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Turpin R, Camp AD, Mandell CJ, Mandeville J, Davidson Mhonde RR, Smith J, Liu H, Dyer T, Mayer KH, Boekeloo B. PrEP Stigma as a Minority Stressor among Black Sexual Minority Men: A Mixed-Methods Study. AIDS Behav 2024:10.1007/s10461-024-04481-1. [PMID: 39287732 DOI: 10.1007/s10461-024-04481-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2024] [Indexed: 09/19/2024]
Abstract
Black sexual minority men (BSMM) remain disproportionately affected by HIV, yet Pre-exposure prophylaxis (PrEP) uptake in this population remains relatively low. Informed by minority stress theory, PrEP stigma may manifest in and exacerbate societal marginalization based on sexuality and race. We used an exploratory sequential mixed-methods approach to determine if PrEP-specific stigma was associated with reduced PrEP uptake among BSMM, and qualitatively explored how PrEP use is stigmatized among BSMM. We analyzed cross-sectional data from a pilot sample of BSMM (n = 151) collected in late 2020 in the United States, testing for associations between PrEP stigma and PrEP use using modified Poisson regression. Subsequently, we selected participants (n = 23) from this sample for qualitative interviews starting in 2022. Responses to questions related to PrEP stigma were analyzed using thematic analysis. PrEP stigma was associated less than half the PrEP use (aPR = 0.43, 95% CI = 0.24, 0.75) among BSMM after adjustment. Qualitatively, we identified three major themes in how PrEP use is stigmatized among BSMM: PrEP-specific sexual stigma, intersections between PrEP and HIV stigma, and PrEP misinformation and disinformation. Aligned with minority stress theory, each theme was based in part in stigma related to sexuality or race. We found strong relationships between PrEP stigma and PrEP use independent of several sociobehavioral factors. Each of our themes were based in part in minority stressors, and underscore the importance of culturally competent PrEP promotion efforts towards BSMM. Addressing stigma is a core component of health equity efforts towards ending the HIV epidemic.
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Affiliation(s)
- Rodman Turpin
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA.
| | - Aaron D Camp
- Heller School for Social Policy and Management, Brandeis University, Waltham, MA, 02453, USA
- INOVA Health System, Fairfax, VA, 22031, USA
| | - C J Mandell
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
| | - Julia Mandeville
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
| | - Rochelle R Davidson Mhonde
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
| | - Jamil Smith
- Grady Health System, Atlanta, GA, 30344, USA
| | - Hongjie Liu
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
| | - Typhanye Dyer
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Bradley Boekeloo
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
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Dunleavy VO, Ahn RJ, Grace LD, Mayo D. Acceptability and Feasibility of "Latinos Unidos": A Microgame Resource Combatting Health Misinformation for Latinos Living with HIV. JOURNAL OF HEALTH COMMUNICATION 2024; 29:307-318. [PMID: 38592967 PMCID: PMC11101303 DOI: 10.1080/10810730.2024.2339238] [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: 04/11/2024]
Abstract
COVID-19 mitigation strategies, including shelter-in-place orders, masking, and social distancing combined with the widespread "infodemic" may interact synergistically to worsen already compromised mental health outcomes of people living with HIV (PLWH). We developed a three-part microgame intervention, "Latino Unidos," targeting media health literacy education that could be mobilized to protect the mental health of Latinx PLWH as well as promote HIV care during the pandemic. We utilized a community-based approach by working with two local community partners and conducted interviews and focus groups from three perspectives: Latino PLWH, ID providers, and community health workers. Participants evaluated three microgame modules for literacy objectives, acceptability, and feasibility. Feedback offered from each round of module review indicated that each of the game experiences supported the aim of addressing health mis/disinformation. Results indicated relative success demonstrated by positive responses on module literacy goals, acceptability, and feasibility. Our approach illuminates the intersection between content development around media literacy and microgame modality as a novel mHealth resource. Study outcomes offer suggestions and strategies for optimizing content effectiveness and intervention material dissemination.
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Affiliation(s)
- Victoria Orrego Dunleavy
- Department of Communication Studies, School of Communication, University of Miami, Miami, Florida, USA
| | - Regina Jihea Ahn
- Department of Strategic Communication, School of Communication, University of Miami, Miami, Florida, USA
| | - Lindsay D Grace
- Department of Interactive Media, School of Communication, University of Miami, Miami, Florida, USA
| | - Daniel Mayo
- College of Public Health, National Taiwan University, Taipei, Taiwan
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Garett R, Cumberland WG, Chakravarthy B, Springer S, Young SD. A Qualitative Exploration of the Potential Role of Using Online Social Media Support Communities to Increase Initiation of Medications for Opioid Use Disorder (MOUD). JOURNAL OF SUBSTANCE USE 2023; 28:880-886. [PMID: 38274090 PMCID: PMC10810551 DOI: 10.1080/14659891.2022.2098846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 07/04/2022] [Indexed: 01/11/2023]
Abstract
Objectives This study sought to explore the potential role of peer-led online communities to increase use of medications for opioid use disorder. Methods From January through March 2020, participants with opioid use disorder and their family members/friends were recruited from paid Facebook ads; public health key stakeholders were recruited from referrals from the study team and opioid experts. Thirty participants from California were interviewed; 23 persons reporting opioid misuse, 3 family members/friends of persons misusing opioids, and 4 public health key stakeholders. We conducted semi-structured interviews asking about preferences, barriers and facilitators of treatment options for opioid use disorder, and perspectives around the use of digital/online communities. The categories of participants interviewed were each asked slightly different questions depending upon their role. Results Results suggest that participants who misuse opioids (1) may prefer to engage in online communities rather than in-person meetings to discuss their opioid use, (2) generally prefer to receive opioid-related information from other patients with opioid use disorder and/or those in recovery rather than from health providers or other individuals, and (3) thought that an online community could be beneficial for helping address their opioid use. Conclusion Results suggest an openness and interest in a peer-led online community to discuss opioid use and treatment among people who misuse opioids.
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Affiliation(s)
| | - William G. Cumberland
- Department of Biostatistics, University of California, Los Angeles, Los Angeles, USA
| | | | - Sandra Springer
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, Yale University, New Haven, USA
| | - Sean D. Young
- Department of Emergency Medicine, University of California, Irvine, Irvine, USA
- University of California Institute for Prediction Technology, Department of Informatics, University of California, Irvine, Irvine, USA
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Garett R, Young SD. The role of social media in monitoring COVID-19 vaccine uptake. J Eval Clin Pract 2022; 28:650-652. [PMID: 35856457 PMCID: PMC9310197 DOI: 10.1111/jep.13656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 12/22/2022]
Affiliation(s)
| | - Sean D Young
- Department of Emergency Medicine, University of California, Irvine, California, USA.,Department of Informatics, Institute for Prediction Technology, University of California, Irvine, California, USA
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Garett R, Young SD. Ethical Views on Sharing Digital Data for Public Health Surveillance: Analysis of Survey Data Among Patients. Front Big Data 2022; 5:871236. [PMID: 35547191 PMCID: PMC9082996 DOI: 10.3389/fdata.2022.871236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
Digital data, including social media, wearable device data, electronic health records, and internet search data, are increasingly being integrated into public health research and policy. Because of the current issues around public distrust of science and other ethical issues in public health research, it is essential that researchers conduct ongoing studies assessing people's perceptions around and willingness to share digital data. This study aims to examine participants' social media use and comfort sharing their data with health researchers. One hundred and sixty-one participants with medical conditions were recruited through social media paid advertisements and referral from a website, and invited to complete surveys on social media use and ethical perspectives on data sharing. Eligibility criteria were adults 18 years old or older, living in the US, self-reported having been diagnosed by a physician with a medical condition, belonging to at least one social media platform, using social media at least twice a week, and owning a smartphone. Study participants were mostly female, White, and with a mean age of 36.31 years. More than one third of participants reported being very comfortable sharing electronic health data and social media data for personalized healthcare and to help others. Findings suggest that participants are very uncomfortable sharing their location and text message data with researchers, with primary concerns centered around loss of privacy, disclosing private information, and that friends, family, and others may find out that they shared text messages with researchers. We discuss the implications of this research before and after the COVID-19 pandemic, along with its potential implications for future collection of digital data for public health.
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Affiliation(s)
| | - Sean D. Young
- Department of Emergency Medicine, University of California, Irvine, Irvine, CA, United States
- Department of Informatics, University of California Institute for Prediction Technology, University of California, Irvine, Irvine, CA, United States
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