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Vines L, Sotelo D, Giddens N, Manza P, Volkow ND, Wang GJ. Neurological, Behavioral, and Pathophysiological Characterization of the Co-Occurrence of Substance Use and HIV: A Narrative Review. Brain Sci 2023; 13:1480. [PMID: 37891847 PMCID: PMC10605099 DOI: 10.3390/brainsci13101480] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
Combined antiretroviral therapy (cART) has greatly reduced the severity of HIV-associated neurocognitive disorders in people living with HIV (PLWH); however, PLWH are more likely than the general population to use drugs and suffer from substance use disorders (SUDs) and to exhibit risky behaviors that promote HIV transmission and other infections. Dopamine-boosting psychostimulants such as cocaine and methamphetamine are some of the most widely used substances among PLWH. Chronic use of these substances disrupts brain function, structure, and cognition. PLWH with SUD have poor health outcomes driven by complex interactions between biological, neurocognitive, and social factors. Here we review the effects of comorbid HIV and psychostimulant use disorders by discussing the distinct and common effects of HIV and chronic cocaine and methamphetamine use on behavioral and neurological impairments using evidence from rodent models of HIV-associated neurocognitive impairments (Tat or gp120 protein expression) and clinical studies. We also provide a biopsychosocial perspective by discussing behavioral impairment in differentially impacted social groups and proposing interventions at both patient and population levels.
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Affiliation(s)
- Leah Vines
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA; (L.V.); (D.S.); (P.M.); (N.D.V.)
| | - Diana Sotelo
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA; (L.V.); (D.S.); (P.M.); (N.D.V.)
| | - Natasha Giddens
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI 53719, USA;
| | - Peter Manza
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA; (L.V.); (D.S.); (P.M.); (N.D.V.)
| | - Nora D. Volkow
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA; (L.V.); (D.S.); (P.M.); (N.D.V.)
| | - Gene-Jack Wang
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA; (L.V.); (D.S.); (P.M.); (N.D.V.)
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2
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Owens C, Gray SJ, Carter K, Hoffman M, Mullen C, Hubach RD. Implementation Facilitators and Barriers for Primary Care Providers Prescribing Daily Oral PrEP to Adolescents in the United States. AIDS Patient Care STDS 2023; 37:379-393. [PMID: 37566536 DOI: 10.1089/apc.2023.0090] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023] Open
Abstract
Primary care providers (PCPs) are critical in prescribing human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) to adolescents at risk of HIV. More research is needed to identify facilitators and barriers PCPs encounter in prescribing PrEP to eligible adolescents post-Food and Drug Administration (FDA) approval. This online cross-sectional survey examined the PrEP implementation facilitators and barriers among a national sample of PCPs in the United States. PCPs (n = 502) specializing in family medicine or pediatrics were recruited from a Qualtrics panel from July 15 to August 9, 2022. We analyzed the collected data using content analysis and applied the Expert Recommendations for Implementing Change (ERIC) to codebook creation and data analysis. We conducted a Fisher's exact chi-square test of independence to compare facilitator and barrier prevalence differences between participants who had and had not prescribed PrEP to an adolescent patient. Results demonstrate that (1) distributing prescriber-focused educational materials, (2) involving parents, (3) changing liability laws, (4) enhancing adolescent PrEP uptake and adherence, (5) changing clinical resources, and (6) using mass/social media to change community norms might be strategies that influence PCPs prescribing PrEP to eligible adolescent patients. Results from this study could facilitate the planning of hybrid implementation-effectiveness trials designed to determine the acceptability, feasibility, and effectiveness of implementation strategies in improving the practices of PCPs prescribing PrEP to at-risk adolescents.
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Affiliation(s)
- Christopher Owens
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Samuel J Gray
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, USA
| | - Kaileigh Carter
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Matt Hoffman
- School of Nursing, Texas A&M University, Bryan, Texas, USA
| | - Cody Mullen
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, USA
| | - Randolph D Hubach
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, USA
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3
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Evans KN, Martinez O, King H, van den Berg JJ, Fields EL, Lanier Y, Hussen SA, Malavé-Rivera SM, Duncan DT, Gaul Z, Buchacz K. Utilizing Community Based Participatory Research Methods in Black/African American and Hispanic/Latinx Communities in the US: The CDC Minority HIV Research Initiative (MARI-Round 4). J Community Health 2023; 48:698-710. [PMID: 36943607 PMCID: PMC10028312 DOI: 10.1007/s10900-023-01209-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 03/23/2023]
Abstract
The Centers for Disease Control and Prevention Minority HIV Research Initiative (MARI) funded 8 investigators in 2016 to develop HIV prevention and treatment interventions in highly affected communities. We describe MARI studies who used community-based participatory research methods to inform the development of interventions in Black/African American and Hispanic/Latinx communities focused on sexual minority men (SMM) or heterosexual populations. Each study implemented best practice strategies for engaging with communities, informing recruitment strategies, navigating through the impacts of COVID-19, and disseminating findings. Best practice strategies common to all MARI studies included establishing community advisory boards, engaging community members in all stages of HIV research, and integrating technology to sustain interventions during the COVID-19 pandemic. Implementing community-informed approaches is crucial to intervention uptake and long-term sustainability in communities of color. MARI investigators' research studies provide a framework for developing effective programs tailored to reducing HIV-related racial/ethnic disparities.
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Affiliation(s)
- Kimberly N Evans
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Omar Martinez
- Department of Population Health Sciences, College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Hope King
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Errol L Fields
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Yzette Lanier
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Sophia A Hussen
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Souhail M Malavé-Rivera
- School of Public Health, University of Puerto Rico-Medical Sciences Campus, San Juan, PR, USA
| | - Dustin T Duncan
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Zaneta Gaul
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Social & Scientific Systems affiliate of DLH, Atlanta, GA, USA
| | - Kate Buchacz
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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4
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Rosenthal AE, Spezia M, Sosnowy C, Chan PA. Acceptability of HIV Prevention Approaches Among USA Faith-Based Leaders. JOURNAL OF RELIGION AND HEALTH 2023; 62:1658-1675. [PMID: 36515812 DOI: 10.1007/s10943-022-01705-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
HIV/AIDS disproportionately impacts underserved communities in the USA. This study evaluated the acceptability of partnering with faith communities to improve HIV prevention, screening, and engagement in care with a focus on Hispanic/Latinx (H/L) communities. We engaged faith-based leaders to identify how the cultural competence and foundations of trust within these communities may be leveraged to improve HIV-related healthcare access for underserved groups including H/L individuals. Using a semi-structured qualitative interview approach, we interviewed N = 20 faith-based leaders in Providence County, Rhode Island (RI). Data were analyzed using the framework approach which utilized inductive generation of themes and systematic grouping into predetermined categories. Seven of the 20 interviewees self-identified as H/L faith leaders and discussed needs specific to H/L communities including destigmatization of HIV, increased access to care, and partnerships founded on mutual respect. The other 13 faith leaders did not personally identify as H/L but all served communities with significant H/L populations. We included these individuals given their communities already performed HIV and/or other health outreach and could provide insight into what approaches could be adapted to the needs expressed by H/L leaders. All interviewees were accepting of developing partnerships with outside organizations to engage in HIV prevention, and all identified potential solutions to identified barriers. Results suggested that faith-based outreach should be further investigated as a method of improving HIV prevention in the general and H/L populations.
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Affiliation(s)
- Alex E Rosenthal
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA.
- Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA.
| | - Marie Spezia
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Collette Sosnowy
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Philip A Chan
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
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5
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Religiosity and Engagement in HIV Care Among African American People Living with HIV. J Racial Ethn Health Disparities 2023; 10:560-572. [PMID: 35079959 DOI: 10.1007/s40615-022-01246-1] [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: 11/21/2021] [Revised: 01/12/2022] [Accepted: 01/19/2022] [Indexed: 10/19/2022]
Abstract
HIV continues to disproportionately impact Black/African Americans. New and innovative strategies are needed to increase and enhance engagement in HIV care. The Black/African American church is a powerful institution with the potential to enhance HIV care among congregants. This study examines perceptions on incorporating religiosity into engagement in HIV care for African Americans living with HIV among Black/African Americans persons living with HIV, church leaders and members, and HIV health and service providers. Findings indicated Black/African Americans living with HIV would be willing to engage in religiously tailored, joint church-health initiatives to increase engagement in care. Church leaders and members and HIV health and service providers also reported a willingness to provide religiously tailored services, and that providing these services would be both acceptable and feasible for implementation. These findings should be considered in future research designed to enhance engagement in HIV care for Black/African Americans living with HIV.
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Walsh JL, John SA, Quinn KG, Hirshfield S, O’Neil A, Petroll AE. Factors associated with quality of life, depressive symptoms, and perceived stress among rural older adults living with HIV in the United States. J Rural Health 2023; 39:488-498. [PMID: 36510755 PMCID: PMC10038895 DOI: 10.1111/jrh.12730] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE Rural older people living with HIV (PLH) in the United States are a population of growing size and significance. A better understanding of factors associated with quality of life (QOL), depressive symptoms, and stress in this population-especially modifiable factors-could inform future interventions. METHODS Online or on paper, we surveyed 446 PLH aged 50+ residing in rural counties across the United States (Mage = 56, 67% male, 67% White, and 23% Black). Associations between social support, HIV stigma, satisfaction with medical care, discrimination in health care settings, and structural barriers and health-related QOL, depressive symptoms, and perceived stress were assessed using multiple linear regressions. FINDINGS Controlling for demographics, greater social support was associated with better QOL, fewer depressive symptoms, and less stress. Greater HIV stigma was associated with more depressive symptoms and stress. Satisfaction with care was associated with better QOL and less stress. Discrimination in medical settings was associated with lower QOL and more depressive symptoms and stress. Finally, experiencing more structural barriers was associated with lower QOL and more depressive symptoms and stress. CONCLUSIONS In addition to engagement in care and viral suppression, QOL and mental health are also critical considerations for rural older PLH. Increasing social support, reducing or providing skills to cope with HIV stigma, improving quality of care, reducing discrimination and stigma in medical settings, and reducing or mitigating the impact of structural barriers present potential targets for interventions aiming to improve the well-being of older rural PLH.
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Affiliation(s)
- Jennifer L. Walsh
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, The Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Steven A. John
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, The Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Katherine G. Quinn
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, The Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Sabina Hirshfield
- STAR Program, Department of Medicine, SUNY Downstate Health Sciences University, New York, New York, USA
| | - Andrew O’Neil
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, The Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Andrew E. Petroll
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, The Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Derose KP, Berkley-Patton J, Hamilton-Burgess C, Thompson CB, Williams ED, Simon S, Allsworth JE. Correlates of HIV-Related Stigmas Among African American Church-Affiliated Populations in Kansas City. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2023; 35:54-68. [PMID: 36735231 PMCID: PMC9907009 DOI: 10.1521/aeap.2023.35.1.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
HIV-related stigmas contribute to disparities, and contact with HIV-positive individuals has been suggested to reduce stigma. Faith-based organizations have been recognized as important to stigma reduction efforts among African American populations; however, relatively few church-based studies have measured HIV-related stigma. This study uses baseline data (N = 1,448) from a study with 14 African American churches in Kansas City, Missouri and Kansas, to examine correlates of HIV-related stigmas among church members and community members accessing church social services using two previously validated scales that measure discomfort interacting with individuals with HIV and anticipated stigma or rejection. Knowing someone with HIV was associated with lower discomfort, even after adjusting for sociodemographic characteristics and sexual risk, HIV knowledge, previous communication about HIV at church, and mean drug and homosexuality stigmas. Knowing someone with HIV was not associated with anticipated stigma or rejection after adjustment. Contact-based interventions hold promise for reducing discomfort around people with HIV among church-affiliated populations.
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Affiliation(s)
- Kathryn P. Derose
- University of Massachusetts Amherst, Department of Health Promotion & Policy
- RAND Corporation
| | | | | | | | | | - Stephen Simon
- University of Missouri - Kansas City, School of Medicine
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8
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Pichon LC, Jewell EN, Williams Stubbs A, Jones D, Campbell B, Kimble KM, Stewart GM, Hurd-Sawyer L, Carroll L, Powell TW. An Engaged Community of Faith to Decrease HIV Stigma in the U.S. South. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2100. [PMID: 36767467 PMCID: PMC9915988 DOI: 10.3390/ijerph20032100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/16/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Community members from a city in the U.S. Deep South identified root causes of HIV racial disparities, including stigma. This meeting report describes how we developed and implemented a conference series to address HIV stigma. We used community feedback and bidirectional learning to host two meetings in observance of National HIV Testing Day (June 2021) and National Southern HIV/AIDS Awareness Day (August 2021). We established a 10-member organizing committee workgroup that met monthly to plan the Faith Summit in honor of National Black HIV Awareness Day (February 2022). Lessons learned include (a) the effectiveness of different community engagement strategies, including participatory evaluative approaches, and (b) strategies to maintain engagement and increase participation, such as reliance on personal and professional networks and prompting the community about forthcoming interventions. Sustaining a conference series to end HIV stigma requires commitment and inclusive participation. This collaborative project offers additional evidence that faith communities can be a part of the solution to ending the HIV epidemic and related health disparities.
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Affiliation(s)
- Latrice C. Pichon
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN 38152, USA
| | - Erin N. Jewell
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN 38152, USA
| | - Andrea Williams Stubbs
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN 38152, USA
| | | | | | | | | | | | - Lacretia Carroll
- University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Terrinieka W. Powell
- Department of Population, Family, and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Owens C, Voorheis E, Lester JN, Green HD, Herbenick D, Dodge B, Hubach RD. The lived experiences of rural HIV social workers. AIDS Care 2023; 35:48-52. [PMID: 34612112 DOI: 10.1080/09540121.2021.1981817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
HIV service providers are the primary implementers of HIV care services, but rural HIV service providers are under researched. We used an interpretative phenomenological analysis to explore rural HIV service providers' lived experiences of working in HIV care, who work in a rural region of a Midwestern state in the United States. From July to August 2019, 15 HIV service providers participated in a one-hour semi-structured telephone interview that elicited their experiences working in the rural HIV care continuum. Participants were tired of constantly educating and working to reduce HIV stigma; however, they received support from family and friends once they educated them about HIV. Participants felt they lacked control over systems and they developed emotional-based coping to address constant occupational stressors. Findings highlight the importance of resiliency and advocacy research and practice across ecological levels.
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Affiliation(s)
- Christopher Owens
- Department of Health and Kinesiology, College of Education and Human Development, Texas A&M University, College Station, TX, USA.,Center for Sexual Health Promotion, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Eva Voorheis
- Center for Sexual Health Promotion, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Jessica N Lester
- Department of Counseling and Educational Psychology, School of Education, Indiana University, Bloomington, IN, USA
| | - Harold D Green
- Center for Sexual Health Promotion, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Debby Herbenick
- Center for Sexual Health Promotion, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Brian Dodge
- Center for Sexual Health Promotion, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Randolph D Hubach
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
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10
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Irie WC, Calabrese SK, Patel RR, Mayer KH, Geng EH, Marcus JL. Preferences for HIV Preexposure Prophylaxis Products Among Black Women in the U.S. AIDS Behav 2022; 26:2212-2223. [PMID: 34985607 DOI: 10.1007/s10461-021-03571-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2021] [Indexed: 01/27/2023]
Abstract
In a nationwide sample of Black women in the U.S., we assessed preferences for HIV preexposure prophylaxis (PrEP) products, including long-acting injectable (LAI) PrEP and once-daily oral PrEP. Among 315 respondents, 32.1% were aware of PrEP and 40.6% were interested in using it; interest increased to 62.2% if PrEP were provided for free. Oral PrEP was the preferred option (51.1%), followed by LAI PrEP (25.7%), vaginal gel (16.5%), and vaginal ring (6.7%). When examining oral and LAI PrEP alone, most (62.7%) preferred oral PrEP. LAI PrEP was more likely to be preferred among respondents with concerns about healthcare costs or PrEP-related stigma, and among those who reported inconsistent condom use and multiple sexual partners. Although most Black women preferred oral PrEP, LAI PrEP may be appealing to a subset with social and structural barriers to PrEP use, such as cost and stigma, and those at increased risk of HIV infection.
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Pichon LC, Stubbs AW, Teti M. Snap out stigma photovoice project in the U.S. South. BMC Health Serv Res 2022; 22:795. [PMID: 35725410 PMCID: PMC9208191 DOI: 10.1186/s12913-022-08147-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 06/01/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The purpose of SNAP Out Stigma (SOS) was to design and implement a community-based intervention to reduce HIV-related stigma for people living with HIV (PLWH) in the Deep South. This region is a subset of 9 states including Memphis, Tennessee (project site) driving the epidemic in the United States. The purpose of this paper is to explain how PLWH in the U.S. South used Photovoice to communicate stigmatizing lived experiences and contextualize their intersection with multi-level sources of support. METHODS PLWH attended one-on-one and/or group sessions with other PLWH. In Session 1, PLWH received a project overview, met other participants, received a camera and camera training, completed a standardized internalized stigma scale, discussed experiences of internalized stigma, and were instructed to take 3-10 pictures that captured stigma. In Session 2, PLWH discussed the pictures and their meaning. In Session 3, PLWH expanded on what they shared in previous sessions in a one-on-one interview. Thematic analysis captured key patterns of how PLWH experienced stigma. RESULTS Forty-seven PLWH attended Session 1 and were issued a camera. Of those, 35 completed sessions 2 and 3. Participants self-identified as cis man who has sex with men (n = 18), ciswoman (n = 5), transwoman (n = 10), and non-binary (n = 2). Four emergent themes intersecting with internalizations of stigma were identified including: medical, social support, church, and self. CONCLUSIONS The SOS intervention created a safe space for PLWH to share lived experiences of stigmatization. Photovoice facilitated discussion topics ranging from healing and recovery to overcoming factors of social determinants of HIV. We identified trauma-informed growth as an area of future programs for PLWH.
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Affiliation(s)
- Latrice C. Pichon
- grid.56061.340000 0000 9560 654XDivision of Social and Behavioral Sciences, The University of Memphis, School of Public Health, 3825 Desoto Avenue
- 209 Robison Hall, TN 38152 Memphis, USA
| | - Andrea Williams Stubbs
- grid.56061.340000 0000 9560 654XDivision of Social and Behavioral Sciences, The University of Memphis, School of Public Health, 3825 Desoto Avenue
- 209 Robison Hall, TN 38152 Memphis, USA
| | - Michelle Teti
- grid.134936.a0000 0001 2162 3504Department of Public Health, The University of Missouri, 806 Lewis Hall, Columbia, MO 65211 USA
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Reif S, Rao D, Wilson E, Beckwith N, Frey S, Cooper H, Ward D, Belden M. Adaptation and Preliminary Testing of an Intervention to Reduce Stigma among Individuals Living with HIV in the Deep South. SOCIAL WORK IN PUBLIC HEALTH 2022; 37:1-13. [PMID: 34464238 DOI: 10.1080/19371918.2021.1965937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
HIV-related stigma has been implicated as a contributor to the disproportionate impact of HIV in the US Deep South. However, effective interventions aimed at reducing HIV-related stigma are limited in the region. This study adapted and piloted an HIV-related stigma reduction intervention, the UNITY Workshop, for use among people living with HIV in the Deep South following a modified framework of the ADAPT-ITT model and the five principles of Corrigan's Model of Strategic Stigma Change. The adapted intervention, named the YOUNITY Workshop, was conducted in an experiential, group format and focused on enhancing stigma coping skills. Workshop satisfaction was high, and most participants reported acquiring new skills for coping with HIV-related stigma and HIV status disclosure. Participants also reported benefitting from the social support generated from the workshop and desired additional opportunities to connect with others in the future. This pilot study demonstrated the feasibility and positive preliminary outcomes of conducting a group-based HIV stigma reduction workshop in the Deep South. Future rigorous testing of the YOUNITY Workshop is planned to better examine health outcomes associated with participation.
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Affiliation(s)
- Susan Reif
- Center for Health Policy and Inequalities Research, Duke University, Durham, North Carolina, United States
| | - Deepa Rao
- Department of Global Health, University of Washington, Seattle, United States
| | - Elena Wilson
- Center for Health Policy and Inequalities Research, Duke University, Durham, North Carolina, United States
| | - Nicole Beckwith
- Center for Health Policy and Inequalities Research, Duke University, Durham, North Carolina, United States
| | - Sarah Frey
- Department of Global Health, University of Washington, Seattle, United States
| | - Haley Cooper
- Center for Health Policy and Inequalities Research, Duke University, Durham, North Carolina, United States
| | | | - Micha Belden
- Center for Health Policy and Inequalities Research, Duke University, Durham, North Carolina, United States
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Daniel NA, Hassan SA, Mohamed F, Sheikh N, Basualdo G, Schwartz R, Gebreselassie BT, Beyene YK, Gabreselassie L, Bayru K, Tadesse B, Libneh HA, Shidane M, Benalfew S, Ali A, Rao D, Kerani RP, Patel RC. Harambee! 2.0: The Impact of HIV-Related and Intersectional Stigmas on HIV Testing Behaviors Among African Immigrant Communities in Seattle, Washington. AIDS Behav 2022; 26:149-164. [PMID: 34368910 PMCID: PMC8349708 DOI: 10.1007/s10461-021-03396-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2021] [Indexed: 02/07/2023]
Abstract
African immigrants are disproportionately affected by HIV compared to U.S.-born individuals, and early HIV testing is the key challenge in ending the HIV epidemic in these communities. HIV-related stigma appears to be the most significant barrier to testing for HIV among African communities in King County, WA. In this formative study, we conducted thirty key informant interviews and five focus group discussions (n = total 72 participants) with Ethiopian, Somali, and Eritrean people living with HIV, health professionals, religious and other community leaders, and lay community members in King County to better understand HIV-related and intersectional stigmas' impact on HIV testing behaviors. We used inductive coding and thematic analysis. Participants from all communities reported similar themes for HIV-related and intersectional stigmas' influences on HIV testing behaviors. Misconceptions or poor messaging, e.g., regarding treatability of HIV, as well as normative or religious/moral beliefs around pre/extramarital sex contributed to HIV-related stigma. Intersecting identities such as immigrant status, race/ethnicity, and having a non-English language preference, all intermingle to further influence access to the U.S. healthcare system, including for HIV testing. These findings can be used to inform future research on community-led approaches to addressing early HIV testing amongst African immigrant communities.
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Affiliation(s)
| | - Shukri A Hassan
- Department of Medicine, UW, 325 9th Ave, Seattle, WA, 98105, USA
| | - Farah Mohamed
- Department of Medicine, UW, 325 9th Ave, Seattle, WA, 98105, USA
- Somali Health Board, Tukwila, WA, USA
| | - Najma Sheikh
- Department of Global Health, UW, Seattle, WA, USA
| | | | - Rahel Schwartz
- Ethiopian Community in Seattle, Seattle, WA, USA
- Ethiopian Health Board, Seattle, WA, USA
| | | | | | | | | | | | | | | | | | - Ahmed Ali
- Somali Health Board, Tukwila, WA, USA
- Department of Global Health, UW, Seattle, WA, USA
| | - Deepa Rao
- Department of Global Health, UW, Seattle, WA, USA
| | - Roxanne P Kerani
- Department of Medicine, UW, 325 9th Ave, Seattle, WA, 98105, USA
| | - Rena C Patel
- Department of Medicine, UW, 325 9th Ave, Seattle, WA, 98105, USA.
- Department of Global Health, UW, Seattle, WA, USA.
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14
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African American Clergy Recommendations to Enhance the Federal Plan to End the HIV Epidemic: A Qualitative Study. AIDS Behav 2022; 26:100-111. [PMID: 34417672 PMCID: PMC8379056 DOI: 10.1007/s10461-021-03415-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2021] [Indexed: 01/06/2023]
Abstract
African Americans in the southern United States continue to be disproportionately affected by HIV. Although faith-based organizations (FBOs) play important roles in the social fabric of African American communities, few HIV screening, care, and PrEP promotion efforts harness the power of FBOs. We conducted 11 focus groups among 57 prominent African American clergy from Arkansas, Mississippi, and Alabama. We explored clergy knowledge about the Ending the HIV Epidemic: A Plan for America (EHE); normative recommendations for how clergy can contribute to EHE; and how clergy can enhance the HIV care continua and PrEP. We explored how clergy have responded to the COVID-19 crisis, and lessons learned from pandemic experiences that are relevant for HIV programs. Clergy reported a moral obligation to participate in the response to the HIV epidemic and were willing to support efforts to expand HIV screening, treatment, PrEP and HIV care. Few clergy were familiar with EHE, U = U and TasP. Many suggested developing culturally tailored messages and were willing to lend their voices to social marketing efforts to destigmatize HIV and promote uptake of biomedical interventions. Nearly all clergy believed technical assistance with biomedical HIV prevention and care interventions would enhance their ability to create partnerships with local community health centers. Partnering with FBOs presents important and unique opportunities to reduce HIV disparities. Clergy want to participate in the EHE movement and need federal resources and technical assistance to support their efforts to bridge community activities with biomedical prevention and care programs related to HIV. The COVID-19 pandemic presents opportunities to build important infrastructure related to these goals.
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15
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Rivera AV, Carrillo SA, Braunstein SL. Prevalence of U = U Awareness and Its Association with Anticipated HIV Stigma Among Low-Income Heterosexually Active Black and Latino Adults in New York City, 2019. AIDS Patient Care STDS 2021; 35:370-376. [PMID: 34463141 DOI: 10.1089/apc.2021.0070] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The fact that people with HIV (PWH) who have an undetectable viral load cannot sexually transmit HIV has been disseminated under the messaging "Undetectable = Untransmittable" (U = U). U = U messaging intends to destigmatize HIV by demonstrating that PWH can have healthy sexual lives. Among a sample of low-income heterosexually active Black and Latino adults, we aimed to (1) measure the prevalence of U = U awareness and (2) determine its association with anticipated HIV stigma. Low-income heterosexually active adults were recruited through respondent-driven sampling in New York City. Among Black and Latino participants who self-reported not having HIV, multiple linear regression was used to determine the association between U = U awareness with the following types of anticipated HIV stigma, as determined by principal component analyses: (1) general; (2) dating related; and (3) sex related. Of 485 participants, 35% were aware of U = U. Those who were aware reported less dating-related [adjusted B: -0.20; 95% confidence interval (CI): -0.37 to -0.03] and sex-related (adjusted B: -0.15; 95% CI: -0.29 to -0.002) anticipated HIV stigma. Although the prevalence of U = U awareness was much lower than reported in other populations (e.g., gender and sexual minorities and PWH), prevalence was moderate in our sample, given that awareness efforts have generally not focused on heterosexually active adults. Our findings provide preliminary evidence that U = U awareness may have an impact on anticipated HIV stigma related to dating and sex. Additional methods to disseminate U = U messaging and dismantle HIV stigma in this population should be explored.
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Affiliation(s)
- Alexis V. Rivera
- HIV Epidemiology Program, Bureau of HIV, New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Sidney A. Carrillo
- HIV Epidemiology Program, Bureau of HIV, New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Sarah L. Braunstein
- HIV Epidemiology Program, Bureau of HIV, New York City Department of Health and Mental Hygiene, New York, New York, USA
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16
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Grundy SA, Mozelewski SR, Adjei Boakye E, Lee M, Levin BL. Faith leaders' perceptions of needle exchange programs in the rural Illinois Delta Region: Religion as a social determinant of health. Am J Addict 2021; 30:560-567. [PMID: 34414629 DOI: 10.1111/ajad.13213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 06/30/2021] [Accepted: 07/31/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Despite increasing drug use in rural communities, potentially life-saving harm reduction interventions, such as needle exchange programs (NEPs), remain underutilized. Religion is an integral component of the rural culture that has been shown to influence health, yet no studies to date have explored rural faith leaders' perceptions of harm reduction strategies. METHODS An online cross-sectional survey was conducted among rural faith leaders (n = 133) in the rural Illinois Delta Region. RESULTS While most of the respondents felt that drug abuse was an issue in their communities, support was mixed regarding whether they were in favor of NEPs with the majority of respondents having never heard of an NEP before this survey. While the majority believed that NEPs would help decrease bloodborne disease transmission, it was also perceived that NEPs would increase drug use. Significant differences in perceptions based on race, marital status, and political party also exist. CONCLUSION AND SCIENTIFIC SIGNIFICANCE Congruent with previous harm reduction literature, many rural faith leaders have varied perceptions of NEPs. Rural faith leaders could benefit from education about NEPs, including the possible positive and negative impacts they can have on the community. Future studies should explore contextual differences among rural faith leaders. To date, no studies have examined faith-based organizations' perceptions of NEPs. The findings have the potential to increase the current body of knowledge and provide data to support recommendations for engaging faith-based organizations in behavioral health service delivery.
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Affiliation(s)
- Stacy A Grundy
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, Illinois, USA.,College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Sasha R Mozelewski
- Southern Illinois University, School of Medicine, Springfield, Illinois, USA
| | - Eric Adjei Boakye
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Minjee Lee
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Bruce L Levin
- Department of Child & Family Studies, College of Behavioral & Community Sciences, and Concentration in Behavioral Health, College of Public Health, University of South Florida, Tampa, Florida, USA
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17
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Williams MS, Poteat T, Bender M, Ugwu P, Burns PA. Revitalizing HIV Prevention Programs: Recommendations From Those Most Impacted by the HIV in the Deep South. Am J Health Promot 2021; 36:155-164. [PMID: 34409888 DOI: 10.1177/08901171211041097] [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] [Indexed: 11/17/2022]
Abstract
PURPOSE The incidence of new HIV infections is disproportionately high among Black men who have sex with men (BMSM) in Mississippi. Community-based organizations received funding through the ACCELERATE! initiative to implement interventions aimed at increasing BMSM's access to HIV prevention, treatment and care interventions. APPROACH We conducted a mixed methods evaluation of the ACCELERATE! initiative to assess its impact. We also explored factors that act as barriers to and facilitators of BMSM's engagement in HIV prevention interventions. SETTING Interviews were conducted between July 2018 and February 2020. PARTICIPANTS Thirty-six BMSM and 13 non-grantee key informants who worked in the field of HIV in Mississippi participated. METHOD The qualitative data from the interview transcripts was analyzed using an iterative, inductive coding process. RESULTS We identified 10 key recommendations that were most common across all participants and that were aligned with UNAIDS Global AIDS Strategy strategic priorities. Several recommendations address the reduction of HIV- and LGBT-stigma. Two of the most common recommendations were to increase representation of the target population in health promotion program leadership and to include HIV with other Black health issues in community-based health education programs rather than singling it out. Another recommendation called for programs aimed at addressing underlying factors associated with HIV-risk behaviors, such as mental illness. CONCLUSION Our results indicate that HIV education interventions in the Deep South need to be revitalized to enhance their reach and effectiveness.
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Affiliation(s)
- Michelle S Williams
- Department of Global and Community Health, George Mason University, Fairfax, VA, USA
| | - Tonia Poteat
- Department of Social Medicine, University of North Carolina Chapel Hill, NC, USA
| | - Melverta Bender
- Office of STD/HIV, Mississippi State Department of Health, Jackson, MS, USA
| | - Precious Ugwu
- Department of Global and Community Health, George Mason University, Fairfax, VA, USA
| | - Paul A Burns
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, MS, USA
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18
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Reif S, Cooper H, Wilson E, Brown G, Beckwith N, Ward D. HIV Stigma Reduction Through Peer-Led Advocacy Training. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021; 33:303-311. [PMID: 34370570 DOI: 10.1521/aeap.2021.33.4.303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
HIV-related stigma is pervasive in the U.S. South and has potential negative effects on health outcomes and emotional well-being, and may act as a barrier to HIV-related advocacy among people living with HIV (PLWH). This article reports on the preliminary outcomes associated with participation in an HIV advocacy training for PLWH, LEAD, that included education and skills building for reducing HIV-related stigma. Fifty-seven PLWH at four sites in the U.S. South participated in the retreat-style training and completed a survey measuring stigma and comfort engaging in advocacy prior to and after the worshop. Participation was associated with statistically significant reduction in internalized HIV stigma and increase in comfort with participation in advocacy; however, participants reported a need for ongoing training and support to further increase comfort with advocacy participation. Although more research is needed on the LEAD Workshop, it shows promise as an option for reducing HIV-related stigma among PLWH.
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Affiliation(s)
- Susan Reif
- Center for Health Policy and Inequalities Research, Duke University, Durham, North Carolina
| | - Haley Cooper
- Center for Health Policy and Inequalities Research, Duke University, Durham, North Carolina
| | - Elena Wilson
- Center for Health Policy and Inequalities Research, Duke University, Durham, North Carolina
| | - Gina Brown
- Southern AIDS Coalition, Birmingham, Alabama
| | - Nicole Beckwith
- Center for Health Policy and Inequalities Research, Duke University, Durham, North Carolina
| | - Dafina Ward
- Southern AIDS Coalition, Birmingham, Alabama
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19
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Husbands W, Kerr J, Calzavara L, Tharao W, Greenspan N, Muchenje-Marisa M, Luyombya H, Nakamwa J, Arnold K, Nakiweewa S, Browne O. Black PRAISE: engaging Black congregations to strengthen critical awareness of HIV affecting Black Canadian communities. Health Promot Int 2021; 36:303-312. [PMID: 32617568 DOI: 10.1093/heapro/daaa057] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In Canada, HIV disproportionately affects Black communities. Though Black faith leaders play an influential role engaging Black communities around social care and social justice, their response to HIV has been somewhat muted. Black PRAISE is a novel intervention for Black churches to strengthen congregants' critical awareness of HIV affecting Black communities. A multi-stakeholder team developed and tested the intervention in 2016 - 17 among six churches in the province of Ontario, where more than half of Black Canadians reside, using a community-based participatory approach. Specifically, the intervention aimed to strengthen how congregants understand HIV among Black communities and reduce their level of stigma toward people living with HIV. We addressed critical awareness among the participating congregations through (i) disseminating a booklet with validated information that promoted critical health literacy related to HIV; (ii) enabling pastors to deliver a sermon on love, compassion and social justice; and (iii) developing and screening a short film that featured Black Canadians discussing their experiences of HIV-related stigma. We assessed changes in knowledge and stigma by surveying congregants (N = 173) at baseline and two follow-ups using validated instruments and other measures. Through Black PRAISE, congregants significantly increased their HIV-related knowledge; moreover, exposure to all the intervention components was associated with a significantly reduced level of stigma. A likely strategic outcome of Black PRAISE is that churches are empowered to help strengthen Black people's community-based response to HIV and join efforts to eliminate the structural conditions that increase Black people's vulnerability to HIV.
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Affiliation(s)
- Winston Husbands
- Ontario HIV Treatment Network, 1300 Yonge Street, Suite 600, Toronto, ON M4T 1X3, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada
| | - Jelani Kerr
- School of Public Health and Information Sciences, University of Louisville, 485 E. Gray St., Room 209, Louisville, KY 40202, USA
| | - Liviana Calzavara
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada
| | - Wangari Tharao
- Women's Health in Women's Hands Community Health Centre, 2 Carlton Street, Suite 500, Toronto, ON M5B 1J3, Canada
| | - Nicole Greenspan
- Toronto Public Health, 277 Victoria Street, Toronto, ON M5B 2L6, Canada
| | - Marvelous Muchenje-Marisa
- Women's Health in Women's Hands Community Health Centre, 2 Carlton Street, Suite 500, Toronto, ON M5B 1J3, Canada
| | - Henry Luyombya
- Ontario HIV Treatment Network, 1300 Yonge Street, Suite 600, Toronto, ON M4T 1X3, Canada
| | - Joanita Nakamwa
- Ontario HIV Treatment Network, 1300 Yonge Street, Suite 600, Toronto, ON M4T 1X3, Canada
| | - Keresa Arnold
- African and Caribbean Council on HIV/AIDS in Ontario, 20 Victoria Street, 4th Floor, Toronto, ON M5C 2N8, Canada
| | - Susan Nakiweewa
- Ontario HIV Treatment Network, 1300 Yonge Street, Suite 600, Toronto, ON M4T 1X3, Canada
| | - Orville Browne
- Meritus Medical Centre, Inc., 11116 Medical Campus Road, Suite 2904, Hagerstown, MD 21742, USA
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20
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Threats M, Brawner BM, Montgomery TM, Abrams J, Jemmott LS, Crouch PC, Freeborn K, Kamitani E, Enah C. A Review of Recent HIV Prevention Interventions and Future Considerations for Nursing Science. J Assoc Nurses AIDS Care 2021; 32:373-391. [PMID: 33929980 PMCID: PMC8715511 DOI: 10.1097/jnc.0000000000000246] [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] [Indexed: 11/26/2022]
Abstract
ABSTRACT As our knowledge of HIV evolved over the decades, so have the approaches taken to prevent its transmission. Public health scholars and practitioners have engaged in four key strategies for HIV prevention: behavioral-, technological-, biomedical-, and structural/community-level interventions. We reviewed recent literature in these areas to provide an overview of current advances in HIV prevention science in the United States. Building on classical approaches, current HIV prevention models leverage intimate partners, families, social media, emerging technologies, medication therapy, and policy modifications to effect change. Although much progress has been made, additional work is needed to achieve the national goal of ending the HIV epidemic by 2030. Nurses are in a prime position to advance HIV prevention science in partnership with transdisciplinary experts from other fields (e.g., psychology, informatics, and social work). Future considerations for nursing science include leveraging transdisciplinary collaborations and consider social and structural challenges for individual-level interventions.
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Affiliation(s)
- Megan Threats
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Bridgette M. Brawner
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Tiffany M. Montgomery
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Jasmine Abrams
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Loretta Sweet Jemmott
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Pierre-Cedric Crouch
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Kellie Freeborn
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Emiko Kamitani
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Comfort Enah
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
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21
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Kerr J, Burton K, Tharao W, Greenspan N, Calzavara L, Browne O, Luyombya H, Arnold K, Nakamwa J, Muchenje-Marisa M, Husbands W. Examining HIV-related stigma among African, Caribbean, and Black church congregants from the Black PRAISE study in Ontario, Canada. AIDS Care 2021; 33:1636-1641. [PMID: 33443449 DOI: 10.1080/09540121.2021.1871723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
HIV-related stigma impedes adoption and implementation of effective HIV prevention and treatment strategies. It may also exacerbate racial/ethnic HIV disparities. Given high levels of religious observance within African, Caribbean, and Black (ACB) communities and the social capital that faith-based organizations hold, these entities may be promising venues for stigma-remediation and effective partners in community-based, HIV-focused programing. However, more research is needed to understand HIV-related stigma in these institutions. This study examines HIV-related stigma among six ACB churches in Ontario, Canada. Surveys were distributed to ACB attendees (N = 316) and linear regressions determined relationships between HIV-related stigma and stigma subdomains with demographics, greater disagreement with same-sex relationships, HIV knowledge, and religiosity. Greater disagreement with same-sex relationships was the only variable associated with the HIV-related stigma scale and all of its subscales. Age, gender, HIV knowledge, religiosity, contact with persons living with HIV, and length of time in Canada were associated with varying aspects of HIV-related stigma. Findings can inform the development of HIV-related stigma interventions and the characteristics of individuals these efforts should target to achieve maximum impact.
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Affiliation(s)
- Jelani Kerr
- Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA
| | - Kelsey Burton
- Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA
| | - Wangari Tharao
- Women's Health in Women's Hands Community Health Centre, Toronto, Canada
| | | | - Liviana Calzavara
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | | | - Henry Luyombya
- MSW Committee for Accessible AIDS Treatment, Toronto, Canada
| | - Keresa Arnold
- African and Caribbean Council on HIV/AIDS in Ontario, Toronto, Canada
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Vital Voices: HIV Prevention and Care Interventions Developed for Disproportionately Affected Communities by Historically Underrepresented, Early-Career Scientists. J Racial Ethn Health Disparities 2020; 8:1456-1466. [PMID: 33128188 PMCID: PMC7598237 DOI: 10.1007/s40615-020-00908-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 10/21/2020] [Accepted: 10/23/2020] [Indexed: 12/19/2022]
Abstract
Abstract Background HIV prevention interventions which support engagement in care and increased awareness of biomedical options, including pre-exposure prophylaxis (PrEP), are highly desired for disproportionately affected Black/African American, Hispanic/Latinx and gay, bisexual, and other men who have sex with men (GBMSM) populations in the United States (US). However, in almost 40 years of HIV research, few interventions have been developed directly by and for these priority populations in domestic counties most at risk. We submit that interventions developed by early-career scientists who identify with and work directly with affected subgroups, and which include social and structural determinants of health, are vital as culturally tailored HIV prevention and care tools. Methods We reviewed and summarized interventions developed from 2007 to 2020 by historically underrepresented early-career HIV prevention scientists in a federally funded research mentoring program. We mapped these interventions to determine which were in jurisdictions deemed as high priority (based on HIV burden) by national prevention strategies. Results We summarized 11 HIV interventions; 10 (91%) of the 11 interventions are in geographic areas where HIV disparities are most concentrated and where new HIV prevention and care activities are focused. Each intervention addresses critical social and structural determinants of health disparities, and successfully reaches priority populations. Conclusion Focused funding that supports historically underrepresented scientists and their HIV prevention and care intervention research can help facilitate reaching national goals to reduce HIV-related disparities and end the HIV epidemic. Maintaining these funding streams should remain a priority as one of the tools for national HIV prevention.
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Maragh-Bass AC, Sloan DH, Alghanim F, Knowlton AR. A mixed-methods exploration of faith, spirituality, and health program interest among older African Americans with HIV. Qual Life Res 2020; 30:507-519. [PMID: 33052513 DOI: 10.1007/s11136-020-02656-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Persons living with HIV (PLWH) are living into old age with more complex care needs that non-PLWH. Promoting quality of life should include advance care planning (ACP) education, particularly among African Americans. We explored faith/spirituality-related correlates of interest in a future quality of life program among African American PLWH. METHODS Data were from the AFFIRM study. Participants were recruited from an HIV clinic and completed surveys, interviews, and focus groups. Quantitative analyses included Logistic regression. Qualitative data were coded using grounded theory. RESULTS Nearly half of participants had less than a high school education (47.9%), and roughly 90% had heard of at least one ACP-related topic (86.6%; N = 315). Qualitative themes related to quality of life and faith/spirituality were: (1) Coping with life challenges; (2) Motivation to improve health for loved ones; and (3) Support programs for people with HIV (N = 39). Satisfaction with religion/spirituality was associated with greater interest in a future program (p < .05); discussing ACP before getting sick was associated with less interest (p < .05). CONCLUSIONS/PRACTICE IMPLICATIONS Prioritizing skill-building and grounding in spirituality with input from faith leaders can reduce ACP inequities and improve health outcomes among African Americans.
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Affiliation(s)
- Allysha C Maragh-Bass
- The Lighthouse Studies at Peer Point, Department of Health, Behavior, Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street 2nd floor, Baltimore, MD, 21205, USA. .,FHI 360, Behavioral, Epidemiological, and Clinical Sciences Division, Durham, NC, USA.
| | - Danetta Hendricks Sloan
- The Lighthouse Studies at Peer Point, Department of Health, Behavior, Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street 2nd floor, Baltimore, MD, 21205, USA
| | - Fahid Alghanim
- Internal Medicine Residency Program, Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Amy R Knowlton
- The Lighthouse Studies at Peer Point, Department of Health, Behavior, Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street 2nd floor, Baltimore, MD, 21205, USA
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An Exploration of U.S. Southern Faith Leaders' Perspectives of HIV Prevention, Sexuality, and Sexual Health Teachings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165734. [PMID: 32784415 PMCID: PMC7460533 DOI: 10.3390/ijerph17165734] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/01/2020] [Accepted: 08/07/2020] [Indexed: 11/16/2022]
Abstract
Reducing human immunodeficiency viruses (HIV) and acquired immune deficiency syndrome (AIDS) racial/ethnic disparities in the Deep South has been a critical objective of the U.S. National HIV/AIDS Strategy. This finding, originally published in 2010 by the Office of National AIDS Policy, serves as a complement to the Health and Human Resources and Services Administration’s Ending the HIV Epidemic (EtHE): A Plan for America. The EtHE plan, released in 2019, emphasizes community stakeholder involvement to achieve the planning goals of decreasing new HIV infections in key U.S. geographic areas. According to the plan, an important stakeholder is faith leaders, especially around stigma reduction. This paper focuses on a community–academic research partnership’s exploration of southern Black faith leaders’ teaching perspectives regarding HIV prevention, sexuality, and sexual health in predominantly Black congregations in Memphis, Tennessee. The partnership conducted four focus groups using a semi-structured discussion interview. Any adult faith leader involved in ministry work in a predominantly Black church was eligible to participate in the discussion. A total of 26 faith leaders with a mean age of 54, representing four Christian denominations, consented to participate in the study. Emerging themes included: (1) restriction of scripture to teach prevention and address sexuality, (2) role of secrecy and silence in living with HIV, and (3) impact of the stigma of HIV and sexuality. Findings may inform nationwide jurisdictional implementation plans, particularly for faith-based interventions in southern churches working toward ending the HIV epidemic.
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Husbands W, Nakamwa J, Tharao W, Greenspan N, Calzavara L, Sathiyamoorthy T, Muchenje-Marisa M, Arnold K, Browne O, Kerr J. Love, Judgement and HIV: Congregants' Perspectives on an Intervention for Black Churches to Promote Critical Awareness of HIV Affecting Black Canadians. J Racial Ethn Health Disparities 2020; 8:507-518. [PMID: 32656731 DOI: 10.1007/s40615-020-00808-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/20/2020] [Accepted: 06/23/2020] [Indexed: 11/25/2022]
Abstract
We assess participants' experience of Black Pastors Raising Awareness and Insight of Stigma through Engagement (Black PRAISE), an intervention for Black churches to promote critical awareness of HIV affecting Black Canadian communities. We used a community-based participatory approach to implement Black PRAISE among six churches in the Greater Toronto Area and Ottawa, in October-November 2016. For the intervention, congregants received a booklet with validated HIV-related information, attended a sermon on compassion and justice, viewed a short film on HIV-related stigma, and completed baseline and follow-up surveys to evaluate the effectiveness of the intervention. We then conducted in-depth interviews with 18 pastors and congregants from the six churches to explore how they experienced the intervention. Three major themes emerged from an iterative exploration of the thematic content of the interviews: the beneficial impact of the intervention; reconciling the moral and theological issues of their faith with the social reality of HIV and stigma; and perspectives on future stigma reduction efforts. Participants spoke approvingly about Black PRAISE and supported stigma reduction but acknowledged uncertainties about their capacity to actualise their commitment. The main overarching lessons from Black PRAISE are as follows: first, our results support a community-based participatory approach to productively engaging Black congregations in stigma reduction and health promotion; second, promising or successful interventions incorporate multiple components to promote critical awareness about the specific health issue for Black life and wellbeing; and third, interventions are more likely to succeed if they support critical reflection on the underlying conceptual issues, implicit assumptions and belief systems among the professional and lay stakeholders.
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Affiliation(s)
- Winston Husbands
- Ontario HIV Treatment Network, Toronto, ON, M4T 1X3, Canada.
- University of Toronto, Toronto, ON, M5T 3M7, Canada.
| | | | - Wangari Tharao
- Women's Health in Women's Hands Community Health Centre, Toronto, ON, M5B 1J3, Canada
| | | | | | | | | | - Keresa Arnold
- African and Caribbean Council on HIV/AIDS in Ontario, Toronto, ON, M5C 2N8, Canada
| | | | - Jelani Kerr
- University of Louisville, Louisville, KY 40292, USA
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26
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Vigliotti V, Taggart T, Walker M, Kusmastuti S, Ransome Y. Religion, faith, and spirituality influences on HIV prevention activities: A scoping review. PLoS One 2020; 15:e0234720. [PMID: 32544212 PMCID: PMC7297313 DOI: 10.1371/journal.pone.0234720] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 06/02/2020] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Strategies to increase uptake of next-generation biomedical prevention technologies (e.g., long-acting injectable pre-exposure prophylaxis (PrEP)) can benefit from understanding associations between religion, faith, and spirituality (RFS) and current primary HIV prevention activities (e.g., condoms and oral PrEP) along with the mechanisms which underlie these associations. METHODS We searched PubMed, Embase, Academic Search Premier, Web of Science, and Sociological Abstracts for empirical articles that investigated and quantified relationships between RFS and primary HIV prevention activities outlined by the United States (U.S.) Department of Health and Human Services: condom use, HIV and STI testing, number of sexual partners, injection drug use treatment, medical male circumcision, and PrEP. We included articles in English language published between 2000 and 2020. We coded and analyzed studies based on a conceptual model. We then developed summary tables to describe the relation between RFS variables and the HIV prevention activities and any underlying mechanisms. We used CiteNetExplorer to analyze citation patterns. RESULTS We identified 2881 unique manuscripts and reviewed 29. The earliest eligible study was published in 2001, 41% were from Africa and 48% were from the U.S. RFS measures included attendance at religious services or interventions in religious settings; religious and/or spirituality scales, and measures that represent the influence of religion on behaviors. Twelve studies included multiple RFS measures. Twenty-one studies examined RFS in association with condom use, ten with HIV testing, nine with number of sexual partners, and one with PrEP. Fourteen (48%) documented a positive or protective association between all RFS factors examined and one or more HIV prevention activities. Among studies reporting a positive association, beliefs and values related to sexuality was the most frequently observed mechanism. Among studies reporting negative associations, behavioral norms, social influence, and beliefs and values related to sexuality were observed equally. Studies infrequently cited each other. CONCLUSION More than half of the studies in this review reported a positive/protective association between RFS and HIV prevention activities, with condom use being the most frequently studied, and all having some protective association with HIV testing behaviors. Beliefs and values related to sexuality are possible mechanisms that could underpin RFS-related HIV prevention interventions. More studies are needed on PrEP and spirituality/subjective religiosity.
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Affiliation(s)
- Vivian Vigliotti
- Robbins Institute for Health Policy & Leadership, Baylor University, Waco, Texas, United States of America
| | - Tamara Taggart
- Department Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America
- Prevention and Community Health, George Washington University School of Public Health, Washington, DC, United States of America
| | - Mahaya Walker
- Department Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Sasmita Kusmastuti
- Department of Public Health, University of Copenhagen, Copenhagen, Kobenhavns, Denmark
| | - Yusuf Ransome
- Department Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America
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Implementation of HIV Interventions Into Faith-Based Organizations: Models and Methodological Considerations. J Acquir Immune Defic Syndr 2020; 82 Suppl 3:S305-S313. [PMID: 31764268 DOI: 10.1097/qai.0000000000002221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Implementation of evidence-based interventions aimed at reducing and treating HIV can have a wider spread if funneled through faith-based organizations. However, there is a paucity of frameworks or process models aimed at providing the best practices to implement HIV interventions into faith-based community organizations. SETTING Implementation framework and process model for African American faith settings. RESULTS Presented here is a systems multilevel implementation framework and implementation process model for integrating HIV interventions into faith-based organizations. We conclude with presentation of key methodological considerations and recommendations and discuss strategies for moving implementation science forward in faith-based organizations. CONCLUSION Because of their key role in the African American community, faith-based settings must be engaged in implementing evidence-based HIV interventions. Through use of a multilevel systems framework and process model, the methods and approaches of implementation science can be leveraged to encourage the spread of HIV interventions in the African American community.
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28
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Golman M, Luu A, Ricks N, Norris V, Nguyen S. Engaging Church Leaders in the Reduction of Teen Birth Rate in High-Risk Areas. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2020; 41:125-132. [PMID: 32228139 DOI: 10.1177/0272684x20915378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Involving faith-based organizations in community health promotion has gained widespread interest and has been a successful approach in addressing various health disparities in vulnerable communities. However, there is comparatively little evidence regarding sexual health promotion among faith-based organizations. Some agencies have responded to the challenge of reducing teen pregnancy with broad-based initiatives involving many different sectors of the community including faith-based organizations. Focus groups with key church leaders (n = 25) from zip codes with identified birth rates of 95 or higher were conducted to explore their perception of teen pregnancy among their communities. Purposive and snowball sampling were utilized. Recruitment was conducted through calls, email, and flyers. This study identified the barriers that church leaders encounter in their efforts to address teen pregnancy in their communities. Common themes that emerged include church education, parent support and communication, cultural barriers, availability of resources, awareness of services, and the need for comprehensive sexual education. Findings and recommendations to help those working in the faith community overcome identified barriers are addressed. Recent decreases in teen birth rates should not lead to complacency; rather they should inspire public health practitioners to do more, especially when some communities have not experienced the same success. Collaborating with faith-based organizations is one method to consider when considering community prevention efforts.
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Affiliation(s)
- Mandy Golman
- School of Health Promotion and Kinesiology, Texas Woman's University
| | - Amy Luu
- Medical School, University of Texas Southwestern Medical Center
| | - Nila Ricks
- Social Work Program, Texas Woman's University
| | - Vanessa Norris
- Medical School, University of Texas Southwestern Medical Center
| | - Sarah Nguyen
- Medical School, University of Texas Southwestern Medical Center
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29
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Mendel P, Green HD, Palar K, Kanouse DE, Bluthenthal RN, Mata MA, Oden CW, Derose KP. Congregational involvement in HIV: A qualitative comparative analysis of factors influencing HIV activity among diverse urban congregations. Soc Sci Med 2019; 246:112718. [PMID: 31931449 DOI: 10.1016/j.socscimed.2019.112718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 11/24/2019] [Accepted: 12/02/2019] [Indexed: 11/29/2022]
Abstract
Religious congregations can potentially reach disproportionately affected populations with HIV programming, however, factors that influence congregational involvement in HIV are not well-studied. Utilizing comparative case methods and in-depth qualitative data from a diverse sample of 14 urban congregations, we examine a range of attitudinal, organizational, resource, and demographic factors to systematically identify different case scenarios-i.e., combinations of characteristics-associated with the level and types of HIV activities in which the congregational cases tended to be involved. For example, White or mixed race congregations with active gay constituencies and an African-American congregation with a strong lay HIV champion were among the high HIV involvement case scenarios, compared to African-American congregations with a health emphasis but no lay HIV champion among the medium HIV involvement scenarios, and fundamentalist African-American and Latino congregations among the low HIV involvement scenarios. Two key factors that appeared influential across case scenarios included the existence of lay champions for HIV activities and the general theological orientation of the congregation.
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Affiliation(s)
| | - Harold D Green
- RAND Corporation, Santa Monica, CA, USA; Indiana University, Bloomington, IN, USA
| | - Kartika Palar
- University of California, San Francisco, San Francisco, CA, USA
| | | | - Ricky N Bluthenthal
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Clyde W Oden
- Bethel Oxnard African Methodist Episcopal Church, Oxnard, CA, USA
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30
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Lanzi RG, Footman AP, Jackson E, Araya BY, Ott C, Sterling RD, Davis TR, Kaiser KA. Love with No Exceptions: A Statewide Faith-Based, University-Community Partnership for Faith-Based HIV Training and Assessment of Needs in the Deep South. AIDS Behav 2019; 23:2936-2945. [PMID: 31321638 DOI: 10.1007/s10461-019-02604-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This project established a faith-based, university-community partnership with the African Methodist Episcopal (AME) church in Alabama to develop a statewide training model to address HIV knowledge and stigma, promote discussion and generate action plans to address HIV in the Deep South. A community-engaged research team consisting of church leadership and university researchers developed and implemented the model, "Love with No Exceptions." Mixed methods were used to evaluate the model delivered in 3-h sessions in five state regions (N = 146 clergy and laity). The majority of participants reported feeling better prepared to serve those living with or affected by HIV and would implement education and awareness activities in their churches. Participants' HIV knowledge increased from pre- to post-training. Stigma-related attitudes showed minor changes from baseline. These results reflect that partnerships between academic institutions and churches can deliver promising steps towards impactful HIV education in the Deep South.
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Affiliation(s)
- Robin G Lanzi
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, 1720 2nd Avenue South, 227 Ryals School of Public Health Building, Birmingham, AL, 35924, USA.
- Center for AIDS Research, University of Alabama at Birmingham, Birmingham, USA.
| | - Alison P Footman
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, 1720 2nd Avenue South, 227 Ryals School of Public Health Building, Birmingham, AL, 35924, USA
- Center for AIDS Research, University of Alabama at Birmingham, Birmingham, USA
| | - Edward Jackson
- Center for AIDS Research, University of Alabama at Birmingham, Birmingham, USA
| | - Brook Y Araya
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, 1720 2nd Avenue South, 227 Ryals School of Public Health Building, Birmingham, AL, 35924, USA
- Center for AIDS Research, University of Alabama at Birmingham, Birmingham, USA
| | - Corilyn Ott
- Center for AIDS Research, University of Alabama at Birmingham, Birmingham, USA
- School of Nursing, University of Alabama at Birmingham, Birmingham, USA
| | - Ronald D Sterling
- Center for AIDS Research, University of Alabama at Birmingham, Birmingham, USA
- Alabama Ninth Episcopal District of the African Methodist Episcopal Church, Birmingham, USA
| | - Tammy R Davis
- Center for AIDS Research, University of Alabama at Birmingham, Birmingham, USA
- Alabama Ninth Episcopal District of the African Methodist Episcopal Church, Birmingham, USA
| | - Kathryn A Kaiser
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, 1720 2nd Avenue South, 227 Ryals School of Public Health Building, Birmingham, AL, 35924, USA
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31
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Nunn A, Jeffries WL, Foster P, McCoy K, Sutten-Coats C, Willie TC, Ransome Y, Lanzi RG, Jackson E, Berkley-Patton J, Keefer M, Coleman JD. Reducing the African American HIV Disease Burden in the Deep South: Addressing the Role of Faith and Spirituality. AIDS Behav 2019; 23:319-330. [PMID: 31444712 DOI: 10.1007/s10461-019-02631-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Nearly half of HIV infections in the United States are concentrated among African Americans, and over half of new HIV infections occur in the South. African Americans have poorer outcomes in the entire continua of HIV and PrEP care. Complex social, structural, and behavioral factors contribute to our nation's alarming racial disparities in HIV infection, particularly in the Deep South. Despite the importance of faith, spirituality and religious practice in the lives of many African Americans, there has been little scientific investment exploring how African Americans' religious participation, faith and spirituality may impact our nation's HIV epidemic. This article summarizes the state of the science on this critical issue. We also identify opportunities for new scholarship on how faith, spirituality and religious participation may impact HIV care continuum outcomes in the South and call for greater federal research investment on these issues.
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Affiliation(s)
- Amy Nunn
- Center for Health Equity Research, Brown University, 121 S. Main St, G-810, Providence, RI, 02903, USA.
- Rhode Island Public Health Institute, Providence, USA.
| | - William L Jeffries
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Antlanta, USA
| | - Pamela Foster
- Department of Community Medicine/Population Health, University of Alabama School of Medicine, Tuscaloosa Regional Campus, Tuscaloosa, USA
| | - Katryna McCoy
- School of Nursing & Health Studies, University of Washington - Bothell, Bothell, USA
| | - Cassandra Sutten-Coats
- Center for Health Equity Research, Brown University, 121 S. Main St, G-810, Providence, RI, 02903, USA
- Rhode Island Public Health Institute, Providence, USA
| | - Tiara C Willie
- Rhode Island Public Health Institute, Providence, USA
- Warren Alpert School of Medicine, Brown University, Providence, USA
| | - Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, USA
| | - Robin Gaines Lanzi
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, USA
- Center for AIDS Research, University of Alabama at Birmingham, Birmingham, USA
| | - Edward Jackson
- Center for AIDS Research, University of Alabama at Birmingham, Birmingham, USA
| | | | - Michael Keefer
- School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, USA
| | - Jason D Coleman
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, USA
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32
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Kamaara E, Oketch D, Chesire I, Coats CS, Thomas G, Ransome Y, Willie TC, Nunn A. Faith and healthcare providers' perspectives about enhancing HIV biomedical interventions in Western Kenya. Glob Public Health 2019; 14:1744-1756. [PMID: 31390958 DOI: 10.1080/17441692.2019.1647263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Adult HIV prevalence in Kenya was 5.9% in 2017. However, in the counties of Kisumu, Siaya, and Homa Bay, HIV prevalence was over 15%. Biomedical interventions, including home-based testing and counselling (HBTC), HIV treatment and pre-exposure prophylaxis (PrEP) provide opportunities to reduce HIV transmission, particularly in rural communities with limited access to health services. Faith-based institutions play an important role in the Kenyan social fabric, providing over 40% of all health care services in Kenya, but have played limited roles in promoting HIV prevention interventions. We conducted qualitative interviews with 45 medical professionals and focus groups with 93 faith leaders in Kisumu and Busia Counties, Kenya. We explored their knowledge, opinions, and experiences in promoting biomedical HIV prevention modalities, including HBTC and PrEP. Knowledge about and engagement in efforts to promote HIV prevention modalities varied; few health providers had partnered with faith leaders on HIV prevention programmes. Faith leaders and health providers agreed about the importance of increasing faith leaders' participation in HIV prevention and were positive about increasing their HIV prevention partnerships. Most faith leaders requested capacity building to better understand biomedical HIV prevention modalities and expressed interest in collaborating with clinical partners to spread awareness about HIV prevention modalities.
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Affiliation(s)
- Eunice Kamaara
- Department of Philosophy & Religious Studies, Moi University , Eldoret , Kenya
| | - Dismas Oketch
- Kenya Medical Research Institute (KEMRI)/CDC Clinical Research Center , Kisumu , Kenya
| | - Irene Chesire
- Department of Behavioral Science, School of Medicine, Moi University , Eldoret , Kenya
| | - Cassandra Sutten Coats
- Center for Health Equity Research, Brown University School of Public Health , Providence , RI , USA
| | - Gladys Thomas
- Department of Behavioral and Social Science, Brown University School of Public Health , Providence , RI , USA
| | - Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health , Hartford , CT , USA
| | - Tiara C Willie
- Department of Medicine, Brown University Warren Alpert Medical School , Providence , RI , USA
| | - Amy Nunn
- Center for Health Equity Research, Brown University School of Public Health , Providence , RI , USA.,Department of Behavioral and Social Science, Brown University School of Public Health , Providence , RI , USA
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Bradley ELP, Sutton MY, Cooks E, Washington-Ball B, Gaul Z, Gaskins S, Payne-Foster P. Developing FAITHH: Methods to Develop a Faith-Based HIV Stigma-Reduction Intervention in the Rural South. Health Promot Pract 2018; 19:730-740. [PMID: 29383967 PMCID: PMC6211576 DOI: 10.1177/1524839917754044] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Human immunodeficiency virus (HIV) disproportionately affects Blacks/African Americans, particularly those residing in the southern United States. HIV-related stigma adversely affects strategies to successfully engage people in HIV education, prevention, and care. Interventions targeting stigma reduction are vital as additional tools to move toward improved outcomes with HIV prevention and care, consistent with national goals. Faith institutions in the South have been understudied as partners in HIV stigma-reduction efforts, and some at-risk, Black/African American communities are involved with southern faith institutions. We describe the collaborative effort with rural, southern faith leaders from various denominations to develop and pilot test Project Faith-based Anti-stigma Initiative Towards Healing HIV/AIDS (FAITHH), an HIV stigma-reduction intervention that built on strategies previously used with other nonrural, Black/African American faith communities. The eight-module intervention included educational materials, myth-busting exercises to increase accurate HIV knowledge, role-playing, activities to confront stigma, and opportunities to develop and practice delivering a sermon about HIV that included scripture-based content and guidance. Engaging faith leaders facilitated the successful tailoring of the intervention, and congregation members were willing participants in the research process in support of increased HIV awareness, prevention, and care.
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Affiliation(s)
- Erin L P Bradley
- 1 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Madeline Y Sutton
- 1 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eric Cooks
- 2 University of Alabama, Tuscaloosa, AL, USA
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