, Donovan E, White JJ, Miller D, Dangerfield DT. Increasing Opportunities for Spiritual and Religious Supports to Improve HIV-Related Outcomes for Black Sexual Minority Men. J Urban Health 2020; 97:704-714. [PMID: 32728845 PMCID: PMC7560667 DOI: 10.1007/s11524-020-00461-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Given the importance of spirituality and religion in the lives of many Black gay, bisexual, and other Black sexual minority men (SMM) and the need for additional resources to improve HIV outcomes within this population, research on how spiritual and religious support can promote HIV prevention and treatment among Black SMM is greatly needed. We conducted nine focus groups with 52 spiritual and religious Black SMM in Baltimore, Maryland, to explore opportunities for HIV-related programming that incorporates spiritual and/or religious supports. Thematic analysis of the focus group transcripts was conducted using an iterative constant comparison coding process. Participants expressed a desire for more spiritual/religious support in non-church-based settings and identified the use of peer supports, inclusion of prayer and gospel music, and messaging related to the ideas that God is love, the Bible says to treat yourself preciously, and taking care of your health can strengthen your relationship with God as ways in which this could be incorporated into HIV-related programming. Participants living with HIV identified the message of "keeping the faith" as important for maintaining their HIV treatment plans. Participants also expressed a need for parental supports to improve HIV-related outcomes for Black SMM and potentially expand opportunities for spiritual and religious support to Black SMM within the church. Spirituality and religion can influence HIV outcomes for Black SMM, and the strategies identified by Black SMM in this study could aid in designing culturally congruent HIV prevention and treatment programs situated in the community.
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Affiliation(s)
- Suzanne M Grieb
- Center for Child and Community Health Research, Johns Hopkins School of Medicine, Baltimore, MD, USA.
| | | | - Jordan J White
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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16
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Shaw SA, Mergenova G, El-Bassel N. Religion and HIV Risk Among Male Market Vendors in Kazakhstan. JOURNAL OF RELIGION AND HEALTH 2020; 59:2019-2031. [PMID: 31605265 DOI: 10.1007/s10943-019-00929-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study examines associations between religion and sexual HIV risk among 1342 male migrant and non-migrant market vendors in Kazakhstan. In the multivariate analysis, religious influence was associated with a lower likelihood of having multiple partners. Regular attendance was associated with a lower likelihood of having anal sex with a male partner, but with increased likelihood of having multiple partners. Spending time socially with friends at a mosque or church was associated with lower risk of anal sex with a male partner and lower risk of unprotected sex.
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Affiliation(s)
- Stacey A Shaw
- 2175 JFSB, School of Social Work, Brigham Young University, Provo, UT, 84602, USA.
| | - Gaukhar Mergenova
- Global Health Research Center of Central Asia, Columbia University, Almaty, Kazakhstan
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17
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John Nutor J, Duodu PA, Agbadi P, Duah HO, Oladimeji KE, Gondwe KW. Predictors of high HIV+ prevalence in Mozambique: A complex samples logistic regression modeling and spatial mapping approaches. PLoS One 2020; 15:e0234034. [PMID: 32497145 PMCID: PMC7272061 DOI: 10.1371/journal.pone.0234034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/18/2020] [Indexed: 01/10/2023] Open
Abstract
Introduction The burden of HIV infection in southern Africa is a public health concern with an increasing number of new infections. This study sought to investigate the predictors of HIV prevalence in Mozambique through a complex samples logistic regression and spatial mapping approach using nationally representative data. Methods We conducted a secondary data analysis using the 2015 Mozambique Demographic and Health Survey and AIDS Indicator Survey. The analysis performed in four stages while incorporating population survey sampling weights did the following: i) created a complex sample plan file in SPSS, ii) performed the weighted estimate of HIV prevalence, iii) performed complex sample chi-square test of independence, and then iv) performed complex sample logistic regression modeling. Results Out of 11,270 participants, 1,469 (13.0%) tested positive for HIV. The prevalence of HIV infection was higher in females (15.1%) than males (10.2%). We found that urban dwellers were more likely to be HIV-positive compared to rural dwellers (AOR: 1.70; CI: 1.27, 2.27). We observed provincial variations in HIV prevalence, with Maputo Cidade (17.4%), Maputo Provincia (22.6%), Gaza (25.2%) recording higher prevalence above the national estimate. Other independent predictors of HIV infection in Mozambique included age, education level, marital status, total lifetime sexual partners, and having had an STI in the last 12 months. Conclusions The study revealed associations between high-risk sexual behavior and HIV infection. Results from our spatial mapping approach can help health policy makers to better allocate resources for cost-effective HIV/AIDS interventions. Pre-Exposure Prophylaxis (PrEP) campaigns among high-risk groups should be pursued to lower the reservoir of HIV among high-risk groups.
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Affiliation(s)
- Jerry John Nutor
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, California, United States of America
- * E-mail:
| | | | - Pascal Agbadi
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Kelechi Elizabeth Oladimeji
- Department of Public Health, Faculty of Health Sciences, University of Fort Hare, Eastern Cape, South Africa
| | - Kaboni Whitney Gondwe
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, United States of America
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18
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Higa DH, Crepaz N, McDonald CM, Adegbite-Johnson A, DeLuca JB, Kamitani E, Sipe TA. HIV Prevention Research on Men Who Have Sex With Men: A Scoping Review of Systematic Reviews, 1988-2017. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2020; 32:1-S7. [PMID: 32073309 DOI: 10.1521/aeap.2020.32.1.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In the United States, men who have sex with men (MSM) are disproportionately affected by HIV. To identify research gaps and inform HIV prevention for MSM, we conducted a scoping review of systematic reviews using CDC's Prevention Research Synthesis database. Eligibility criteria comprised English-language systematic reviews focused on HIV prevention for MSM, published during 1988-2017, and included at least one U.S. primary study. We coded data type, subpopulations, topics, and key findings. To assess study quality, we used the Assessment of Multiple Systematic Reviews (AMSTAR). Among 129 relevant systematic reviews, study quality was high or moderate for 63%. Most common topics were sexual behavior and disease vulnerability. The most frequently mentioned MSM subgroups were HIV-positive, Black or African American, and young. Research gaps include Hispanic/Latino MSM, pre-exposure prophylaxis (PrEP), treatment as prevention, social determinants of health, health disparities, syndemics, and protective factors for sexual health.
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Affiliation(s)
- Darrel H Higa
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Nicole Crepaz
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Christina M McDonald
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | | | - Julia B DeLuca
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Emiko Kamitani
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Theresa Ann Sipe
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
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Barnes SL, Hollingsworth C. Spirituality and Social Media: The Search for Support Among Black Men Who Have Sex With Men in Tennessee. JOURNAL OF HOMOSEXUALITY 2020; 67:79-103. [PMID: 30307800 DOI: 10.1080/00918369.2018.1525945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Young Black Men Who Have Sex With Men (BMSM) have been the subject of much research focused on health disparities in HIV occurrence, stigma, and mental health. Although such research is important, fewer studies focus on other equally salient areas of their lives such as spirituality, religious practices, and social support. Informed by literature on social support, this research endeavors to better understand these dynamics for a group of young BMSM who reside in a metropolitan city in Tennessee. Focus group results and content analysis uncover themes related to religion and resilience; queering Christianity; and virtual spirituality. Participants expressed an overarching need for support, safe spaces, genuine relationships, and godly instruction, conveyed through traditional Black Church involvement and nontraditional Internet usage. Findings are important for strategic, proactive, cross-generational collaboration with young BMSM to holistically meet their varied needs.
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Affiliation(s)
- Sandra L Barnes
- Department of Human and Organizational Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Charrise Hollingsworth
- Department of Human and Organizational Development, Vanderbilt University, Nashville, Tennessee, USA
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20
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Lassiter JM, Saleh L, Grov C, Starks T, Ventuneac A, Parsons JT. Spirituality and Multiple Dimensions of Religion Are Associated with Mental Health in Gay and Bisexual Men: Results From the One Thousand Strong Cohort. PSYCHOLOGY OF RELIGION AND SPIRITUALITY 2019; 11:408-416. [PMID: 31803345 PMCID: PMC6892427 DOI: 10.1037/rel0000146] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The purpose of this study was to determine the association between religion, spirituality, and mental health among gay and bisexual men (GBM). A U.S. national sample of 1,071 GBM completed an online survey that measured demographic characteristics, religiosity, religious coping, spirituality, and four mental health constructs (i.e., depressive symptoms, rejection sensitivity, resilience, and social support). Hierarchal linear regressions determined the associations between each mental health construct, demographic variables, and the spirituality and religion variables. Controlling for demographic characteristics, spirituality was negatively associated with depression and rejection sensitivity, and positively associated with resilience and social support (all p < .001). Religiosity was positively associated with rejection sensitivity (p < .05) and negatively associated with resilience (p < .01). Religious coping was positively associated with depression (p < .001) and rejection sensitivity (p < .05) and negatively associated with resilience (p < .05) and social support (p < .05). The interaction of spirituality with religion was significantly associated with all mental health variables. In general, religious GBM with higher levels of spirituality had better mental health outcomes. Spirituality was significantly positively associated with positive mental health outcomes and negatively associated with negative ones. Religion-solely expressed through behaviors and lacking the functional components of spirituality such as meaning-making and connection to the sacred-was associated with mental health problems among GBM. Public health interventions and clinical practice aimed at decreasing negative mental health outcomes among GBM may find it beneficial to integrate spirituality into their work.
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Affiliation(s)
- Jonathan M. Lassiter
- Center for HIV/AIDS Educational Studies and Training (CHEST)
- Department of Psychology, Muhlenberg College
| | - Lena Saleh
- Center for HIV/AIDS Educational Studies and Training (CHEST)
| | - Christian Grov
- Center for HIV/AIDS Educational Studies and Training (CHEST)
- City University of New York (CUNY) Graduate School of Public Health
and Health Policy
| | - Tyrel Starks
- Center for HIV/AIDS Educational Studies and Training (CHEST)
- Department of Psychology, Hunter College of CUNY
- Health Psychology and Clinical Science Doctoral Program, The
Graduate Center of CUNY. New York, NY. USA
| | - Ana Ventuneac
- Center for HIV/AIDS Educational Studies and Training (CHEST)
| | - Jeffrey T. Parsons
- Center for HIV/AIDS Educational Studies and Training (CHEST)
- Department of Psychology, Hunter College of CUNY
- Health Psychology and Clinical Science Doctoral Program, The
Graduate Center of CUNY. New York, NY. USA
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21
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Poteat T, Lassiter JM. Positive religious coping predicts self-reported HIV medication adherence at baseline and twelve-month follow-up among Black Americans living with HIV in the Southeastern United States. AIDS Care 2019; 31:958-964. [PMID: 30836764 PMCID: PMC6702942 DOI: 10.1080/09540121.2019.1587363] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This paper presents the results of secondary data analyses investigating the influence of religious coping on HIV medication adherence across time among 167 Black Americans living with HIV (BALWH) in the Southeastern United States. Participants were recruited from a large urban clinic in Atlanta, GA and completed questionnaires about their religious coping at baseline assessment and about their medication adherence at baseline and 12-month follow-up assessment. Descriptive analyses and multiple linear regression were used to determine the association between religious coping and HIV medication adherence. Findings indicated that after controlling for age and depressive symptoms at baseline, positive religious coping significantly predicted medication adherence at baseline and 12-month follow-up. Negative religious coping was inversely associated with medication adherence at baseline after controlling for age and depressive symptoms but not at 12-month follow-up. The implications of these findings for future research and intervention work related to medication adherence among BALWH are discussed.
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Affiliation(s)
- Tonia Poteat
- Epidemiology Department, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Jonathan Mathias Lassiter
- Psychology Department, Muhlenberg College, Allentown, PA. Twitter: @matjl,Correspondence should be addressed to the first author at: 2400 Chew Street, Allentown, PA 18104, 484-664-4312,
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22
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Ward LM, Bruce MA, Thorpe RJ, Mena L, Nunn A, Crosby R. Correlates Associated With Willingness to Start Pre-exposure Prophylaxis Among Young Black Men Who Have Sex With Men (MSM) in Jackson, Mississippi. FAMILY & COMMUNITY HEALTH 2019; 42:189-196. [PMID: 31107729 DOI: 10.1097/fch.0000000000000225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Black men who have sex with men have the greatest risk for human immunodeficiency virus infection. Pre-exposure prophylaxis (PrEP) is a highly effective prevention method. However, uptake in this group is extremely low. Data from a sample of 225 human immunodeficiency virus-negative young black men who have sex with men residing in Jackson, Mississippi, were analyzed to examine correlates associated with willingness to start PrEP. Consistent condom users for both insertive and receptive sex were more likely to be willing to start PrEP than inconsistent condom users. Heterogeneity among this high-risk population is an important consideration for future studies assessing PrEP uptake and evaluating prevention efforts.
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Affiliation(s)
- Lori M Ward
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson (Drs Ward, Bruce, Thorpe, and Mena); Program for Research on Faith and Health, Center for Research on Men's Health, and Center for Medicine, Health, and Society, Vanderbilt University, Nashville, Tennessee (Dr Bruce); Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, and Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Thorpe); Division of Infectious Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson (Dr Mena); Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island (Dr Nunn); and Department of Health Behavior, College of Public Health, University of Kentucky, Lexington (Dr Crosby)
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da Cunha GH, Lima MAC, Galvão MTG, Fechine FV, Fontenele MSM, Siqueira LR. Prevalence of arterial hypertension and risk factors among people with acquired immunodeficiency syndrome. Rev Lat Am Enfermagem 2018; 26:e3066. [PMID: 30379250 PMCID: PMC6206821 DOI: 10.1590/1518-8345.2684.3066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 08/14/2018] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES to verify the prevalence of arterial hypertension and its risk factors among people with acquired immunodeficiency syndrome under antiretroviral therapy. METHOD cross-sectional study with 208 patients. Data collection was conducted through interviews using a form containing data on sociodemographic, clinical and epidemiological aspects, hypertension risk factors, blood pressure, weight, height, body mass index and abdominal circumference. Mean, standard deviation, odds ratio and confidence interval were calculated, t-test and Chi-square test were used, considering P < 0.05 as statistically significant. Hypertension associated variables were selected for logistic regression. RESULTS patients were male (70.7%), self-reported as mixed-race (68.2%), had schooling between 9 and 12 years of study (46.6%), had no children (47.6%), were single (44.2%), in the sexual exposure category (72.1%) and heterosexual (60.6%). The prevalence of people with acquired immunodeficiency syndrome and arterial hypertension was 17.3%. Logistic regression confirmed the influence of age greater than 45 years, family history of hypertension, being overweight and antiretroviral therapy for more than 36 months for hypertension to occur. CONCLUSION the prevalence of hypertension was 17.3%. Patients with acquired immunodeficiency syndrome and hypertension were older than 45 years, had family history of hypertension, were overweight and under antiretroviral therapy for more than 36 months.
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Affiliation(s)
| | | | | | - Francisco Vagnaldo Fechine
- Universidade Federal do Ceará, Centro de Pesquisa e Desenvolvimento
de Medicamentos, Fortaleza, CE, Brazil
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24
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Lim SH, Brown SE, Shaw SA, Kamarulzaman A, Altice FL, Beyrer C. "You Have to Keep Yourself Hidden": Perspectives From Malaysian Malay-Muslim Men Who Have Sex With Men on Policy, Network, Community, and Individual Influences on HIV Risk. JOURNAL OF HOMOSEXUALITY 2018; 67:104-126. [PMID: 30307803 DOI: 10.1080/00918369.2018.1525946] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Malay-Muslim men who have sex with men (MSM) are marginalized and hidden in Malaysia, a predominantly Muslim country in southeast Asia. We explored the policy, network, community, and individual factors related to HIV infection among Malay-Muslim MSM through 26 in-depth interviews and one focus group discussion (n = 5) conducted in Kuala Lumpur and Kota Bharu between October 2013 and January 2014. As religion plays an important role in their lives, participants viewed homosexuality as a sin. Low risk perception and misconceptions about HIV/AIDS were common, and most participants expressed reluctance to consult a doctor unless they had symptoms. Additionally, buying condoms was embarrassing and anxiety-producing. Fear of discrimination by health care providers and community hindered participants from disclosing sexual behaviors and accessing health services. Homophobic comments and policies by the government and religious leaders were concerns of participants. A safe and enabling environment is needed to reduce HIV risks among Malay-Muslim MSM.
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Affiliation(s)
- Sin How Lim
- Centre of Excellence for Research in AIDS (CERiA), Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Stacey A Shaw
- Department of Social Work, Brigham Young University, Provo, Utah, USA
| | - Adeeba Kamarulzaman
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Frederick L Altice
- Yale School of Public Health, Division of Epidemiology of Microbial Diseases, New Haven, Connecticut, USA
| | - Chris Beyrer
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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25
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Drumhiller K, Nanín JE, Gaul Z, Sutton MY. The Influence of Religion and Spirituality on HIV Prevention Among Black and Latino Men Who Have Sex with Men, New York City. JOURNAL OF RELIGION AND HEALTH 2018; 57:1931-1947. [PMID: 29696488 DOI: 10.1007/s10943-018-0626-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The influence of religion and spirituality (R/S) on HIV prevention has been understudied, especially for Black and/or Latino men who have sex with men (BLMSM), who bear a disproportionate burden of HIV, and who are part of racial/ethnic communities with high engagement in R/S. The specific aim of this study was to explore perspectives about R/S among BLMSM to inform HIV prevention strategies and reduce HIV-related health disparities. Data from 105 qualitative interviews with BLMSM were analyzed; 58 (55%) stated that R/S had no personal influence on HIV prevention. For those reporting any R/S influence, main themes were: (1) R/S positively influenced decision-making and self-respect, (2) perceived judgment and stigma by religious communities, (3) belief in a higher power, and (4) altruism. These findings can inform faith-based HIV prevention interventions for BLMSM.
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Affiliation(s)
- Kathryn Drumhiller
- Division of HIV/AIDS Prevention, NCHHSTP, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-45, Atlanta, GA, 30329, USA.
- Chenega Professional and Technical Services, Chesapeake, VA, USA.
| | - José E Nanín
- Community Health Program/Department of Health, Physical Education, and Recreation, Kingsborough Community College, Brooklyn, NY, USA
| | - Zaneta Gaul
- Division of HIV/AIDS Prevention, NCHHSTP, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-45, Atlanta, GA, 30329, USA
- ICF, Atlanta, GA, USA
| | - Madeline Y Sutton
- Division of HIV/AIDS Prevention, NCHHSTP, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-45, Atlanta, GA, 30329, USA
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Screening for developmental disabilities in HIV positive and HIV negative children in South Africa: Results from the Asenze Study. PLoS One 2018; 13:e0199860. [PMID: 29969474 PMCID: PMC6029795 DOI: 10.1371/journal.pone.0199860] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 06/14/2018] [Indexed: 12/31/2022] Open
Abstract
Background While neurodevelopmental abnormalities are common in children with HIV infection, their detection can be challenging in settings with limited availability of health professionals. The aim of this study was to assess the ability to identify developmental disability among HIV positive and HIV negative children living in South Africa with an internationally used screen. Methods and findings This analysis uses a sample of 1,330 4–6 year old children and 1,231 of their caregivers in KwaZulu-Natal, South Africa, including administration of the Ten Questions (TQ) screen, a standardized medical history and physical examination conducted by a medical doctor, with hearing and vision screening, psychological assessment for cognition and language delay, and voluntary HIV testing. There was a high prevalence of disability among the sample. Compared to HIV negative children, HIV positive children were more likely to screen positive on at least one TQ item (59.3 vs 42.8%, p = 0.01), be delayed in sitting, standing or walking (OR 3.89, 95% CI = 2.1–7.2) and have difficulty walking or weakness in the arms or legs (OR = 2.7, 95%CI = 0.8–9.37). By medical doctor assessment, HIV positive children were more likely to be diagnosed with gross motor disability (OR = 3.5, 95%CI = 1.3–9.2) and hearing disability (OR = 2.5, 95%CI = 1.2–5.3). By independent psychological assessment, HIV positive children were more likely to have cognitive delay (OR = 2.2, 95%CI = 1.2–3.9) and language delay (OR = 4.3, 95%CI = 2.2–8.4). Among HIV positive children, the sensitivity and specificity of the TQ for serious disability (vs. no disability) was 100% and 51.2%, respectively. Among HIV-negative children, the sensitivity and specificity of the TQ for serious disability (vs. no disability) was 90.2% and 63.9%, respectively. Conclusions In this first report of the use of the TQ screen in the isiZulu language, it was found to have high sensitivity for detecting serious developmental disabilities in children, especially HIV positive children. The performance of the TQ in this sample indicates utility for making best use of limited neurodevelopmental resources by screening HIV positive children.
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27
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Shaw SA, McCrimmon T, Mergenova G, Sultangaliyeva A, El-Bassel N. Islamic Influence on HIV Risk and Protection Among Central Asian Male Migrant Workers in Kazakhstan. QUALITATIVE HEALTH RESEARCH 2017; 27:1553-1561. [PMID: 28728529 DOI: 10.1177/1049732317697101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
HIV incidence is increasing in Central Asia, where migrant workers experience risks for acquiring sexually transmitted HIV. As a social and structural factor that may influence perceptions and behavior, we examine how Islam shapes HIV risk and protection. Phenomenological qualitative interviews examine religion and contexts of HIV risk among 48 male Central Asian migrant workers residing in Almaty, Kazakhstan. Men described nonvaginal sex, alcohol use, premarital sex, and extramarital sex as forbidden or frowned upon. Religious networks were unlikely to discuss HIV risks, and some men viewed religious affiliation or practices as protective. Marital practices including neke (religious marriage), polygyny, and bride kidnapping may be linked to risk. Findings suggest adhering to Islamic ideals may be protective for some men, but for others, assumptions of protection may enhance risk. HIV prevention strategies among Central Asian migrants may be strengthened by attention to religious and cultural understandings of risk and protection.
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Affiliation(s)
- Stacey A Shaw
- 1 Brigham Young University School of Social Work, Provo, Utah, USA
| | - Tara McCrimmon
- 2 Columbia University School of Social Work, New York, New York, USA
| | | | | | - Nabila El-Bassel
- 2 Columbia University School of Social Work, New York, New York, USA
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Abstract
BACKGROUND Religion can profoundly impact the sociocultural contexts that shape sexual HIV vulnerability among men who have sex with men (MSM). However, the relationship between religion and HIV vulnerability remains poorly understood for MSM in China, where religious affiliations and practices are rapidly increasing. METHODS Using cross-sectional survey data collected in Beijing and Tianjin, China, from 2013 to 2014 (n = 400), this study tests 3 hypotheses regarding religion and HIV sexual risk: (1) HIV vulnerabilities and testing patterns among religiously affiliated MSM are lower than for areligious MSM, (2) religiosity is inversely associated with HIV vulnerabilities and testing, and (3) the magnitude of inverse association between religiosity and HIV vulnerabilities/testing will be stronger among Christian and Muslim MSM than Buddhist and areligious MSM. RESULTS Compared with areligious participants, Buddhists had higher odds of reporting unprotected anal intercourse [adjusted odds ratio (AOR): 2.06, 95% confidence interval (CI): 1.13 to 3.75] and more male sex partners (AOR: 1.95, 1.16-3.27), whereas Muslims had lower odds of reporting unprotected anal intercourse (AOR: 0.33, 95% CI: 0.15 to 0.73) and higher odds of reporting male circumcision (AOR: 3.04, 95% CI: 1.45 to 6.40). Reporting of forced sex was associated with more frequent participation in social religious activities (AOR: 1.25, 95% CI: 1.02 to 1.52) and private religious activities (AOR: 1.30, 95% CI: 1.04 to 1.61). Among Christians, participation in private religious activities was associated with lower odds of reporting anal intercourse (AOR: 0.49, 95% CI: 0.27 to 0.88). CONCLUSIONS The sustained growth of multiple religious traditions in China appears to have important implications for HIV vulnerability among religious minority MSM.
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Carrico AW, Storholm ED, Flentje A, Arnold EA, Pollack LM, Neilands TB, Rebchook GM, Peterson JL, Eke A, Johnson W, Kegeles SM. Spirituality/religiosity, substance use, and HIV testing among young black men who have sex with men. Drug Alcohol Depend 2017; 174:106-112. [PMID: 28319751 PMCID: PMC5482005 DOI: 10.1016/j.drugalcdep.2017.01.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/10/2017] [Accepted: 01/12/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Spirituality and religiosity may serve as both a resource and a barrier to HIV prevention with young black men who have sex with men (YBMSM). We examined indices of spirituality/religiosity as correlates of binge drinking, stimulant use, and recent HIV testing in a sample of YBMSM. METHODS From 2011-2013, annual venue-based surveys of sexually active YBMSM ages 18-29 were conducted in Dallas and Houston, Texas. Binge drinking and stimulant use were assessed in the past two months. Participants recently tested for HIV (i.e., within the past six months) were compared to those without recent HIV testing (i.e., never tested or tested more than six months ago). RESULTS Among the 1565 HIV-negative or HIV-unknown YBMSM enrolled, more engagement in spiritual and religious activities was associated with greater odds of reporting stimulant use (Adjusted Odds Ratio [AOR]=1.20; 95% CI=1.04-1.40) while higher spiritual coping was associated with lower odds of reporting stimulant use (AOR=0.66; 95% CI=0.56-0.78). Binge drinking was independently associated with 29% lower odds of recent HIV testing (AOR=0.71; 95% CI=0.55-0.92), but lower odds of binge drinking did not mediate the association of engagement in spiritual and religious activities with 27% greater odds of recent HIV testing (AOR=1.27; 95% CI=1.11-1.46). CONCLUSIONS Among YBMSM, culturally tailored approaches addressing spirituality/religiosity could support prevention of stimulant use and increase HIV testing. In particular, expanded efforts are needed to promote HIV testing in binge drinkers.
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Affiliation(s)
- Adam W. Carrico
- University of Miami, School of Medicine, Department of Public Health Sciences
| | | | - Annesa Flentje
- University of California, San Francisco School of Nursing, Department of Community Health Systems
| | - Emily A. Arnold
- University of California, San Francisco, Center for AIDS Prevention Studies
| | - Lance M. Pollack
- University of California, San Francisco, Center for AIDS Prevention Studies
| | | | | | | | - Agatha Eke
- Centers for Disease Control and Prevention
| | | | - Susan M. Kegeles
- University of California, San Francisco, Center for AIDS Prevention Studies
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