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Moline T, Duncan DT, Knox J, Regan S, Mehranbod CA, Shrader CH, Schneider J, Kim B. Neighborhood Factors as Correlates of Alcohol Use in the N2 Cohort Study of Black Sexual Minority Men and Transgender Women. RESEARCH SQUARE 2024:rs.3.rs-4626549. [PMID: 39070645 PMCID: PMC11276003 DOI: 10.21203/rs.3.rs-4626549/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Sexually minoritized men (SMM), transgender women (TW), and particularly Black SMM and Black TW may be disproportionately impacted by alcohol-related problems. Few studies have empirically examined neighborhood factors that may contribute to alcohol use, specifically among these populations. Using data from the N2 longitudinal cohort study in Chicago, IL, survey data from the second wave of longitudinal assessment (n = 126), and GPS mobility data collected during study enrollment were used to evaluate neighborhood alcohol outlet availability, neighborhood disorder, and neighborhood poverty as correlates for individual alcohol use. Neighborhood exposures were measured using 200-m derived activity space areas, created from GPS data, and with publicly accessible geospatial contextual data. Separate multi-variable quasi-poison regression models tested for association between neighborhood alcohol outlet density (AOD), measured separately for on-premise (e.g. bars) and off-premise consumption outlets (e.g. liquor stores), neighborhood poverty (defined as the percentage of neighborhood areas at 150% or greater of the U.S. poverty line), exposure to vacant buildings, and neighborhood violent crime density. Separate analytical models found no significant effect between alcohol use and on-premise neighborhood AOD (IRR = 0.99, p = 0.35), off-premise consumption AOD (IRR = 0.92, p = 0.33), or neighborhood violent crime (IRR = 1.00, p = 0.65). Vacant buildings (IRR = 1.03, p = 0.05) and levels of neighborhood poverty (1.05, p = 0.01) were found to be significantly associated with increased alcohol use. Among this population, opposed to geospatial access, neighborhood measurements indicative of disorder and poverty may have greater influence on shaping alcohol use.
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Affiliation(s)
| | | | - Justin Knox
- Columbia University Mailman School of Public Health
| | - Seann Regan
- Columbia University Mailman School of Public Health
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Knox JR, Dolotina B, Moline T, Matthews I, Durrell M, Hanson H, Almirol E, Hotton A, Pagkas-Bather J, Chen YT, English D, Manuzak J, Rower JE, Miles C, Millar B, Jean-Louis G, Rendina HJ, Martins SS, Grov C, Hasin DS, Carrico AW, Shoptaw S, Schneider JA, Duncan DT. HIV Prevention and Care Among Black Cisgender Sexual Minority Men and Transgender Women: Protocol for an HIV Status-Neutral Cohort Study Using an Observational-Implementation Hybrid Approach. JMIR Res Protoc 2023; 12:e48548. [PMID: 38039075 PMCID: PMC10724817 DOI: 10.2196/48548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Black cisgender gay, bisexual, and other sexual minority men (SMM) and transgender women (TW) continue to be heavily affected by HIV. Further research is needed to better understand HIV prevention and care outcomes in this population. In particular, there is a need for research examining the impact of substance use and sleep health on HIV prevention and treatment outcomes among Black SMM and TW. OBJECTIVE This paper outlines the study methods being used in the recently launched follow-up study to the Neighborhoods and Networks (N2) study, which we refer to as N2 Part 2 (N2P2). N2P2 aims to address this gap in the literature, build off the findings of the original N2 study, and identify socioenvironmental determinants of health, including whether neighborhood and network factors mediate and moderate these relationships. METHODS Building on the N2 cohort study in Chicago from 2018 to 2022, N2P2 used a prospective longitudinal cohort design and an observational-implementation hybrid approach. With sustained high levels of community engagement, we aim to recruit a new sample of 600 Black SMM and TW participants residing in the Chicago metropolitan statistical area. Participants are asked to participate in 3 study visits across an 18-month study period (1 visit every 9 months). Four different forms of data are collected per wave: (1) an in-person survey, (2) biological specimen collection, (3) a daily remote ecological momentary assessment for 14 days after each study visit, and (4) data from electronic health records. These forms of data collection continue to assess neighborhood and network factors and specifically explore substance use, sleep, immune function, obesity, and the implementation of potential interventions that address relevant constructs (eg, alcohol use and pre-exposure prophylaxis adherence). RESULTS The N2P2 study was funded in August 2021 by the National Institute of Drug Abuse (R01DA054553 and R21DA053156) and National Heart, Lung, and Blood Institute (R01HL160325). This study was launched in November 2022. Recruitment and enrollment for the first wave of data collection are currently ongoing. CONCLUSIONS The N2P2 study is applying innovative methods to comprehensively explore the impacts of substance use and sleep health on HIV-related outcomes among an HIV status-neutral cohort of Black SMM and TW in Chicago. This study is applying an observational-implementation hybrid design to help us achieve findings that support rapid translation, a critical priority among populations such as Black SMM and TW that experience long-standing inequities with regard to HIV and other health-related outcomes. N2P2 will directly build off the findings that have resulted from the original N2 study among Black SMM and TW in Chicago. These findings provide a better understanding of multilevel (eg, individual, network, and neighborhood) factors that contribute to HIV-related outcomes and viral suppression among Black SMM and TW. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/48548.
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Affiliation(s)
- Justin R Knox
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Brett Dolotina
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Tyrone Moline
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Isabella Matthews
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Mainza Durrell
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Hillary Hanson
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Ellen Almirol
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Anna Hotton
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Jade Pagkas-Bather
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Yen-Tyng Chen
- Department of Psychiatry, Rutgers University, New Brunswick, NJ, United States
| | - Devin English
- Department of Psychiatry, Rutgers University, New Brunswick, NJ, United States
| | - Jennifer Manuzak
- Division of Immunology, School of Medicine, Tulane University, New Orleans, LA, United States
| | - Joseph E Rower
- Center for Human Toxicology, University of Utah, Salt Lake City, UT, United States
| | - Caleb Miles
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Brett Millar
- Department of Psychiatry, Rutgers University, New Brunswick, NJ, United States
| | - Girardin Jean-Louis
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | - H Jonathon Rendina
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Silvia S Martins
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Christian Grov
- Einstein-CUNY-Rockefeller Center for AIDS Research, School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Deborah S Hasin
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Adam W Carrico
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | - Steve Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Dustin T Duncan
- Mailman School of Public Health, Columbia University, New York, NY, United States
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Zimmerman ME, Hart LJ, Medrano P, Piccone C, Ramirez DM, Huggins LK, Sotres-Alvarez D, Fish LJ, Østbye T, Holliday KM. COVID-19 in the Community: Changes to Women's Mental Health, Financial Security, and Physical Activity. AJPM FOCUS 2023; 2:100095. [PMID: 37234692 PMCID: PMC10039779 DOI: 10.1016/j.focus.2023.100095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
Abstract
Introduction This study describes changes in the mental health, financial security, and physical activity levels of women in North Carolina during the COVID-19 pandemic. Methods Data were collected from women aged 20-40 years receiving primary care at 2 health centers in North Carolina during 2020-2022. Surveys (N=127) evaluated changes in mental health, financial security, and physical activity during the COVID-19 pandemic. These outcomes were analyzed both descriptively and for association with sociodemographic factors using logistic regression. A subset of participants (n=46) participated in semistructured interviews. Interview transcripts were reviewed and evaluated for recurring themes by primary and secondary coders using a rapid-coding technique. Analysis was conducted in 2022. Results Women surveyed were 28.4% non-Hispanic White, 38.6% non-Hispanic Black, and 33.1% Hispanic/Latina. Compared with reports before the pandemic, participants reported increased frustration or boredom (69.1%), loneliness (51.6%), anxiety (64.3%), depression (52.4%), and changed sleep patterns (68.3%). Increased alcohol and other recreational substance use were associated with race and ethnicity (p<0.05) after adjustment for other sociodemographic factors. Participants reported difficulty in paying for basic expenses (44.0%). Financial difficulties during COVID-19 were associated with non-Hispanic Black race and ethnicity, less education, and lower prepandemic household income. Data showed pandemic-associated reductions in mild (32.8%), moderate (39.5%), and strenuous (43.3%) exercise, with a correlation between increased depression and reduced mild exercise. Interviews identified themes including reduced activity while working remotely, lack of gym access, and reduced motivation for exercise. Conclusions This mixed-methods study is one of the first to evaluate the mental health, financial security, and physical activity challenges women aged between 20 and 40 years in the southern U.S. faced during the COVID-19 pandemic.
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Affiliation(s)
| | - Lauren J. Hart
- Department of Family Medicine & Community Health, Duke University School of Medicine, Durham, North Carolina
| | - Perla Medrano
- Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Caitlin Piccone
- Department of Family Medicine & Community Health, Duke University School of Medicine, Durham, North Carolina
| | - Diana M. Ramirez
- Sanford School of Public Policy, Duke University, Durham, North Carolina
| | - Lenique K.L. Huggins
- Duke Global Health Institute, Duke University, Durham, North Carolina
- Department of Biology, Trinity College of Arts and Sciences, Duke University, Durham, North Carolina
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Gillings School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Laura J. Fish
- Department of Family Medicine & Community Health, Duke University School of Medicine, Durham, North Carolina
| | - Truls Østbye
- Department of Family Medicine & Community Health, Duke University School of Medicine, Durham, North Carolina
- Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Katelyn M. Holliday
- Department of Family Medicine & Community Health, Duke University School of Medicine, Durham, North Carolina
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Gill A, Felker-Kantor E, Cunningham-Myrie C, Greene LG, Lyew-Ayee P, Atkinson U, Abel W, Anderson SG, Theall KP. Neighborhoods and adolescent polysubstance use in Jamaica. PeerJ 2023; 11:e14297. [PMID: 36815978 PMCID: PMC9933737 DOI: 10.7717/peerj.14297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 10/03/2022] [Indexed: 02/15/2023] Open
Abstract
Background The purpose of this study was to identify latent classes of polysubstance use among adolescents in Jamaica and the role of neighborhood factors in the association with polysubstance use class membership. Methods This secondary analysis utilized a national cross-sectional household drug use survey conducted across 357 households in Jamaica (April 2016-July 2016) among a total of 4,625 individuals. A total of 750 adolescents (11-17 years) were included in this analysis. Latent class analysis (LCA) was conducted to identify polysubstance use patterns as well as latent neighborhood constructs. Neighborhood factors included social disorganization, concentrated disadvantage, community resources, community violence, and police station concentration. Multinomial regression analysis was implemented to evaluate the association between polysubstance use class membership and latent classes of neighborhood factors. Result The prevalence of lifetime polysubstance use was 27.56%. Four classes of polysubstance use were identified by comparing a series of five class models. The Bootstrap Likelihood Ratio Test (BLRT) indicated a good fit for the four-class model (<0.001). The prevalence of alcohol latent classes was: (1) heavy alcohol users and experimental smokers (Class I) (15.20%), (2) most hazardous polysubstance users (Class II) (5.33%), (3) heavy smokers and moderate alcohol users (Class III) (7.07%), and (4) experimental alcohol users (Class IV) (72.44%). Three classes of neighborhoods were identified by comparing a series of four-class models. The prevalence of the neighborhood classes was: (1) low social disorganization and disadvantage (Class I) (58.93%), (2) high social disorganization and moderate disadvantage (Class II) (10.93%), and (3) high social disorganization related to perceived drug use and disadvantage (Class III) (30.13%). The BLRT indicated a good fit for the three-class model (p = < 0.004). Multinomial regression analysis indicated that adolescents living in neighborhoods with high disorder and moderate disadvantage (Class II) were 2.43 times (odds ratio (OR)) = 2.43, confidence interval (CI)) = 1.30-4.56) more likely to be heavy alcohol users and experimental smokers (Class I) compared to experimental alcohol users, adjusting for sex, age, ethnicity, religion, and income. Class II of neighborhood classes presented with the highest levels of community violence (100%), perceived disorder crime (64.6%), police station concentration (6.7%), and community resources (low resources is 87.6%), while the concentrated disadvantage was moderate (14.8%). Conclusions Alcohol polysubstance use latent classes were identified among youth in this context. Neighborhoods with high disorder and moderate disadvantage (Class II) were associated with a higher likelihood of polysubstance use. The role of neighborhood conditions in shaping adolescent polysubstance use should be considered in policy, prevention, and treatment interventions.
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Affiliation(s)
- Amrita Gill
- Department of Social, Behavioural and Population Sciences, Tulane University, New Orleans, LA, United States of America
| | - Erica Felker-Kantor
- Department of Social, Behavioural and Population Sciences, Tulane University, New Orleans, LA, United States of America
| | - Colette Cunningham-Myrie
- Department of Community Health and Psychiatry, University of the West Indies, Mona, Kingston, Jamaica
| | - Lisa-Gaye Greene
- Mona Geoinformatics Institute, University of the West Indies, Mona, Kingston, Jamaica
| | - Parris Lyew-Ayee
- Mona Geoinformatics Institute, University of the West Indies, Mona, Kingston, Jamaica
| | - Uki Atkinson
- Ministry of Health and Wellness, National Council on Drug Abuse, Kingston, Jamaica
| | - Wendel Abel
- Department of Community Health and Psychiatry, University of the West Indies, Mona, Kingston, Jamaica
| | - Simon G. Anderson
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom,The George Alleyne Chronic Disease Research Centre, Caribbean Institute of Health Research, University of the West Indies, Cave Hill, Barbados
| | - Katherine P. Theall
- Department of Social, Behavioural and Population Sciences, Tulane University, New Orleans, LA, United States of America,Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States of America
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Chen YT, Duncan DT, Del Vecchio N, Timmins L, Pagkas-Bather J, Knox J, Lacap S, Hanson H, Schneider JA. COVID-19 Conspiracy Beliefs are not Barriers to HIV Status Neutral Care Among Black Cisgender Sexual Minority Men and Black Transgender Women at the Initial Peak of the COVID-19 Pandemic in Chicago, USA. AIDS Behav 2022; 26:3939-3949. [PMID: 35731308 PMCID: PMC9214465 DOI: 10.1007/s10461-022-03720-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2022] [Indexed: 11/24/2022]
Abstract
We examined associations between COVID-19 conspiracy beliefs and HIV status neutral care engagement among Black cisgender sexual minority men (BCSMM) and Black transgender women (BTW). Throughout April–July 2020, a total of 226 (222 in the current analysis: 196 BCSMM, 20 BTW, and 6 other) participants in Chicago’s Neighborhoods and Networks (N2) cohort study completed virtual assessments. Participants reported their HIV status, changes in the frequency of PrEP/ART use, and COVID-19 conspiracy beliefs. Three-quarters of the sample believed at least one conspiracy theory that COVID-19 was either government-created or lab-created accidentally or purposefully. Believing one or more COVID-19 conspiracy theories was significantly associated with better PrEP or ART engagement (using PrEP more frequently or continuously using PrEP/Missing ART less or continuously using ART) (aPR = 0.75 [95% CI 0.56–0.99], p < 0.05). Believing COVID-19 came about naturally was strongly associated with worse PrEP engagement (i.e., use PrEP less or not on PrEP) or worse ART engagement (i.e., missed ART more or not on ART) (aPR = 1.56 [95% CI 1.23, 1.98], p < 0.001). Findings suggested substantial COVID-19 conspiracies among BCSMM and BTW, and this was associated with HIV care engagement.
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Affiliation(s)
- Yen-Tyng Chen
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA. .,Department of Public Health, William Paterson University of New Jersey, Wayne, NJ, USA. .,Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA.
| | - Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Natascha Del Vecchio
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA.,Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Liadh Timmins
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.,School of Psychology, Faculty of Medicine, Health and Life Sciences, Swansea University, Swansea, Wales, UK
| | - Jade Pagkas-Bather
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA.,Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Justin Knox
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Shaina Lacap
- Department of Public Health, William Paterson University of New Jersey, Wayne, NJ, USA
| | | | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA.,Department of Medicine, University of Chicago, Chicago, IL, USA.,Department of Public Health Sciences, University of Chicago, Chicago, IL, USA.,Crown School of Social Work, University of Chicago, Chicago, IL, USA
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Chavez-Baray SM, Martinez O, Chaparro P, Moya EM. The Use of Photovoice Methodology to Assess Health Needs and Identify Opportunities Among Migrant Transgender Women in the U.S.-Mexico Border. Front Public Health 2022; 10:865944. [PMID: 35664104 PMCID: PMC9160798 DOI: 10.3389/fpubh.2022.865944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 03/11/2022] [Indexed: 11/21/2022] Open
Abstract
Psychosocial, social and structural conditions have rarely been studied among transgender women in the U.S.-Mexico Border. This study used Photovoice methodology to empower migrant transgender women of color (TWC) to reflect on realities from their own perspectives and experiences and promote critical dialogue, knowledge, and community action. Sixteen participants documented their daily experiences through photography, engaged in photo-discussions to assess needs and identify opportunities, and developed a community-informed Call to Action. Four major themes emerged from the participants' photographs, discussions, and engagement: (1) mental health, (2) migration experiences and challenges, (3) stigma, discrimination, and resiliency, and (4) impact of the COVID-19 pandemic. Through active community engagement, a Call to Action was developed. A binational advisory committee of decision makers and scholars reviewed a set of recommendations to better respond to the needs of TWC in the U.S.-Mexico Border. Photovoice served as an empowerment tool for TWC to assess the myriad of syndemic conditions, including mental health, stigma, discrimination and COVID-19, affecting them daily and identify initiatives for change.
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Affiliation(s)
- Silvia M. Chavez-Baray
- Department of Social Work, University of Texas at El Paso, El Paso, TX, United States,Chicano Studies, College of Liberal Arts, University of Texas at El Paso, El Paso, TX, United States,Border Biomedical Research Center, College of Science, University of Texas at El Paso, El Paso, TX, United States,*Correspondence: Silvia M. Chavez-Baray
| | - Omar Martinez
- School of Social Work, College of Public Health, Temple University Philadelphia, Philadelphia, PA, United States,Omar Martinez
| | - Perla Chaparro
- Department of Social Work, University of Texas at El Paso, El Paso, TX, United States
| | - Eva M. Moya
- Department of Social Work, University of Texas at El Paso, El Paso, TX, United States,Border Biomedical Research Center, College of Science, University of Texas at El Paso, El Paso, TX, United States,Eva M. Moya
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