1
|
Logie CH, Lys C, Sokolovic N, Malama K, Mackay KI, McNamee C, Lad A, Kanbari A. Examining Pathways from Food Insecurity to Safer Sex Efficacy Among Northern and Indigenous Adolescents in the Northwest Territories, Canada. Int J Behav Med 2024; 31:582-594. [PMID: 37410271 DOI: 10.1007/s12529-023-10195-w] [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] [Accepted: 06/21/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Food insecurity is a social determinant of health linked with elevated HIV exposure. Safer sex efficacy (SSE), the ability to navigate sexual decision-making and condom use, is an important marker of sexual wellbeing. Pathways from food insecurity to SSE are understudied, particularly among adolescents in Arctic regions who are at the nexus of food insecurity and sexual health disparities. We examined pathways from food insecurity to SSE among adolescents in the Northwest Territories (NWT), Canada. METHODS We implemented cross-sectional surveys with adolescents aged 13-18 recruited through venue-based sampling in 17 NWT communities. We conducted multivariable logistic regression to assess socio-demographic factors associated with food insecurity. We then conducted structural equation modeling (SEM) using maximum likelihood estimation to assess direct effects of food insecurity on SSE and indirect effects via resilience, depression, and relationship power inequity. We assessed both condom use SSE (e.g., confidence in using condoms) and situational SSE (e.g., SSE under partner pressure). RESULTS Most participants (n = 410) identified as Indigenous (79%) and 45% reported experiencing food insecurity. In SEM, we did not find a significant direct effect from food insecurity to SSE; however, we found indirect effects from food insecurity to condom use SSE through resilience and depression and from food insecurity to situational SSE through resilience. CONCLUSIONS Findings call for structural interventions to address food insecurity, alongside resilience-focused strategies that address the intersection of sexual and mental health. Sexual health strategies focused on individual behavior change are insufficient to address larger contexts of poverty among Northern youth.
Collapse
Affiliation(s)
- Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada.
- United Nations University Institute for Water, Environment & Health, Hamilton, ON, Canada.
- Center for Gender &, Sexual Health Equity, Vancouver, BC, Canada.
| | - Candice Lys
- Fostering Open eXpression among Youth (FOXY), 5029 57th Street, Yellowknife, Northwest Territories, Canada
| | - Nina Sokolovic
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada
| | - Kalonde Malama
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada
| | - Kayley Inuksuk Mackay
- Fostering Open eXpression among Youth (FOXY), 5029 57th Street, Yellowknife, Northwest Territories, Canada
| | - Clara McNamee
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada
| | - Anoushka Lad
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada
| | - Amanda Kanbari
- Fostering Open eXpression among Youth (FOXY), 5029 57th Street, Yellowknife, Northwest Territories, Canada
| |
Collapse
|
2
|
Kimaru LJ, Habila MA, Mantina NM, Madhivanan P, Connick E, Ernst K, Ehiri J. Neighborhood characteristics and HIV treatment outcomes: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002870. [PMID: 38349915 PMCID: PMC10863897 DOI: 10.1371/journal.pgph.0002870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 12/21/2023] [Indexed: 02/15/2024]
Abstract
Recognizing challenges faced by people living with HIV is vital for improving their HIV treatment outcomes. While individual-level interventions play a crucial role, community factors can shape the impact of individual interventions on treatment outcomes. Understanding neighborhood characteristics' association with HIV treatment outcomes is crucial for optimizing effectiveness. This review aims to summarize the research scope on the association between neighborhood characteristics and HIV treatment outcomes. The databases PubMed, CINAHL (EBSCOhost), Embase (Elsevier), and PsychINFO (EBSCOhost) were searched from the start of each database to Nov 21, 2022. Screening was performed by three independent reviewers. Full-text publications of all study design meeting inclusion criteria were included in the review. There were no language or geographical limitations. Conference proceedings, abstract only, and opinion reports were excluded from the review. The search yielded 7,822 publications, 35 of which met the criteria for inclusion in the review. Studies assessed the relationship between neighborhood-level disadvantage (n = 24), composition and interaction (n = 17), social-economic status (n = 18), deprivation (n = 16), disorder (n = 8), and rural-urban status (n = 7) and HIV treatment outcomes. The relationship between all neighborhood characteristics and HIV treatment outcomes was not consistent across studies. Only 7 studies found deprivation had a negative association with HIV treatment outcomes; 6 found that areas with specific racial/ethnic densities were associated with poor HIV treatment outcomes, and 5 showed that disorder was associated with poor HIV treatment outcomes. Three studies showed that rural residence was associated with improved HIV treatment outcomes. There were inconsistent findings regarding the association between neighborhood characteristics and HIV treatment outcomes. While the impact of neighborhood characteristics on disease outcomes is highly recognized, there is a paucity of standardized definitions and metrics for community characteristics to support a robust assessment of this hypothesis. Comparative studies that define and assess how specific neighborhood indicators independently or jointly affect HIV treatment outcomes are highly needed.
Collapse
Affiliation(s)
- Linda Jepkoech Kimaru
- Department of Health Promotion Sciences, The University of Arizona, Tucson, Arizona, United States of America
| | - Magdiel A. Habila
- Department of Epidemiology and Biostatistics, The University of Arizona, Tucson, Arizona, United States of America
| | - Namoonga M. Mantina
- Department of Health Promotion Sciences, The University of Arizona, Tucson, Arizona, United States of America
| | - Purnima Madhivanan
- Department of Health Promotion Sciences, The University of Arizona, Tucson, Arizona, United States of America
| | - Elizabeth Connick
- Department of Medicine, The University of Arizona, Tucson, Arizona, United States of America
| | - Kacey Ernst
- Department of Epidemiology and Biostatistics, The University of Arizona, Tucson, Arizona, United States of America
| | - John Ehiri
- Department of Health Promotion Sciences, The University of Arizona, Tucson, Arizona, United States of America
| |
Collapse
|
3
|
Lin Q, Aguilera JAR, Williams LD, Mackesy-Amiti ME, Latkin C, Pineros J, Kolak M, Boodram B. Social-spatial network structures among young urban and suburban persons who inject drugs in a large metropolitan area. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 122:104217. [PMID: 37862848 DOI: 10.1016/j.drugpo.2023.104217] [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: 06/27/2022] [Revised: 09/24/2023] [Accepted: 09/25/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Recent studies underscore the significance of adopting a syndemics approach to study opioid misuse, overdose, hepatitis C (HCV) and HIV infections, within the broader context of social and environmental contexts in already marginalized communities. Social interactions and spatial contexts are crucial structural factors that remain relatively underexplored. This study examines the intersections of social interactions and spatial contexts around injection drug use. More specifically, we investigate the experiences of different residential groups among young (aged 18-30) people who inject drugs (PWID) regarding their social interactions, travel behaviors, and locations connected to their risk behaviors. By doing so, we aim to achieve a more comprehensive understanding of the multidimensional risk environment, thereby facilitating the development of informed policies. METHODS We collected and examined data regarding young PWID's egocentric injection network and geographic activity spaces (i.e., where they reside, inject drugs, purchase drugs, and meet sex partners). Participants were stratified based on the location of all place(s) of residence in the past year i.e., urban, suburban, and transient (both urban and suburban) to i) elucidate geospatial concentration of risk activities within multidimensional risk environments based on kernel density estimates; and ii) examine spatialized social networks for each residential group. RESULTS Participants were mostly non-Hispanic white (59%); 42% were urban residents, 28% suburban, and 30% transient. We identified a spatial area with concentrated risky activities for each residential group on the West side of Chicago in Illinois where a large outdoor drug market area is located. The urban group (80%) reported a smaller concentrated area (14 census tracts) compared to the transient (93%) and suburban (91%) with 30 and 51 tracts, respectively. Compared to other areas in Chicago, the identified area had significantly higher neighborhood disadvantages. Significant differences were observed in social network structures and travel behaviors: suburban participants had the most homogenous network in terms of age and residence, transient participants had the largest network (degree) and more non-redundant connections, while the urban group had the shortest travel distance for all types of risk activities. CONCLUSION Distinct residential groups exhibit varying patterns of network interaction, travel behaviors, and geographical contexts related to their risk behaviors. Nonetheless, these groups share common concentrated risk activity spaces in a large outdoor urban drug market area, underscoring the significance of accounting for risk spaces and social networks in addressing syndemics within PWID populations.
Collapse
Affiliation(s)
- Qinyun Lin
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg.
| | | | - Leslie D Williams
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago.
| | - Mary Ellen Mackesy-Amiti
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago.
| | - Carl Latkin
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
| | - Juliet Pineros
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago.
| | - Marynia Kolak
- Department of Geography and GIScience, University of Illinois, Urbana-Champaign.
| | - Basmattee Boodram
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago.
| |
Collapse
|
4
|
Crockett KB, Schember CO, Bian A, Rebeiro PF, Keruly J, Mayer K, Mathews C, Moore RD, Crane H, Geng E, Napravnik S, Shepherd BE, Mugavero MJ, Turan B, Pettit AC. Relationships Between Patient Race and Residential Race Context With Missed Human Immunodeficiency Virus Care Visits in the United States, 2010-2015. Clin Infect Dis 2023; 76:2163-2170. [PMID: 36757336 PMCID: PMC10273374 DOI: 10.1093/cid/ciad069] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/30/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Racial inequities exist in retention in human immunodeficiency virus (HIV) care and multilevel analyses are needed to contextualize and address these differences. Leveraging data from a multisite clinical cohort of people with HIV (PWH), we assessed the relationships between patient race and residential characteristics with missed HIV care visits. METHODS Medical record and patient-reported outcome (PRO; including mental health and substance-use measures) data were drawn from 7 participating Center for AIDS Research Network of Integrated Clinical Systems (CNICS) sites including N = 20 807 PWH from January 2010 through December 2015. Generalized estimating equations were used to account for nesting within individuals and within census tracts in multivariable models assessing the relationship between race and missed HIV care visits, controlling for individual demographic and health characteristics and census tract characteristics. RESULTS Black PWH resided in more disadvantaged census tracts, on average. Black PWH residing in census tracts with higher proportion of Black residents were more likely to miss an HIV care visit. Non-Black PWH were less likely to miss a visit regardless of where they lived. These relationships were attenuated when PRO data were included. CONCLUSIONS Residential racial segregation and disadvantage may create inequities between Black PWH and non-Black PWH in retention in HIV care. Multilevel approaches are needed to retain PWH in HIV care, accounting for community, healthcare setting, and individual needs and resources.
Collapse
Affiliation(s)
- Kaylee B Crockett
- Department of Family and Community Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Cassandra O Schember
- Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Aihua Bian
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Peter F Rebeiro
- Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jeanne Keruly
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Kenneth Mayer
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Global Health and Population, Harvard Medical School, Boston, Massachusetts, USA
| | - Christopher Mathews
- School of Medicine, University of California San Diego, San Diego, California, USA
| | - Richard D Moore
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Heidi Crane
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Elvin Geng
- Division of Infectious Diseases, Washington University in St Louis School of Medicine, St Louis, Missouri, USA
| | - Sonia Napravnik
- Division of Infectious Disease, University of North Carolina Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
- Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Bryan E Shepherd
- Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Michael J Mugavero
- Division of Infectious Diseases, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Bulent Turan
- Department of Psychology, College of Social Sciences and Humanities, Koc University, Istanbul, Turkey
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - April C Pettit
- Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|
5
|
Fogarty H, Jones MD, Moore SJ, Harper GW, Camacho-González A, del Rio C, Hussen SA. Examining HIV Organizational Structures and their Influence on Engagement with Young Black Gay, Bisexual, and other Men who have Sex with Men in Atlanta, Georgia. JOURNAL OF GAY & LESBIAN SOCIAL SERVICES 2023; 36:58-79. [PMID: 38650676 PMCID: PMC11034743 DOI: 10.1080/10538720.2023.2184438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Young Black gay, bisexual, and other men who have sex with men (YB-GBMSM) are disproportionately impacted by HIV. Structural influences on these disparities, including characteristics of the various organizations that serve YB-GBMSM living with HIV, remain understudied. We drew on Weick's model of organizing to conduct and analyze qualitative interviews with 28 HIV service providers representing healthcare and community-based organizations in Atlanta, Georgia. Enactment of HIV service provision was described as following simplified and standardized responses-defined as "rules", and/or more dynamic exchanges to formulate responses -otherwise known as "communication behavior cycles" (CBCs). Rules, including patient quotas and limited hours of operation, were viewed as rigid, out-of-touch, and inhibiting engagement with YB-GBMSM. CBCs, such as patient feedback loops and rejection of traditional hierarchies, fostered creative insights to combating the epidemic and increased levels of cultural awareness and community buy-in. Organizations should strive to enact CBCs, to foster culturally congruent approaches to service delivery for YB-GBMSM.
Collapse
Affiliation(s)
- Hannah Fogarty
- Hubert Department of Global Health, Emory University Rollins School of Public Health
| | - Marxavian D. Jones
- Hubert Department of Global Health, Emory University Rollins School of Public Health
| | - Shamia J. Moore
- Hubert Department of Global Health, Emory University Rollins School of Public Health
| | - Gary W. Harper
- Department of Health Behavior and Health Education, University of Michigan School of Public Health
| | - Andrés Camacho-González
- Department of Pediatrics, Division of Infectious Diseases, Emory University School of Medicine
| | - Carlos del Rio
- Hubert Department of Global Health, Emory University Rollins School of Public Health
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine
| | - Sophia A. Hussen
- Hubert Department of Global Health, Emory University Rollins School of Public Health
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine
| |
Collapse
|
6
|
Lin Q, Rojas Aguilera JA, Williams LD, Mackesy-Amiti ME, Latkin C, Pineros J, Kolak M, Boodram B. Social-spatial network structures among young urban and suburban persons who inject drugs in a large metropolitan area. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.02.21.23286255. [PMID: 36865191 PMCID: PMC9980242 DOI: 10.1101/2023.02.21.23286255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Background It is estimated that there are 1.5% US adult population who inject drugs in 2018, with young adults aged 18-39 showing the highest prevalence. PWID are at a high risk of many blood-borne infections. Recent studies have highlight the importance of employing the syndemic approach to study opioid misuse, overdose, HCV and HIV, along with the social and environmental contexts where these interrelated epidemics occur in already marginalized communities. Social interactions and spatial contexts are important structural factors that are understudied. Methods Egocentric injection network and geographic activity spaces for young (aged 18-30) PWID and their injection, sexual, and social support network members (i.e., where reside, inject drugs, purchase drugs, and meet sex partners) were examined using baseline data from an ongoing longitudinal study (n=258). Participants were stratified based on the location of all place(s) of residence in the past year i.e., urban, suburban, and transient (both urban and suburban) to i) elucidate geospatial concentration of risk activities within multi-dimensional risk environments based on kernel density estimates; and ii) examine spatialized social networks for each residential group. Results Participants were mostly non-Hispanic white (59%); 42% were urban residents, 28% suburban, and 30% transient. We identified a spatial area with concentrated risky activities for each residence group on the West side of Chicago where a large outdoor drug market area is located. The urban group (80%) reported a smaller concentrated area (14 census tracts) compared to the transient (93%) and suburban (91%) with 30 and 51 tracts, respectively. Compared to other areas in Chicago, the identified area had significantly higher neighborhood disadvantages (e.g., higher poverty rate, p <0.001). Significant ( p <0.01 for all) differences were observed in social network structures: suburban had the most homogenous network in terms of age and residence, transient participants had the largest network (degree) and more non-redundant connections. Conclusion We identified concentrated risk activity spaces among PWID from urban, suburban, and transient groups in a large outdoor urban drug market area, which highlights the need for considering the role of risk spaces and social networks in addressing the syndemics in PWID populations.
Collapse
|
7
|
Rafiei S, Raoofi S, Pashazadeh Kan F, Masoumi M, Doustmehraban M, Biparva AJ, Ashari A, Vali N, Khani S, Abdollahi B, Vaziri Shahrebabak ESV, Heydari M, Momeni Z, Kasaie ZA, Beliad M, Ghashghaee A. Global prevalence of suicide in patients living with HIV/AIDS: A systematic review and meta-analysis. J Affect Disord 2023; 323:400-408. [PMID: 36455715 DOI: 10.1016/j.jad.2022.11.061] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/05/2022] [Accepted: 11/20/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND In fact, people living with HIV are at a greater risk of mental health disorders. Based on lack of necessary information in this area the present systematic review and meta-analysis study was conducted to determine the magnitude of committed suicides among HIV/AIDS people as well as their associated factors in a global setting. METHOD Firstly we registered the protocol of study in PROSPRO. Then the publications were searched in the 4 main databases from January 2000 to April 2022. After removing duplication and inappropriate studies we applied inclusion and exclusion criteria. Finally 60 studies were included for analysis. Comprehensive meta-analysis software were used for analyzing. RESULTS After reviewing 60 articles published from January 2000 to April 2021 in 24 countries, the total prevalence rate of suicide among 61,904 patients was estimated at 0.249 (95 % CI, 0.2-0.306). Findings indicated that the highest suicide prevalence was related to single patients estimated at 0.257 (95 % CI, 0.184-0.347). A gender-based meta-analysis depicted that the prevalence of suicide/ suicidal ideation was higher among females estimated at 0.22 (95 % CI, 0.15-0.29) compared with men at 0.17 (95 % CI, 0.11-0.23). CONCLUSION Health planners and policymakers should develop suicide-prevention strategies aimed at female patients in younger age groups who live alone and are deprived of social support to effectively promote their self-efficacy in successful management of the disease. Integrating mental health services into anti-retroviral therapy for HIV/AIDS patients is also suggested in order to effectively design integrated programs for the management of individuals living with HIV/AIDS.
Collapse
Affiliation(s)
- Sima Rafiei
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Samira Raoofi
- Student Research Committee, Faculty of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran; Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Pashazadeh Kan
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Masoumi
- Clinical Research and Development Center, Qom University of Medical Sciences
| | - Maryam Doustmehraban
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Akbar Javan Biparva
- Student Research Committee, School of Health Management and Medical Informatics, Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arezou Ashari
- Department of Community Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Negin Vali
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Saghar Khani
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Bahare Abdollahi
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mohadeseh Heydari
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Zeinab Momeni
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Zeynab Alsadat Kasaie
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | | | - Ahmad Ghashghaee
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
| |
Collapse
|
8
|
Tucker JA, Buscemi J, Murphy JG, Reed DD, Vuchinich RE. Addictive behavior as molar behavioral allocation: Distinguishing efficient and final causes in translational research and practice. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:1-12. [PMID: 35787099 PMCID: PMC9811182 DOI: 10.1037/adb0000845] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Translational research on addictive behaviors viewed as molar behavioral allocation is critically reviewed. This work relates rates of behavior to rates of reinforcement over time and has been fruitfully applied to addictive behaviors, which involve excessive allocation to short-term rewards with longer term costs. METHOD Narrative critical review. RESULTS This approach distinguishes between final and efficient causes of discrete behaviors. The former refers to temporally extended behavior patterns into which the act fits. The latter refers to environmental stimuli or internal psychological mechanisms immediately preceding the act. Final causes are most clear when addictive behaviors are studied over time as a function of changing environmental circumstances. Discrete acts of addictive behavior are part of an extended/molar behavior pattern when immediate constraints on engagement are low and few rewarding alternatives are available. Research framed by efficient causes often use behavioral economic simulation tasks as individual difference variables that precede discrete acts. Such measures show higher demand for addictive commodities and steeper discounting in various risk groups, but whether they predict molar addictive behavior patterning is understudied. CONCLUSIONS Although efficient cause analysis has dominated translational research, research supports viewing addictive behavior as molar behavioral allocation. Increasing concern with rate variables underpinning final cause analysis and considering how study methods and temporal units of analysis inform an efficient or final cause analysis may advance understanding of addictive behaviors that occur over time in dynamic environmental contexts. This approach provides linkages between behavioral science and disciplines that study social determinants of health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
- Jalie A. Tucker
- University of Florida and Center for Behavioral Economic Health
Research, Gainesville, FL
| | | | | | - Derek D. Reed
- University of Kansas and Cofrin Logan Center for Addiction Research
& Treatment, Lawrence, KS
| | | |
Collapse
|
9
|
Gou H, Liu H, Feldman MW. How Does Migration Affect HIV Sexual Risk Behaviors Among Involuntary Bachelors? The Mediating Roles of Neighborhoods and Social Networks. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:267-281. [PMID: 36044127 DOI: 10.1007/s10508-022-02391-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 06/15/2023]
Abstract
The sex ratio imbalance in China since the 1980s has resulted in a large number of involuntary bachelors in rural China. Previous studies have found an association between migration and HIV sexual risk behaviors among involuntary bachelors, but how migration affects these bachelors' HIV sexual risk behaviors remain poorly understood. Using data from a cross-sectional survey in 2017 (a sample of 740 male respondents who had rural household registration, had never been married, and were aged 28-49 years), we investigated the relationship between migration and HIV sexual risk behaviors. Logistic regressions show that migration, neighborhood characteristics, and social networks were significantly associated with commercial sex and multiple sex partners, whereas only neighborhood characteristics and social networks were positively correlated with sexual partnership concurrency. Neighborhood characteristics and social networks mediated the relationships of migration with commercial sex and migration with multiple sex partners. Social networks mediated the association between neighborhood characteristics and concurrency. Multiple-step mediation analysis showed that the indirect effect of migration on commercial sex and multiple sexual partners through neighborhood characteristics and social networks was significant. Our findings suggest that further interventions should address neighborhood characteristics and social networks together.
Collapse
Affiliation(s)
- Huanying Gou
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xianning West Road, Xi'an, 710049, Shaanxi Province, China
- Institute for Population and Social Policy Studies, School of Management, Xi'an Polytechnic University, Xi'an, China
| | - Huijun Liu
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xianning West Road, Xi'an, 710049, Shaanxi Province, China.
| | - Marcus W Feldman
- Department of Biology, Morrison Institute for Population and Resource Studies, Stanford University, Stanford, CA, USA
| |
Collapse
|
10
|
Nassel A, Wilson-Barthes MG, Howe CJ, Napravnik S, Mugavero MJ, Agil D, Dulin AJ. Characterizing the neighborhood risk environment in multisite clinic-based cohort studies: A practical geocoding and data linkages protocol for protected health information. PLoS One 2022; 17:e0278672. [PMID: 36580446 PMCID: PMC9799318 DOI: 10.1371/journal.pone.0278672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 11/21/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Maintaining patient privacy when geocoding and linking residential address information with neighborhood-level data can create challenges during research. Challenges may arise when study staff have limited training in geocoding and linking data, or when non-study staff with appropriate expertise have limited availability, are unfamiliar with a study's population or objectives, or are not affordable for the study team. Opportunities for data breaches may also arise when working with non-study staff who are not on-site. We detail a free, user-friendly protocol for constructing indices of the neighborhood risk environment during multisite, clinic-based cohort studies that rely on participants' protected health information. This protocol can be implemented by study staff who do not have prior training in Geographic Information Systems (GIS) and can help minimize the operational costs of integrating geographic data into public health projects. METHODS This protocol demonstrates how to: (1) securely geocode patients' residential addresses in a clinic setting and match geocoded addresses to census tracts using Geographic Information System software (Esri, Redlands, CA); (2) ascertain contextual variables of the risk environment from the American Community Survey and ArcGIS Business Analyst (Esri, Redlands, CA); (3) use geoidentifiers to link neighborhood risk data to census tracts containing geocoded addresses; and (4) assign randomly generated identifiers to census tracts and strip census tracts of their geoidentifiers to maintain patient confidentiality. RESULTS Completion of this protocol generates three neighborhood risk indices (i.e., Neighborhood Disadvantage Index, Murder Rate Index, and Assault Rate Index) for patients' coded census tract locations. CONCLUSIONS This protocol can be used by research personnel without prior GIS experience to easily create objective indices of the neighborhood risk environment while upholding patient confidentiality. Future studies can adapt this protocol to fit their specific patient populations and analytic objectives.
Collapse
Affiliation(s)
- Ariann Nassel
- Lister Hill Center for Health Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Marta G. Wilson-Barthes
- Center for Epidemiologic Research, Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, United States of America
| | - Chanelle J. Howe
- Center for Epidemiologic Research, Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, United States of America
| | - Sonia Napravnik
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Michael J. Mugavero
- Division of Infectious Diseases, Department of Medicine, Center for AIDS Research, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Deana Agil
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Akilah J. Dulin
- Center for Health Promotion and Health Equity, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, United States of America
| |
Collapse
|
11
|
Clipman SJ, Mehta SH, Mohapatra S, Srikrishnan AK, Zook KJC, Duggal P, Saravanan S, Nandagopal P, Kumar MS, Lucas GM, Latkin CA, Solomon SS. Deep learning and social network analysis elucidate drivers of HIV transmission in a high-incidence cohort of people who inject drugs. SCIENCE ADVANCES 2022; 8:eabf0158. [PMID: 36260674 PMCID: PMC9581475 DOI: 10.1126/sciadv.abf0158] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 08/31/2022] [Indexed: 06/16/2023]
Abstract
Globally, people who inject drugs (PWID) experience some of the fastest-growing HIV epidemics. Network-based approaches represent a powerful tool for understanding and combating these epidemics; however, detailed social network studies are limited and pose analytical challenges. We collected longitudinal social (injection partners) and spatial (injection venues) network information from 2512 PWID in New Delhi, India. We leveraged network analysis and graph neural networks (GNNs) to uncover factors associated with HIV transmission and identify optimal intervention delivery points. Longitudinal HIV incidence was 21.3 per 100 person-years. Overlapping community detection using GNNs revealed seven communities, with HIV incidence concentrated within one community. The injection venue most strongly associated with incidence was found to overlap six of the seven communities, suggesting that an intervention deployed at this one location could reach the majority of the sample. These findings highlight the utility of network analysis and deep learning in HIV program design.
Collapse
Affiliation(s)
- Steven J. Clipman
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shruti H. Mehta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shobha Mohapatra
- YR Gaitonde Centre for AIDS Research and Education (YRGCARE), Chennai, India
| | | | - Katie J. C. Zook
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Priya Duggal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shanmugam Saravanan
- YR Gaitonde Centre for AIDS Research and Education (YRGCARE), Chennai, India
| | | | | | - Gregory M. Lucas
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Carl A. Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sunil S. Solomon
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
12
|
López Rios J, Lentz C, Balán IC, Grosskopf N, D'Angelo A, Stief M, Grov C. Engagement in Care Among Newly Diagnosed HIV-Positive Gay, Bisexual, and Other Men Who Have Sex With Men in the United States: Results From the Together 5,000 Study. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2022; 34:349-364. [PMID: 36181497 PMCID: PMC9619412 DOI: 10.1521/aeap.2022.34.5.349] [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: 06/16/2023]
Abstract
One-quarter of gay, bisexual, and other men who have sex with men (GBMSM) with diagnosed HIV are not engaged in HIV care. Between 2018 and 2019, 50 GBMSM completed qualitative interviews 3 months after receiving an HIV-positive result. Interviews explored barriers to and facilitators of engagement and retention in HIV testing and care. Thematic analysis revealed five major themes: (1) reason for HIV testing (e.g., self-testing), (2) linkage to care (e.g., appointment/logistic issues and social support as encouragement), (3) barriers to engagement in care (e.g., financial burden, competing priorities, and fear/stigma), (4) facilitators of engagement (e.g., financial assistance, patient-provider relationships, auxiliary support services, and health agency), and (5) PrEP as a missed prevention opportunity. Addressing individual-, social-, and policy-level barriers could improve GBMSM's engagement in HIV care. Further, capitalizing on GBMSM's health agency through partnerships with local agencies and fostering better patient-provider relationships could optimize HIV care continuity.
Collapse
Affiliation(s)
- Javier López Rios
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Cody Lentz
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, New York
| | - Iván C Balán
- Center for Translational Behavioral Science, Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, Florida
| | - Nicholas Grosskopf
- Department of Health and Human Performance, York College of the City University of New York, Queens, New York
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York. Christian Grov is also affiliated with the CUNY Institute for Implementation Science in Population Health, New York
| | - Alexa D'Angelo
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York. Christian Grov is also affiliated with the CUNY Institute for Implementation Science in Population Health, New York
| | - Matthew Stief
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York. Christian Grov is also affiliated with the CUNY Institute for Implementation Science in Population Health, New York
| | - Christian Grov
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York. Christian Grov is also affiliated with the CUNY Institute for Implementation Science in Population Health, New York
| |
Collapse
|
13
|
Ransome Y, Luan H, Dean LT, Quick H, Nassau T, Kawachi I, Brady KA. Is race-specific neighborhood social cohesion key to reducing racial disparities in late HIV diagnosis: A multiyear ecological study. Spat Spatiotemporal Epidemiol 2022; 42:100508. [PMID: 35934322 PMCID: PMC9912753 DOI: 10.1016/j.sste.2022.100508] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 03/01/2022] [Accepted: 04/18/2022] [Indexed: 11/21/2022]
Abstract
We examined whether race/ethnic-specific social cohesion is associated with race/ethnic-specific HIV diagnosis rates using Bayesian space-time zero-inflated Poisson multivariable models, across 376 Census tracts. Social cohesion data were from the Southeastern Pennsylvania Household Health Survey, 2008-2015 and late HIV diagnosis data from eHARS system, 2009-2016. Areas where trust in neighbors reported by Black/African Americans was medium (compared to low) had lower rates of late HIV diagnosis among Black/African Americans (Relative Risk (RR)=0.52, 95% credible interval (CrI)= 0.34, 0.80). In contrast, areas where trust in neighbors reported by Black/African Americans were highest had lower late HIV diagnosis rates among Whites (RR=0.35, 95% CrI= 0.16, 0.76). Race/ethnic-specific differences in social cohesion may have implications for designing interventions aimed at modifying area-level social factors to reduce racial disparities in late HIV diagnosis.
Collapse
Affiliation(s)
- Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, LEPH 4th Floor, New Haven, CT 06520.
| | - Hui Luan
- Department of Geography, Spatial Cognition, Computation, and Complexity (S3C) Lab, University of Oregon, 107D Condon Hall, 1251 University of Oregon, Eugene OR, 97403; School of Geodesy and Geomatics, Wuhan University, 129 Luoyu Road, Wuchang District, Wuhan, Hubei, China, 430079
| | - Lorraine T Dean
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615N Wolfe St, E6650, Baltimore, MD, 21205
| | - Harrison Quick
- Department of Epidemiology and Biostats, Drexel University Dornsife School of Public Health, 3215 Market St, Philadelphia, PA, 19104
| | - Tanner Nassau
- AIDS Activities Coordinating Office, Philadelphia Department of Public Health, 1101 Market St., 8th Floor, Philadelphia, PA, 19107
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building 7th Floor, Boston MA, 02115
| | - Kathleen A Brady
- AIDS Activities Coordinating Office, Philadelphia Department of Public Health, 1101 Market St., 8th Floor, Philadelphia, PA, 19107
| |
Collapse
|
14
|
Eike D, Hogrebe M, Kifle D, Tregilgas M, Uppal A, Calmy A. How the COVID-19 Pandemic Alters the Landscapes of the HIV and Tuberculosis Epidemics in South Africa: A Case Study and Future Directions. EPIDEMIOLGIA (BASEL, SWITZERLAND) 2022; 3:297-313. [PMID: 36417259 PMCID: PMC9620941 DOI: 10.3390/epidemiologia3020023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 12/14/2022]
Abstract
South Africa has long grappled with one of the highest HIV and tuberculosis (TB) burdens in the world. The COVID-19 pandemic poses challenges to the country's already strained health system. Measures to contain COVID-19 virus may have further hampered the containment of HIV and TB in the country and further widened the socioeconomic gap. South Africa's handling of the pandemic has led to disruptions to HIV/TB testing and treatment. It has, furthermore, influenced social risk factors associated with increased transmission of these diseases. Individuals living with HIV and/or TB also face higher risk of developing severe COVID-19 disease. In this case study, we contextualize the HIV/TB landscape in South Africa and analyze the direct and indirect impact of the COVID-19 pandemic on the country's efforts to combat these ongoing epidemics.
Collapse
Affiliation(s)
- Daniel Eike
- Global Studies Institute, University of Geneva, 1205 Geneva, Switzerland; (M.H.); (D.K.); (M.T.); (A.U.)
- Correspondence:
| | - Maximilia Hogrebe
- Global Studies Institute, University of Geneva, 1205 Geneva, Switzerland; (M.H.); (D.K.); (M.T.); (A.U.)
| | - Dagem Kifle
- Global Studies Institute, University of Geneva, 1205 Geneva, Switzerland; (M.H.); (D.K.); (M.T.); (A.U.)
| | - Miriam Tregilgas
- Global Studies Institute, University of Geneva, 1205 Geneva, Switzerland; (M.H.); (D.K.); (M.T.); (A.U.)
| | - Anshu Uppal
- Global Studies Institute, University of Geneva, 1205 Geneva, Switzerland; (M.H.); (D.K.); (M.T.); (A.U.)
| | - Alexandra Calmy
- HIV/AIDS Unit, Division of Infectious Disease, Geneva University Hospitals, 1205 Geneva, Switzerland;
| |
Collapse
|
15
|
Taggart T, Jonathon Rendina H, Boone CA, Burns P, Carter J, English D, Hull S, Massie JS, Mbaba M, Mena L, Río-González AMD, Shalhav O, Talan AJ, Wolfer C, Bowleg L. Stigmatizing Spaces and Places as Axes of Intersectional Stigma Among Sexual Minority Men in HIV Prevention Research. Am J Public Health 2022; 112:S371-S373. [PMID: 35763746 PMCID: PMC9241459 DOI: 10.2105/ajph.2021.306676] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 02/04/2023]
Affiliation(s)
- Tamara Taggart
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - H Jonathon Rendina
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Cheriko A Boone
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Paul Burns
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Joseph Carter
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Devin English
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Shawnika Hull
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Jenné S Massie
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Mary Mbaba
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Leandro Mena
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Ana María Del Río-González
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Ore Shalhav
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Ali J Talan
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Carly Wolfer
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Lisa Bowleg
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| |
Collapse
|
16
|
Doherty R, Walsh JL, Quinn KG, John SA. Association of Race and Other Social Determinants of Health With HIV Pre-Exposure Prophylaxis Use: A County-Level Analysis Using the PrEP-to-Need Ratio. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2022; 34:183-194. [PMID: 35647866 PMCID: PMC9196948 DOI: 10.1521/aeap.2022.34.3.183] [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: 06/03/2023]
Abstract
Research is limited on the effect of racism and social determinants of health on HIV pre-exposure prophylaxis (PrEP) use. This study used the PrEP-to-Need Ratio (PNR), which measures PrEP prescriptions divided by HIV diagnoses in the county, to evaluate sufficient PrEP use. AIDSVu datasets were compared to county-level social determinants of health. Standardized regression coefficients (β) were compared to identify strongest associations with PNR. Overall, factors including percent African American and percent uninsured had negative correlations with PNR, whereas median household income and severe housing cost burden had positive associations. Stratifying for population size, percent African American, percent uninsured, and severe housing cost burden were significant for low population areas, whereas median household income, percent in poverty, percent uninsured, and percent African American were significant for large populations. To reduce PrEP disparities, public health must develop strategies to reach those most in need, especially historically disadvantaged communities.
Collapse
Affiliation(s)
- Ryan Doherty
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jennifer L. Walsh
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Katherine G. Quinn
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Steven A. John
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| |
Collapse
|
17
|
Brawner BM, Kerr J, Castle BF, Bannon JA, Bonett S, Stevens R, James R, Bowleg L. A Systematic Review of Neighborhood-Level Influences on HIV Vulnerability. AIDS Behav 2022; 26:874-934. [PMID: 34480256 PMCID: PMC8415438 DOI: 10.1007/s10461-021-03448-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2021] [Indexed: 12/27/2022]
Abstract
A better understanding of the social-structural factors that influence HIV vulnerability is crucial to achieve the goal of ending the HIV epidemic by 2030. Given the role of neighborhoods in HIV outcomes, synthesis of findings from such research is key to inform efforts toward HIV eradication. We conducted a systematic review to examine the relationship between neighborhood-level factors (e.g., poverty) and HIV vulnerability (via sexual behaviors and substance use). We searched six electronic databases for studies published from January 1, 2007 through November 30, 2017 (PROSPERO CRD42018084384). We also mapped the studies' geographic distribution to determine whether they aligned with high HIV prevalence areas and/or the "Ending the HIV Epidemic: A Plan for the United States". Fifty-five articles met inclusion criteria. Neighborhood disadvantage, whether measured objectively or subjectively, is one of the most robust correlates of HIV vulnerability. Tests of associations more consistently documented a relationship between neighborhood-level factors and drug use than sexual risk behaviors. There was limited geographic distribution of the studies, with a paucity of research in several counties and states where HIV incidence/prevalence is a concern. Neighborhood influences on HIV vulnerability are the consequence of centuries-old laws, policies and practices that maintain racialized inequities (e.g., racial residential segregation, inequitable urban housing policies). We will not eradicate HIV without multi-level, neighborhood-based approaches to undo these injustices. Our findings inform future research, interventions and policies.
Collapse
Affiliation(s)
- Bridgette M Brawner
- M. Louise Fitzpatrick College of Nursing, Villanova University, 800 E. Lancaster Avenue, Office 212, Villanova, PA, 19085, USA.
| | - Jelani Kerr
- Department of Health Promotion and Behavioral Sciences, School of Public Health & Information Sciences, University of Louisville, Louisville, KY, USA
| | - Billie F Castle
- Department of Public Health Sciences, Xavier University of Louisiana, New Orleans, LA, USA
| | - Jaqueline A Bannon
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Stephen Bonett
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Robin Stevens
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, USA
| | - Richard James
- Biomedical Library, University of Pennsylvania, Philadelphia, PA, USA
| | - Lisa Bowleg
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| |
Collapse
|
18
|
Hovhannisyan L, Coelho LE, Velasque L, De Boni RB, Clark J, Cardoso SW, Lake J, Veloso VG, Grinsztejn B, Luz PM. Multilevel Analysis of Individual and Neighborhood Characteristics Associated with Viral Suppression Among Adults with HIV in Rio de Janeiro, Brazil. AIDS Behav 2022; 26:947-962. [PMID: 34564777 PMCID: PMC8898026 DOI: 10.1007/s10461-021-03450-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2021] [Indexed: 11/29/2022]
Abstract
Understanding the impact of neighborhood context on viral suppression outcomes may help explain health disparities and identify future interventions. We assessed the relationship between individual characteristics, neighborhood socioeconomic context, and viral suppression using multilevel logistic regression models. Adults with HIV initiating antiretroviral therapy (ART) between 2000 and 2017, who resided in Rio de Janeiro and had an HIV-1 RNA level (viral load) measured 90-270 days after ART initiation were included. Overall, 83.9% achieved viral suppression. Participants who were older, had a higher level of education, and identified as heterosexual cisgender men and cisgender men-who-have-sex-with-men had increased odds of viral suppression. Later calendar year of ART initiation carried the strongest association with viral suppression, reflecting the increased effectiveness and tolerability of ART over time. Neighborhood socioeconomic indicators did not predict viral suppression in unadjusted or adjusted analyses, which may result from the integrated care provided in our health care facility together with Brazil's universal treatment.
Collapse
Affiliation(s)
- Lyolya Hovhannisyan
- South American Program in HIV Prevention Research (SAPHIR), University of California Los Angeles, Los Angeles, USA.
- Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, USA.
| | - Lara E Coelho
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Luciane Velasque
- Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Raquel B De Boni
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Jesse Clark
- South American Program in HIV Prevention Research (SAPHIR), University of California Los Angeles, Los Angeles, USA
- Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, USA
| | - Sandra W Cardoso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Jordan Lake
- South American Program in HIV Prevention Research (SAPHIR), University of California Los Angeles, Los Angeles, USA
- Department of Medicine, Division of Infectious Diseases, McGovern Medical School at University of Texas Health Science Center at Houston (UTHealth) , Houston, USA
| | - Valdilea G Veloso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Beatriz Grinsztejn
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Paula M Luz
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| |
Collapse
|
19
|
Witkiewitz K, Pfund RA, Tucker JA. Mechanisms of Behavior Change in Substance Use Disorder With and Without Formal Treatment. Annu Rev Clin Psychol 2022; 18:497-525. [PMID: 35138868 DOI: 10.1146/annurev-clinpsy-072720-014802] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This article provides a narrative review of studies that examined mechanisms of behavior change in substance use disorder. Several mechanisms have some support, including self-efficacy, craving, protective behavioral strategies, and increasing substance-free rewards, whereas others have minimal support (e.g., motivation, identity). The review provides recommendations for expanding the research agenda for studying mechanisms of change, including designs to manipulate putative change mechanisms, measurement approaches that expand the temporal units of analysis during change efforts, more studies of change outside of treatment, and analytic approaches that move beyond mediation tests. The dominant causal inference approach that focuses on treatment and individuals as change agents could be expanded to include a molar behavioral approach that focuses on patterns of behavior in temporally extended environmental contexts. Molar behavioral approaches may advance understanding of how recovery from substance use disorder is influenced by broader contextual features, community-level variables, and social determinants of health. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
Collapse
Affiliation(s)
- Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA; .,Center on Alcohol, Substance Use and Addictions, University of New Mexico, Albuquerque, New Mexico, USA
| | - Rory A Pfund
- Center on Alcohol, Substance Use and Addictions, University of New Mexico, Albuquerque, New Mexico, USA
| | - Jalie A Tucker
- Department of Health Education & Behavior and Center for Behavioral Economic Health Research, University of Florida, Gainesville, Florida, USA
| |
Collapse
|
20
|
Nace A, Johnson G, Eastwood E. Comparison of HIV Viral Suppression Between a Sample of Foreign-Born and U.S.-Born Women of Color in the United States. J Immigr Minor Health 2021; 23:1129-1135. [PMID: 33974177 DOI: 10.1007/s10903-021-01213-8] [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] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Abstract
We investigate the association between nativity status (U.S.- vs foreignborn) and viral suppression among women of color (WOC) with HIV (HIV +) and whether this association was modified by education and housing. METHODS Data were from 549 HIV + WOC, who participated in the Health Resources and Services Administration-funded WOC Initiative 2009-2013. We used generalized estimating equation models to quantify the association between the respondents' nativity status and viral suppression. RESULTS After adjusting for covariates, foreign-born WOC were 2.2 times (95% confidence interval: 1.25, 3.85) more likely to achieve viral suppression than U.S.-born WOC. This association was not modified by education or housing status. CONCLUSIONS Despite facing barriers to care, foreign-born WOC were more likely to achieve viral suppression than U.S.-born WOC. Programs aiming to end the HIV epidemic and reduce HIV disparities in the U.S. should consider these findings as they provide a more nuanced understanding of HIV + WOC.
Collapse
Affiliation(s)
- Amanda Nace
- CUNY Graduate School of Public Health and Health Policy, Health Policy and Management, 55 W 125 th Street, 5 th Fl. NY, New York, 10027, USA.
| | - Glen Johnson
- CUNY Graduate School of Public Health and Health Policy, Health Policy and Management, 55 W 125 th Street, 5 th Fl. NY, New York, 10027, USA
| | - Elizabeth Eastwood
- CUNY Graduate School of Public Health and Health Policy, Health Policy and Management, 55 W 125 th Street, 5 th Fl. NY, New York, 10027, USA
| |
Collapse
|
21
|
Social-spatial network structures and community ties of egocentric sex and confidant networks: A Chicago case study. Soc Sci Med 2021; 291:114462. [PMID: 34763134 DOI: 10.1016/j.socscimed.2021.114462] [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: 04/05/2021] [Revised: 08/17/2021] [Accepted: 10/05/2021] [Indexed: 11/20/2022]
Abstract
Exploring how sexual and confidant networks overlap spatially and socially could facilitate a better understanding of sexually transmitted infection risk, as well as help identify areas for interventions. This study aims to examine how a sexual and peer-affiliate network is impacted or shaped by interconnected social relationships and spatial patterns. We used data collected from a sample of 618 young black men who have sex with men (YBMSM) and transgender women in Chicago (2013-2014) that includes partner and confidant links, geolocations, and pre-exposure prophylaxis (PrEP) awareness. We spatialize different types of social networks and examine joint social-spatial community ties to both identify and differentiate social-spatial behavioral patterns. We explore the spatial structures of the social network by comparing ego-alter network residence patterns, visualizing ego-alter community ties in aggregate, and grouping different types of dyad relationships based on their spatial structure. Findings showed overlapping social and sexual networks. Egos with partners residing in more resourced communities furthest away, with wider alter-ego power differentials, also tended to be at greatest risk. Identifying the social-spatial structures of community ties is critical to enhance our understanding of the spatial context of social relationships, and further distill risk heterogeneity in vulnerable populations within an equitable health framework.
Collapse
|
22
|
Sallabank G, Chavanduka TMD, Walsh AR, Sullivan P, Wolfe J, Filipowicz R, Bonar EE, Horvath KJ, Hailu B, Bauermeister J, Stephenson R. Mapping LGBTQ+ Youth Resource Density Across Four High HIV Prevalence Corridors in the US. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2021; 20:300-314. [PMID: 34703505 PMCID: PMC8532447 DOI: 10.1007/s13178-021-00660-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/14/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Studies using geospatial data to understand LGBTQ+-friendly sexual health and wellness resource availability have often focused on services catered to adults. While HIV rates have increased in adolescents in recent years, few studies have explored disparities in resource access for adolescent gay and bisexual men (AGBMSM). METHODS We used geospatial data of resources (collected and verified 2017-2018) from the iReach app to understand disparities in resource access for AGBMSM within and between 4 high HIV prevalence corridors in the US. RESULTS AGBMSM in non-metro areas had access to fewer resources and some rural counties had no LGBTQ+ -friendly resources. Corridors comprising states with legacies of punitive laws targeting sexual and gender minorities demonstrate stark geographic disparities across the US. CONCLUSIONS Policy-makers must understand the granularity of disparities within regions. Online resources may be able to surmount LGBTQ+ resource deserts. However, physical access to LGBTQ+ -friendly services must be improved as a fundamental strategy for reducing HIV among AGBMSM. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s13178-021-00660-0.
Collapse
Affiliation(s)
- Gregory Sallabank
- Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI USA
| | - Tanaka M. D. Chavanduka
- Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI USA
| | - Alison R. Walsh
- Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI USA
| | - Patrick Sullivan
- Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - James Wolfe
- School of Nursing, University of Pennsylvania, Philadelphia, PA USA
| | | | - Erin E. Bonar
- Dept of Psychiatry and Addiction Center, Injury Prevention Center, Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI USA
| | - Keith J. Horvath
- Department of Psychology, San Diego State University, San Diego, CA USA
| | - Benyam Hailu
- Division of Clinical & Health Services Research, National Institute On Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD USA
| | | | - Rob Stephenson
- Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI USA
| |
Collapse
|
23
|
Phillips G, McCuskey D, Ruprecht MM, Curry CW, Felt D. Structural Interventions for HIV Prevention and Care Among US Men Who Have Sex with Men: A Systematic Review of Evidence, Gaps, and Future Priorities. AIDS Behav 2021; 25:2907-2919. [PMID: 33534056 PMCID: PMC7856612 DOI: 10.1007/s10461-021-03167-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2021] [Indexed: 12/01/2022]
Abstract
The preponderance of HIV interventions have been behavioral, targeting individual, dyadic, or group dynamics. However, structural-level interventions are required to decrease HIV transmission and increase engagement in care, especially for men who have sex with men (MSM), particularly Black and Latinx MSM. A systematic literature review was conducted to assess the current state of structural interventions; only two studies detailing structural interventions related to HIV for Black and Latinx MSM in the US were identified. An additional 91 studies which discussed structural-level barriers to optimal HIV outcomes among MSM, yet which did not directly evaluate a structural intervention, were also identified. While this paucity of findings was discouraging, it was not unexpected. Results of the systematic review were used to inform guidelines for the implementation and evaluation of structural interventions to address HIV among MSM in the U.S. These include deploying specific interventions for multiply marginalized individuals, prioritizing the deconstruction of structural stigma, and expanding the capacity of researchers to evaluate “natural” policy-level structural interventions through a standardization of methods for rapid evaluative response, and through universal application of sex, sexual orientation, and gender identity demographic measures.
Collapse
Affiliation(s)
- Gregory Phillips
- Evaluation, Data Integration, and Technical Assistance (EDIT) Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave #14-043, Chicago, IL, 60611, USA.
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - David McCuskey
- Evaluation, Data Integration, and Technical Assistance (EDIT) Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave #14-043, Chicago, IL, 60611, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Megan M Ruprecht
- Evaluation, Data Integration, and Technical Assistance (EDIT) Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave #14-043, Chicago, IL, 60611, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Caleb W Curry
- Evaluation, Data Integration, and Technical Assistance (EDIT) Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave #14-043, Chicago, IL, 60611, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Case Western Reserve University Undergraduate Studies, Cleveland, OH, USA
| | - Dylan Felt
- Evaluation, Data Integration, and Technical Assistance (EDIT) Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave #14-043, Chicago, IL, 60611, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
24
|
Farahani M, Radin E, Saito S, Sachathep KK, Hladik W, Voetsch AC, Auld AF, Balachandra S, Tippett Barr BA, Low A, Smart TF, Musuka G, Jonnalagadda S, Hakim AJ, Wadonda-Kabondo NW, Jahn A, Mugurungi O, Williams DB, Barradas DT, Payne D, Parekh B, Patel H, Wiesner L, Hoos D, Justman JE. Population Viral Load, Viremia, and Recent HIV-1 Infections: Findings From Population-Based HIV Impact Assessments (PHIAs) in Zimbabwe, Malawi, and Zambia. J Acquir Immune Defic Syndr 2021; 87:S81-S88. [PMID: 33560041 PMCID: PMC10998157 DOI: 10.1097/qai.0000000000002637] [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] [Indexed: 11/25/2022]
Abstract
BACKGROUND HIV population viral load (PVL) can reflect antiretroviral therapy program effectiveness and transmission potential in a community. Using nationally representative data from household surveys conducted in Zimbabwe, Malawi, and Zambia in 2015-16, we examined the association between various VL measures and the probability of at least one recent HIV-1 infection in the community. METHODS We used limiting-antigen avidity enzyme immunoassay, viral load suppression (VLS) (HIV RNA <1000 copies/mL), and antiretrovirals in the blood to identify recent HIV-1 cases. RESULTS Among 1510 enumeration areas (EAs) across the 3 surveys, 52,036 adults aged 15-59 years resided in 1363 (90.3%) EAs with at least one HIV-positive adult consenting to interview and blood draw and whose VL was tested. Mean HIV prevalence across these EAs was 13.1% [95% confidence intervals (CI) 12.7 to 13.5]. Mean VLS prevalence across these EAs was 58.7% (95% CI: 57.3 to 60.0). In multivariable analysis, PVL was associated with a recent HIV-1 case in that EA (adjusted odds ratio: 1.4, 95% CI: 1.2 to 1.6, P = 0.001). VLS prevalence was inversely correlated with recent infections (adjusted odds ratio: 0.3, 95% CI: 0.1 to 0.6, P = 0.004). The 90-90-90 indicators, namely, the prevalence of HIV diagnosis, antiretroviral therapy coverage, and VLS at the EA level, were inversely correlated with HIV recency at the EA level. CONCLUSIONS We found a strong association between PVL and VLS prevalence and recent HIV-1 infection at the EA level across 3 southern African countries with generalized HIV epidemics. These results suggest that population-based measures of VLS in communities may serve as a proxy for epidemic control.
Collapse
Affiliation(s)
| | | | | | | | - Wolfgang Hladik
- Division of Global HIV&TB, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Andrew C Voetsch
- Division of Global HIV&TB, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Andrew F Auld
- Division of Global HIV&TB, U.S. Centers for Disease Control and Prevention (CDC), Malawi
| | - Shirish Balachandra
- Division of Global HIV&TB, U.S. Centers for Disease Control and Prevention (CDC), Côte d'Ivoire
| | - Beth A Tippett Barr
- Division of Global HIV&TB, U.S. Centers for Disease Control and Prevention (CDC), Zimbabwe
| | - Andrea Low
- ICAP at Columbia University, New York, NY
| | | | | | - Sasi Jonnalagadda
- Division of Global HIV&TB, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Avi J Hakim
- Division of Global HIV&TB, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | | | | | | | - Daniel B Williams
- Division of Global HIV&TB, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Danielle T Barradas
- Division of Global HIV&TB, U.S. Centers for Disease Control and Prevention (CDC), Zambia and
| | - Danielle Payne
- Division of Global HIV&TB, U.S. Centers for Disease Control and Prevention (CDC), Malawi
| | - Bharat Parekh
- Division of Global HIV&TB, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Hetal Patel
- Division of Global HIV&TB, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Lubbe Wiesner
- Pharmacology Research Laboratory, University of Cape Town, Cape Town, South Africa; and
| | - David Hoos
- ICAP at Columbia University, New York, NY
| | | |
Collapse
|
25
|
Lawal FJ, Omotayo MO, Lee TJ, Srinivasa Rao ASR, Vazquez JA. HIV Treatment Outcomes in Rural Georgia Using Telemedicine. Open Forum Infect Dis 2021; 8:ofab234. [PMID: 34104669 PMCID: PMC8180244 DOI: 10.1093/ofid/ofab234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 05/04/2021] [Indexed: 11/29/2022] Open
Abstract
Background The increasing shortage of specialized health care services contributes to the ongoing HIV epidemic. Telemedicine (TM) is a potential tool to improve HIV care, but little is known about its effectiveness when compared with traditional (face-to-face [F2F]) care in rural populations. The objective of this study was to compare the effectiveness of HIV care delivered through TM with the F2F model. Methods We conducted a retrospective chart review of a subset of patients with HIV who attended a TM clinic in Dublin, Georgia, and an F2F clinic in Augusta, Georgia, between May 2017 and April 2018. All TM patients were matched to F2F patients based on gender, age, and race. HIV viral load (VL) and CD4 count gain were compared using t test and Mann-Whitney U statistics. Results Three hundred eighty-five patients were included in the analyses (F2F = 200; TM = 185). The mean CD4 in the TM group was higher (643.9 cells/mm3) than that of the F2F group (596.3 cells/mm3; P < .001). There was no statistically significant difference in VL reduction, control, or mean VL (F2F = 416.8 cp/mL; TM = 713.4 cp/mL; P = .30). Thirty-eight of eighty-five patients with detectable VL achieved viral suppression during the study period (F2F = 24/54; TM = 14/31), with a mean change of 3.34 × 104 and –1 to 0.24 × 104, respectively (P = 1.00). Conclusions TM was associated with outcome measures comparable to F2F. Increased access to specialty HIV care through TM can facilitate HIV control in communities with limited health care access in the rural United States. Rigorous prospective evaluation of TM for HIV care effectiveness is warranted.
Collapse
Affiliation(s)
- Folake J Lawal
- Division of Infectious Diseases, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Moshood O Omotayo
- Centre for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA.,Division of Pediatric Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Tae Jin Lee
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Arni S R Srinivasa Rao
- Laboratory for Theory and Mathematical Modeling, Division of Infectious Diseases, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Jose A Vazquez
- Division of Infectious Diseases, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| |
Collapse
|
26
|
Dulin AJ, Earnshaw VA, Dale SK, Carey MP, Fava JL, Wilson-Barthes M, Mugavero MJ, Dougherty-Sheff S, Johnson B, Napravnik S, Howe CJ. A Concept Mapping Study to Understand Multilevel Resilience Resources Among African American/Black Adults Living with HIV in the Southern United States. AIDS Behav 2021; 25:773-786. [PMID: 32940827 DOI: 10.1007/s10461-020-03042-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 12/25/2022]
Abstract
Resilience may help people living with HIV (PLWH) overcome adversities to disease management. This study identifies multilevel resilience resources among African American/Black (AA/B) PLWH and examines whether resilience resources differ by demographics and neighborhood risk environments. We recruited participants and conducted concept mapping at two clinics in the southeastern United States. Concept Mapping incorporates qualitative and quantitative methods to represent participant-generated concepts via two-dimensional maps. Eligible participants had to attend ≥ 75% of their scheduled clinic appointments and did not have ≥ 2 consecutive detectable HIV-1 viral load measurements in the past 2 years. Of the 85 AA/B PLWH who were invited, forty-eight participated. Twelve resilience resource clusters emerged-five individual, two interpersonal, two organizational/policy and three neighborhood level clusters. There were strong correlations in cluster ratings for demographic and neighborhood risk environment comparison groups (r ≥ 0.89). These findings could inform development of theories, measures and interventions for AA/B PLWH.
Collapse
|
27
|
Yu Y, Chen Z, Huang S, Chen Z, Zhang K. What determines employment quality among people living with HIV: An empirical study in China. PLoS One 2020; 15:e0243069. [PMID: 33259563 PMCID: PMC7707494 DOI: 10.1371/journal.pone.0243069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 11/14/2020] [Indexed: 11/18/2022] Open
Abstract
At the intersection of research areas on health and employment, little attention has been paid on employment quality among people living with HIV (PLWH). The objective of the current study is to identify critical factors and empirically examine their effects on employment quality among PLWH. Based on the social-ecological perspective, we identified negative self-image, workplace discrimination, social support, and policy support as critical factors associated with employment quality among PLWH. Thereafter, a questionnaire survey was conducted to gather information from 339 employed PLWH in China. Hierarchical regression analyses were further performed to analyze the effects of the identified factors on employment quality among PLWH. We obtained three main findings. First, negative self-image and workplace discrimination are detrimental to employment quality among PLWH; whereas social support and policy support are conducive to their employment quality. Second, older, male, and highly educated PLWH can better leverage the undesirable effects of negative self-image and workplace discrimination on employment quality compared with their peers. Third, male, and highly educated PLWH can better utilize social support and policy support to advance employment quality compared with their peers. However, the employment quality effects of the identified factors did not differ by marital status. Our findings provided some useful implications for PLWH, employers, community service providers, and policy makers to promote employment quality among PLWH.
Collapse
Affiliation(s)
- Yunjiang Yu
- School of International Economics and Trade, Shanghai Lixin University of Accounting and Finance, Shanghai, China
| | - Zhi Chen
- School of Business Administration, Shanghai Lixin University of Accounting and Finance, Shanghai, China
| | - Shenglan Huang
- School of Business Administration, Shanghai Lixin University of Accounting and Finance, Shanghai, China
- * E-mail:
| | - Zhicheng Chen
- School of Business Administration, Shanghai Lixin University of Accounting and Finance, Shanghai, China
| | - Kailin Zhang
- School of Finance, Shanghai Lixin University of Accounting and Finance, Shanghai, China
| |
Collapse
|
28
|
Chen W, Page TF, Sun W. Racial/Ethnic Disparities in Opioid Use Disorder and Poisoning Emergency Department Visits in Florida. J Racial Ethn Health Disparities 2020; 8:1395-1405. [PMID: 33140289 DOI: 10.1007/s40615-020-00901-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To examine the role of individual race/ethnicity and community racial/ethnic mix on the type of opioid-related emergency department (ED) visits in Florida. METHODS The study identifies opioid-related ED visits that involved heroin, non-heroin poisoning, and opioid use disorder (OUD) from the first quarter of 2010 to the second quarter of 2018 in Florida. The trend is depicted by patients' race/ethnicity and racial/ethnic mix of residential communities. Combined with zip code tabulation area data, the study builds a multilevel model and examines how individual-level and community-level covariates relate to the type of opioid-related ED visits. RESULTS While opioid-related ED visit rate was highest among white patients, majority-black communities caught up with the majority-white communities in the visit rate. The multilevel model results suggest that the likelihood of an opioid-related ED visit involving heroin, non-heroin poisoning, or OUD differed by patient race/ethnicity as well as community racial/ethnic mix. Opioid-related ED visits among minority patients were more likely to involve non-heroin poisoning than non-Hispanic white patients, whereas patients from minority-dominant communities were more likely to involve heroin poisoning than from majority-white communities. However, community racial/ethnic mix was not significantly or less significantly associated with the likelihood of involving OUD ED visits. CONCLUSIONS The study highlights the heterogeneity of the opioid overdose problem across racial/ethnic patients and communities with different racial/ethnic mixes. Future policies may consider the effect of living in different racial/ethnic mixed communities in addition to individual race/ethnicity.
Collapse
Affiliation(s)
- Weiwei Chen
- Department of Economics, Finance and Quantitative Analysis, Michael J. Coles College of Business, Kennesaw State University, 560 Parliament Garden Way, Kennesaw, GA, 30144, USA.
| | - Timothy F Page
- Department of Management, H. Wayne Huizenga College of Business and Entrepreneurship, Nova Southeastern University, 3301 College Ave, Davie, FL, 33314, USA
| | - Wenjie Sun
- Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th St, Miami, FL, 33199, USA
| |
Collapse
|
29
|
Phillips Ii G, McCuskey DJ, Felt D, Raman AB, Hayford CS, Pickett J, Shenkman J, Lindeman PT, Mustanski B. Geospatial perspectives on health: The PrEP4Love campaign and the role of local context in health promotion messaging. Soc Sci Med 2020; 265:113497. [PMID: 33187750 DOI: 10.1016/j.socscimed.2020.113497] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/05/2020] [Accepted: 10/30/2020] [Indexed: 12/18/2022]
Abstract
Pre-exposure prophylaxis (PrEP) remains one of the most effective biomedical interventions for the prevention of HIV transmission. However, uptake among populations most impacted by the HIV epidemic remains low. La rge-scale awareness and mobilization campaigns have sought to address gaps in knowledge and motivation in order to improve PrEP diffusion. Such campaigns must be cognizant of the historical, physical, and structural contexts in which they exist. In urban contexts, neighborhood segregation has the potential to impact health outcomes and amplify disparities. Therefore, we present novel geospatial approaches to the evaluation of a Chicago-based PrEP messaging campaign (PrEP4Love) in a 2018 cohort of men who have sex with men and transgender women, contextualizing results within the localized infrastructure and public health landscape, and examining associations between geographic location and campaign efficacy. Results revealed notable variance in rates of PrEP uptake associated with campaign exposure by Chicago planning area, which are likely explained by the historical and contemporary impacts of racist structures on physical environment and city infrastructure. Findings have important implications for the evaluation and implementation of future messaging campaigns, which should take the unique historical, structural, and geospatial factors of their particular settings into account in order to achieve maximum impact.
Collapse
Affiliation(s)
- Gregory Phillips Ii
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., 14th Floor, Suite 1400, Chicago, IL, 60611, USA; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., 14th Floor, Chicago, IL, 60611, USA; Third Coast Center for AIDS Research, 625 N Michigan Ave., 14th Floor, Suite 1400, Chicago, IL, 60611, USA.
| | - David J McCuskey
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., 14th Floor, Suite 1400, Chicago, IL, 60611, USA; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., 14th Floor, Chicago, IL, 60611, USA
| | - Dylan Felt
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., 14th Floor, Suite 1400, Chicago, IL, 60611, USA; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., 14th Floor, Chicago, IL, 60611, USA
| | - Anand B Raman
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., 14th Floor, Suite 1400, Chicago, IL, 60611, USA; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., 14th Floor, Chicago, IL, 60611, USA
| | - Christina S Hayford
- Third Coast Center for AIDS Research, 625 N Michigan Ave., 14th Floor, Suite 1400, Chicago, IL, 60611, USA
| | - Jim Pickett
- AIDS Foundation of Chicago, 200 W. Monroe St., Suite 1150, Chicago, IL, 60606, USA
| | - Julia Shenkman
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., 14th Floor, Suite 1400, Chicago, IL, 60611, USA; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., 14th Floor, Chicago, IL, 60611, USA
| | - Peter T Lindeman
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., 14th Floor, Suite 1400, Chicago, IL, 60611, USA; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., 14th Floor, Chicago, IL, 60611, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., 14th Floor, Suite 1400, Chicago, IL, 60611, USA; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., 14th Floor, Chicago, IL, 60611, USA; Third Coast Center for AIDS Research, 625 N Michigan Ave., 14th Floor, Suite 1400, Chicago, IL, 60611, USA
| |
Collapse
|
30
|
Tieu HV, Koblin BA, Latkin C, Curriero FC, Greene ER, Rundle A, Frye V. Neighborhood and Network Characteristics and the HIV Care Continuum among Gay, Bisexual, and Other Men Who Have Sex with Men. J Urban Health 2020; 97:592-608. [PMID: 29845586 PMCID: PMC7560681 DOI: 10.1007/s11524-018-0266-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
In order for treatment as prevention to work as a national strategy to contain the HIV/AIDS epidemic in the United States (US), the HIV care continuum must become more robust, retaining more individuals at each step. The majority of people living with HIV/AIDS (PLWHA) in the US are gay, bisexual, and other men who have sex with men (MSM). Within this population, there are distinct race- and ethnicity-based disparities in rates of HIV infection, engagement, and retention in HIV care, and viral suppression. Compared with White MSM, HIV-infected Black MSM are less likely to be on anti-retroviral therapy (ART), adhere to ART, and achieve viral suppression. Among MSM living in urban areas, falling off the continuum may be influenced by factors beyond the individual level, with new research identifying key roles for network- and neighborhood-level characteristics. To inform multi-level and multi-component interventions, particularly to support Black MSM living in urban areas, a clearer understanding of the pathways of influence among factors at various levels of the social ecology is required. Here, we review and apply the empirical literature and relevant theoretical perspectives to develop a series of potential pathways of influence that may be further evaluated. Results of research based on these pathways may provide insights into the design of interventions, urban planning efforts, and assessments of program implementation, resulting in increased retention in care, ART adherence, and viral suppression among urban-dwelling, HIV-infected MSM.
Collapse
Affiliation(s)
- Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
| | - Beryl A Koblin
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
| | - Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Frank C Curriero
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emily R Greene
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
| | - Andrew Rundle
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Victoria Frye
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, USA.
| |
Collapse
|
31
|
Chandran A, Edmonds A, Benning L, Wentz E, Adedimeji A, Wilson TE, Blair-Spence A, Palar K, Cohen M, Adimora A. Longitudinal Associations Between Neighborhood Factors and HIV Care Outcomes in the WIHS. AIDS Behav 2020; 24:2811-2818. [PMID: 32170507 PMCID: PMC7483905 DOI: 10.1007/s10461-020-02830-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Identifying structural determinants affecting HIV outcomes is important for informing interventions across heterogeneous geographies. Longitudinal hierarchical generalized mixed-effects models were used to quantify the associations between changes in certain structural-level factors on HIV care engagement, medication adherence, and viral suppression. Among women living with HIV in the WIHS, ten-unit increases in census-tract level proportions of unemployment, poverty, and lack of car ownership were inversely associated with viral suppression and medication adherence, while educational attainment and owner-occupied housing were positively associated with both outcomes. Notably, increased residential stability (aOR 5.68, 95% CI 2.93, 9.04) was positively associated with HIV care engagement, as were unemployment (aOR: 1.59, 95% CI 1.57, 1.60), lack of car ownership (aOR 1.14, 95% CI 1.13, 1.15), and female-headed households (aOR 1.23, 95% CI 1.22, 1.23). This underscores the importance of understanding neighborhood context, including factors that may not always be considered influential, in achieving optimal HIV-related outcomes.
Collapse
Affiliation(s)
- Aruna Chandran
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andrew Edmonds
- Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lorie Benning
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Eryka Wentz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Adebola Adedimeji
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Tracey E. Wilson
- Department of Community Health Sciences, State University of New York, Downstate Health Sciences University, School of Public Health, Brooklyn, NY, USA
| | - Amanda Blair-Spence
- Department of Medicine, Division of Infectious Disease and Travel Medicine, Georgetown University, Washington, DC, USA
| | - Kartika Palar
- Division of HIV, Infectious Disease and Global Medicine, School of Medicine, University of California, San Francisco, CA, USA
| | - Mardge Cohen
- Cook County Health and Hospital System, Chicago, IL, USA
| | - Adaora Adimora
- Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
32
|
Iwuji C, Chimukuche RS, Zuma T, Plazy M, Larmarange J, Orne-Gliemann J, Siedner M, Shahmanesh M, Seeley J. Test but not treat: Community members' experiences with barriers and facilitators to universal antiretroviral therapy uptake in rural KwaZulu-Natal, South Africa. PLoS One 2020; 15:e0239513. [PMID: 32970730 PMCID: PMC7514038 DOI: 10.1371/journal.pone.0239513] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 09/08/2020] [Indexed: 01/20/2023] Open
Abstract
Introduction Antiretroviral therapy (ART) has revolutionised the care of HIV-positive individuals resulting in marked decreases in morbidity and mortality, and markedly reduced transmission to sexual partners. However, these benefits can only be realised if individuals are aware of their HIV-positive status, initiated and retained on suppressive lifelong ART. Framed using the socio-ecological model, the present study explores factors contributing to poor ART uptake among community members despite high acceptance of HIV-testing within a Treatment as Prevention (TasP) trial. In this paper we identify barriers and facilitators to treatment across different levels of the socio-ecological framework covering individual, community and health system components. Methods This research was embedded within a cluster-randomised trial (ClinicalTrials.gov, number NCT01509508) of HIV treatment as Prevention in rural KwaZulu-Natal, South Africa. Data were collected between January 2013 and July 2014 from resident community members. Ten participants contributed to repeat in-depth interviews whilst 42 participants took part in repeat focus group discussions. Data from individual interviews and focus group discussions were triangulated using community walks to give insights into community members’ perception of the barriers and facilitators of ART uptake. We used thematic analysis guided by a socio-ecological framework to analyse participants’ narratives from both individual interviews and focus group discussions. Results Barriers and facilitators operating at the individual, community and health system levels influence ART uptake. Stigma was an over-arching barrier, across all three levels and expressed variably as fear of HIV disclosure, concerns about segregated HIV clinical services and negative community religious perceptions. Other barriers were individual (substance misuse, fear of ART side effects), community (alternative health beliefs). Facilitators cited by participants included individual (expectations of improved health and longer life expectancy following ART, single tablet regimens), community (availability of ART in the community through mobile trial facilities) and health system factors (fast and efficient service provided by friendly staff). Discussion We identified multiple barriers to achieving universal ART uptake. To enhance uptake in HIV care services, and achieve the full benefits of ART requires interventions that tackle persistent HIV stigma, and offer people with HIV respectful, convenient and efficient services. These interventions require evaluation in appropriately designed studies.
Collapse
Affiliation(s)
- Collins Iwuji
- Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Falmer, United Kingdom
- Africa Health Research Institute, Berea, KwaZulu-Natal, South Africa
- * E-mail:
| | | | - Thembelihle Zuma
- Africa Health Research Institute, Berea, KwaZulu-Natal, South Africa
| | - Melanie Plazy
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Bordeaux, France
| | - Joseph Larmarange
- Institut de Recherche pour le Développement(IRD), Centre Population et Développement (Ceped), Paris, France
| | - Joanna Orne-Gliemann
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Bordeaux, France
| | - Mark Siedner
- Africa Health Research Institute, Berea, KwaZulu-Natal, South Africa
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Maryam Shahmanesh
- Africa Health Research Institute, Berea, KwaZulu-Natal, South Africa
- Institute for Global Health, University College London, London, United Kingdom
| | - Janet Seeley
- Africa Health Research Institute, Berea, KwaZulu-Natal, South Africa
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
33
|
McGee-Avila JK, Doose M, Nova J, Kumar R, Stroup AM, Tsui J. Patterns of HIV testing among women diagnosed with invasive cervical cancer in the New Jersey Medicaid Program. Cancer Causes Control 2020; 31:931-941. [PMID: 32803402 DOI: 10.1007/s10552-020-01333-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 08/04/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE Practice-based guidelines recommend HIV testing during initial invasive cervical cancer (ICC) workup. Determinants of HIV testing during diagnosis of AIDS-defining cancers in vulnerable populations, where risk for HIV infection is higher, are under-explored. METHODS We examine factors associated with patterns of HIV testing among Medicaid enrollees diagnosed with ICC. Using linked data from the New Jersey State Cancer Registry and New Jersey Medicaid claims and enrollment files, we evaluated HIV testing among 242 ICC cases diagnosed from 2012 to 2014 in ages 21-64 at (a) any point during Medicaid enrollment (2011-2014) and (b) during cancer workup 6 months pre ICC diagnosis to 6 months post ICC diagnosis. Logistic regression models identified factors associated with HIV testing. RESULTS Overall, 13% of women had a claim for HIV testing during ICC workup. Two-thirds (68%) of women did not have a claim for HIV testing (non-receipt of HIV testing) while enrolled in Medicaid. Hispanic/NH-API/Other women had lower odds of non-receipt of HIV testing compared with NH-Whites (OR: 0.40; 95% CI: 0.17-0.94). Higher odds of non-receipt of HIV testing were observed among cases with no STI testing (OR: 4.92; 95% CI 2.27-10.67) and < 1 year of Medicaid enrollment (OR: 3.07; 95% CI 1.14- 8.26) after adjusting for other factors. CONCLUSIONS Few women had HIV testing claims during ICC workup. Opportunities for optimal ICC care are informed by knowledge of HIV status. Further research should explore if lack of HIV testing claims during ICC workup is an accurate indicator of ICC care, and if so, to assess testing barriers during workup.
Collapse
Affiliation(s)
- Jennifer K McGee-Avila
- School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ, USA
- François-Xavier Bagnoud Center, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Michelle Doose
- School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
- Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Jose Nova
- Center for State Health Policy, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Rizie Kumar
- Department of Sociology, University of Maryland, College Park, College Park, MD, USA
| | - Antoinette M Stroup
- School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
- Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
- New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, NJ, USA
| | - Jennifer Tsui
- School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
- Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
- Center for State Health Policy, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA.
| |
Collapse
|
34
|
Abstract
Depressive symptoms may differ in severity and change over time in people living with HIV (PLWH). Describing depression trajectories and associated clinical characteristics of PLWH in an interventional study may help in developing a more personalized medicine approach. Using latent class growth analysis four, 15-month self-reported depression trajectories were identified in 416 PLWH participating in a collaborative care program. The four subgroups were characterized by improving (58.4% [of participants]), worsening (9.4%), highly responsive (19.5%) and persistently severe (12.7%) depressive symptoms. A high proportion of individuals were in trajectories marked by improvement. Further, the highly responsive group had on average, over 50% reduction of self-reported depressive symptoms. Self-reported trauma, posttraumatic stress disorder, lower neighborhood-level education and fewer HIV and psychiatry clinic visits were associated with worsening or persistently severe depressive symptom trajectories. Members of the persistently severe group were less likely to be virally suppressed after 12-months. Identifying subgroups of PLWH based on changes in self-reported depressive symptoms may further inform intervention approaches that can advance care.
Collapse
|
35
|
Wallace M, Felker-Kantor E, Madkour A, Ferguson T, Welsh D, Molina P, Theall KP. Adverse Childhood Experiences, Smoking and Alcohol Use, and Allostatic Load Among People Living with HIV. AIDS Behav 2020; 24:1653-1662. [PMID: 31559525 DOI: 10.1007/s10461-019-02684-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Allostatic load is an indicator of multisystem physiologic dysregulation that may arise from prolonged or accumulated exposure to stress, including adverse childhood experiences (ACEs) and chronic stressors persisting into adulthood. People living with HIV (PLWH) may be particularly vulnerable given their high burdens of adversity across the life course. Using data from a cohort of middle aged PLWH, we examined associations between ACEs and two measures of allostatic load. In order to determine whether the negative impact of ACEs on allostatic load operates through increasing the adoption of adverse coping behaviors, we tested for mediation by smoking and alcohol use. PLWH who had experienced 4 or more ACEs had on average higher allostatic load in adulthood compared to those who experienced fewer. Neither smoking nor alcohol use mediated this relationship, however, suggesting alternative mechanisms may be at play.
Collapse
Affiliation(s)
- Maeve Wallace
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., suite 2200, New Orleans, LA, 70112, USA.
| | - Erica Felker-Kantor
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., suite 2200, New Orleans, LA, 70112, USA
| | - Aubrey Madkour
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., suite 2200, New Orleans, LA, 70112, USA
| | - Tekeda Ferguson
- Department of Epidemiology, Louisiana State University School of Public Health, 2020 Gravier St., 5th floor, New Orleans, LA, 70112, USA
| | - David Welsh
- Section of Pulmonary/Critical Care, Louisiana State University School of Medicine, 2020 Gravier St., 5th floor, New Orleans, LA, 70112, USA
| | - Patricia Molina
- Department of Physiology, Louisiana State University School of Medicine, 2020 Gravier St., 5th floor, New Orleans, LA, 70112, USA
| | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., suite 2200, New Orleans, LA, 70112, USA
| |
Collapse
|
36
|
Card KG, Lachowsky NJ, Althoff KN, Schafer K, Hogg RS, Montaner JSG. A systematic review of the geospatial barriers to antiretroviral initiation, adherence and viral suppression among people living with HIV. Sex Health 2020; 16:1-17. [PMID: 30409243 DOI: 10.1071/sh18104] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 07/04/2018] [Indexed: 11/23/2022]
Abstract
Background With the emergence of antiretroviral therapy (ART), Treatment as Prevention (TasP) has become the cornerstone of both HIV clinical care and HIV prevention. However, despite the efficacy of treatment-based programs and policies, structural barriers to ART initiation, adherence and viral suppression have the potential to reduce TasP effectiveness. These barriers have been studied using Geographic Information Systems (GIS). While previous reviews have examined the use of GIS for HIV testing - an essential antecedent to clinical care - to date, no reviews have summarised the research with respect to other ART-related outcomes. METHODS Therefore, the present review leveraged the PubMed database to identify studies that leveraged GIS to examine the barriers to ART initiation, adherence and viral suppression, with the overall goal of understanding how GIS has been used (and might continue to be used) to better study TasP outcomes. Joanna Briggs Institute criteria were used for the critical appraisal of included studies. RESULTS In total, 33 relevant studies were identified, excluding those not utilising explicit GIS methodology or not examining TasP-related outcomes. CONCLUSIONS Findings highlight geospatial variation in ART success and inequitable distribution of HIV care in racially segregated, economically disadvantaged, and, by some accounts, increasingly rural areas - particularly in the United States. Furthermore, this review highlights the utility and current limitations of using GIS to monitor health outcomes related to ART and the need for careful planning of resources with respect to the geospatial movement and location of people living with HIV (PLWH).
Collapse
Affiliation(s)
- Kiffer G Card
- Faculty of Health Science, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Nathan J Lachowsky
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Keri N Althoff
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Katherine Schafer
- Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
| | - Robert S Hogg
- Faculty of Health Science, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Julio S G Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| |
Collapse
|
37
|
Carrasquillo O, Seay J, Jhaveri V, Long T, Kenya S, Thomas E, Sussman D, Trevil D, Koru-Sengul T, Kobetz E. Increasing uptake of evidence-based screening services though a community health worker-delivered multimodality program: study protocol for a randomized pragmatic trial. Trials 2020; 21:368. [PMID: 32349789 PMCID: PMC7191705 DOI: 10.1186/s13063-020-4213-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/27/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Underserved ethnic minority populations experience significant disparities in HIV, hepatitis C virus (HCV), colorectal cancer (CRC), and cervical cancer incidence and mortality. Much of the excess burden of these diseases among underserved communities is due to lack of preventive care, including screening. Barriers to disease screening include low awareness, lack of access to care and health insurance, and cultural beliefs regarding disease prevention. Our current trial aims to examine community health worker (CHW)-delivered, home-based multi-modality screening for HIV, HCV, CRC, and cervical cancer simultaneously. DESIGN We are conducting a randomized pragmatic trial among 900 Haitian, Hispanic, and African-American participants from diverse underserved communities in South Florida. People between the ages of 50 and 65 who have not had appropriate HIV, HCV, CRC, and cervical cancer screening per United States Preventive Services Task Force (USPSTF) recommendations are eligible for the study. Participants are recruited by CHWs and complete a structured interview to assess multilevel determinants of disease risk. Participants are then randomized to receive HIV, HCV, CRC, and cervical cancer screening via navigation to care by a CHW (Group 1) or via CHW-delivered home-based screening (Group 2). The primary outcome is completion of screening for each of these diseases within 6 months post-enrollment. DISCUSSION Our trial is among the first to examine the effectiveness of a CHW-delivered, multimodality, home-based disease-screening approach. If found to be effective, this approach may represent a cost-effective strategy for disease screening within underserved and underscreened minority groups. TRIAL REGISTRATION Clinical Trials.gov # NCT02970136, registered November 21, 2016.
Collapse
Affiliation(s)
- Olveen Carrasquillo
- Sylvester Comprehensive Cancer Center, Clinical Research Building, University of Miami, Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136 USA
- Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136 USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136 USA
| | - Julia Seay
- Sylvester Comprehensive Cancer Center, Clinical Research Building, University of Miami, Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136 USA
- Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136 USA
| | - Vasanti Jhaveri
- Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136 USA
| | - Timothy Long
- Health Choice Network, 9064 N.W. 13 Terrace, Miami, FL 33172 USA
| | - Sonjia Kenya
- Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136 USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136 USA
| | - Emmanuel Thomas
- Sylvester Comprehensive Cancer Center, Clinical Research Building, University of Miami, Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136 USA
- Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136 USA
| | - Daniel Sussman
- Sylvester Comprehensive Cancer Center, Clinical Research Building, University of Miami, Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136 USA
- Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136 USA
| | - Dinah Trevil
- Sylvester Comprehensive Cancer Center, Clinical Research Building, University of Miami, Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136 USA
| | - Tulay Koru-Sengul
- Sylvester Comprehensive Cancer Center, Clinical Research Building, University of Miami, Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136 USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136 USA
| | - Erin Kobetz
- Sylvester Comprehensive Cancer Center, Clinical Research Building, University of Miami, Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136 USA
- Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136 USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136 USA
| |
Collapse
|
38
|
Goldenberg SM, Amram O, Braschel M, Moreheart S, Shannon K. Urban gentrification and declining access to HIV/STI, sexual health, and outreach services amongst women sex workers between 2010-2014: Results of a community-based longitudinal cohort. Health Place 2020; 62:102288. [PMID: 32479365 PMCID: PMC7574814 DOI: 10.1016/j.healthplace.2020.102288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 01/10/2020] [Accepted: 01/16/2020] [Indexed: 01/07/2023]
Abstract
Despite increasing gentrification across North American cities, little is known about impacts on work and living environments and health access for marginalized women. Drawing upon prospective cohort and external spatial data, we examined changes in land use and sex workers' work/living environments in relation to gentrification exposure in Metro Vancouver (2010-2014), and modeled independent effects of gentrification exposure on reduced utilization of HIV/STI testing, sexual health, and sex worker support services. These decreases occurred despite efforts to scale-up HIV services for marginalized populations. Planning of healthcare, housing, and other support services should be responsive to shifting urban landscapes for marginalized women.
Collapse
Affiliation(s)
- Shira M Goldenberg
- Centre for Gender and Sexual Health Equity, 1081, Burrard Street, Vancouver, BC, V6Z 1Y6, Canada; Faculty of Health Sciences, Simon Fraser University, 8888, University Drive, Burnaby, BC, V5A 1S6, Canada.
| | - Ofer Amram
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Melissa Braschel
- Centre for Gender and Sexual Health Equity, 1081, Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Sarah Moreheart
- Centre for Gender and Sexual Health Equity, 1081, Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Kate Shannon
- Centre for Gender and Sexual Health Equity, 1081, Burrard Street, Vancouver, BC, V6Z 1Y6, Canada; Faculty of Medicine, University of British Columbia, Vancouver, BC, V6Z 1Y6, Canada
| |
Collapse
|
39
|
Theall KP, Wallace M, Felker-Kantor E, Madkour AS, Brashear M, Ferguson T, Welsh D, Molina P. Neighborhood Alcohol Environment: Differential Effects on Hazardous Drinking and Mental Health by Sex in Persons Living with HIV (PLWH). AIDS Behav 2019; 23:3237-3246. [PMID: 31401740 PMCID: PMC7467156 DOI: 10.1007/s10461-019-02632-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Despite greater mental health co-morbidities and heavier alcohol use among PLWH, few studies have examined the role of the neighborhood alcohol environment on either alcohol consumption or mental health. Utilizing cross-sectional data from a cohort study in a southern U.S. metropolitan area, we examine the association between neighborhood alcohol environments on hazardous drinking and mental health among 358 in-care PLWH (84% African American, 31% female). Multilevel models were utilized to quantify associations between neighborhood alcohol exposure on hazardous drinking and effect modification by sex. Neighborhood alcohol density was associated with hazardous drinking among men but not women. Women living in alcohol dense neighborhoods were nearly two-fold likely to report depression compared to those in less dense neighborhoods, with no association between neighborhood alcohol density and depression among men. Neighborhood alcohol environments may be an important contextual factor to consider in reducing heavy alcohol consumption and improving mental health among PLWH.
Collapse
Affiliation(s)
- K P Theall
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
- Louisiana State University Health Sciences Center Comprehensive Alcohol and HIV Research Center (CARC), New Orleans, LA, USA.
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., Mailstop 8319, New Orleans, LA, 70112, USA.
| | - M Wallace
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
- Louisiana State University Health Sciences Center Comprehensive Alcohol and HIV Research Center (CARC), New Orleans, LA, USA
| | - E Felker-Kantor
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - A S Madkour
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - M Brashear
- Louisiana State University Health Sciences Center Comprehensive Alcohol and HIV Research Center (CARC), New Orleans, LA, USA
| | - T Ferguson
- Louisiana State University Health Sciences Center Comprehensive Alcohol and HIV Research Center (CARC), New Orleans, LA, USA
- Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, USA
| | - D Welsh
- Louisiana State University Health Sciences Center Comprehensive Alcohol and HIV Research Center (CARC), New Orleans, LA, USA
| | - P Molina
- Louisiana State University Health Sciences Center Comprehensive Alcohol and HIV Research Center (CARC), New Orleans, LA, USA
| |
Collapse
|
40
|
Zullo AR, Adams JW, Gantenberg JR, Marshall BDL, Howe CJ. Examining neighborhood poverty-based disparities in HIV/STI prevalence: an analysis of Add Health data. Ann Epidemiol 2019; 39:8-14.e4. [PMID: 31679893 DOI: 10.1016/j.annepidem.2019.09.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 09/12/2019] [Accepted: 09/23/2019] [Indexed: 12/27/2022]
Abstract
PURPOSE The purpose of the study was to estimate the effect of exposure to neighborhood poverty in adolescence on HIV/STI prevalence in early adulthood. METHODS Longitudinal data from three waves of the National Longitudinal Study of Adolescent to Adult Health were analyzed. The primary exposure was living in a high- versus medium/low-poverty neighborhood during wave I. The outcome was having a sexually transmitted infection (STI) or receiving a HIV/STI diagnosis in the past 12 months at wave III. Covariates included sociodemographic, behavioral, and mental health-related factors. Inverse probability weighted marginal structural models were used to estimate neighborhood poverty-based differences in HIV/STI prevalence. RESULTS The analytic sample comprised 8232 National Longitudinal Study of Adolescent to Adult Health participants. Of these, 16% and 84% resided in high- and medium/low-poverty neighborhoods, respectively. Eleven percent currently had an STI or HIV/STI diagnosis within the prior 12 months. Accounting for measured potential sources of confounding and selection bias, the HIV/STI prevalence difference (95% confidence limits) for those who grew up in high- versus medium/low-poverty neighborhoods was 0.015 (-0.015, 0.045). CONCLUSIONS Strong evidence for neighborhood poverty-based differences in HIV/STI prevalence was not observed. Researchers should continue to investigate the effect of neighborhood-level socioeconomic position measures and, if warranted, identify etiologically relevant exposure periods.
Collapse
Affiliation(s)
- Andrew R Zullo
- Departments of Health Services, Policy, and Practice and Epidemiology, Brown University School of Public Health, Centers for Evidence Synthesis and Gerontology and Healthcare Research, Providence, RI; Providence Veterans Affairs Medical Center, Center of Innovation in Long-Term Services and Supports, Providence, RI.
| | - Joëlla W Adams
- Department of Epidemiology, Brown University School of Public Health, Centers for Epidemiology and Environmental Health, Providence, RI
| | - Jason R Gantenberg
- Department of Epidemiology, Brown University School of Public Health, Centers for Epidemiology and Environmental Health, Providence, RI
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health, Centers for Epidemiology and Environmental Health, Providence, RI
| | - Chanelle J Howe
- Department of Epidemiology, Brown University School of Public Health, Centers for Epidemiology and Environmental Health, Providence, RI
| |
Collapse
|
41
|
Kim B, Callander D, DiClemente R, Trinh-Shevrin C, Thorpe LE, Duncan DT. Location of Pre-exposure Prophylaxis Services Across New York City Neighborhoods: Do Neighborhood Socio-demographic Characteristics and HIV Incidence Matter? AIDS Behav 2019; 23:2795-2802. [PMID: 31321639 DOI: 10.1007/s10461-019-02609-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Despite an increasing pre-exposure prophylaxis (PrEP) use among populations at highest risk of HIV acquisition, comprehensive and easy access to PrEP is limited among racial/ethnic minorities and low-income populations. The present study analyzed the geographic distribution of PrEP providers and the relationship between their location, neighborhood characteristics, and HIV incidence using spatial analytic methods. PrEP provider density, socio-demographics, healthcare availability, and HIV incidence data were collected by ZIP-code tabulation area in New York City (NYC). Neighborhood socio-demographic measures of race/ethnicity, income, insurance coverage, or same-sex couple household, were not associated with PrEP provider density, after adjusting for spatial autocorrelation, and PrEP providers were located in high HIV incidence neighborhoods (P < 0.01). These findings validate the need for ongoing policy interventions (e.g. public health detailing) vis-à-vis PrEP provider locations in NYC and inform the design of future PrEP implementation strategies, such as public health campaigns and navigation assistance for low-cost insurance.
Collapse
Affiliation(s)
- Byoungjun Kim
- Department of Population Health, School of Medicine, New York University, 180 Madison Ave, 3rd Floor, New York, NY, 10016, USA.
| | - Denton Callander
- Department of Population Health, School of Medicine, New York University, 180 Madison Ave, 3rd Floor, New York, NY, 10016, USA
| | - Ralph DiClemente
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY, USA
| | - Chau Trinh-Shevrin
- Department of Population Health, School of Medicine, New York University, 180 Madison Ave, 3rd Floor, New York, NY, 10016, USA
| | - Lorna E Thorpe
- Department of Population Health, School of Medicine, New York University, 180 Madison Ave, 3rd Floor, New York, NY, 10016, USA
| | - Dustin T Duncan
- Department of Population Health, School of Medicine, New York University, 180 Madison Ave, 3rd Floor, New York, NY, 10016, USA
| |
Collapse
|
42
|
Knerich V, Jones AA, Seyedin S, Siu C, Dinh L, Mostafavi S, Barr AM, Panenka WJ, Thornton AE, Honer WG, Rutherford AR. Social and structural factors associated with substance use within the support network of adults living in precarious housing in a socially marginalized neighborhood of Vancouver, Canada. PLoS One 2019; 14:e0222611. [PMID: 31545818 PMCID: PMC6756550 DOI: 10.1371/journal.pone.0222611] [Citation(s) in RCA: 10] [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: 06/13/2019] [Accepted: 09/03/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The structure of a social network as well as peer behaviours are thought to affect personal substance use. Where substance use may create health risks, understanding the contribution of social networks to substance use may be valuable for the design and implementation of harm reduction or other interventions. We examined the social support network of people living in precarious housing in a socially marginalized neighborhood of Vancouver, and analysed associations between social network structure, personal substance use, and supporters' substance use. METHODS An ongoing, longitudinal study recruited 246 participants from four single room occupancy hotels, with 201 providing social network information aligned with a 6-month observation period. Use of tobacco, alcohol, cannabis, cocaine (crack and powder), methamphetamine, and heroin was recorded at monthly visits. Ego- and graph-level measures were calculated; the dispersion and prevalence of substances in the network was described. Logistic mixed effects models were used to estimate the association between ego substance use and peer substance use. Permutation analysis was done to test for randomness of substance use dispersion on the social network. RESULTS The network topology corresponded to residence (Hotel) with two clusters differing in demographic characteristics (Cluster 1 -Hotel A: 94% of members, Cluster 2 -Hotel B: 95% of members). Dispersion of substance use across the network demonstrated differences according to network topology and specific substance. Methamphetamine use (overall 12%) was almost entirely limited to Cluster 1, and absent from Cluster 2. Different patterns were observed for other substances. Overall, ego substance use did not differ over the six-month period of observation. Ego heroin, cannabis, or crack cocaine use was associated with alter use of the same substances. Ego methamphetamine, powder cocaine, or alcohol use was not associated with alter use, with the exception for methamphetamine in a densely using part of the network. For alters using multiple substances, cannabis use was associated with lower ego heroin use, and lower ego crack cocaine use. Permutation analysis also provided evidence that dispersion of substance use, and the association between ego and alter use was not random for all substances. CONCLUSIONS In a socially marginalized neighborhood, social network topology was strongly influenced by residence, and in turn was associated with type(s) of substance use. Associations between personal use and supporter's use of a substance differed across substances. These complex associations may merit consideration in the design of interventions to reduce risk and harms associated with substance use in people living in precarious housing.
Collapse
Affiliation(s)
- Verena Knerich
- Departments of Computer Science, and Cultural Anthropology, Ludwig-Maximilians University, Munich, Germany
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Andrea A. Jones
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Sam Seyedin
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Christopher Siu
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Louie Dinh
- Department of Computer Science, University of British Columbia, Vancouver, BC, Canada
| | - Sara Mostafavi
- Department of Statistics, University of British Columbia, Vancouver, BC, Canada
- Medical Genetics, Department Office, University of British Columbia, Vancouver, BC, Canada
| | - Alasdair M. Barr
- Department of Anesthesia, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - William J. Panenka
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Allen E. Thornton
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
| | - William G. Honer
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | | |
Collapse
|
43
|
Jiang Y, Li X, Cho H, Brown MJ, Qiao S, Haider MR. Effects of individual and neighborhood socioeconomic status on antiretroviral therapy adherence: The role of adherence self-efficacy. J Health Psychol 2019; 26:1143-1153. [PMID: 31419916 DOI: 10.1177/1359105319869809] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to examine the potential mediation effect of adherence self-efficacy on the associations between individual and neighborhood socioeconomic status and antiretroviral therapy adherence in a sample of 337 people living with HIV in South Carolina, United States. Results showed that there were no direct effects of individual or neighborhood socioeconomic status on antiretroviral therapy adherence, whereas both individual socioeconomic status and neighborhood socioeconomic status were associated with adherence self-efficacy, which in turn were related to antiretroviral therapy adherence. These findings suggest that interventions targeting adherence self-efficacy may improve antiretroviral therapy adherence among people living with HIV with low socioeconomic status or those living in socioeconomically disadvantaged neighborhoods.
Collapse
|
44
|
Hermanstyne KA, Green HD, Tieu HV, Hucks-Ortiz C, Wilton L, Shoptaw S. The Association Between Condomless Anal Sex and Social Support Among Black Men Who Have Sex With Men (MSM) in Six U.S. Cities: A Study Using Data from the HIV Prevention Trials Network BROTHERS Study (HPTN 061). AIDS Behav 2019; 23:1387-1395. [PMID: 30377980 DOI: 10.1007/s10461-018-2315-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We assessed how egocentric (i.e., self-generated descriptions of a person's social contacts) network structure and composition corresponded with reported instances of condomless receptive and insertive anal intercourse with men who were reportedly HIV-infected or of unknown HIV serostatus in a sample of black men who have sex with men (MSM) in six U.S. cities. Ratings showing a higher percentage of network members who provided social participation and medical support were positively associated with reporting condomless sex. There were also significant positive associations between stimulant use and condomless insertive and receptive anal sex. Future research should examine the social processes that underlie these associations and explore ways that social support can affect HIV prevention efforts for black MSM.
Collapse
Affiliation(s)
- Keith A Hermanstyne
- Department of Psychiatry, UCSF Weil Institute for Neurosciences, University of California, 1930 Market Street, San Francisco, CA, 94102, USA.
| | - Harold D Green
- Indiana University Network Science Institute, Bloomington, IN, USA
- Center for Applied Network Analysis and Systems Science, RAND Corporation, Santa Monica, CA, USA
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
- Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | | | - Leo Wilton
- Department of Human Development, State University of New York at Binghamton, Binghamton, NY, USA
- Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - Steven Shoptaw
- Department of Family Medicine, University of California, Los Angeles, CA, USA
| |
Collapse
|
45
|
Crockett KB, Edmonds A, Johnson MO, Neilands TB, Kempf MC, Konkle-Parker D, Wingood G, Tien PC, Cohen M, Wilson TE, Logie CH, Sosanya O, Plankey M, Golub E, Adimora AA, Parish C, Weiser SD, Turan JM, Turan B. Neighborhood Racial Diversity, Socioeconomic Status, and Perceptions of HIV-Related Discrimination and Internalized HIV Stigma Among Women Living with HIV in the United States. AIDS Patient Care STDS 2019; 33:270-281. [PMID: 31166786 PMCID: PMC6588105 DOI: 10.1089/apc.2019.0004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Relationships that traverse sociodemographic categories may improve community attitudes toward marginalized groups and potentially protect members of those groups from stigma and discrimination. The present study evaluated whether internalized HIV stigma and perceived HIV-related discrimination in health care settings differ based on individual- and neighborhood-level characteristics of women living with HIV (WLHIV). We also sought to extend previous conceptual and empirical work to explore whether perceived HIV-related discrimination mediated the association between neighborhood racial diversity and internalized HIV stigma. A total of 1256 WLHIV in the Women's Interagency HIV Study (WIHS) attending 10 sites in metropolitan areas across the United States completed measures of internalized HIV stigma and perceived HIV-related discrimination in health care settings. Participants also provided residential information that was geocoded into Federal Information Processing Standard (FIPS) codes and linked with census-tract level indicators. In cross-sectional analyses, greater neighborhood racial diversity was associated with less internalized HIV stigma and less perceived HIV-related discrimination regardless of individual race. Neighborhood median income was positively associated with internalized HIV stigma and perceived discrimination, while individual income was negatively associated with perceptions of stigma and discrimination. In an exploratory mediation analysis, neighborhood racial diversity had a significant indirect effect on internalized HIV stigma through perceived HIV-related discrimination. An indirect effect between neighborhood income and internalized stigma was not supported. These findings suggest that greater neighborhood racial diversity may lessen HIV stigma processes at the individual level and that HIV stigma-reduction interventions may be most needed in communities that lack racial diversity.
Collapse
Affiliation(s)
- Kaylee B Crockett
- 1 Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Andrew Edmonds
- 2 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Mallory O Johnson
- 3 Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Torsten B Neilands
- 3 Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Mirjam-Colette Kempf
- 4 School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama
- 5 School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
- 6 School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Deborah Konkle-Parker
- 7 Department of Medicine/Infectious Diseases, University of Mississippi Medical Center, Jackson, Mississippi
| | - Gina Wingood
- 8 Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York
| | - Phyllis C Tien
- 3 Department of Medicine, University of California, San Francisco, San Francisco, California
- 9 Medical Service, Department of Veteran Affairs Medical Center, San Francisco, California
| | - Mardge Cohen
- 10 Department of Medicine, Stroger Hospital of Cook County Bureau of Health and Hospital Systems, Chicago, Illinois
| | - Tracey E Wilson
- 11 Department of Community Health Sciences, State University of New York Downstate Medical Center, School of Public Health, Brooklyn, New York
| | - Carmen H Logie
- 12 Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | | | - Michael Plankey
- 14 Georgetown University Medical Center, Washington, District of Columbia
| | - Elizabeth Golub
- 15 Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Adaora A Adimora
- 16 Division of Infectious Diseases, University of North Carolina School of Medicine Chapel Hill, North Carolina
- 17 UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Carrigan Parish
- 18 Mailman School of Public Health, Department of Sociomedical Sciences, Columbia University Miami Research Center, Miami, Florida
| | - Sheri D Weiser
- 19 Division of HIV, ID and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Janet M Turan
- 20 Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Bulent Turan
- 1 Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| |
Collapse
|
46
|
Turner CM, Arayasirikul S, Trujillo D, Lê V, Wilson EC. Social Inequity and Structural Barriers to Completion of Ecological Momentary Assessments for Young Men Who Have Sex With Men and Trans Women Living With HIV in San Francisco. JMIR Mhealth Uhealth 2019; 7:e13241. [PMID: 31066714 PMCID: PMC6530262 DOI: 10.2196/13241] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 03/25/2019] [Accepted: 03/29/2019] [Indexed: 01/15/2023] Open
Abstract
Background Ecological momentary assessments (EMAs) administered via text messaging facilitate real-time data collection. With widespread cell phone access, EMAs are becoming more available to even the most disenfranchised communities, such as those living with HIV. However, structural barriers disproportionately burden young men who have sex with men (MSM) and trans women (TW) living with HIV and threaten participation in HIV research. Objective We aim to identify structural barriers to completing EMA text surveys nested within a digital HIV care intervention for young MSM and TW living with HIV in San Francisco. Methods A total of 10,800 EMA text messages were delivered daily over 90 days to 120 participants enrolled in the Health eNav intervention (2017-2018) at the San Francisco Department of Public Health. EMA surveys inquired about participants’ daily affect, sexual behaviors, substance use, and treatment adherence. Survey completion was calculated after 30, 60, and 90 days of follow-up. We described characteristics of nonstarters (those who provided less than four complete responses to the first seven EMA surveys) and analyzed structural correlates of days to first weeklong or more EMA survey noncompletion using multivariable Cox proportional hazards regression. Qualitative interviews were used to evaluate the acceptability of EMA surveys. Results Participants completed 4384 of 10,800 (40.59%) EMA surveys. Completion of 70% or more of EMA surveys was attained by 56 of 120 participants (46.7%) at 30 days of follow-up, 40/120 (33.3%) at 60 days of follow-up, and 30/120 (25.0%) by the end of the 90-day study period. Twenty-eight participants (23.3%) were identified as nonstarters, and were more likely to be recently incarcerated (prevalence ratio [PR] 2.3, 95% CI 1.3-4.4), forego basic needs for HIV medications (PR 2.4, 95% CI 1.3-4.5), and be diagnosed with HIV in the last year (PR 2.2, 95% CI 1.1-4.1). Adjusting for nonstarters, young MSM and TW living in temporary/transitional housing (adjusted hazard ratio [aHR] 1.8, 95% CI 1.1-3.0), foregoing HIV medications to afford basic needs (aHR 1.7, 95% CI 1.1-2.7), and having less than a college education (aHR 3.5, 95% CI 1.4-9.0) had greater hazard of weeklong or more EMA survey noncompletion. Overall, there was high acceptability of the EMA surveys. Conclusions Although access to and use of technology is increasingly ubiquitous, this analysis demonstrates persisting gaps in EMA completion by socioeconomic factors such as incarceration, education level, housing, and competing needs for young MSM and TW living with HIV in San Francisco. Moreover, those recently diagnosed with HIV were more likely to experience an immediate drop-off in completing EMA surveys. EMAs are feasible for individuals not experiencing social inequity and structural barriers. HIV prevention technologies addressing these barriers and leveraging similar methodology may prove effective for young MSM and TW living with HIV.
Collapse
Affiliation(s)
- Caitlin M Turner
- San Francisco Department of Public Health, San Francisco, CA, United States
| | - Sean Arayasirikul
- San Francisco Department of Public Health, San Francisco, CA, United States
| | - Dillon Trujillo
- San Francisco Department of Public Health, San Francisco, CA, United States
| | - Victory Lê
- San Francisco Department of Public Health, San Francisco, CA, United States
| | - Erin C Wilson
- San Francisco Department of Public Health, San Francisco, CA, United States
| |
Collapse
|
47
|
De Jesus M, Williams DR. The Care and Prevention in the United States Demonstration Project: A Call for More Focus on the Social Determinants of HIV/AIDS. Public Health Rep 2019; 133:28S-33S. [PMID: 30457952 DOI: 10.1177/0033354918801353] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Maria De Jesus
- 1 School of International Service and Center on Health, Risk, and Society, American University, Washington, DC, USA
| | - David R Williams
- 2 Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,3 Department of African and African American Studies, Harvard University, Cambridge, MA, USA
| |
Collapse
|
48
|
Ochigbo SO, Torty C, Anah M. Prevalence of HIV infection among siblings of HIV positive children in Calabar, Nigeria. Pan Afr Med J 2019; 32:179. [PMID: 31312293 PMCID: PMC6620075 DOI: 10.11604/pamj.2019.32.179.16837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 03/10/2019] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Early diagnosis and treatment of paediatric HIV is key as mortality of untreated patients is very high in the first two years of life, and reaches 80% by four years. Case finding efforts for children especially outside Prevention of mother-to-child transmission (PMTCT) is inadequate. Targeting siblings of index HIV-exposed and infected children is an important way of improving identification and enrolment into care thereby reducing paediatric mortality. The study therefore aimed to determine the prevalence of HIV infection among siblings of HIV positive children in care in Calabar. METHODS This descriptive cross-sectional study was conducted among children aged six weeks to 15 years who are siblings of HIV positive children receiving care. Parental consent and child assent were obtained, the children were tested for HIV at their homes irrespective of their prior test results. Ethical clearance certificates were obtained from the health institutions. RESULTS Siblings of 401 index patients were tested for HIV, four were positive giving a prevalence rate of 1%. Three hundred and sixty-seven 367(91.5%) had been tested previously while 34(8.5%) never had HIV test. Among the siblings who were HIV positive, 1(0.3%) was a male while 3(0.7%) were females. There were more HIV positive siblings in the 11-15 years age group. CONCLUSION All the four HIV positive siblings were from the lower socioeconomic class (p=0.022). The routine screening of siblings of HIV positive children should be sustained with focus on adolescents from the lower socioeconomic class. This will improve early identification and enrolment into care thereby reducing paediatric mortality.
Collapse
Affiliation(s)
| | - Chimaeze Torty
- Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Maxwell Anah
- Faculty of Medicine, Department of Paediatrics, University of Calabar, Calabar, Nigeria
| |
Collapse
|
49
|
Dillon FR, Eklund A, Ebersole R, Ertl MM, Martin JL, Verile MG, Gonzalez SR, Johnson S, Florentin D, Wilson L, Roberts S, Fisher N. Heterosexual Self-Presentation and Other Individual- and Community-Based Correlates of HIV testing among Latino Men Who Have Sex With Men. PSYCHOLOGY OF MEN & MASCULINITY 2019; 20:238-251. [PMID: 31592191 PMCID: PMC6779342 DOI: 10.1037/men0000166] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
From 2010 to 2014, HIV diagnoses among Latino men who have sex with other men (LMSM) have increased by 14%, while diagnoses declined by 11% among white, non-Latino MSM. This health disparity is in part due to exposure to other LMSM with undiagnosed HIV infections. To effectively engage LMSM who are unaware of their serostatus, profiles of men differing in theorized determinants of HIV testing must be considered. In this retrospective study, we examined data from 546 LMSM to investigate whether hypothesized individual- (traditional masculine gender role conformity; sexual identity development status; alcohol and illicit drug use; sexual risk behaviors; perceived HIV susceptibility; and HIV stigma) and community-based (HIV prevention programming, access to health care, social support, neighborhood collective efficacy) factors were associated with differences in HIV testing. Latent profile analysis was used to identify profiles of men, and subsequent analyses examined whether profiles exhibited differential proportions of HIV testing. Four latent profiles were observed. One profile (50.3% tested) differed markedly from all other profiles (5.1 to 11% tested) in HIV testing. Characteristics of participants in this unique profile included reporting lower levels of heterosexual self-presentation, sexual identity uncertainty (and high levels of sexual identity commitment), condom use, HIV stigma, education, and perceived HIV susceptibility than all other profiles. Findings could improve HIV testing rates among LMSM by specifying ways in which public health advertisements/campaigns and community-based testing outreach efforts could be tailored to men most at-risk for transmitting HIV due to unknown serostatus.
Collapse
|
50
|
Xie F, Zheng H, Huang L, Yuan Z, Lu Y. Social Capital Associated with Quality of Life among People Living with HIV/AIDS in Nanchang, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E276. [PMID: 30669364 PMCID: PMC6352181 DOI: 10.3390/ijerph16020276] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 01/14/2019] [Accepted: 01/15/2019] [Indexed: 11/21/2022]
Abstract
Background: This study aims to explore the relationship between quality of life (QOL) and social capital factors among "people living with HIV/AIDS" (PLWHA), in order to improve their quality of life and help them to release AIDS discrimination. Methods: A cross-sectional survey with 225 PLWHA was done in Nanchang, China, between January and June of 2015. Questionnaires consisted of a socio-demographic questionnaire, Personal Social Capital Scale and Medical Outcomes Study HIV Health Survey. To identify social capital factors influencing QOL among PLWHA, t-test and multiple linear regression were used as statistical tools. The analysis of data was conducted using SPSS 22.0 with a significant value of p < 0.05. Results: The scores of total social capital, bonding social capital and bridging social capital were 23.68 ± 5.55, 14.11 ± 3.40 and 9.46 ± 3.43 respectively. The scores of Physical Health Summary (PHS) and Mental Health Summary (MHS) were 51.88 ± 7.04 and 49.29 ± 6.60. Multiple linear regression analysis showed that age (B = -0.137, p = 0.020), income (B = 0.2170, p ≤ 0.001), employment (B = 0.112, p = 0.043) and bonding social capital (B = 0.178, p = 0.001) had significant effects on PHS. Bonding social capital was the most important influencing factor for MHS (B = 0.506, p < 0.001). There was no significant relationship between bridging social capital and QOL (p > 0.05). Conclusions: The PLWHA community has low social capital and a poor QOL in Nanchang. Bonding social capital had a positive impact on the QOL of PLWHA. There is an urgent need to build a better social support system based on bonding social capital for PLWHA. It is worth further exploring to identify how to make full use of bridging social capital for improving QOL among PLWHA.
Collapse
Affiliation(s)
- Fei Xie
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China.
| | - Huilie Zheng
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China.
| | - Ling Huang
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China.
- Center for Disease Prevention and Control of Pudong New District, Shanghai 200136, China.
| | - Zhaokang Yuan
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China.
| | - Yuanan Lu
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China.
- Department of Public Health Sciences, University of Hawaii at Manoa, Honolulu, HI 96822, USA.
| |
Collapse
|