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Henry BF, Hartmann J, Goddard-Eckrich D, Chang M, Wu E, Hunt T, Gilbert L, Wimberly AS, El-Bassel N. Typologies of Stressful Life Events and Their Association With Sexual Risk Behaviors and Communication Among Justice-Involved Males and Their Female Sex Partners. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2022; 34:379-394. [PMID: 36181499 PMCID: PMC9576004 DOI: 10.1521/aeap.2022.34.5.379] [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
Stressful life events are prevalent among justice-involved populations and are associated with sexual risk behaviors and partner communication regarding safe-sex practices. We describe patterns of stress exposure for heterosexual couples (where males are under community supervision) and how stress patterns are associated with sexual risk behaviors and communication (460 individuals; 230 couples). Latent class analysis identified patterns of stress. Multinominal logistic regression models identified associations between sex, race, ethnicity, and stress classes. Multilevel Poisson regression models described relationships between sexual risk behaviors and frequency of communication about condoms/HIV, and stress classes. We found four classes that differed by sex, race, and ethnicity and were associated with the number of sexual partners, condom use self-efficacy, discussing condoms with partner, and discussing HIV prevention with partner. Partner class was associated with the number of sexual partners. Findings inform future assessment/interventions for sexual health that consider patterns of stress and demographics.
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Affiliation(s)
- Brandy F Henry
- School of Social Work, Columbia University, New York, New York
- College of Education, Pennsylvania State University State College, Pennsylvania
| | | | | | - Mingway Chang
- School of Social Work, Columbia University, New York, New York
| | - Elwin Wu
- School of Social Work, Columbia University, New York, New York
| | - Timothy Hunt
- School of Social Work, Columbia University, New York, New York
| | - Louisa Gilbert
- School of Social Work, Columbia University, New York, New York
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Banks DE, Hensel DJ, Zapolski TCB. Integrating Individual and Contextual Factors to Explain Disparities in HIV/STI Among Heterosexual African American Youth: A Contemporary Literature Review and Social Ecological Model. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1939-1964. [PMID: 32157486 PMCID: PMC7321914 DOI: 10.1007/s10508-019-01609-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 12/03/2019] [Accepted: 12/10/2019] [Indexed: 05/21/2023]
Abstract
Heterosexual African American youth face substantial disparities in sexual health consequences such as HIV and STI. Based on the social ecological framework, the current paper provides a comprehensive, narrative review of the past 14 years of literature examining HIV/STI risk, including risky sexual behavior, among heterosexual African American youth and a conceptual model of risk among this population. The review found that individual psychological and biological factors are insufficient to explain the sexual health disparities faced by this group; instead, structural disadvantage, interpersonal risk, and community dysfunction contribute to the disparity in HIV/STI outcomes directly and indirectly through individual psychological factors. The conceptual model presented suggests that for African American youth, (1) HIV/STI risk commonly begins at the structural level and trickles down to the community, social, and individual levels, (2) risk works in a positive feedback system such that downstream effects compound the influence of structural risks, and (3) contextual and individual risk factors must be considered within the advanced stage of the epidemic facing this population. Despite advanced HIV and STI epidemics among heterosexual African American youth, multisystemic interventions that target structural risk factors and their downstream effects are posited to reduce the disparity among this high-risk population.
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Affiliation(s)
- Devin E Banks
- Department of Psychology, Indiana University Purdue University-Indianapolis, 402 N. Blackford St., LD 124, Indianapolis, IN, 46202, USA.
| | - Devon J Hensel
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tamika C B Zapolski
- Department of Psychology, Indiana University Purdue University-Indianapolis, 402 N. Blackford St., LD 124, Indianapolis, IN, 46202, USA
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Pregnancy Coercion as a Risk Factor for HIV and Other Sexually Transmitted Infections Among Young African American Women. J Acquir Immune Defic Syndr 2020; 82 Suppl 2:S155-S161. [PMID: 31658204 PMCID: PMC6820702 DOI: 10.1097/qai.0000000000002174] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pregnancy coercion (PC), defined as a restriction of women's reproductive autonomy, may be associated with increased HIV and sexually transmitted infection (STI) risk. However, there are few empirical studies defining the association between PC and HIV risk, particularly among vulnerable African American women. SETTING AND METHODS African American women (N = 560), ages 17-24, completed an audio computer-assisted self-interview assessing PC prevalence and its association with HIV/STI risk. Women were screened for prevalent STIs using polymerase chain reaction assays. Multivariate logistic and linear regressions evaluated the association of PC and multiple HIV/STI risk-associated outcomes. RESULTS Women who had experienced PC in the last 3 months, relative to those not experiencing PC, were 78% more likely to test positive for an STI [adjusted odds ratio = 1.78, 95% confidence interval (CI) = 1.10 to 2.90]. Among women who experienced PC, odds of noncondom use in their last sexual encounter were 3.45-fold greater relative to women not experiencing PC (95% CI = 1.55 to 7.85). Women who experienced PC had lower condom use intentions (coefficient, -1.31, P = 0.002), greater fear of condom negotiation, and perceived more barriers to condom use (coefficients, 3.89 and 5.74, respectively, both P < 0.001). Women who experienced PC had 1.98 (95% CI = 1.22 to 3.21) and 1.82 (95% CI = 1.09 to 3.04) odds of depression and HIV worry relative to women not experiencing PC. CONCLUSION Among African American women, PC was associated with a range of adverse sexual health outcomes and HIV/STI-related behaviors and attitudes. The findings underscore the need for promoting gender-equitable social norms in HIV prevention interventions.
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Sales JM, Sheth AN. Associations Among Perceived HIV Risk, Behavioral Risk and Interest in PrEP Among Black Women in the Southern US. AIDS Behav 2019; 23:1871-1876. [PMID: 30387025 DOI: 10.1007/s10461-018-2333-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Utilizing data from Southern women, we created an HIV risk index with expanded partner-level factors to better capture women who may benefit from HIV pre-exposure prophylaxis (PrEP). We examined the relationships between potential HIV risk as estimated by laboratory-confirmed bacterial STIs, HIV risk index, perceived HIV risk, and interest in PrEP. Women had multiple PrEP indications; partner characteristics better differentiated STI status than other indicators. Perceived HIV risk differentiated STI status, significantly correlated with the HIV risk index, as well as predicted greater interest in PrEP. Findings can inform how best to evaluate HIV risk and PrEP acceptability among women.
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Affiliation(s)
- Jessica M Sales
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road, Room 570, Atlanta, GA, 30322, USA.
| | - Anandi N Sheth
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, USA
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Segrin C. Indirect Effects of Social Skills on Health Through Stress and Loneliness. HEALTH COMMUNICATION 2019; 34:118-124. [PMID: 29053380 DOI: 10.1080/10410236.2017.1384434] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The social skills deficit vulnerability model predicts that people with inadequate social skills are at risk for a range of psychosocial problems, especially when confronted with stress. People with poor social skills often experience stress and loneliness and these two constructs were tested as potential pathways by which the poor social skills confer a risk for compromised mental and physical health. An online survey was completed by 775 adults, aged 18-91. The sample matched national demographics for race/ethnicity and age, among those over 18. Structural equation modeling revealed indirect effects of social skills on both mental and physical health through both stress and loneliness. The models showed that poor social skills were associated with poor mental and physical health through elevated stress and increased loneliness. The findings reveal that social skills deficits are associated with physical as well as mental health problems.
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Affiliation(s)
- Chris Segrin
- a Department of Communication , University of Arizona
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Thames AD, Hammond A, Nunez RA, Mahmood Z, Jones F, Carter SL, Bilder RM, Fisher S, Bivens-Davis T, Jones L. Sexual Health Behavior and Mental Health Among Older African American Women: The Sistahs, Sexuality, and Mental Health Well-Being Project. J Womens Health (Larchmt) 2018; 27:1177-1185. [PMID: 30070959 DOI: 10.1089/jwh.2017.6777] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In Los Angeles County, the rates of sexually transmitted infections and diseases among African Americans represent a significant public health disparity. Older African American women are at particular risk as they are more likely to engage in high-risk sexual behaviors and report social isolation and loneliness than their younger counterparts. However, the literature on the relationship between sexual health and mental health in this group is limited. The purpose of this study was to use a community-based participatory research (CBPR) approach to better understand sexual health behaviors and mental health among African American women over 50 years of age who reside in South Los Angeles. MATERIALS AND METHODS This project was divided into two phases. Phase I (January-March 2017) of the project consisted of four dialog/focus groups (N = 45) (ages: 50-80; Mage = 67). The purpose of Phase II (April 2017) was to present study results from Phase I to the community via a community-based conference, as well as gather feedback and generate discussion about the next steps for community prevention/intervention. RESULTS Women reported that they did not feel comfortable discussing sexual practices with their physician, partners, and friends. Most women identified depression, loneliness, and self-esteem issues as reasons for engaging in high-risk sexual behaviors. During Phase II, potential intervention avenues emerged to address issues such as lack of physician-patient communication, lack of community support, and dialogs about sex. CONCLUSIONS The use of CBPR greatly enhanced our knowledge of the core issues surrounding sexual health and mental health among older African American women.
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Affiliation(s)
- April D Thames
- 1 Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles , Los Angeles, California
| | - Andrea Hammond
- 1 Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles , Los Angeles, California
| | - Rodolfo A Nunez
- 1 Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles , Los Angeles, California.,2 Department of Psychology, University of California Los Angeles , Los Angeles, California
| | - Zanjbeel Mahmood
- 1 Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles , Los Angeles, California
| | - Felica Jones
- 3 Healthy African American Families II , Los Angeles, California
| | | | - Robert M Bilder
- 1 Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles , Los Angeles, California
| | - Steven Fisher
- 5 Fox Hills Ladera Healthy Families Association , Los Angeles, California
| | | | - Loretta Jones
- 3 Healthy African American Families II , Los Angeles, California
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Curran T. An actor-partner interdependence analysis of cognitive flexibility and indicators of social adjustment among mother-child dyads. PERSONALITY AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.paid.2018.01.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sales JM, Steiner RJ, Brown JL, Swartzendruber A, Patel AS, Sheth AN. PrEP Eligibility and Interest Among Clinic- and Community-Recruited Young Black Women in Atlanta, Georgia, USA. Curr HIV Res 2018. [PMID: 30062969 DOI: 10.2174/1570162×16666180731143756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
BACKGROUND Atlanta has been identified as an HIV "hot spot" for Black women and ranks 5th in the US with new infections. Yet little is known about PrEP eligibility or interest among young Black women in Atlanta. METHODS A convenience sample of 1,261 Black women (ages 14-24 years) were recruited from two settings: community venues and sexual health clinics. They provided self-reported sexual behavior data and specimens for laboratory testing for chlamydia (CT) and gonorrhea (GC) infections. For each woman, the number of key self-reported behavioral HIV risk factors was calculated (0-6 factors for the clinic sample, 0-3 factors for the community sample). A single item assessed PrEP interest in the community sample only. RESULTS Bacterial STI positivity, an indicator for PrEP eligibility, was 20.5% (17.1% CT, 6.3% GC) and 20.9% (18.8% CT, 5.2% GC) for the clinic and community samples, respectively. Of the 144 STI positive women from the clinic sample, 20.1% reported no behavioral risk indicators and 47.2% reported > 2 behavioral indicators. Of the 117 STI positive women from the community sample, 21.4% reported no behavioral risk indicators. 60.7% of the community sample reported they would be likely or very likely to use PrEP if available. CONCLUSION Young Black women in Atlanta, whether sampled from community or sexual health settings, are at substantial risk for HIV infection and meet several PrEP eligibility criteria. Scaling up PrEP among women in Atlanta could have significant implications for HIV in this high burden region.
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Affiliation(s)
- J M Sales
- Rollins School of Public Health, Emory University, Atlanta, GA, 30322, United States
| | - R J Steiner
- Rollins School of Public Health, Emory University, Atlanta, GA, 30322, United States
| | - J L Brown
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, United States
| | - A Swartzendruber
- College of Public Health, University of Georgia, Athens, Georgia, United States
| | - A S Patel
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, United States
| | - A N Sheth
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, United States
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Sales J, Steiner R, Brown J, Swartzendruber A, Patel A, Sheth A. PrEP Eligibility and Interest Among Clinic- and Community-Recruited Young Black Women in Atlanta, Georgia, USA. Curr HIV Res 2018; 16:250-255. [PMID: 30062969 PMCID: PMC6352727 DOI: 10.2174/1570162x16666180731143756] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 05/24/2018] [Accepted: 05/24/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Atlanta has been identified as an HIV "hot spot" for Black women and ranks 5th in the US with new infections. Yet little is known about PrEP eligibility or interest among young Black women in Atlanta. METHODS A convenience sample of 1,261 Black women (ages 14-24 years) were recruited from two settings: community venues and sexual health clinics. They provided self-reported sexual behavior data and specimens for laboratory testing for chlamydia (CT) and gonorrhea (GC) infections. For each woman, the number of key self-reported behavioral HIV risk factors was calculated (0-6 factors for the clinic sample, 0-3 factors for the community sample). A single item assessed PrEP interest in the community sample only. RESULTS Bacterial STI positivity, an indicator for PrEP eligibility, was 20.5% (17.1% CT, 6.3% GC) and 20.9% (18.8% CT, 5.2% GC) for the clinic and community samples, respectively. Of the 144 STI positive women from the clinic sample, 20.1% reported no behavioral risk indicators and 47.2% reported > 2 behavioral indicators. Of the 117 STI positive women from the community sample, 21.4% reported no behavioral risk indicators. 60.7% of the community sample reported they would be likely or very likely to use PrEP if available. CONCLUSION Young Black women in Atlanta, whether sampled from community or sexual health settings, are at substantial risk for HIV infection and meet several PrEP eligibility criteria. Scaling up PrEP among women in Atlanta could have significant implications for HIV in this high burden region.
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Affiliation(s)
- J.M. Sales
- Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - R.J. Steiner
- Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - J.L. Brown
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - A. Swartzendruber
- College of Public Health, University of Georgia, Athens, Georgia, USA
| | - A.S. Patel
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - A.N. Sheth
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
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