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Weinstein ER, Broos HC, Lozano A, Jones MA, Serrano LP, Harkness A. Longitudinal predictors of post-exposure prophylaxis awareness among latino sexual minority men in South Florida. J Behav Med 2024; 47:434-445. [PMID: 38409554 PMCID: PMC11209855 DOI: 10.1007/s10865-024-00466-6] [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] [Received: 07/16/2023] [Accepted: 01/08/2024] [Indexed: 02/28/2024]
Abstract
Biomedical tools for HIV prevention such as post-exposure prophylaxis (PEP) continue to be underutilized by subgroups experiencing significant HIV inequities. Specifically, factors associated with both PEP awareness and uptake both cross-sectionally and longitudinally are under-researched, despite PEP being a part of the United States' Plan for Ending the HIV Epidemic. The current study examined longitudinal predictors of PEP awareness among Latino sexual minority men (LSMM) living in South Florida. This current study (N = 290) employed hierarchal linear modeling across three timepoints (baseline, 4-months, 8-months) to assess within-person and between-person effects over time for several psychosocial and structural factors. Most participants (67.5%) reported little to no awareness of PEP at baseline with general PEP awareness growing slightly across the study (60.5% reporting little to no awareness of PEP at 8 months). Results of the final conditional model suggest significant within-person effects of PrEP knowledge (p = 0.02) and PrEP self-efficacy (p < 0.001), as well as a significant positive between-person effect of PrEP knowledge (p < 0.01) on PEP awareness. Between-person HIV knowledge was also a significant predictor in this model (p = 0.01). This longitudinal analysis of LSMM's PEP awareness indicates that more must be done to increase PEP awareness among this subgroup. Future studies should explore how to build on existing interventions focused on HIV and PrEP knowledge and PrEP self-efficacy to incorporate information about PEP to increase the reach of this effective biomedical HIV prevention tool.
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Affiliation(s)
| | - Hannah C Broos
- Department of Psychology, University of Miami, Coral Gables, USA
| | - Alyssa Lozano
- School of Nursing and Health Studies, University of Miami, Coral Gables, USA
| | - Megan A Jones
- Department of Psychology, University of Miami, Coral Gables, USA
| | | | - Audrey Harkness
- Department of Psychology, University of Miami, Coral Gables, USA.
- School of Nursing and Health Studies, University of Miami, Coral Gables, USA.
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2
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Robles G, Lee JJ, Yu M, Starks TJ. Multilevel Analysis of Sociopolitical Contexts, Social Support, Mental Health, and Alcohol Use Among Partnered Sexual Minority Latino Men in the U.S. J Racial Ethn Health Disparities 2024; 11:1618-1627. [PMID: 37222939 DOI: 10.1007/s40615-023-01637-y] [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] [Received: 07/08/2022] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVE The objective of this paper is to examine how state-level characteristics relate to social support and mental health outcomes among Latino sexual minority men in the U.S. METHODS Multilevel linear regression analyses were used to estimate the effect of social support and contextual-level characteristics on mental health and alcohol use among Latino sexual minority men (n = 612). Individual-level data were collected via a national, online survey between November 2018 and May 2019. State-level data were drawn from the 2019 American Community Survey and the Human Rights Campaign's 2018 State Equality Index score cards. RESULTS The interaction between friend support and supportive LGBTQ+ policies was associated with anxiety (B = 1.77; 95% CI 0.69, 2.85; p = 0.001) and depression (B = 2.25; 95% CI 0.99, 3.50; p<0.001). The interaction between friend support and Latino population size was associated with greater problematic alcohol use (B = 0.06; 95% CI 0.03, 0.10; p<0.001). The interaction between partner support and supportive LGBTQ+ policies were also associated problematic drinking (B = -1.72; 95% CI -3.05, -0.38; p<0.012). CONCLUSIONS Contextual factors can affect the everyday experiences of Latino sexual minority men. The effect of social support on mental health outcomes may depend on state-level factors. Public health efforts that seek to address the mental health and problematic drinking behaviors of Latino sexual minority men must consider the impact of macro-level policies on program and intervention development.
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Affiliation(s)
- Gabriel Robles
- School of Social Work, Rutgers University, New Brunswick, NJ, USA.
| | - Jane J Lee
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Melanie Yu
- School of Social Work, Rutgers University, New Brunswick, NJ, USA
| | - Tyrel J Starks
- Department of Psychology, Hunter College of the City University of New York, New York, NY, USA
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3
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Cross FL, Marchand AD, Diaz M, Waller A, Ledón C, Kruger DJ. The Role of Documentation Status Concerns, Perceived Discrimination, and Social Support on Latinx Adults' Physical and Mental Health. J Racial Ethn Health Disparities 2024; 11:946-957. [PMID: 37010800 PMCID: PMC10069344 DOI: 10.1007/s40615-023-01575-9] [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] [Received: 10/24/2022] [Revised: 03/14/2023] [Accepted: 03/19/2023] [Indexed: 04/04/2023]
Abstract
There is a growing number of immigrants arriving in the USA, with the majority being of Latinx descent. Coupled with this increase, there has also been growing anti-immigration legislation which impacts the experiences this group faces and creates additional concerns for those who are residing in this country without documentation. Experiences of overt and covert discrimination and marginalization have been shown to relate to poorer mental and physical health outcomes. Drawing from Menjivar and Abrego's Legal Violence Framework, this paper explores the impact of perceived discrimination and social support on the mental and physical health of Latinx adults. We further observe whether these relationships differ based on participants' concerns about their documentation status. This data comes from a community-based participatory study conducted in a Midwestern County. Our analytic sample was comprised of 487 Latinx adults. We found social support to be related to fewer self-reported days of mental health symptoms for all participants regardless of documentation status concern. Perceived discrimination was found to be related to worse physical health for participants with concerns about their status. These findings point to the pernicious role of discrimination for Latinx's physical health and the importance of social support as an asset beneficial for their mental health.
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Affiliation(s)
- Fernanda Lima Cross
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI, 48109-1106, USA.
| | - Aixa D Marchand
- University of Illinois at Urbana-Champaign, 1310 S. Sixth Street, Champaign, IL, 61820, USA
| | - Melissa Diaz
- Rhodes College, 2000 North Pkwy, Memphis, TN, 38112, USA
| | | | | | - Daniel J Kruger
- Population Studies Center, Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI, 48109-1248, USA
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Dillon FR, Ertl MM, Eklund AC, Westbrook J, Balek G, Algarin A, Martin J, Sánchez FJ, Ebersole R. Sexual Identity Development and Social Ecological Facilitators and Barriers of PrEP Uptake and Adherence Among Latinx Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1197-1211. [PMID: 38212437 DOI: 10.1007/s10508-023-02776-3] [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] [Received: 06/02/2023] [Revised: 10/20/2023] [Accepted: 11/30/2023] [Indexed: 01/13/2024]
Abstract
Latinx gay, bisexual, and other men who have sex with men (LMSM) report lower pre-exposure prophylaxis (PrEP) use than their white, non-Latinx counterparts. We hypothesize that this disparity is partially attributable to social ecological factors that can be addressed via prevention interventions. In this retrospective study, we first examined data from 253 LMSM to determine whether theorized associations existed between acquisition of a PrEP prescription (uptake) in relation to several social ecological factors based on a conceptual framework of determinants of access to and uptake of PrEP for LMSM. We also explored relations between frequency of PrEP use (adherence) and social ecological factors with a subsample of 33 LMSM who had initiated PrEP 12 months prior to assessment. In this study, individual-level factors from this framework included age and socioeconomic status. Perceived access to medical care represented both individual- and community-level determinants of PrEP uptake and adherence. Interpersonal-level factors were social support and relationship status. Structural/cultural-level factors were sexual identity development status, the masculinity norm of heterosexual self-presentation, traditional Latinx masculine gender role beliefs of machismo and caballerismo, racial identity, and immigration status. Results indicated that older men and those who endorsed the synthesis/integration status of sexual identity development were more likely to acquire a PrEP prescription during their lifetime in comparison to peers. PrEP adherence was linked with being older, reporting higher socioeconomic status, reporting more appraisal social support, self-identifying as white-Latinx, being U.S.-born, and endorsing less sexual identity uncertainty and more heterosexual self-presentation. Results specify modifiable factors that may inform tailored, community-based prevention efforts to increase PrEP use and decrease existing HIV/AIDS disparities among LMSM.
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Affiliation(s)
- Frank R Dillon
- School of Counseling and Counseling Psychology, Arizona State University, 446 Payne Hall, MC-0811, Tempe, AZ, 85287-0811, USA.
| | - Melissa M Ertl
- HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Austin C Eklund
- Department of Educational & Counseling Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - Jaelen Westbrook
- School of Counseling and Counseling Psychology, Arizona State University, 446 Payne Hall, MC-0811, Tempe, AZ, 85287-0811, USA
| | - Gabrielle Balek
- Department of Counseling and Educational Psychology, New Mexico State University, Las Cruces, NM, USA
| | - Angel Algarin
- School of Counseling and Counseling Psychology, Arizona State University, 446 Payne Hall, MC-0811, Tempe, AZ, 85287-0811, USA
| | - Jessica Martin
- Department of Educational & Counseling Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - Francisco J Sánchez
- School of Counseling and Counseling Psychology, Arizona State University, 446 Payne Hall, MC-0811, Tempe, AZ, 85287-0811, USA
| | - Ryan Ebersole
- Department of Educational & Counseling Psychology, University at Albany, State University of New York, Albany, NY, USA
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Twersky SE, Jefferson R, Garcia-Ortiz L, Williams E, Pina C. The Impact of Limited English Proficiency on Healthcare Access and Outcomes in the U.S.: A Scoping Review. Healthcare (Basel) 2024; 12:364. [PMID: 38338249 PMCID: PMC10855368 DOI: 10.3390/healthcare12030364] [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: 12/29/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
A majority of individuals with limited English proficiency (LEP) in the U.S. are foreign-born, creating a complex intersection of language, socio-economic, and policy barriers to healthcare access and achieving good outcomes. Mapping the research literature is key to addressing how LEP intersects with healthcare. This scoping review followed PRISMA-ScR guidelines and included PubMed/MEDLINE, CINAHL, Sociological Abstracts, EconLit, and Academic Search Premier. Study selection included quantitative studies since 2000 with outcomes specified for adults with LEP residing in the U.S. related to healthcare service access or defined health outcomes, including healthcare costs. A total of 137 articles met the inclusion criteria. Major outcomes included ambulatory care, hospitalization, screening, specific conditions, and general health. Overall, the literature identified differential access to and utilization of healthcare across multiple modalities with poorer outcomes among LEP populations compared with English-proficient populations. Current research includes inconsistent definitions for LEP populations, primarily cross-sectional studies, small sample sizes, and homogeneous language and regional samples. Current regulations and practices are insufficient to address the barriers that LEP individuals face to healthcare access and outcomes. Changes to EMRs and other data collection to consistently include LEP status and more methodologically rigorous studies are needed to address healthcare disparities for LEP individuals.
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Affiliation(s)
- Sylvia E. Twersky
- Department of Public Health, The College of New Jersey, Ewing Township, NJ 08618, USA; (L.G.-O.)
| | - Rebeca Jefferson
- R. Barbara Gitenstein Library, The College of New Jersey, Ewing Township, NJ 08618, USA;
| | - Lisbet Garcia-Ortiz
- Department of Public Health, The College of New Jersey, Ewing Township, NJ 08618, USA; (L.G.-O.)
| | - Erin Williams
- Department of Public Health, The College of New Jersey, Ewing Township, NJ 08618, USA; (L.G.-O.)
| | - Carol Pina
- Department of Public Health, The College of New Jersey, Ewing Township, NJ 08618, USA; (L.G.-O.)
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Agénor M, Lett E, Ramanayake N, Zubizarreta D, Murchison GR, Eiduson R, Gordon AR. Racial/Ethnic Differences in Sexually Transmitted Infection Testing Among Transgender Men and Nonbinary Assigned Female at Birth Young Adults in the United States: a National Study. J Racial Ethn Health Disparities 2023; 10:2900-2910. [PMID: 36469284 DOI: 10.1007/s40615-022-01467-4] [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] [Received: 07/12/2022] [Revised: 11/20/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Sexually transmitted infections (STIs) cause a major burden of disease in the United States (US)-especially among structurally marginalized populations, including transgender and nonbinary people, individuals assigned female at birth (AFAB), Black and Latinx/e individuals, and young adults. Although screening can help detect and prevent STIs, research on STI testing among populations at diverse intersections of multiple forms of structural marginalization, including Black, Latinx/e, and other racially/ethnically minoritized transgender men and nonbinary AFAB US young adults, is extremely scarce. METHODS We conducted a national cross-sectional online survey of transgender and nonbinary US young adults from February to July 2019. Using Poisson regression, we estimated prevalence ratios (PR) and 95% confidence intervals (CI) for the associations between race/ethnicity-which we conceptualized as a system of structural inequality that shapes individuals' and groups' exposure to racism-and lifetime and past-year STI testing among transgender men and nonbinary AFAB US young adults aged 18-30 years with at least one-lifetime sexual partner (N = 378). RESULTS Approximately 74% of participants had received an STI test in their lifetime, and, among those, 72% with a past-year sexual partner had been tested for an STI in the last 12 months. We observed no statistically significant association between race/ethnicity and lifetime STI testing among transgender and nonbinary AFAB young adults with a lifetime sexual partner. In contrast, Black (PR = 1.32; 95%: 1.03, 1.68) and Latinx/e (PR = 1.39; 95% CI: 1.11, 1.75) transgender men and nonbinary AFAB young adults who ever received an STI test and had a past-year sexual partner were significantly more likely to have received an STI test in the last 12 months relative to their White counterparts, adjusting for demographic factors. Further adjustment for lifetime STI diagnosis and health insurance status did not appreciably attenuate these observed adjusted differences; however, the adjusted difference in the prevalence of past-year STI testing between Black (but not Latinx/e) and White transgender men and nonbinary AFAB young adults was no longer statistically significant upon further adjustment for educational attainment and employment status, possibly due to small sample sizes. CONCLUSION The higher adjusted prevalence of past-year STI testing among Black and Latinx/e compared to White transgender men and nonbinary AFAB US young adults may reflect racist and xenophobic sexual stereotypes about Black and Latinx/e people among health care providers and institutions, the history of hyper-surveillance of Black and Latinx/e people by public health institutions in the context of infectious disease containment, and/or agency and resistance among Black and Latinx/e transgender men and nonbinary AFAB young adults with regard to sexual health promotion in the face of multiple compounding systems of oppression.
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Affiliation(s)
- Madina Agénor
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Box G-S121-8, Providence, RI, 02912, USA.
- Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI, USA.
- The Fenway Institute, Fenway Health, Boston, MA, USA.
| | - Elle Lett
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Applied Transgender Studies, Chicago, IL, USA
- Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA
| | | | - Dougie Zubizarreta
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Gabriel R Murchison
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Rose Eiduson
- Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Allegra R Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
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Hassan R, Saldana CS, Garlow EW, Gutierrez M, Hershow RB, Elimam D, Adame JF, Andía JF, Padilla M, Gonzalez Jimenez N, Freeman D, Johnson EN, Reed K, Holland DP, Orozco H, Pedraza G, Hayes C, Philpott DC, Curran KG, Wortley P, Agnew-Brune C, Gettings JR. Barriers and Facilitators to HIV Service Access among Hispanic/Latino Gay, Bisexual, and Other Men Who Have Sex with Men in Metropolitan Atlanta-a Qualitative Analysis. J Urban Health 2023; 100:1193-1201. [PMID: 38012505 PMCID: PMC10728373 DOI: 10.1007/s11524-023-00809-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 11/29/2023]
Abstract
Hispanic/Latino persons are disproportionately impacted by HIV in the US, and HIV diagnoses among Hispanic/Latino men in Georgia have increased over the past decade, particularly in metropolitan Atlanta. In 2022, the Georgia Department of Public Health detected five clusters of rapid HIV transmission centered among Hispanic/Latino gay, bisexual, and other men who have sex with men (HLMSM) in metropolitan Atlanta. We conducted in-depth interviews with 65 service providers and 29 HLMSM to identify barriers and facilitators to HIV service access for HLMSM. Interviews were audio recorded, transcribed, and translated, if needed. Initial data analyses were conducted rapidly in the field to inform public health actions. We then conducted additional analyses including line-by-line coding of the interview transcripts using a thematic analytic approach. We identified four main themes. First, inequity in language access was a predominant barrier. Second, multiple social and structural barriers existed. Third, HLMSM encountered intersectional stigma. Finally, the HLMSM community is characterized by its diversity, and there is not a one-size-fits-all approach to providing appropriate care to this population. The collection of qualitative data during an HIV cluster investigation allowed us to quickly identity barriers experienced by HLMSM when accessing HIV and other medical care, to optimize public health response and action. Well-designed program evaluation and implementation research may help elucidate specific strategies and tools to reduce health disparities, ensure equitable service access for HLMSM, and reduce HIV transmission in this population.
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Affiliation(s)
- Rashida Hassan
- Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd, Atlanta, GA, 30329, USA.
| | - Carlos S Saldana
- Fulton County Board of Health, Atlanta, GA, USA
- Emory University School of Medicine, Atlanta, GA, USA
| | | | - Mariana Gutierrez
- Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd, Atlanta, GA, 30329, USA
| | - Rebecca B Hershow
- Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd, Atlanta, GA, 30329, USA
- Epidemic Intelligence Service, CDC, Atlanta, GA, USA
| | - Dena Elimam
- Georgia Department of Public Health, Atlanta, GA, USA
| | - Jose F Adame
- Georgia Department of Public Health, Atlanta, GA, USA
| | - Jonny F Andía
- Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd, Atlanta, GA, 30329, USA
| | - Mabel Padilla
- Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd, Atlanta, GA, 30329, USA
| | | | - Dorian Freeman
- Gwinnett, Newton, and Rockdale County Health Department, Lawrenceville, GA, USA
| | | | - Karrie Reed
- Cobb and Douglas Public Health, Marietta, GA, USA
| | - David P Holland
- Fulton County Board of Health, Atlanta, GA, USA
- Emory University School of Medicine, Atlanta, GA, USA
| | | | | | - Craig Hayes
- Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd, Atlanta, GA, 30329, USA
| | - David C Philpott
- Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd, Atlanta, GA, 30329, USA
- Epidemic Intelligence Service, CDC, Atlanta, GA, USA
| | - Kathryn G Curran
- Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd, Atlanta, GA, 30329, USA
| | | | - Christine Agnew-Brune
- Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd, Atlanta, GA, 30329, USA
| | - Jenna R Gettings
- Georgia Department of Public Health, Atlanta, GA, USA
- Epidemic Intelligence Service, CDC, Atlanta, GA, USA
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Lee YG, Alessi EJ, Lynn M, Starks TJ, Robles G. Everyday Discrimination and HIV Testing Among Partnered Latino/x Sexual Minority Men in the United States: A Stratified Analysis by Birth Location. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2023; 35:376-389. [PMID: 37843904 DOI: 10.1521/aeap.2023.35.5.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
We examined the association between everyday discrimination and HIV testing patterns-current (≤ 6 months), recent (7-12 months), and delayed (> 12 months or never tested)-among partnered Latino/x sexual minority men (SMM). Multinomial regression analyses revealed that in the full sample (N = 484) experiencing discrimination based on sexual orientation and race/ethnicity attributions concurrently (vs. no discrimination) was associated with higher odds of delayed (vs. current) HIV testing (AOR = 2.6, 95% CI [1.0, 6.7]). Similarly, in the subset of Latino/x SMM born outside the mainland U.S. (n = 209), experiencing concurrent sexual orientation- and race/ethnicity-based discrimination (vs. no discrimination) was associated with higher odds of recent (AOR = 12.4, 95% CI [1.3, 115.7]) and delayed HIV testing (AOR = 7.3, 95% CI [1.6, 33.0]), compared with current testing. Findings suggest that addressing discrimination may improve HIV testing uptake among partnered Latino/x SMM, particularly those born outside the U.S.
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Affiliation(s)
- Yong Gun Lee
- School of Social Work, Rutgers University, New Brunswick, New Jersey
| | - Edward J Alessi
- School of Social Work, Rutgers University, New Brunswick, New Jersey
| | - Matthew Lynn
- School of Social Work, Rutgers University, New Brunswick, New Jersey
| | - Tyrel J Starks
- Department of Psychology, Hunter College of the City University of New York, New York, New York
| | - Gabriel Robles
- School of Social Work, Rutgers University, New Brunswick, New Jersey
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Chen L, Jiang T, Wang H, Hong H, Ge R, Tang H, Wang S, Xu K, Chai C, Ma Q, Jiang J. Development and validation of a risk score for predicting inconsistent condom use with women among men who have sex with men and women. BMC Public Health 2023; 23:734. [PMID: 37085861 PMCID: PMC10120174 DOI: 10.1186/s12889-023-15672-1] [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: 09/01/2022] [Accepted: 04/13/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Men who have sex with men and women (MSMW) are the most important bridge population for HIV transmission. Condom use plays an important role for HIV infection. However the predictors for condom ues with females are not well characterized. METHODS This was a cross-sectional study. Participants were enrolled by four community-based organizations (CBOs) by offline (bathrooms, bars), and online (gay applications, chat room) from April to December 2019. Electronic questionnare was fulfilled after a face-to-face training led by CBOs. We identified predictors of inconsistent condom use with females by creating a risk score based on regression coefficients. We externally validated this score via an independent cross-sectional survey conducted in Zhejiang Province in 2021. A total of 917, 615 MSMW were included in analysis in 2019 and 2021, seperately. RESULTS Among 917 MSMW, 73.2% reported heterosexual behavior in the prior 6 months and 38.3% reported inconsistent condom use with females (ICUF) over that time. Compared with heterosexual/unsure MSMW, bisexual MSMW reported more male and female sex partners, higher proportion of inconsistent condom use with males, less commercial sex with males (p < 0.05). Four risky predictors of ICUF were identified: Duration of local residence ≦6 months; more than one male partner in the prior 6 months; inconsistent condom use with males in the prior 6 months; and never heard post-exposure prophylaxis (PEP). The proportions of respondents indicating ICUF in the low- (0), medium- (2-4) and high-risk (6-20) groups (according to our risk scoring system) were 11.7% (14/120), 26.9% (96/357), and 78.1% (125/160), respectively (Ptrend < 0.001). In the validation survey, the respective proportions of those reporting ICUF were 13.4% (15/112), 17.8% (24/185) and 87.3% (96/110) (Ptrend < 0.001). CONCLUSIONS We developed and validated a predictive risk score for ICUF among MSMW; four factors were identified, of which inconsistent condom use with men was the most important. Risk reduction intervention programs should focus on MSM who report inconsistent condom use with males, never heard PEP, having multiple partners and living in local less than 6 months.
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Affiliation(s)
- Lin Chen
- Department of HIV/AIDS and STDs Control and Prevention; Department of Zhejiang Key Lab of Vaccine, Prevention and Control of Infectious Disease, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, People's Republic of China
| | - Tingting Jiang
- Department of HIV/AIDS and STDs Control and Prevention; Department of Zhejiang Key Lab of Vaccine, Prevention and Control of Infectious Disease, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, People's Republic of China
| | - Hui Wang
- Department of HIV/AIDS and STDs Control and Prevention; Department of Zhejiang Key Lab of Vaccine, Prevention and Control of Infectious Disease, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, People's Republic of China
| | - Hang Hong
- Department of HIV/AIDS and STDs Control and Prevention, Ningbo Center for Disease Control and Prevention, Ningbo, People's Republic of China
| | - Rui Ge
- Department of HIV/AIDS and STDs Control and Prevention, Jiaxing Center for Disease Control and Prevention, Zhejiang Province, Jiaxing, People's Republic of China
| | - Huiling Tang
- Department of HIV/AIDS and STDs Control and Prevention, Jinhua Center for Disease Control and Prevention,, Jinhua, People's Republic of China
| | - Shanling Wang
- Department of HIV/AIDS and STDs Control and Prevention, Taizhou Center for Disease Control and Prevention, Taizhou, People's Republic of China
| | - Ke Xu
- Department of HIV/AIDS and STDs Control and Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, People's Republic of China
| | - Chengliang Chai
- Department of HIV/AIDS and STDs Control and Prevention; Department of Zhejiang Key Lab of Vaccine, Prevention and Control of Infectious Disease, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, People's Republic of China
| | - Qiaoqin Ma
- Department of HIV/AIDS and STDs Control and Prevention; Department of Zhejiang Key Lab of Vaccine, Prevention and Control of Infectious Disease, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, People's Republic of China
| | - Jianmin Jiang
- Department of HIV/AIDS and STDs Control and Prevention; Department of Zhejiang Key Lab of Vaccine, Prevention and Control of Infectious Disease, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, People's Republic of China.
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Lardier DT, Opara I, Asabor EN, Bell F, Garcia-Reid P, Reid RJ. HIV knowledge and protective factors among racial-ethnic minority youth: Moderation by Ethnic identity and LGBQ+ identity. JOURNAL OF LGBT YOUTH 2023; 21:526-548. [PMID: 39131490 PMCID: PMC11313272 DOI: 10.1080/19361653.2023.2200425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/01/2023] [Indexed: 08/13/2024]
Abstract
Due to systemic racism and homophobia, Lesbian, Gay, Bisexual, and Queer (LGBQ+) youth of color are disproportionately affected by HIV (human immunodeficiency virus) / AIDS (acquired immunodeficiency syndrome) and viral hepatitis (VH). Innovative approaches that acknowledge strengths such as ethnic identity need to be examined to understand specific protective factors that can support LGBQ+ youth of color. This study aimed to examine the moderating effects of ethnic identity and LGBQ+ identity on indicators of HIV knowledge (i.e., VH knowledge, sexual negotiation skills, and perception of sexual risk). Youth who identified as Hispanic/Latinx, African American/Black, and mixed racial-identity (N = 564) were included in the delimited sample. Using linear regression modeling, results showed that there was a positive association between sexual negotiation skill, sexual risk perception, ethnic identity and HIV knowledge. Ethnic identity displayed a positive and significant moderating effect between predictors and HIV knowledge. Three-way interactions between predictors by ethnic identity x LGBQ+ interaction showed equally interesting associations with HIV knowledge. Study implications include the need for strengthening ethnic identity and pride among LGBQ+ youth of color within HIV prevention programming.
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Affiliation(s)
- David T Lardier
- The University of New Mexico School of Medicine, Department of Psychiatry and Behavioral Sciences, Division of Community Behavioral Health, The University of New Mexico Health Sciences Center
| | | | | | - Felicity Bell
- The University of New Mexico, Department of Psychology
| | - Pauline Garcia-Reid
- Montclair State University, College of Education and Human Services, Department of Family Science and Human Development
| | - Robert J Reid
- Montclair State University, College of Education and Human Services, Department of Family Science and Human Development
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11
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Bouey JZH, Han J, Liu Y, Vuckovic M, Zhu K, Zhou K, Su Y. A case study of HIV/AIDS services from community-based organizations during COVID-19 lockdown in China. BMC Health Serv Res 2023; 23:288. [PMID: 36973805 PMCID: PMC10042409 DOI: 10.1186/s12913-023-09271-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 03/10/2023] [Indexed: 03/29/2023] Open
Abstract
INTRODUCTION People living with HIV (PLHIV) relied on community-based organizations (CBOs) in accessing HIV care and support during the COVID-19 pandemic in China. However, little is known about the impact of, and challenges faced by Chinese CBOs supporting PLHIV during lockdowns. METHODS A survey and interview study was conducted among 29 CBOs serving PLHIV in China between November 10 and November 23, 2020. Participants were asked to complete a 20-minute online survey on their routine operations, organizational capacity building, service provided, and challenges during the pandemic. A focus group interview was conducted with CBOs after the survey to gather CBOs' policy recommendations. Survey data analysis was conducted using STATA 17.0 while qualitative data was examined using thematic analysis. RESULTS HIV-focused CBOs in China serve diverse clients including PLHIV, HIV high-risk groups, and the public. The scope of services provided is broad, ranging from HIV testing to peer support. All CBOs surveyed maintained their services during the pandemic, many by switching to online or hybrid mode. Many CBOs reported adding new clients and services, such as mailing medications. The top challenges faced by CBOs included service reduction due to staff shortage, lack of PPE for staff, and lack of operational funding during COVID-19 lockdowns in 2020. CBOs considered the ability to better network with other CBOs and other sectors (e.g., clinics, governments), a standard emergency response guideline, and ready strategies to help PLHIV build resilience to be critical for future emergency preparation. CONCLUSION Chinese CBOs serving vulnerable populations affected by HIV/AIDS are instrumental in building resilience in their communities during the COVID-19 pandemic, and they can play significant roles in providing uninterrupted services during emergencies by mobilizing resources, creating new services and operation methods, and utilizing existing networks. Chinese CBOs' experiences, challenges, and their policy recommendations can inform policy makers on how to support future CBO capacity building to bridge service gaps during crises and reduce health inequalities in China and globally.
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Affiliation(s)
- Jennifer Z H Bouey
- Department of Global Health, School of Health, Georgetown University, 3700 Reservoir Road NW, Washington, DC, 20057, USA.
- RAND Corporation, Santa Monica, CA, USA.
| | - Jing Han
- Ditan Infectious Disease Hospital, Beijing, China
| | - Yuxuan Liu
- Department of Global Health, School of Health, Georgetown University, 3700 Reservoir Road NW, Washington, DC, 20057, USA
| | - Myriam Vuckovic
- Department of Global Health, School of Health, Georgetown University, 3700 Reservoir Road NW, Washington, DC, 20057, USA
| | - Keren Zhu
- RAND Corporation, Santa Monica, CA, USA
| | | | - Ye Su
- Home of Red Ribbon, Beijing, China
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12
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Crepaz N, Salabarría-Peña Y, Mullins MM, Gunn JK, Higa DH. Systematic Review of Social Determinants of Health Associated With HIV Testing Among Hispanic/Latino Gay, Bisexual, and Other Men Who Have Sex With Men in the United States. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2023; 35:36-S6. [PMID: 36735227 PMCID: PMC9915884 DOI: 10.1521/aeap.2023.35.1.36] [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: 06/18/2023]
Abstract
This systematic review synthesized published literature (January 2008-October 2021) about the association between social determinants of health (SDOH) and HIV testing among Hispanic/Latino gay, bisexual, and other men who have sex with men (HLMSM), a group disproportionally affected by HIV. Having higher education than a high school diploma, health insurance and access to health care services, and visiting a health care provider in the past 12 months were some of the determinants associated with HIV testing, while limited English proficiency was associated with reduced odds of HIV-testing among HLMSM. More research is needed to understand the relationship of SDOH (especially neighborhood) and HIV testing, how SDOH may affect HIV testing among different HLMSM groups, and how to increase self-testing and use of e-health in this priority population. Additionally, culturally and linguistically appropriate multilevel interventions and health services for HLMSM are urgently needed to diagnose HIV as early as possible after infection.
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Affiliation(s)
- Nicole Crepaz
- Division of HIV Prevention, the U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yamir Salabarría-Peña
- Division of HIV Prevention, the U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary M. Mullins
- Division of HIV Prevention, the U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jayleen K.L. Gunn
- Division of HIV Prevention, the U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
- United States Public Health Service, Washington, D.C
| | - Darrel H. Higa
- Division of HIV Prevention, the U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
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13
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Tobin KE, Heidari O, Winiker A, Pollock S, Rothwell MD, Alexander K, Owczarzak J, Latkin C. Peer Approaches to Improve HIV Care Cascade Outcomes: a Scoping Review Focused on Peer Behavioral Mechanisms. Curr HIV/AIDS Rep 2022; 19:251-264. [PMID: 35798989 DOI: 10.1007/s11904-022-00611-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE OF REVIEW There are three main components of peer-based approaches regardless of type: education, social support, and social norms. The purpose of this scoping review was to examine evidence in the literature among peer-based interventions and programs of components and behavioral mechanisms utilized to improve HIV care cascade outcomes. RECENT FINDINGS Of 522 articles found, 40 studies were included for data abstraction. The study outcomes represented the entire HIV care cascade from HIV testing to viral suppression. Most were patient navigator models and 8 of the studies included all three components. Social support was the most prevalent component. Role modeling of behaviors was less commonly described. This review highlighted the peer behavioral mechanisms that operate in various types of peer approaches to improve HIV care and outcomes in numerous settings and among diverse populations. The peer-based approach is flexible and commonly used, particularly in resource-poor settings.
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Affiliation(s)
- Karin E Tobin
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Omeid Heidari
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Abigail Winiker
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Sarah Pollock
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Melissa Davey Rothwell
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | - Jill Owczarzak
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Carl Latkin
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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14
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Coleman TA, Phillips NE, Rizkalla C, Tran B, Coulombe S, Davis C, Cameron R, Travers R, Wilson C, Woodford M. Exploring community enabling factors associated with recent HIV testing in a regional sample of gay, bisexual, and other men who have sex with men. AIDS Care 2022; 35:942-952. [PMID: 35637571 DOI: 10.1080/09540121.2022.2074959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
HIV testing and diagnosis are the gateway into treatment and eventual viral suppression. With gay, bisexual, and other men who have sex with men (GBMSM) persistently over-representing new HIV diagnoses in Canada, combined with the evolving nature of community social connection, an exploration of factors associated with recent HIV testing is warranted. As most studies of GBMSM rely on samples obtained from larger metropolitan regions, examining HIV testing from an under-researched region is necessary. With data collected from an online survey of LGBTQ+ persons 16 or older living, working, or residing in the Region of Waterloo, Ontario, Canada, we used multinomial logistic regression to explore socio-demographic, behavioural, and psychosocial factors associated with recent HIV testing for GBMSM. In the final multivariate multinomial logistic regression model: sense of belonging was associated with more recently testing, as was having an increasing proportion of LGBT friends, app use to find sex partners in the past 12 months, access to the local AIDS service organization, and general sense of belonging to local community, among other. This analysis highlights the continued importance of enabling and need factors when accessing testing, and suggests areas for further testing promotion in physical and virtual spaces frequented by GBMSM.
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Affiliation(s)
- Todd A. Coleman
- Department of Health Sciences, Wilfrid Laurier University, Ontario, Canada
| | | | - Celina Rizkalla
- Department of Health Sciences, Wilfrid Laurier University, Ontario, Canada
| | - Billy Tran
- Department of Health Sciences, Wilfrid Laurier University, Ontario, Canada
- Institute of Medical Science, University of Toronto, Ontario, Canada
| | - Simon Coulombe
- Department of Psychology, Wilfrid Laurier University, Ontario, Canada
| | - Charlie Davis
- Department of Psychology, Wilfrid Laurier University, Ontario, Canada
| | - Ruth Cameron
- Department of Psychology, Wilfrid Laurier University, Ontario, Canada
- AIDS Committee of Cambridge, Kitchener, Waterloo and Area, Ontario, Canada
| | - Robb Travers
- Department of Health Sciences, Wilfrid Laurier University, Ontario, Canada
| | - Ciann Wilson
- Department of Psychology, Wilfrid Laurier University, Ontario, Canada
| | - Michael Woodford
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Ontario, Canada
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15
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Jiao K, Wei R, Li H, Chow EPF, Piqueiras E, Lewis T, Xu Z, Ren C, Ma W. HIV testing frequency and associated factors among five key populations in ten cities of China: a cross-sectional study. BMC Infect Dis 2022; 22:195. [PMID: 35227217 PMCID: PMC8883696 DOI: 10.1186/s12879-022-07189-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 02/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Regular HIV testing is the best way to detect people living with HIV promptly, yet not much is known about the characteristics of frequent, voluntary testers. This study explores factors related to HIV testing frequency among five key populations in China including men who have sex with men (MSM), female sex workers (FSWs), people who use drugs (PWUD), men who have casual sex with women (MCSW) and sero-negative partners among sero-discordant couples (SNPs). METHODS We conducted a cross-sectional study in ten cities of China from November 2018 to September 2019 using convenience sampling to recruit participants. Univariate and multivariate partial proportional odds models were adopted to compare socio-behavioral factors associated with HIV testing frequencies among the five key populations. RESULTS Among the 2022 recruited participants, 36.6% reported not testing for HIV in the past year, whereas 37.0% tested once and 26.4% tested twice. Compared with MSM, FSWs (AOR = 1.97, 95% CI: 1.36-2.86) and SNPs (AOR = 3.63, 95% CI: 2.40-5.49) were more likely to test for HIV, but MCSW (AOR = 0.23, 95% CI: 0.17-0.32) were less likely. Additionally, SNPs (AOR = 4.02, 95% CI: 2.78-5.83) were more likely to be frequent HIV testers, while FSWs (AOR = 0.49, 95% CI: 0.32-0.76) and MCSW (AOR = 0.29, 95% CI: 0.20-0.41) were less likely to be frequent testers. Factors identified as barriers to HIV testing include the following: higher education level and > 5000 CNY monthly income for FSWs; elder age and a married/cohabitating status for PWUD; reported alcohol use for MCSW; and non-Han ethnicity and non-local household for SNPs. Facilitators to frequent testing included the following: higher education level for MSM and SNPs; higher AIDS knowledge score for MSM and PWUD; > 5000 CNY monthly income for FSWs and PWUD; and reporting high-risk sexual behaviors for MSM, FSW and PWUD. CONCLUSIONS HIV testing frequencies and associated factors were not equivalent across the five key populations in China. Public health officials should take heed of the identified high-risk populations reporting high testing rates, perhaps with intensive and tailored behavioral interventions or biochemical prophylaxis.
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Affiliation(s)
- Kedi Jiao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Ran Wei
- Shandong Provincial Chest Hospital, Jinan, Shandong, People's Republic of China
| | - Haochu Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Eric P F Chow
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Australia.,Central Clinical School, Monash University, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Eduardo Piqueiras
- Department of Anthropology, School of Social Work, Wayne State University, Detroit, MI, USA
| | - Taylor Lewis
- Research Triangle Institute (RTI) International, Washington, DC, USA
| | - Zece Xu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Ci Ren
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China.
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16
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Torregosa M, Patricio O. The Mediating Role of Sexual Self-Efficacy on Protected Sex. J Prim Care Community Health 2022; 13:21501319221129934. [PMID: 36345219 PMCID: PMC9647276 DOI: 10.1177/21501319221129934] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Ascribed traditional gender role has rarely been examined in the topical area of protected sex. OBJECTIVE The purpose of this study was to examine the relationship between HIV knowledge, ascribed cultural gender roles of machismo and marianismo, acculturation, attitudes toward risky sexual behaviors and sexual self-efficacy on protected sex, and the mediating effect of sexual self-efficacy between these predictors and protected sex. METHODS Part of a larger study, Hispanic college students from a Hispanic-serving institution in a U.S. southern border city were recruited. RESULTS AND CONCLUSION Sexual self-efficacy was found a significant mitigating factor against sexual risks associated with machismo as well as a positive reinforcing element on attitudes toward protected sex. Study findings have implications toward the development of culturally sensitive evidence-based interventions that promote sexual self-efficacy skills among Hispanic males who strongly identify with culturally ascribed gender roles.
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17
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Lyu H, Zhou Y, Dai W, Zhen S, Huang S, Zhou L, Huang L, Tang W. Solidarity and HIV Testing Willingness During the COVID-19 Epidemic: A Study Among Men Who Have Sex With Men in China. Front Public Health 2021; 9:752965. [PMID: 34957014 PMCID: PMC8695798 DOI: 10.3389/fpubh.2021.752965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/01/2021] [Indexed: 01/08/2023] Open
Abstract
Background: Solidarity, such as community connectedness and social cohesion, may be useful in improving HIV testing uptake among men who have sex with men (MSM). This study aimed to evaluate the impact of solidarity on HIV testing before the coronavirus disease 2019 (COVID-19) and HIV testing willingness during COVID-19 among MSM in China. Materials and Methods: An online survey was conducted to collect sociodemographic, sexual behavioral, and solidarity items' information from the participants. We first used factor analysis to reveal the principal component of the solidarity items and then used logistic regression to study the impact of solidarity on HIV testing, by adjusting the possible confounding factors, such as age and education. Results: Social cohesion and community connectedness were revealed by the factor analysis. MSM with high community connectedness were more willing to undergo HIV testing before the epidemic adjusted by age [odds ratio (OR): 1.07, 95% CI: 1.01-1.13]. The community connectedness was also related to the willingness of HIV testing during the epidemic, with adjustments of 1.09 (95% CI: 1.03-1.15). People who did not test for HIV before the COVID-19 epidemic were more willing to have the HIV test during the epidemic, which was correlated with the community connectedness, and the OR value was 1.14 (95%: 1.03-1.25). Conclusion: A high level of community connectedness helped to increase the HIV testing rate before COVID-19 and the willingness of HIV testing during the epidemic among MSM. Strategies can strengthen the role of the community in the management and service of MSM.
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Affiliation(s)
- Hang Lyu
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Yi Zhou
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Wencan Dai
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | | | - Shanzi Huang
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Lanlan Zhou
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Liqun Huang
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Weiming Tang
- Dermatology Hospital of Southern Medical University, Guangzhou, China.,University of North Carolina Project-China, Guangzhou, China
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18
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Kurtzman ET, Wyche KF. Prevalence and Correlates of HIV Testing among Sexual Minorities. Am J Health Behav 2021; 45:879-894. [PMID: 34702435 DOI: 10.5993/ajhb.45.5.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: We established baseline prevalence rates of HIV testing among adult, sexual minorities and identified the correlates of never being HIV tested. Methods: We used a 20-state sample of the 2017-2019 Behavioral Risk Factor Surveillance System to identify sexual minorities who responded to the HIV testing question (N=433,042). Using weighted multivariate logistic regression analysis, we identified the characteristics associated with never being HIV tested and the impact of state health departments' HIV testing messages on testing status. Results: Overall, 41.6% of sexual minorities reported never being HIV tested with statistically significant state-level variation. Being younger (18-24 years) or older (65+ years), not black, married, and in good health significantly increased the odds of never being HIV tested as did lacking regular healthcare access and reporting no high-risk HIV behaviors. States' HIV testing messages had no statistically significant effect on HIV testing status. Conclusions: Although sexual minorities were less likely than straight respondents to report never being HIV tested, a sizable population remained untested. Specific characteristics associated with sexual minorities' HIV testing status can be used to tailor public health messages and optimize testing rates.
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Affiliation(s)
- Ellen T. Kurtzman
- Ellen T. Kurtzman, Associate Professor, School of Nursing, The George Washington University, Washington, DC, United States;,
| | - Karen Fraser Wyche
- Karen Fraser Wyche, Clinical Professor, School of Nursing, The George Washington University, Washington, DC, United States
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19
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Grubb J, Lopez D, Mohan B, Matta J. Network centrality for the identification of biomarkers in respondent-driven sampling datasets. PLoS One 2021; 16:e0256601. [PMID: 34428228 PMCID: PMC8384166 DOI: 10.1371/journal.pone.0256601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 08/10/2021] [Indexed: 12/24/2022] Open
Abstract
Networks science techniques are frequently used to provide meaningful insights into the populations underlying medical and social data. This paper examines SATHCAP, a dataset related to HIV and drug use in three US cities. In particular, we use network measures such as betweenness centrality, closeness centrality, and eigenvector centrality to find central, important nodes in a network derived from SATHCAP data. We evaluate the attributes of these important nodes and create an exceptionality score based on the number of nodes that share a particular attribute. This score, along with the underlying network itself, is used to reveal insight into the attributes of groups that can be effectively targeted to slow the spread of disease. Our research confirms a known connection between homelessness and HIV, as well as drug abuse and HIV, and shows support for the theory that individuals without easy access to transportation are more likely to be central to the spread of HIV in urban, high risk populations.
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Affiliation(s)
- Jacob Grubb
- Computer Science Department, Southern Illinois University Edwardsville, Edwardsville, IL, United States of America
| | - Derek Lopez
- Computer Science Department, Southern Illinois University Edwardsville, Edwardsville, IL, United States of America
| | - Bhuvaneshwar Mohan
- Computer Science Department, Southern Illinois University Edwardsville, Edwardsville, IL, United States of America
| | - John Matta
- Computer Science Department, Southern Illinois University Edwardsville, Edwardsville, IL, United States of America
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20
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Paine EA, Lee YG, Vinogradov V, Zhakupova G, Hunt T, Primbetova S, Terlikbayeva A, El-Bassel N, Wu E. HIV Stigma, Homophobia, Sexual and Gender Minority Community Connectedness and HIV Testing Among Gay, Bisexual, and Other Men and Transgender People Who Have Sex with Men in Kazakhstan. AIDS Behav 2021; 25:2568-2577. [PMID: 33743115 DOI: 10.1007/s10461-021-03217-9] [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] [Accepted: 02/28/2021] [Indexed: 11/28/2022]
Abstract
Although HIV incidence is rising among gay, bisexual, and other men (MSM) and transgender people who have sex with men (TSM) in Kazakhstan, whether stigmatizing attitudes and connectedness are associated with HIV testing in this region is not known. We analyzed data from one-time interviews with 304 adult MSM and TSM conducted 2018-2019 in three cities in Kazakhstan. Logistic regression determined whether HIV stigma, internalized homophobia, sexual and gender minority (SGM) connectedness predicted HIV testing (within the lifetime, past year, and past 6 months) before and after adjustment for sociodemographic characteristics. 80% of participants reported ever receiving an HIV test. Gay-identified participants reported less HIV stigma and internalized homophobia as well as greater connectedness relative to those with bisexual or other identities. In adjusted models, those who had ever tested reported lower HIV stigma (aOR 0.83, 95% CI 0.76-0.91, P < .001) and higher connectedness (aOR 1.17, 95% CI 1.06-1.29, P = .003) than those who had not; those who had ever tested reported lower internalized homophobia in the unadjusted model only (OR 0.95, 95% CI 0.91-0.99, P = .01). Similar differences and trends were found in models examining testing in the past year and past 6 months. Addressing stigmatizing attitudes and connectedness may improve uptake of HIV testing among MSM and TSM in Kazakhstan.
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Affiliation(s)
- Emily Allen Paine
- HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, New York, NY, 10032, USA.
| | - Yong Gun Lee
- Social Intervention Group, Columbia University School of Social Work, New York, NY, 10027, USA
| | | | | | - Timothy Hunt
- Social Intervention Group, Columbia University School of Social Work, New York, NY, 10027, USA
- Global Health Research Center of Central Asia, Almaty, Kazakhstan
| | | | | | - Nabila El-Bassel
- Social Intervention Group, Columbia University School of Social Work, New York, NY, 10027, USA
- Global Health Research Center of Central Asia, Almaty, Kazakhstan
| | - Elwin Wu
- Social Intervention Group, Columbia University School of Social Work, New York, NY, 10027, USA
- Global Health Research Center of Central Asia, Almaty, Kazakhstan
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21
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Rhodes SD, Kuhns LM, Alexander J, Alonzo J, Bessler PA, Courtenay-Quirk C, Denson DJ, Evans K, Galindo CA, Garofalo R, Gelaude DJ, Hotton AL, Johnson AK, Mann-Jackson L, Muldoon A, Ortiz R, Paul JL, Perloff J, Pleasant K, Reboussin BA, Refugio Aviles L, Song EY, Tanner AE, Trent S. Evaluating Locally Developed Interventions to Promote PrEP Among Racially/Ethnically Diverse Transgender Women in the United States: A Unique CDC Initiative. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021. [PMID: 34370565 DOI: 10.1521/aeap.2021.33.4.345]] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
In the United States, transgender women are disproportionately affected by HIV. However, few evidence-based prevention interventions exist for this key population. We describe two promising, locally developed interventions that are currently being implemented and evaluated through the Centers for Disease Control and Prevention Combination HIV Prevention for Transgender Women Project: (a) ChiCAS, designed to promote the uptake of pre-exposure prophylaxis (PrEP), condom use, and medically supervised hormone therapy among Spanish-speaking transgender Latinas, and (b) TransLife Care, designed to address the structural drivers of HIV risk through access to housing, employment, legal services, and medical services, including HIV preventive care (e.g., PrEP use) among racially/ethnically diverse urban transgender women. If the evaluation trials determine that these interventions are effective, they will be among the first such interventions for use with transgender women incorporating PrEP, thereby contributing to the evidence-based resources that may be used to reduce HIV risk among this population.
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Affiliation(s)
- Scott D Rhodes
- Department of Social Sciences and Health Policy and CTSI Program in Community-Engaged Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Lisa M Kuhns
- Northwestern University, Department of Pediatrics, Feinberg School of Medicine, and the Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | | | - Jorge Alonzo
- Department of Social Sciences and Health Policy and CTSI Program in Community-Engaged Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | | | - Damian J Denson
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kaiji Evans
- Chicago House and Social Service Agency, Chicago, Illinois
| | - Carla A Galindo
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Robert Garofalo
- Northwestern University, Department of Pediatrics, Feinberg School of Medicine, and the Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | | | - Anna L Hotton
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Amy K Johnson
- Northwestern University, Department of Pediatrics, Feinberg School of Medicine, and the Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy and CTSI Program in Community-Engaged Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Abigail Muldoon
- Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | - Reyna Ortiz
- Chicago House and Social Service Agency, Chicago, Illinois
| | | | - Judy Perloff
- Chicago House and Social Service Agency, Chicago, Illinois
| | - Kevin Pleasant
- Chicago House and Social Service Agency, Chicago, Illinois
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | | | - Amanda E Tanner
- University of North Carolina Greensboro, Greensboro, North Carolina
| | - Scott Trent
- Triad Health Project, Greensboro, North Carolina
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22
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Rhodes SD, Kuhns LM, Alexander J, Alonzo J, Bessler PA, Courtenay-Quirk C, Denson DJ, Evans K, Galindo CA, Garofalo R, Gelaude DJ, Hotton AL, Johnson AK, Mann-Jackson L, Muldoon A, Ortiz R, Paul JL, Perloff J, Pleasant K, Reboussin BA, Refugio Aviles L, Song EY, Tanner AE, Trent S. Evaluating Locally Developed Interventions to Promote PrEP Among Racially/Ethnically Diverse Transgender Women in the United States: A Unique CDC Initiative. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021; 33:345-360. [PMID: 34370565 PMCID: PMC8565450 DOI: 10.1521/aeap.2021.33.4.345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In the United States, transgender women are disproportionately affected by HIV. However, few evidence-based prevention interventions exist for this key population. We describe two promising, locally developed interventions that are currently being implemented and evaluated through the Centers for Disease Control and Prevention Combination HIV Prevention for Transgender Women Project: (a) ChiCAS, designed to promote the uptake of pre-exposure prophylaxis (PrEP), condom use, and medically supervised hormone therapy among Spanish-speaking transgender Latinas, and (b) TransLife Care, designed to address the structural drivers of HIV risk through access to housing, employment, legal services, and medical services, including HIV preventive care (e.g., PrEP use) among racially/ethnically diverse urban transgender women. If the evaluation trials determine that these interventions are effective, they will be among the first such interventions for use with transgender women incorporating PrEP, thereby contributing to the evidence-based resources that may be used to reduce HIV risk among this population.
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Affiliation(s)
- Scott D Rhodes
- Department of Social Sciences and Health Policy and CTSI Program in Community-Engaged Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Lisa M Kuhns
- Northwestern University, Department of Pediatrics, Feinberg School of Medicine, and the Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | | | - Jorge Alonzo
- Department of Social Sciences and Health Policy and CTSI Program in Community-Engaged Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | | | - Damian J Denson
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kaiji Evans
- Chicago House and Social Service Agency, Chicago, Illinois
| | - Carla A Galindo
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Robert Garofalo
- Northwestern University, Department of Pediatrics, Feinberg School of Medicine, and the Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | | | - Anna L Hotton
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Amy K Johnson
- Northwestern University, Department of Pediatrics, Feinberg School of Medicine, and the Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy and CTSI Program in Community-Engaged Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Abigail Muldoon
- Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | - Reyna Ortiz
- Chicago House and Social Service Agency, Chicago, Illinois
| | | | - Judy Perloff
- Chicago House and Social Service Agency, Chicago, Illinois
| | - Kevin Pleasant
- Chicago House and Social Service Agency, Chicago, Illinois
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | | | - Amanda E Tanner
- University of North Carolina Greensboro, Greensboro, North Carolina
| | - Scott Trent
- Triad Health Project, Greensboro, North Carolina
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23
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Crepaz N, Mullins MM, Higa D, Gunn JK, Salabarría-Peña Y. A Rapid Review of Disparities in HIV Prevention and Care Outcomes Among Hispanic/Latino Men Who Have Sex With Men in the United States. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021; 33:276-289. [PMID: 34370568 PMCID: PMC9641187 DOI: 10.1521/aeap.2021.33.4.276] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In the United States, Hispanic/Latino men who have sex with men (HLMSM) are disproportionally affected by HIV. We conducted a rapid review of national surveillance data to examine disparities in HIV prevention and care outcomes among HLMSM. Thirteen reports provided relevant data from 2011 to 2018. Compared to White MSM, a higher percentage of HIV-negative HLMSM reported not taking PrEP and engaging in condomless sex; a lower percentage of HIV-negative HLMSM at risk for HIV reported PrEP awareness and use; and a lower percentage of HIV-positive HLMSM were aware of their status, linked to HIV care, and virally suppressed. Viral suppression rates in HLMSM were better among Ryan White clients than the national rates, suggesting that access to comprehensive care/services reduces disparities. Findings also call for identifying individual, social, and structural factors contributing to condomless sex without PrEP use and HIV status unawareness and identifying best approaches for scaling up comprehensive care/services.
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Affiliation(s)
- Nicole Crepaz
- Division of HIV/AIDS Prevention, the U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary M. Mullins
- Division of HIV/AIDS Prevention, the U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Darrel Higa
- Division of HIV/AIDS Prevention, the U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jayleen K.L. Gunn
- Division of HIV/AIDS Prevention, the U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
- United States Public Health Service
| | - Yamir Salabarría-Peña
- Division of HIV/AIDS Prevention, the U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
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24
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Öztürk S, Şimşek Ç, Ardıç E, Ağalar C. Turkish validity and reliability of the Internalized AIDS-Related Stigma Scale. Perspect Psychiatr Care 2021; 57:1292-1298. [PMID: 33295019 DOI: 10.1111/ppc.12688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/25/2020] [Accepted: 10/31/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study was conducted methodologically to adapt the Internalized AIDS-Related Stigma Scale (IA-RSS) to Turkish society. DESIGN AND METHODS: The universe of the study consisted of 250 people who were treated in the infectious diseases outpatient clinic. A total of 60 individuals living with human immunodeficiency virus (HIV) composed the sample. The Individual Information Form and IA-RSS were used for data collection. FINDINGS All the statistical procedures performed in the validity and reliability stages of the study show that the scale is a valid, reliable measurement tool for the Turkish culture. PRACTICE IMPLICATIONS: The Turkish version of the IA-RSS was determined as a valid and reliable screening tool that measures internal stigmatization in living with HIV.
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Affiliation(s)
- Servet Öztürk
- Infectious Diseases and Clinical Microbiology Clinic, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Bostancı, Turkey
| | - Çağlar Şimşek
- Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Taksim, Turkey
| | - Elif Ardıç
- Department of Nursing, Faculty of Health Sciences, Marmara University, İstanbul, Maltepe, Turkey
| | - Canan Ağalar
- Infectious Diseases and Clinical Microbiology Clinic, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Bostancı, Turkey
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25
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Assessing the Role of Gay Community Attachment, Stigma, and PrEP Stereotypes on Young Men Who Have Sex with Men's PrEP Uptake. AIDS Behav 2021; 25:1761-1776. [PMID: 33211207 DOI: 10.1007/s10461-020-03106-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2020] [Indexed: 10/22/2022]
Abstract
Negative stereotypes about pre-exposure prophylaxis (PrEP) hinder PrEP uptake among young men who have sex with men (YMSM). Prior research suggests community homophobia may be linked to negative PrEP attitudes. Conversely, individuals with high gay community attachments (GCA) may have more access to credible PrEP information/resources. Among 285 YMSM recruited online, we estimated structural equation models to test competing conceptual models that inform pathways from perceived stigmas, GCA, and negative PrEP stereotype endorsements to PrEP uptake. In Model A, perceived stigma was directly associated with PrEP uptake, partially mediated by stereotype endorsement (β = - 0.05; 95% CI [- 0.09, - 0.01]) and GCA (β = - 0.06; 95% CI [- 0.11, 0.02]). In Model B, perceived stigma was associated with PrEP uptake (β = - 0.07; 95% CI [- 0.14, - 0.01]) through stereotype endorsement among high GCA YMSM. Complemented by anti-stigma initiatives, PrEP outreach for YMSM should utilize sex-positive messaging and disentangle negative PrEP stereotypes within gay-centric social spaces.
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26
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Rhodes SD, Mann-Jackson L, Alonzo J, Garcia M, Tanner AE, Smart BD, Horridge DN, Van Dam CN, Wilkin AM. A Rapid Qualitative Assessment of the Impact of the COVID-19 Pandemic on a Racially/Ethnically Diverse Sample of Gay, Bisexual, and Other Men who Have Sex with Men Living with HIV in the US South. AIDS Behav 2021; 25:58-67. [PMID: 32830296 PMCID: PMC7443372 DOI: 10.1007/s10461-020-03014-w] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Persons living with HIV (PLWH) may be at increased risk for severe COVID-19-related illness. Our community-based participatory research partnership collected and analyzed semi-structured interview data to understand the early impact of the COVID-19 pandemic on a sample of racially/ethnically diverse gay, bisexual, and other men who have sex with men living with HIV. Fifteen cisgender men participated; their mean age was 28. Six participants were Black/African American, five were Spanish-speaking Latinx, and four were White. Seventeen themes emerged that were categorized into six domains: knowledge and perceptions of COVID-19; COVID-19 information sources and perceptions of trustworthiness; impact of COVID-19 on behaviors, health, and social determinants of health; and general COVID-19-related concerns. Interventions are needed to ensure that PLWH have updated information and adhere to medication regimens, and to reduce the impact of COVID-19 on social isolation, economic stability, healthcare access, and other social determinants of health within this vulnerable population.
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Affiliation(s)
- Scott D Rhodes
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.
- Wake Forest Clinical and Translational Science Institute, Program in Community-Engaged Research, Winston-Salem, NC, USA.
- Section on Infectious Diseases, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Wake Forest Clinical and Translational Science Institute, Program in Community-Engaged Research, Winston-Salem, NC, USA
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Wake Forest Clinical and Translational Science Institute, Program in Community-Engaged Research, Winston-Salem, NC, USA
| | - Manuel Garcia
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Wake Forest Clinical and Translational Science Institute, Program in Community-Engaged Research, Winston-Salem, NC, USA
| | - Amanda E Tanner
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Benjamin D Smart
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Wake Forest Clinical and Translational Science Institute, Program in Community-Engaged Research, Winston-Salem, NC, USA
| | - Danielle N Horridge
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Wake Forest Clinical and Translational Science Institute, Program in Community-Engaged Research, Winston-Salem, NC, USA
| | | | - Aimee M Wilkin
- Section on Infectious Diseases, Wake Forest School of Medicine, Winston-Salem, NC, USA
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27
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Ramírez-Ortiz D, Sheehan DM, Moore MP, Ibañez GE, Ibrahimou B, De La Rosa M, Cano MÁ. HIV Testing Among Latino Emerging Adults: Examining Associations with Familism Support, Nativity, and Gender. J Immigr Minor Health 2020; 22:1039-1048. [PMID: 32222904 PMCID: PMC7442717 DOI: 10.1007/s10903-020-01000-x] [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] [Indexed: 10/24/2022]
Abstract
Research examining factors associated with low uptake of HIV testing among Latino emerging adults is scarce. Thus, this study examined the association between familism support and lifetime history of HIV testing among Latino emerging adults, and whether nativity status and gender moderated this association. A cross-sectional online survey of 157 Latino emerging adults aged 18-25 years living in Arizona and Florida was conducted and data were analyzed using robust Poisson regression models. Results indicated that 59.9% of participants reported a lifetime history of HIV testing. Higher familism support was associated with a decreased prevalence of lifetime history of HIV testing (aPR = 0.81, 95% CI: 0.68- 0.95). Nativity status moderated the association between familism support and lifetime history of HIV testing, with this negative association, only found among immigrants (aPR = 0.46, 95% CI: 0.28-0.74). Gender did not moderate this association. Familism support plays a role in HIV testing behaviors, and thus should be considered when developing programs to increase HIV testing among Latinos.
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Affiliation(s)
- Daisy Ramírez-Ortiz
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC 5-488, Miami, FL, 33199, USA
| | - Diana M Sheehan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC 5-488, Miami, FL, 33199, USA
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Research Center in Minority Institutions, Florida International University, Miami, FL, USA
| | - Melanie Paige Moore
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gladys E Ibañez
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC 5-488, Miami, FL, 33199, USA
| | - Boubakari Ibrahimou
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Mario De La Rosa
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Department of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Miguel Ángel Cano
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC 5-488, Miami, FL, 33199, USA.
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
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28
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Rhodes SD, Mann-Jackson L, Alonzo J, Garcia M, Tanner AE, Smart BD, Horridge DN, Van Dam CN, Wilkin AM. A rapid qualitative assessment of the impact of the COVID-19 pandemic on a racially/ethnically diverse sample of gay, bisexual, and other men who have sex with men living with HIV in the US South. RESEARCH SQUARE 2020. [PMID: 32818212 PMCID: PMC7430588 DOI: 10.21203/rs.3.rs-57507/v1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Persons living with HIV (PLWH) may be at increased risk for severe COVID-19-related illness. Our community-based participatory research partnership collected and analyzed semi-structured interview data to understand the early impact of the COVID-19 pandemic on a sample of racially/ethnically diverse gay, bisexual, and other men who have sex with men living with HIV. Fifteen cisgender men participated; their mean age was 28. Six participants were Black/African American, five were Spanish-speaking Latinx, and four were White. Seventeen themes emerged that were categorized into six domains: knowledge and perceptions of COVID-19; COVID-19 information sources and perceptions of trustworthiness; impact of COVID-19 on behaviors, health, and social determinants of health; and general COVID-19-related concerns. Interventions are needed to ensure that PLWH have updated information and adhere to medication regimens, and to reduce the impact of COVID-19 on social isolation, economic stability, healthcare access, and other social determinants of health within this vulnerable population.
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29
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Benbow ND, Aaby DA, Rosenberg ES, Brown CH. County-level factors affecting Latino HIV disparities in the United States. PLoS One 2020; 15:e0237269. [PMID: 32785252 PMCID: PMC7423131 DOI: 10.1371/journal.pone.0237269] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/22/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To determine which county-level social, economic, demographic, epidemiologic and access to care factors are associated with Latino/non-Latino White disparities in prevalence of diagnosed HIV infection. METHODS AND FINDINGS We used 2016 county-level prevalence rates of diagnosed HIV infection rates for Latinos and non-Latino Whites obtained from the National HIV Surveillance System and factors obtained from multiple publicly available datasets. We used mixed effects Poisson modeling of observed HIV prevalence at the county-level to identify county-level factors that explained homogeneous effects across race/ethnicity and differential effects for Latinos and NL-Whites. Overall, the median Latinos disparity in HIV prevalence is 2.4; 94% of the counties have higher rates for Latinos than non-Latinos, and one-quarter of the counties' disparities exceeded 10. Of the 41 county-level factors examined, 24 showed significant effect modification when examined individually. In multi-variable modeling, 11 county-level factors were found that significantly affected disparities. Factors that increased disparity with higher, compared to lower values included proportion of HIV diagnoses due to injection drug use, percent Latino living in poverty, percent not English proficient, and percent Puerto Rican. Latino disparities increased with decreasing percent severe housing, drug overdose mortality rate, percent rural, female prevalence rate, social association rate, percent change in Latino population, and Latino to NL-White proportion of the population. These factors while significant had minimal effects on diminishing disparity, but did substantially reduce the variance in disparity rates. CONCLUSIONS Large differences in HIV prevalence rates persist across almost all counties even after controlling for county-level factors. Counties that are more rural, have fewer Latinos, or have lower NL-White prevalence rates tend to have higher disparities. There is also higher disparity when community risk is low.
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Affiliation(s)
- Nanette D. Benbow
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
- * E-mail:
| | - David A. Aaby
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Eli S. Rosenberg
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Rensselaer, New York, United States of America
| | - C. Hendricks Brown
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
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30
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Rhodes SD, Alonzo J, Mann-Jackson L, Song EY, Tanner AE, Garcia M, Smart BD, Baker LS, Eng E, Reboussin BA. A peer navigation intervention to prevent HIV among mixed immigrant status Latinx GBMSM and transgender women in the United States: outcomes, perspectives and implications for PrEP uptake. HEALTH EDUCATION RESEARCH 2020; 35:165-178. [PMID: 32441760 PMCID: PMC7243724 DOI: 10.1093/her/cyaa010] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 04/11/2020] [Indexed: 05/23/2023]
Abstract
The Latinx population in the United States is disproportionately affected by HIV. Our community-based participatory research partnership developed, implemented and evaluated a Spanish-language peer navigation intervention designed to increase HIV testing and condom use among social networks of immigrant Spanish-speaking Latinx gay, bisexual and other men who have sex with men (GBMSM) and transgender women (TW). We randomized 21 social networks of Latinx GBMSM and TW, ages 18-55 years, to the intervention, known as HOLA, or a waitlist control group. Social network participants (n = 166) completed structured assessments at baseline and 12-month follow-up (24 months after baseline). Follow-up retention was 95%. Individual in-depth interviews with a sample of participants documented their intervention-related experiences, needs, and priorities to inform future research. At follow-up, HOLA participants reported increased HIV testing (adjusted odds ratio = 8.3; 95% CI = 3.0-23.0; P < 0.0001). All study participants reported increased condom use; there was no significant difference between HOLA and waitlist control participants. In-depth interviews identified critical intervention elements and impacts and community needs and priorities. The HOLA intervention is effective for increasing HIV testing among Latinx GBMSM and TW, an initial step within the HIV prevention and care continua, and may be adaptable to promote pre-exposure prophylaxis uptake.
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Affiliation(s)
- Scott D Rhodes
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
- Wake Forest Clinical and Translational Science Institute, Program in Community Engagement, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
- Wake Forest Clinical and Translational Science Institute, Program in Community Engagement, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Eunyoung Y Song
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Amanda E Tanner
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC 27402, USA
| | - Manuel Garcia
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Benjamin D Smart
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
- Wake Forest Clinical and Translational Science Institute, Program in Community Engagement, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Logan S Baker
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Eugenia Eng
- Department of Health Behavior, University of North Carolina at Chapel Hill, Rosenau Hall, Chapel Hill, NC 27599, USA
| | - Beth A Reboussin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
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31
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The Association Between Social Support, Violence, and Social Service Needs Among a Select Sample of Urban Adults in Baltimore City. J Community Health 2020; 45:987-996. [PMID: 32303919 DOI: 10.1007/s10900-020-00817-9] [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: 10/24/2022]
Abstract
Experiencing violence has been associated with negative health outcomes. The objectives of this study were to determine whether experiencing violence is associated increased support service needs and suboptimal general health indicators. In addition, we explore the relationship between these and perceived social support among a select sample of urban predominantly male adults in Baltimore City. A cross-sectional survey was conducted among 187 adults being seen in one of seven urban partner agencies participating in a parent HIV prevention and treatment demonstration project. Associations were examined using a multivariable logistic regression model, adjusting for the clinic site at which the client was being seen as well as age and gender identity. There was a significant amount of violence experienced by this population; 131 (72%) reported having seen someone be physically assaulted, and 89 (49%) had been physically assaulted without a weapon. Direct victimization from violence was associated with a threefold increased odds of needing housing and mental health/substance use services. Exposure to violence was associated with a threefold increase in needing housing and mental health/substance use services, and with sub-optimal health status. Perceived social support was associated with 30% decreased reports of experiencing violence. In conclusion, our select sample of urban adults report having experienced high rates of violence, and this is associated with increased support service needs as well as suboptimal perceived health status. Incorporating care for the effects of experiencing violence as well as social service needs are important in optimizing the health of urban populations.
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32
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Horridge DN, Oh TS, Alonzo J, Mann-Jackson L, Tanner AE, Song EY, Smart BD, Van Dam CN, Baker LS, Rhodes SD. Barriers to HIV Testing Within a Sample of Spanish-speaking Latinx Gay, Bisexual, and Other Men Who Have Sex with Men: Implications for HIV Prevention and Care. HEALTH BEHAVIOR RESEARCH 2019; 2:https://doi.org/10.4148/2572-1836.1069. [PMID: 31799502 PMCID: PMC6889883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
Gay, bisexual, and other men who have sex with men (GBMSM) have higher rates of HIV infection compared to the general population in the United States, and the infection rate is growing among Latinx GBMSM, compared to a decline in most other demographic subgroups. Uptake of pre-exposure prophylaxis (PrEP), a biomedical strategy designed to reduce HIV transmission, is very low among Latinx GBMSM. HIV testing is a critical first step in the HIV prevention and care continua. We analyzed data from a community-based sample of Latinx GBMSM in the southeastern United States to identify the most common HIV testing barriers and the factors associated with barriers. The five most commonly reported HIV testing barriers included not knowing where to get tested, not having health insurance, fear of being HIV positive, practicing safer sex and perceiving not needing to be tested, and not being recommended to get tested. Using multivariable logistic regression modeling, speaking only Spanish, being unemployed, and adhering to traditional notions of masculinity were associated with increased barriers to HIV testing. We recommend that interventions to increase HIV testing among Latinx GBMSM be in Spanish and use culturally congruent messaging, be accessible to those who are unemployed, and incorporate positive risk-reducing aspects of masculinity.
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Affiliation(s)
| | | | | | - Lilli Mann-Jackson
- Wake Forest School of Medicine and Wake Forest Clinical and Translational Science Institute, Program in Community Engagement
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