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Kaufman MR, Wright K, Eschliman EL, Levine D, Simon J. A Mobile App to Assist the Mentors of African American Young Men Who Have Sex With Men: Usability Study. JMIR Form Res 2023; 7:e48515. [PMID: 37889552 PMCID: PMC10638633 DOI: 10.2196/48515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Mentoring can promote positive youth development. Owing to social and structural factors, young people in underresourced communities often lack adequate access to mentors, and naturally occurring mentors are more common than formal, programmatic mentors. There is little information on the impact of naturally occurring mentors on youth in general and even less on the role that mentors may play in promoting healthy outcomes in sexual and gender minority youth. African American young men who have sex with men (YMSM) are more likely to reside in communities with limited access to formalized mentorship programs and may benefit from naturally occurring mentoring relationships that address health outcomes, specifically related to HIV. OBJECTIVE This study is a usability test of a mobile app designed for the mentors of African American YMSM to increase mentors' knowledge of and confidence in talking about HIV prevention and related topics with mentees. METHODS Following consent, eligible and naturally occurring mentoring pairs involving African American YMSM in Baltimore; Philadelphia; and Washington, District of Columbia, tested the app, UrbanMentorHub, for usability. Participants downloaded the app and used it for 1 month, completed pre- and postintervention surveys, and participated in a follow-up focus group discussion. Participants' sociodemographic characteristics and HIV- and mentorship-related measures were characterized using descriptive statistics. Wilcoxon signed rank tests were used to test for pre- and postintervention differences in knowledge, confidence, and outcome expectancy measures. Focus group discussions were audio recorded and transcribed. Transcripts were thematically coded and analyzed to identify ways that UrbanMentorHub could be improved in the mentoring context. RESULTS Nine mentorship pairs participated in this usability study (N=18). Mentors obtained high scores on knowledge, confidence, outcome expectancies, skills, and intentions related to HIV and mentoring. No pre- or postintervention changes were observed in these measures. Mentors reported usually initiating conversations around HIV testing and pre-exposure prophylaxis; mentees and mentors equally initiated conversations on sexual practices and same-sex relationships. Mentors reported sexual practices as the most frequently discussed topic in the past month and pre-exposure prophylaxis being the least discussed. Mentees reported high comfort with HIV-related conversations. No pre- or postintervention change was observed regarding HIV knowledge. Most mentees reported having discussed most HIV-related topics with their mentor in the past month. Mentor feedback on the app was mostly neutral, although they reported positive perceptions of the idea of the app, indicating the potential for addressing a need in their communities. Mentors suggested ways to improve the app content and design elements. CONCLUSIONS Although there was no observed statistical change in measured outcomes, and qualitative feedback was overall neutral, the results of this usability study can inform future work to design and promote interventions and resources that support mentoring relationships for African American YMSM.
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Affiliation(s)
- Michelle R Kaufman
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Kate Wright
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Evan L Eschliman
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Deborah Levine
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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Tao Y, Xiao X, Ma J, Wang H. The relationship between HIV-related stigma and HIV self-management among men who have sex with men: The chain mediating role of social support and self-efficacy. Front Psychol 2022; 13:1094575. [PMID: 36600713 PMCID: PMC9807034 DOI: 10.3389/fpsyg.2022.1094575] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022] Open
Abstract
HIV infection becomes a manageable disease, and self-management is one of the key indicators of achieving optimal health outcomes. Men who have sex with men (MSM) living with HIV face many psychosocial challenges when managing HIV infection, such as sexual minority pressure and HIV-related stigma. Higher perceived HIV-related stigma had been related to low self-management. However, the mechanisms underlying the association between HIV-related stigma and HIV self-management are unclear. Two possible mediators include social support and self-efficacy. This study aimed to examine the relationship between HIV-related stigma and HIV self-management among MSM living with HIV and to explore the single mediating effect of social support and self-efficacy and the chain mediating effect of these two variables on this relationship in China. Convenience sampling was used to recruit participants from the Center for Disease Control (CDC) in Changsha City, Hunan province, China. A total of 459 MSM living with HIV completed questionnaires regarding sociodemographic and disease-related information, HIV-related stigma, social support, self-efficacy, and HIV self-management. Descriptive statistics analysis, one-way ANOVA, independent t-tests, Pearson's bivariate correlation, and multiple regression were conducted using the SPSS v24.0. Process macro in SPSS was used to analyze the single and chain mediating effect among variables. Our findings showed that the indirect and total effect of HIV-related stigma on HIV self-management was significant, while the direct effect was not statistically significant. Social support and self-efficacy mediated the relationship between HIV-related stigma and HIV self-management, respectively. Moreover, the chain mediating model confirmed that the association between HIV-related stigma and HIV self-management was mediated by social support and self-efficacy sequentially. Future interventions focusing on improving HIV self-management among MSM living with HIV should consider a multi-faced approach.
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Prince DM, Ray-Novak M, Gillani B, Peterson E. Sexual and Gender Minority Youth in Foster Care: An Evidence-Based Theoretical Conceptual Model of Disproportionality and Psychological Comorbidities. TRAUMA, VIOLENCE & ABUSE 2022; 23:1643-1657. [PMID: 33942681 DOI: 10.1177/15248380211013129] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Sexual and gender minority youth (SGMY) are overrepresented in the foster care system and experience greater foster-care-related stressors than their non-SGM peers. These factors may further elevate their risk of anxiety/depressive, post-traumatic stress disorder, self-harm, and suicidality. The system currently produces unequal and disproportionate adverse mental health outcomes for SGMY and needs points of intervention to disrupt this status quo. This article provides an empirically grounded conceptual-theoretical model of disproportionate representation and burden of psychological comorbidities experienced by SGMY in the foster care system. We apply findings from an integrated literature review of empirical research on factors related to overrepresentation and mental health burden among SGMY to minority stress theory to explicate how and why the foster care system exacerbates mental health comorbidities for SGMY. Searches were conducted in June 2020 in PubMed using MeSH terms and title/abstract terms for foster care, sexual or gender minorities, and psychological comorbidities. Inclusion criteria are studies conducted in the United States, published in English, focused on mental illness, and published between June 2010 and 2020. Developmental/intellectual and eating disorders were excluded. The initial search returned 490 results. After applying inclusion criteria, 229 results remained and are utilized to build our conceptual-theoretical model. We assert that the phenomenon of disproportionate psychological comorbidities for SGMY in foster care is best represented as a complex and dynamic system with multiple feedback loops. Extant empirical and theoretical literature identifies three critical areas for intervention: family acceptance, community belonging and queer chosen/constructed family, and affirming and nondiscriminatory child welfare policy.
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Affiliation(s)
- Dana M Prince
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, 2546Case Western Reserve University, Cleveland, OH, USA
| | - Meagan Ray-Novak
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, 2546Case Western Reserve University, Cleveland, OH, USA
| | - Braveheart Gillani
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, 2546Case Western Reserve University, Cleveland, OH, USA
| | - Emily Peterson
- Department of Psychological Sciences, 2546Case Western Reserve University, Cleveland, OH, USA
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Arnold EA, Saberi P, Wong JO, Pollack LM, Neilands TB, Benjamin M, Lockett G, Kegeles SM. We are Family: A Feasibility and Acceptability Study of an HIV Prevention Intervention With the House Ball and Gay Family Communities. J Acquir Immune Defic Syndr 2021; 88:S6-S11. [PMID: 34757987 PMCID: PMC8579983 DOI: 10.1097/qai.0000000000002805] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Black and Latinx sexual minority youth are disproportionately affected by HIV. The House Ball and gay family communities encompass sexual and ethnic minority youth who form chosen families that promote protective HIV-related health behaviors. We conducted a small-scale trial of the We Are Family intervention, leveraging these existing social dynamics to address HIV. METHODS From September 2018 to September 2019, we enrolled N = 118 for baseline and 6-month follow-up assessments. Eligible participants were 18 years or older, San Francisco Bay Area residents, members of a house or gay family or ball attendees in the past year, smartphone users, and sexually active. The intervention included one 2-hour in-person group session, community-level events, a mobile health app, and a dedicated service provider. RESULTS Ninety-seven percent of our participants were people of color, 94% were retained through follow-up. 73% attended at least 1 group session, 100% used the mobile health app, and 56% attended a community-level event. Modest changes were observed baseline to follow-up: among all participants, any condomless anal intercourse past 3 months (74.6%-66.7%, P = 0.064); among HIV-negative participants (N = 82) HIV testing past 6 months (80.7%-87.2%, P = 0.166); among HIV-positive participants (N = 34) receiving HIV primary care past 6 months (64.5%-78.8%, P = 0.139), and adherent to ART past 30 days (22.6%-28.1%, P = 0.712). 86% would be willing to refer a friend to the app, and 65% found the app to be personally relevant. CONCLUSIONS We Are Family reaches and retains its target population, is feasible, acceptable, and shows promise for improving HIV-related health behavior.
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Affiliation(s)
- Emily A. Arnold
- Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, CA; and
| | - Parya Saberi
- Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, CA; and
| | - Jeffrey O. Wong
- Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, CA; and
| | - Lance M. Pollack
- Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, CA; and
| | - Torsten B. Neilands
- Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, CA; and
| | | | | | - Susan M. Kegeles
- Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, CA; and
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Kaufman MR, Lin C, Levine D, Salcido M, Casella A, Simon J, DuBois DL. The Formation and Benefits of Natural Mentoring for African American Sexual and Gender Minority Adolescents: A Qualitative Study. JOURNAL OF ADOLESCENT RESEARCH 2021. [DOI: 10.1177/07435584211064284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study explored how mentoring begins and the benefits provided for African American sexual and/or gender minority (SGM) youth. Participants were mentors and mentees living in three Mid-Atlantic cities. Mentees (ages 15–21, n = 14) identified as African American; cisgender male, transgender female, or non-binary assigned male; and had sexual interest in men. Mentor participants (ages 18+, n = 13) mentored such youth. Qualitative in-depth interviews were conducted with mentoring relationship partners (both partners did not necessarily participate). All interviews were audio-recorded, transcribed, and imported into Atlas.ti. Using a basic interpretive qualitative analysis, a codebook was developed through inductive and deductive techniques. Analysis focused on mentees’ and mentors’ descriptions and interpretations about how they formed a mentoring relationship and any observed benefits that arose. Themes showed mentoring relationships were formed through introductions via social circles or social media. Mentoring was described as providing a trusted confidant and support with identity formation, relationships, transitioning to adulthood, and health. Results indicate a potential for natural mentoring relationships to provide trusted adult support to SGM adolescents in ways that are experienced as authentic and beneficial to the mental health of African American SGM male youth.
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Affiliation(s)
| | - Chichun Lin
- University of British Columbia, Vancouver, BC, Canada
| | | | | | - Albert Casella
- Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
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Sterrett-Hong EM, Birkett M, Kuhns L, Zhang D, Mustanski B. The Impact of Closeness to Non-Parental Adults in Social Networks on Substance Use among Young Men Who Have Sex with Men. JOURNAL OF HOMOSEXUALITY 2021; 68:1727-1744. [PMID: 31902312 PMCID: PMC7334073 DOI: 10.1080/00918369.2019.1705670] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Non-parental adults (NPAs), or adults in social networks other than parents and romantic/sexual partnersare an under-examined potential resource in the lives of young men who have sex with men (YMSM). Using survey and social network data from a sample (n = 169) of ethnically diverse YMSM in a Midwestern city, this article examines longitudinal associations between emotional closeness to NPAs and subsequent substance use among YMSM. After controlling for race/ethnicity, closer relationships with NPAs were associated with a lower likelihood of binge-drinking and marijuana use six months later. In an exploratory set of analyses, the level of connectedness between NPAs and other members of social networks was not associated with substance use. Future studies should continue to examine the protective role of NPAs for both substance use and other health behaviors among YMSM.
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Affiliation(s)
- Emma M. Sterrett-Hong
- Couple and Family Therapy Program, Kent School of Social Work, University of Louisville, Louisville, Kentucky, USA
| | - Michelle Birkett
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA
| | - Lisa Kuhns
- Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, USA
| | - Donghang Zhang
- Couple and Family Therapy Program, Kent School of Social Work, University of Louisville, Louisville, Kentucky, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA
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Individual and Social Network Factors Associated with High Self-efficacy of Communicating about Men's Health Issues with Peers among Black MSM in an Urban Setting. J Urban Health 2020; 97:668-678. [PMID: 32740700 PMCID: PMC7560668 DOI: 10.1007/s11524-020-00458-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Black men who have sex with men (BMSM) bear a disproportionate burden of HIV in the USA. BMSM face stigma, discrimination and barriers to health care access, and utilization. Peers (male or female) may assist BMSM in navigating their health issues by engaging in communication to support in their health care needs. Individuals with high self-efficacy of communicating about men's health issues with peers can be trained as community popular opinion leaders (CPOLs) to change peer behaviors by promoting risk reduction communication. We examined the characteristics associated with high self-efficacy of communicating with peers about men's health issues among 256 BMSM from a behavioral HIV intervention conducted in Baltimore, Maryland. In the multivariate logistic model, gay identity (AOR: 2.10, 95% CI: 1.15,3.83), involvement in the house and ballroom community (AOR: 2.50, 95% CI: 1.14,5.49), larger number of network members who are living with HIV (AOR: 6.34, 95% CI: 1.48,27.11), and larger number of network members who would loan them money (AOR: 1.46, 95% CI: 1.05,2.03) were statistically significantly associated with high self-efficacy of communicating with peers about men's health issues. We also found that having depressive symptoms (AOR: 0.43, 95% CI: 0.24, 0.77) was negatively associated with high self-efficacy of communicating with peers about men's health issues. Findings from the current study can inform future studies to identify better CPOLs who are able to communicate effectively with peers about men's health issues for BMSM.
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White JJ, Dangerfield DT, Donovan E, Miller D, Grieb SM. Exploring the role of LGBT-affirming churches in health promotion for Black sexual minority men. CULTURE, HEALTH & SEXUALITY 2020; 22:1191-1206. [PMID: 31594476 PMCID: PMC7141971 DOI: 10.1080/13691058.2019.1666429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 09/08/2019] [Indexed: 06/01/2023]
Abstract
In the USA, Black sexual minority men (BSMM) remain disproportionately impacted upon by HIV and other sexual health issues. Individuals who attend church have lower rates of morbidity and mortality than those that do not; however, church attendance presents a paradox of being protective for some health outcomes and a risk for others among this population. Lesbian, gay, bisexual, and transgender (LGBT) affirming churches may offer support, but little is known about the role of LGBT-affirming churches in the lives of BSMM and how they may impact HIV and other health outcomes. This study explored the role of LGBT-affirming churches in the lives of BSMM. Nine focus groups (N = 52) were conducted in Baltimore City, Maryland between December 2017 and April 2018. Thematic analysis evaluated domains related to how men perceived, experienced, and engaged with LGBT-affirming churches. Three primary themes identified: (1) preferring traditional church environments over LGBT-affirming churches; (2) experiencing the LGBT-affirming church as a space of acceptance, emotional healing, and modelling loving same-sex relationships; and (3) perceiving LGBT-affirming churches as opportunities to engage community members to promote the well-being of BSMM. A secondary theme identified involvement in the house and ballroom community as an LGBT-affirming religious experience.
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Affiliation(s)
- Jordan J White
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | - Suzanne M Grieb
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Clark JL, Perez-Brumer AG, Reisner SL, Salazar X, McLean S, Huerta L, Silva-Santisteban A, Moriarty KM, Mimiaga MJ, Sanchez J, Mayer KH, Lama JR. Social Network Organization, Structure, and Patterns of Influence Within a Community of Transgender Women in Lima, Peru: Implications for Biomedical HIV Prevention. AIDS Behav 2020; 24:233-245. [PMID: 30989553 PMCID: PMC6801001 DOI: 10.1007/s10461-019-02506-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Understanding social network structures can contribute to the introduction of new HIV prevention strategies with socially marginalized populations like transgender women (TW). We conducted 20 semi-structured interviews and four focus groups (n = 32) with TW from selected social networks in Lima, Peru between May and July, 2015. Participants described layers of social influence from diverse actors in their social networks. The majority identified a close relative as their primary social support, with whom they confided secrets but avoided issues of transgender identity, sexuality, and sex work. Participants described close circles of TW friends with whom they shared information about gender identity, body modification, and sexual partners, but avoided issues like HIV. Community leadership included political leaders (who advocated for transgender rights) as well as social leaders (who introduced TW to hormone therapy, body modification, and commercial sex). Detailed analysis of TW social networks can contribute to implementation and acceptability of new HIV prevention technologies.
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Affiliation(s)
- J L Clark
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Leconte Avenue, CHS 37-121, Los Angeles, CA, 90095, USA.
| | - A G Perez-Brumer
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - S L Reisner
- Department of Pediatrics, Harvard Medical School and Boston Children's Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - X Salazar
- Instituto de Estudios de Sexualidad y Derechos Humanos, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - S McLean
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - L Huerta
- Asociacion Civil Impacta Salud y Educacion, Lima, Peru
| | - A Silva-Santisteban
- Instituto de Estudios de Sexualidad y Derechos Humanos, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - K M Moriarty
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Leconte Avenue, CHS 37-121, Los Angeles, CA, 90095, USA
- Brown University Alpert School of Medicine, Providence, RI, USA
| | - M J Mimiaga
- Center for Health Equity Research, Brown University, Providence, RI, USA
- Departments of Behavioral and Social Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Brown University Alpert School of Medicine, Providence, RI, USA
| | - J Sanchez
- Asociacion Civil Impacta Salud y Educacion, Lima, Peru
- CITBM, Universidad Nacional Mayor San Marcos, Lima, Peru
- Department of Global Health, University of Washington School of Medicine, Seattle, WA, USA
| | - K H Mayer
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - J R Lama
- Asociacion Civil Impacta Salud y Educacion, Lima, Peru
- Department of Global Health, University of Washington School of Medicine, Seattle, WA, USA
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Saberi P, Berrean B, Milionis C, Wong JO, Arnold E. We are family: designing and developing a mobile health application for the San Francisco bay area House Ball and Gay Family communities. Mhealth 2020; 6:42. [PMID: 33437838 PMCID: PMC7793014 DOI: 10.21037/mhealth-19-234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 04/14/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The House Ball community (HBC) and its affiliated Gay Families (GFs) consist of predominantly African American and Latinx sexual, gender, and ethnic minorities (SGEM), who form chosen families often as a way to provide support, and in the case of the HBC, to constitute houses that then compete in performative categories in balls. Members of both communities are disproportionately impacted by HIV. Although public health professionals have engaged with the HBC and GFs to improve HIV testing and clinical care, most intervention activities have relied on in-person modes of outreach and delivery. Little research has been conducted with the members of the HBC and GFs to develop and produce culturally-informed mobile health (mHealth) applications that would enable them to increase HIV-related knowledge, connect to HIV-related resources, receive HIV health support, and to celebrate their unique identities and communities in a safe space. METHODS We conducted 45 in-depth interviews with HBC and GF members who attended balls. Topics included HIV-related health needs, suggestions for mHealth components, current usage of apps and desirable features, and wishes around privacy and security. Following analysis of the interview data, we convened a series of four workshops with N=15 participants who were split into two groups. The purpose of the workshops was to co-design a digital tool to help provide information, reduce HIV-related stigma, and locate HIV resources for participants. Each group attended two workshops. Data were analyzed by a team of social scientists, community members, and mobile health experts. Findings were used to design an mHealth app related to HIV prevention and care. RESULTS Participants requested an app that clearly reflected the community. The desired features of the app included accurate information and education on HIV transmission; links to resources such as HIV testing, lube and condoms, PrEP, and other health-related services; and the ability to rate and review local resources. In workshops, participants proposed several design elements and functions for the app. It had to be 'Mobile and Modern', 'Relatable, Raw, and "Reflective of Me"', 'Positive and Fun', feature community-generated content, and provide a safe space for users. Using these clear directives, the team designed an mHealth tool to be fielded as part of the larger "We Are Family" intervention that would provide HIV-specific information, resources, and support in a platform that was congruent with community norms and expectations. CONCLUSIONS Designing and fielding an mHealth app as part of a larger HIV prevention intervention that reflects the social support and relationships within existing House Ball and Gay Family communities allows those youth most at risk for HIV-related health disparities to gain access to HIV testing, or link and re-engage young people to care.
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Affiliation(s)
- Parya Saberi
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Beth Berrean
- School of Medicine, Dean’s Office, Technology Services Unit, University of California, San Francisco, San Francisco, CA, USA
| | - Cynthia Milionis
- School of Medicine, Dean’s Office, Technology Services Unit, University of California, San Francisco, San Francisco, CA, USA
| | - Jeffrey O. Wong
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Emily Arnold
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
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Zarwell M, Ransome Y, Barak N, Gruber D, Robinson WT. PrEP indicators, social capital and social group memberships among gay, bisexual and other men who have sex with men. CULTURE, HEALTH & SEXUALITY 2019; 21:1349-1366. [PMID: 30724712 PMCID: PMC6684860 DOI: 10.1080/13691058.2018.1563912] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 12/23/2018] [Indexed: 05/25/2023]
Abstract
Efforts to reduce HIV among gay, bisexual and other men who have sex with men include increasing awareness and uptake of pre-exposure prophylaxis (PrEP). Social capital may facilitate engagement in HIV prevention. Membership of social groups including chosen families (i.e. friends as family relationships) - one potential indicator of social capital - may be protective against HIV risk and infection. In this cross-sectional quantitative study, we examined social capital items and social group membership in association with PrEP outcomes. In 2014, the New Orleans arm of the National HIV Behavioral Surveillance recruited 353 HIV-negative men, of whom 46% identified as Black, Latino or Other Race and 54% as Non-Hispanic White, using venue-based sampling to complete a structured survey. Multivariable logistic regression models tested the relations between social group membership and social capital with PrEP indicators. Men who reported community group participation were more likely to be aware of PrEP compared to those who did not. Men in chosen families associated with a family name were least likely to be aware of and willing to take PrEP compared to those not in any other social groups. Social group membership is a potential social capital indicator for assessing HIV prevention among men.
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Affiliation(s)
- Meagan Zarwell
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Narquis Barak
- NO/AIDS Task Force d.b.a CrescentCare Health, New Orleans, LA, USA
| | - DeAnn Gruber
- Department of Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
- STD/HIV Program, Louisiana Office of Public Health, New Orleans, LA, USA
| | - William T. Robinson
- Department of Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
- STD/HIV Program, Louisiana Office of Public Health, New Orleans, LA, USA
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Hosek S, Castillo M, Hotton A, Balthazar C, Gwiazdowski B, Laboy R, Davis K, Lemos D, Harper GW, Bell M. Comparison of Two Distinct House Ball Communities Involved in an HIV Prevention Study: Baseline Data from the POSSE Project. JOURNAL OF HIV/AIDS & SOCIAL SERVICES 2019; 18:399-416. [PMID: 33013233 PMCID: PMC7531774 DOI: 10.1080/15381501.2019.1673868] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 06/11/2023]
Abstract
For many Black/African American gay, bisexual, and other young men who have sex with men (B-GBMSM), the House/Ball Community (HBC) offers a social network where they can be free to express diverse sexual and gender identities, but HIV prevalence and stigma are high. The POSSE project is an effectiveness-implementation trial of a popular opinion leader intervention designed to address HIV prevention in the Chicago and Philadelphia HBCs. In June 2016 baseline behavioral data were collected along with HIV, gonorrhea and Chlamydia testing. Eligible participants were sexually-active YMSM or transgender women (TGW), between the ages of 15-24, who self-identified as Black. One-third participants (32.5%) met or exceeded the clinical cut-off for depressive symptoms. Approximately 18% of the participants across both cities reported that they were HIV-positive. Overall, the baseline data establishes the need for HIV and STI prevention interventions across both cities, as well as interventions to address other co-occurring epidemics.
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Affiliation(s)
- Sybil Hosek
- Department of Psychiatry, John Stroger Hospital of Cook County, Chicago, IL USA
| | - Marne Castillo
- Division of Adolescent Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Anna Hotton
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL USA
| | | | - Bevin Gwiazdowski
- Division of Adolescent Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Richard Laboy
- Division of Adolescent Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Kortez Davis
- Department of Psychiatry, John Stroger Hospital of Cook County, Chicago, IL USA
| | | | - Gary W. Harper
- School of Public Health, University of Michigan, Ann Arbor, MI USA
| | - Margo Bell
- Division of Adolescent Medicine, John Stroger Hospital of Cook County, Chicago, IL USA
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13
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Abstract
The HIV burden among gay, bisexual, and other men who have sex with men (GBM) may be related to variations in network characteristics of the individual's social and sexual network. This study investigates variations in network properties among 188 Black and 295 White GBM recruited in New Orleans during the National HIV Behavioral Surveillance in 2014. Participants described up to five people who provided social support and five sex partners in the past 3 months. Network properties and network dissimilarity indicators were aggregated to the participant level as means or proportions and examined using PROC GLM. White participants reported larger networks (p = 0.0027), had known network members longer (p = 0.0033), and reported more substance use (p < 0.0001) within networks. Black participants reported networks with fewer men (p = 0.0056) and younger members (p = 0.0110) than those of White GBM. Network properties among GBM differ by race in New Orleans which may inform prevention interventions.
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14
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Levitt HM. A Psychosocial Genealogy of LGBTQ+ Gender: An Empirically Based Theory of Gender and Gender Identity Cultures. PSYCHOLOGY OF WOMEN QUARTERLY 2019. [DOI: 10.1177/0361684319834641] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this invited article, I present an inclusive theory of gender that clarifies its interconnections with gender identity, gender expression, and sexuality. To support this functionalist theory, I summarize findings from an extensive body of mixed methods research on lesbian, gay, bisexual, transgender, queer, and other (LGBTQ+) genders in the United States. I use a feminist-intersectional lens to empirically base and historically situate a theory of gender that is grounded in research of LGBTQ+ communities (butch, femme, bear, leathermen, transgender, drag queens, and family/house systems). I define genders as either sets of personal qualities within a culture associated with physiological sex or sets of qualities that evolve in reaction to limitations of existing genders. The evolution of genders functions to meet needs in four domains: (1) psychological: an experience of fit between a core aspect of self and a gender construct; (2) cultural: the creation of an LGBTQ+ culture that asserts sets of gender characteristics, which were denied and stigmatized within preexisting cultural norms; (3) interpersonal: the communicating of affiliation and status to enhance safety; and (4) sexual: an erotic embodiment of signifiers of these needs via an aesthetic that structures sexual attraction. I detail how each function affects identity, security, belonging, and personal and social values. Online slides for instructors who want to use this article for teaching are available on PWQ's website at http://journals.sagepub.com/page/pwq/suppl/index
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Affiliation(s)
- Heidi M. Levitt
- Department of Psychology, University of Massachusetts Boston, Boston, MA, USA
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15
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Abstract
: Transgender women have recently been acknowledged as a unique and important risk group in HIV research and care. Although transgender men also face specific problems related to HIV infection, less is known about the risk behaviours and HIV prevalence of this important population. This article highlights key issues relating to the epidemiology, prevention, treatment and management of complications of HIV infection in transgender adults living with HIV, and explores future areas for HIV-related research, with the ultimate goal of improving healthcare provision and quality of life for transgender persons worldwide.
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Affiliation(s)
- Jordan E Lake
- University of Texas Health Science Center at Houston, Houston, Texas
| | - Jesse L Clark
- David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, USA
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16
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Zarwell M, Robinson WT. Development of a social capital scale for constructed families of gay, bisexual, and other men who have sex with men. PLoS One 2018; 13:e0208781. [PMID: 30543653 PMCID: PMC6292593 DOI: 10.1371/journal.pone.0208781] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 11/26/2018] [Indexed: 11/18/2022] Open
Abstract
Despite previous empirical studies which have linked social capital to a number of health outcomes, few studies have investigated sub-group specific social capital among populations at increased risk for HIV infection such as gay, bisexual and other men who have sex with men (GBM). Many GBM of color belong to constructed families in which friends refer to each other with kinship terms such as parents and children. No studies have measured social capital provisions within constructed family networks. This study developed a preliminary instrument for assessing social capital among constructed families. The network level social capital scale incorporated the following theoretical domains hypothesized to define social capital derived from network membership: social influence, multiplex ties, heterogeneity, social cohesion, trust, quality of support, and compositional quality. A cross-sectional survey administered an eight-item scale to 131 GBM who belonged to constructed families. The factor structure and confirmatory factor analysis were assessed. Reliability was evaluated using Cronbach's alpha to measure internal consistency. A final single factor solution was obtained which was comprised of six items with high factor loadings. The resulting measures were highly correlated with an alpha of 0.84 and each factor loading was well above 0.3. This study assessed the psychometric properties of a preliminary network level social capital instrument among GBM in constructed families. Future studies may utilize or adopt this scale to measure network-level social capital within other populations.
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Affiliation(s)
- Meagan Zarwell
- LSU Health Sciences Center, School of Public Health, Behavioral and Community Health Sciences, New Orleans, Louisiana, United States of America
- NO/AIDS Task Force, d.b.a CrescentCare, New Orleans, Louisiana, United States of America
- Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - William T. Robinson
- NO/AIDS Task Force, d.b.a CrescentCare, New Orleans, Louisiana, United States of America
- Louisiana Office of Public Health, STD/HIV Program, New Orleans, Louisiana, United States of America
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