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Wise JM, Kempf MC, Ott C, Footman AP, Hardy C, Araya BY, Walker C, Latham C, Stockett R, Daniels GL, Alexander M, Lanzi RG. Faith-based Community Engagement in HIV-Testing and Awareness of HIV Status in Southern, Rural, African American Communities. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02122-w. [PMID: 39287762 DOI: 10.1007/s40615-024-02122-w] [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: 05/20/2024] [Revised: 07/29/2024] [Accepted: 08/02/2024] [Indexed: 09/19/2024]
Abstract
The Deep South is the epicenter of the HIV-epidemic in the United States, with rural AAs bearing the greatest burden. Traditional efforts to improve testing efforts have been largely unsuccessful due to their failure to recognize and leverage the sociopolitical and cultural factors that affect the uptake of HIV-screening interventions at the community level. The purpose of this study was to gain a deeper understanding of the socio-cultural contexts impacting HIV-testing in the rural South, and to assess strategies to increase testing in rural, Southern communities. Focus groups (n = 8) and semi-structured interviews (n = 31) were conducted among community and faith-based leaders in Alabama and Mississippi, to inform our understanding of local perceptions of HIV infection, barriers and facilitators impacting HIV-testing, and best strategies for improving testing efforts at the local level. Interviews and focus groups were audio-recorded, transcribed verbatim, and analyzed to extract major themes. While both faith-based and community leaders reported at least some stigmatizing attitudes towards HIV infection, faith-based leaders were more likely to report discomfort being around someone with HIV and were more likely to link the spread of HIV to immoral behaviors. The combination of the cultural importance of the Church, deep-seated religiosity among community members, and faith-based messages associating HIV infection with immorality directly impacted HIV stigma within the community-in turn, decreasing willingness to participate in HIV-testing, disclose positive HIV serostatus, or openly discuss transmission protection behaviors. The Church was identified as crucial to include to improve HIV-testing efforts in the rural South, due to their prominent sociopolitical roles within communities and ability to influence community members' perceptions of HIV stigma. Faith-based leaderships should be included in initiatives to increase improve HIV-testing and awareness of status and reduce HIV disparities in the Deep South.
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Affiliation(s)
- J M Wise
- Department of Family, Community and Health Systems, School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, AL, 35294, USA.
| | - M C Kempf
- Department of Family, Community and Health Systems, School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, AL, 35294, USA
- Department of Health Behavior, School of Public Health, UAB, Birmingham, AL, 35294, USA
- Department of Epidemiology, School of Public Health, UAB, Birmingham, AL, 35294, USA
- Division of Infectious Disease, Heersink School of Medicine, UAB, Birmingham, AL, 35294, USA
| | - C Ott
- Department of Family, Community and Health Systems, School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, AL, 35294, USA
| | - A P Footman
- Department of Health Behavior, School of Public Health, UAB, Birmingham, AL, 35294, USA
| | - C Hardy
- Department of Medicine, Heerskink School of Medicine, UAB, Birmingham, AL, 35294, USA
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, 35294, USA
| | - B Y Araya
- Department of Health Behavior, School of Public Health, UAB, Birmingham, AL, 35294, USA
| | - C Walker
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, 35294, USA
| | - C Latham
- , 100 Black Men of America, Atlanta, USA
| | - R Stockett
- , 100 Black Men of America, Atlanta, USA
| | - G L Daniels
- , 100 Black Men of America, Atlanta, USA
- Department of Journalism and Creative Media, University of Alabama, Birmingham, AL, 35294, USA
| | | | - R G Lanzi
- Department of Health Behavior, School of Public Health, UAB, Birmingham, AL, 35294, USA
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2
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Bowser BP. Social-Economic Backgrounds to US County-Based COVID-19 Deaths: PLS-SEM Analysis. J Racial Ethn Health Disparities 2024; 11:2304-2317. [PMID: 37531017 DOI: 10.1007/s40615-023-01698-z] [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: 11/08/2022] [Revised: 05/30/2023] [Accepted: 06/24/2023] [Indexed: 08/03/2023]
Abstract
A complex interplay of social, economic, and environmental factors drove the COVID-19 epidemic. Understanding these factors is crucial in explaining the racial disparities observed in COVID-19 deaths. This research investigated various hypotheses, including ecological, racial, demographic, economic, and political party factors, to determine their impact on COVID-19 deaths. The study utilized data from the National Center for Health Statistics (NCHS), specifically focusing on COVID-19 deaths categorized by race and Hispanic origin in US counties, with over 100 recorded deaths as of July 11, 2022. METHOD To analyze the data, the study employed partial least squares (PLS) as the statistical approach, considering the presence of multicollinearity in the county-level socioeconomic data. SmartPLS4 software was utilized to illustrate paths depicting variance and covariance and to conduct significance tests. The analysis encompassed overall COVID-19 deaths and deaths among White, Black, and Hispanic Americans, utilizing the same latent variables and paths. RESULTS The results revealed that the number of residents aged 65 years or older in a county was the most influential predictor of COVID-19 deaths, irrespective of race. Economic factors emerged as the second strongest predictors. However, when considering each racial group separately, distinct factors aligned with the five hypotheses emerged as significant contributors to COVID-19 deaths. Furthermore, the diagrams illustrating the relationships between these factors (covariates) varied among racial groups, indicating that the underlying social influences differed across races. DISCUSSION In light of these findings, it becomes evident that a "one-size-fits-all" approach to prevention strategies is suboptimal. Instead, targeted prevention efforts tailored to specific racial and social classes at high risk of COVID-19 death could have provided more precise messaging and necessitate direct engagement.
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Affiliation(s)
- Benjamin P Bowser
- Department of Sociology, California State University, East Bay, 25800 Carlos Bee Blvd, Hayward, CA, 94542, USA.
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Gibas KM, Rebeiro PF, Brantley M, Mathieson S, Maurer L, Pettit AC. Geographic disparities in late HIV diagnoses in Tennessee: Opportunities for interventions in the rural Southeast. J Rural Health 2024:10.1111/jrh.12829. [PMID: 38361431 PMCID: PMC11324855 DOI: 10.1111/jrh.12829] [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: 09/07/2023] [Revised: 01/15/2024] [Accepted: 02/02/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE Incident HIV remains an important public health issue in the US South, the region leading the nation in HIV incidence, rural HIV cases, and HIV-related deaths. Late diagnoses drive incident HIV and understanding factors driving late diagnoses is critical for developing locally relevant HIV testing and prevention interventions, decreasing HIV transmission, and ending the HIV epidemic. METHODS Retrospective cohort study utilizing Tennessee Department of Health (TDH) surveillance data and US Census Bureau data. Adults of ≥18-year old with a new HIV diagnosis between January 1, 2015 and December 31, 2019 identified in the TDH electronic HIV/AIDS Reporting System were included. Individuals were followed from initial HIV diagnosis until death, 90 days of follow-up for outcome assessment, or administrative censoring 90 days after study enrollment closed. FINDINGS We included 3652 newly HIV-diagnosed individuals; median age was 31 years (IQR: 25, 42), 2909 (79.7%) were male, 2057 (56.3%) were Black, 246 (6.7%) were Hispanic, 408 (11.2%) were residing in majority-rural areas at diagnosis, and 642 (17.6%) individuals received a late HIV diagnosis. Residents of majority-rural counties (adjusted risk ratios [aRR] = 1.39, 95% confidence intervals [CI]: 1.16-1.67) and Hispanic individuals (aRR = 1.87, 95% CI: 1.50-2.33) had an increased likelihood of receiving a late diagnosis after controlling for race/ethnicity, age, and year of HIV diagnosis. CONCLUSIONS Rural residence and Hispanic ethnicity were associated with an increased risk of receiving a late HIV diagnosis in Tennessee. Future HIV testing and prevention efforts should be adapted to the needs of these vulnerable populations.
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Affiliation(s)
- Kevin M. Gibas
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department of Epidemiology & Infection Prevention, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Peter F. Rebeiro
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
- Department of Medicine and Department of Biostatistics, Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Meredith Brantley
- Section of HIV, Sexually Transmitted Infections, and Viral Hepatitis, Tennessee Department of Health, Nashville, Tennessee, USA
| | - Samantha Mathieson
- Section of HIV, Sexually Transmitted Infections, and Viral Hepatitis, Tennessee Department of Health, Nashville, Tennessee, USA
| | - Laurie Maurer
- Section of HIV, Sexually Transmitted Infections, and Viral Hepatitis, Tennessee Department of Health, Nashville, Tennessee, USA
| | - April C. Pettit
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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4
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Li X, Trovão NS, Wertheim JO, Baele G, de Bernardi Schneider A. Optimizing ancestral trait reconstruction of large HIV Subtype C datasets through multiple-trait subsampling. Virus Evol 2023; 9:vead069. [PMID: 38046219 PMCID: PMC10691791 DOI: 10.1093/ve/vead069] [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: 06/26/2023] [Revised: 10/29/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023] Open
Abstract
Large datasets along with sampling bias represent a challenge for phylodynamic reconstructions, particularly when the study data are obtained from various heterogeneous sources and/or through convenience sampling. In this study, we evaluate the presence of unbalanced sampled distribution by collection date, location, and risk group of human immunodeficiency virus Type 1 Subtype C using a comprehensive subsampling strategy and assess their impact on the reconstruction of the viral spatial and risk group dynamics using phylogenetic comparative methods. Our study shows that a most suitable dataset for ancestral trait reconstruction can be obtained through subsampling by all available traits, particularly using multigene datasets. We also demonstrate that sampling bias is inflated when considerable information for a given trait is unavailable or of poor quality, as we observed for the trait risk group. In conclusion, we suggest that, even if traits are not well recorded, including them deliberately optimizes the representativeness of the original dataset rather than completely excluding them. Therefore, we advise the inclusion of as many traits as possible with the aid of subsampling approaches in order to optimize the dataset for phylodynamic analysis while reducing the computational burden. This will benefit research communities investigating the evolutionary and spatio-temporal patterns of infectious diseases.
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Affiliation(s)
| | - Nídia S Trovão
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, 31 Center Dr, Bethesda, MA 20892, USA
| | - Joel O Wertheim
- Department of Medicine, University of California, La Jolla, San Diego, CA 92093, USA
| | - Guy Baele
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven BE-3000, Belgium
| | - Adriano de Bernardi Schneider
- Genomics Institute, University of California Santa Cruz, Santa Cruz, CA 95064, USA
- Ningbo No.2 Hospital, Ningbo 315010, China
- Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo 315000, China
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Vitsupakorn S, Pierce N, Ritchwood TD. Cultural interventions addressing disparities in the HIV prevention and treatment cascade among Black/African Americans: a scoping review. BMC Public Health 2023; 23:1748. [PMID: 37679765 PMCID: PMC10485990 DOI: 10.1186/s12889-023-16658-9] [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: 10/17/2022] [Accepted: 08/30/2023] [Indexed: 09/09/2023] Open
Abstract
Culture is an important determinant of HIV risk and protective behaviors; yet, we know little about how it is integrated in HIV interventions. This scoping review characterizes the integration of culture in HIV prevention and treatment interventions focused on Black/African Americans. We searched MEDLINE, PsycINFO, CINAHL, and Google Scholar for peer-reviewed manuscripts published between July 1, 2011, and June 28, 2021. Twenty-five interventions were identified, with 96% focused on prevention. Most (40%) targeted men who have sex with men or transgender women. Only three were grounded in cultural theory. Although all interventions were labeled "culturally based," only two explicitly defined culture. Moreover, there was much diversity regarding the ways in which interventions integrated cultural elements, with some conflating race/ethnicity with culture. To improve uptake and HIV-related outcomes, interventions integrating culture are greatly needed. Additionally, HIV interventions purporting to be "culturally based" must include basic information to support rigor and reproducibility.
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Affiliation(s)
| | - Nia Pierce
- College of Humanities and Social Sciences, North Carolina State University, Raleigh, NC, USA
| | - Tiarney D Ritchwood
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
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6
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Wyatt GE, Chin D, Loeb TB, Norwood-Scott E, McEwan JA, Zhang M, Smith-Clapham AM, Cooley-Strickland M, Trinidad C, Flint JR, Wells Y, Divinity R, Liu H. Women-Centered Program for Women of Color (WC4WC): A Community-Based Participatory, Culturally Congruent Sexual Health Intervention in Los Angeles County, California. Am J Public Health 2023; 113:S110-S114. [PMID: 37339413 PMCID: PMC10282859 DOI: 10.2105/ajph.2023.307296] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 06/22/2023]
Abstract
The Women-Centered Program for Women of Color, a culturally congruent sexual health intervention, was implemented in 2018 in Los Angeles County, California, according to the principles of community-based participatory research: enhancing community capacity, establishing sustainable programs, and translating research findings to community settings. Participants exhibited significantly increased knowledge of and interest in preexposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) over time, but no significant change in condom use was evident. Booster sessions are needed to maintain interest in PrEP and PEP given concerns about reproductive and sexual health. (Am J Public Health. 2023;113(S2):S110-S114. https://doi.org/10.2105/AJPH.2023.307296).
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Affiliation(s)
- Gail E Wyatt
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Dorothy Chin
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Tamra B Loeb
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Enricka Norwood-Scott
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Jenna A McEwan
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Muyu Zhang
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Amber M Smith-Clapham
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Michele Cooley-Strickland
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Cheryl Trinidad
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Janette R Flint
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Yvette Wells
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Rosalynd Divinity
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Honghu Liu
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
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Xiao C, Jike C, Liu D, Jia P, Xu X, Xiao L, Yu G, Nan L, Sun X, Ge J, Wang J, Wang K, Liao Q, Wang Q, Wenwen Z, Yang S. The changing modes of human immunodeficiency virus transmission and spatial variations among women in a minority prefecture in southwest China: An exploratory study. Medicine (Baltimore) 2020; 99:e18776. [PMID: 32028390 PMCID: PMC7015565 DOI: 10.1097/md.0000000000018776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Liangshan Yi Autonomous Prefecture in Southwest China has a high human immunodeficiency virus (HIV) prevalence rate. This study examined the changing modes of HIV transmission among women with new HIV infections and explored the spatial heterogeneities in the factors associated with heterosexual transmission in this minority region.The data consisting of women with new HIV infections from 2011 to 2014 were collected from multiple sources. New infections were identified by BED capture enzyme immunoassay. The Bayesian hierarchical model was used to estimate the proportion of women with new HIV infections via heterosexual transmission across all townships in the Prefecture. A geographically weighted regression (GWR) model was utilized to investigate spatial variations in the sociodemographic characteristics associated with the changing modes of HIV transmission.An analytical sample of 927 women with new HIV infections was constructed and utilized to investigate the changing mode of HIV transmission. The rate of heterosexual transmission among women with new HIV infections in 2011 was below 20%. However, by 2014 this rate dramatically increased to nearly 80%. Among sociodemographic characteristics, GWR results revealed significant ethnic differences in heterosexual HIV transmission between Yi women and women in other ethnic groups, with Yi women demonstrating a lower risk of infection through heterosexual transmission. However, such ethnic differences were observed only in 30% of the townships in the Prefecture. Moreover, having a primary education decreased the odds of heterosexual transmission, which was observed in about 56% of the townships. Also, being involved in occupations other than agriculture or animal husbandry and being single or married decreased the odds of HIV infection through heterosexual contact among women, which did not significantly vary across the Prefecture.Heterosexual transmission was the predominant mode of HIV transmission among women in the Prefecture, and this transformation was clearly marked by a fast-growing trend and a spatial diffusion pattern. Spatial variations also existed in sociodemographic factors that were associated with the changing modes of HIV transmission.
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Affiliation(s)
- Chenghan Xiao
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu
| | - Chunnong Jike
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Danping Liu
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu
| | - Peng Jia
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China
- International Initiative on Spatial Lifecourse Epidemiology (ISLE)
- Faculty of Geo-information Science and Earth Observation, University of Twente, Enschede, The Netherlands
| | - Xiaohe Xu
- School of Public Administration, Sichuan University, Chengdu
- Department of Sociology, The University of Texas at San Antonio, TX
| | - Lin Xiao
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Gang Yu
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Lei Nan
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Xiaxia Sun
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu
| | - Jingjing Ge
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu
| | - Ju Wang
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Ke Wang
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Qiang Liao
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Qixing Wang
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Zhai Wenwen
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu
| | - Shujuan Yang
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu
- International Initiative on Spatial Lifecourse Epidemiology (ISLE)
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8
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Agénor M, Pérez AE, Koma JW, Abrams JA, McGregor AJ, Ojikutu BO. Sexual Orientation Identity, Race/Ethnicity, and Lifetime HIV Testing in a National Probability Sample of U.S. Women and Men: An Intersectional Approach. LGBT Health 2019; 6:306-318. [PMID: 31314667 PMCID: PMC6740155 DOI: 10.1089/lgbt.2019.0001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: We examined differences in lifetime human immunodeficiency virus (HIV) testing in relation to both sexual orientation identity and race/ethnicity among U.S. women and men. Methods: We used 2013-2017 National Health Interview Survey data and multivariable logistic regression to assess the distribution of lifetime HIV testing across and within sexual orientation identity and racial/ethnic groups of U.S. women (n = 60,867) and men (n = 52,201) aged 18-64 years. Results: Among women, Black lesbian (74.1%) and bisexual (74.0%) women had the highest prevalence whereas Asian lesbian women (32.5%) had the lowest prevalence of lifetime HIV testing. Among men, the prevalence of lifetime HIV testing was the highest among Latino gay men (92.6%) and the lowest among Asian heterosexual men (32.0%). In most cases, Black women and Black and Latino men had significantly higher adjusted odds whereas Asian women and men had lower adjusted odds of lifetime HIV testing compared with their White counterparts within sexual orientation identity groups. In many instances, bisexual women and gay men had significantly higher adjusted odds of lifetime HIV testing relative to their heterosexual counterparts within racial/ethnic groups. Compared with White heterosexual individuals, most sexual orientation identity and racial/ethnic subgroups had significantly higher adjusted odds whereas Asian heterosexual, bisexual, and lesbian women and Asian heterosexual and bisexual men may have lower adjusted odds of lifetime HIV testing. Conclusion: Culturally relevant, linguistically appropriate, and structurally competent programs and practices are needed to facilitate lifetime HIV testing among diverse sexual orientation identity and racial/ethnic subgroups of women and men, including multiply marginalized subgroups that are undertested or disproportionately affected by HIV/AIDS.
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Affiliation(s)
- Madina Agénor
- Department of Community Health, Tufts University, Medford, Massachusetts
- The Fenway Institute, Fenway Health, Boston, Massachusetts
- Center for Interdisciplinary Research on AIDS, Yale University, New Haven, Connecticut
| | - Ashley E. Pérez
- Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, California
| | - Jonathan Wyatt Koma
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jasmine A. Abrams
- Center for Interdisciplinary Research on AIDS, Yale University, New Haven, Connecticut
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, Maryland
| | - Alecia J. McGregor
- Department of Community Health, Tufts University, Medford, Massachusetts
| | - Bisola O. Ojikutu
- The Fenway Institute, Fenway Health, Boston, Massachusetts
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
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Gabbidon K, Shaw-Ridley M. Characterizing Sexual Health Conversations Among Afro-Caribbean Families: Adolescent and Parent Perspectives. JOURNAL OF ADOLESCENT RESEARCH 2019. [DOI: 10.1177/0743558419826064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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10
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Milburn NG, Hamilton AB, Lopez S, Wyatt GE. Mentoring the next generation of behavioral health scientists to promote health equity. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2019; 89:369-377. [PMID: 31070422 PMCID: PMC7577403 DOI: 10.1037/ort0000415] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Health inequities and disparities among various racial/ethnic minority, sexual minority, and rural populations are the focus of increasing national efforts. Three health problems disproportionately affecting these populations-HIV/AIDS, substance abuse, and trauma-deserve particular attention because of their harmful effects on health across the life span. To address these problems, our training program, the UCLA HIV/AIDS, Substance Abuse, and Trauma Training Program (HA-STTP), mentors and trains early career behavioral health scientists to conduct research using scientifically sound, culturally collaborative, and population-centered approaches. HA-STTP has been highly successful in training a diverse, productive, nationwide group of scholars. The program provides 2 years of training and mentorship to 20 (5 per year over 4 years) scholars. It is unique in its attention to traumatic stress as a form of dysregulation, particularly as experienced by underserved populations. Furthermore, our training program embraces a uniquely comprehensive, culturally grounded understanding of traumatic stress and its implications for substance abuse and HIV. HA-STTP advances scholars' knowledge of the interconnections among substance abuse, HIV/AIDS, traumatic stress, and health disparities, particularly in underrepresented populations; provides intensive mentorship to support scholars' research interests and career trajectories; capitalizes on a multidisciplinary, multiracial/ethnic network of expert faculty; and evaluates the program's impact on scholars' knowledge and productivity. By fostering the growth of scholars committed to conducting research with underrepresented populations that are disproportionately affected by HIV/AIDS, substance abuse, and traumatic stress, this program enhances nationwide efforts to diminish the prevalence of these problems and improve health and quality of life. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Norweeta G Milburn
- Department of Psychiatry and Biobehavioral Sciences, Division of Population Behavioral Health, Semel Institute for Neuroscience & Human Behavior, University of California
| | - Alison B Hamilton
- Department of Psychiatry and Biobhavioral Sciences, University of California, Los Angeles
| | - Susana Lopez
- Department of Psychiatry and Biobehavioral Sciences, Division of Population Behavioral Health, University of California
| | - Gail E Wyatt
- Department of Psychiatry and Biobhavioral Sciences, University of California, Los Angeles
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11
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Effectiveness of peer education approach on improving HIV/AIDS related healthy behaviors among immigrant street children: A randomized controlled trial. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2018. [DOI: 10.1016/j.cegh.2017.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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12
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Gabbidon KS, Shaw-Ridley M. "Sex Is a sin": Afro-Caribbean Parent and Teen Perspectives on Sex Conversations. J Immigr Minor Health 2018; 20:1447-1457. [PMID: 29349715 DOI: 10.1007/s10903-018-0695-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study characterized (a) mothers' childhood and teenage experiences with sex conversations and (b) families' perceptions of current parent-child sex conversations within two underserved Afro-Caribbean communities in the U.S. Fourteen dyads comprised of Haitian and Jamaican mothers and teens (aged 14-18) living in Miami, Florida, completed semi-structured interviews sharing their experiences with sex conversations. Researchers analyzed data using thematic content analysis. Mothers' mean age was 41.85 years, (SD = 5.50) and teens' mean age was 16.35 years, (SD = 1.31). Most mothers reported forbidden or little childhood experiences with parent-child sex conversations. They affected their sexual attitudes, behaviors, and ability to discuss sex with their children. Although some mothers benefited from educational and skill development others shared fear-based messages with their children that some teens believed adversely affected the mother-child relationship quality. Culturally appropriate, skill-based approaches are necessary to improve families' communication self-efficacy for healthy sex conversations to occur in Afro-Caribbean families.
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Affiliation(s)
- Kemesha S Gabbidon
- Department of Psychology, University of South Florida St. Petersburg, 140 7th Avenue S., St. Petersburg, FL, 33701, USA.
| | - Mary Shaw-Ridley
- Behavioral and Environmental Health, School of Public Health, Jackson State University, 350 West Woodrow Wilson Ave, Jackson, MS, 39213, USA
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Dale SK, Pierre-Louis C, Bogart LM, O’Cleirigh C, Safren SA. Still I rise: The need for self-validation and self-care in the midst of adversities faced by Black women with HIV. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2018; 24:15-25. [PMID: 28604021 PMCID: PMC5726949 DOI: 10.1037/cdp0000165] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVES Psychosocial factors of trauma and abuse, racial discrimination, HIV stigma, and gender-related stressors (e.g., prioritizing others' needs) have been associated with antiretroviral treatment (ART) nonadherence and poor viral suppression among Black women living with HIV (BWLWH). To inform the development of an intervention addressing these psychosocial factors to improve ART adherence, the authors sought the insight of BWLWH. METHOD Qualitative semistructured interviews were conducted with 30 BWLWH to gather information on their experiences with trauma, racism, HIV stigma, gender-related stressors, ART adherence, and coping strategies, and their insights on the proposed intervention. Participants' interviews were audio-recorded, transcribed, and coded using thematic content analysis and grounded theory. RESULTS Participants shared (a) their experiences with trauma/abuse, racism, HIV-stigma, gender-related stress, and medication adherence; (b) coping strategies they use (e.g., social support, awareness [acknowledging systemic racism], assertiveness, selective disclosure of HIV status, and prioritizing the self); (c) how each of these adversities relate to their medication adherence and how they found ways to self-validate and practice self-primacy and self-care, including medication adherence in spite of adversities; and (d) enthusiasm for the proposed intervention. CONCLUSIONS Culturally adapted interventions are needed to improve the health of BWLWH by enhancing coping strategies for the multiple adversities they face and promoting self-validation, self-primacy, and self-care in spite of adversities. (PsycINFO Database Record
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Affiliation(s)
- Sannisha K. Dale
- Massachusetts General Hospital
- Harvard Medical School
- University of Miami, Department of Psychology
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Operario D, Lee JH, Kuo C, Zaller N. Racial and Ethnic Disparities in HIV and STIs in the United States--National Health and Nutrition Examination Survey 1999-2012. AIDS Patient Care STDS 2015; 29:635-8. [PMID: 26398316 DOI: 10.1089/apc.2015.0169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Don Operario
- School of Public Health, Brown University, Providence, Rhode Island
| | - Ji Hyun Lee
- School of Public Health, Brown University, Providence, Rhode Island
| | - Caroline Kuo
- Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Sturides, Brown University, Providence, Rhode Island
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Nickolas Zaller
- Fay W. Boozman College of Public Health, University of Arkansas, Little Rock, Arkansas
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15
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Kumanyika SK, Page JB, González Castro F. Forum on culture, health promotion, and health equity: current issues & future directions. Prev Med 2012; 55:581-2. [PMID: 23218181 DOI: 10.1016/j.ypmed.2012.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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