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Urquhart R, Adams M, Chakraborty S, Burns JC. Real Talk: Conversations on HIV with Black Heterosexual Men in Healthcare Settings. J Community Health 2024:10.1007/s10900-024-01388-9. [PMID: 39126616 DOI: 10.1007/s10900-024-01388-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2024] [Indexed: 08/12/2024]
Abstract
Nearly half of heterosexually transmitted human immunodeficiency virus (HIV) infections occur among Black men in the United States. Yet Black heterosexual men (BHM) are largely ignored in HIV programming, policy implementation, and research. This study explores how masculinity, mental health, and socioeconomic factors such as income, education, and insurance (e.g., enrollment and coverage) correlate with the likelihood of BHM having important conversations surrounding HIV with their healthcare providers and family members. Conversations among social networks (e.g., peers, family, and neighbors) create an opportunity to increase comfortability while discussing HIV-related topics around condom use and testing. This study used a cross-sectional survey design and convenience sampling (N = 279) to recruit participants from a community-academic partnership involving a Federally Qualified Health Center (FQHC) in Detroit between June 1, 2020, and July 31, 2020. Descriptive statistics were used to report demographics, socioeconomic information, and sexual health-related behavior variables. Spearman's correlation test was used to report bivariate correlations between predictor and outcome variables. 49.3% of the study participants disclosed having ever talked to a healthcare provider about HIV/acquired immune deficiency syndrome (AIDS), and 40.9% disclosed having ever talked to a family member about HIV/AIDS and sexually transmitted infections (STIs). The results from this article highlight potential barriers that may inhibit BHM from engaging in conversations about HIV with their healthcare providers and family members. It is important to include BHM in future research that focuses on HIV prevention and education to support community leaders and clinicians who work to address these disparities.
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Affiliation(s)
- Rakira Urquhart
- School of Health and Human Sciences, University of North Carolina at Greensboro, 1408 Walker Ave 437 Coleman Bldg, Greensboro, NC, 27412, USA.
| | - Mackenzie Adams
- School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Shawtaabdee Chakraborty
- College of Human Medicine, Michigan State University, 15 Michigan St, NE Grand Rapids, MI, 49503, USA
| | - Jade C Burns
- School of Nursing, University of Michigan, 400 North Ingalls Street Room 3175, 400 NIB, Ann Arbor, MI, 48109, USA
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Shrader CH, Dt D, Driver R, Chen YT, Knox J, Bond K, Weinstein ER, Durrell M, Hanson H, Eavou R, Goedel WC, Schneider JA. Social Network Characteristics Associated with More Frequent HIV and STI Prevention Conversations: The N2 Cohort Study in Chicago. AIDS Behav 2024; 28:2463-2475. [PMID: 38703338 DOI: 10.1007/s10461-024-04348-5] [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] [Accepted: 04/12/2024] [Indexed: 05/06/2024]
Abstract
Black cisgender sexually minoritized men (SMM) and transgender women (TW) are subgroups at highest risk of HIV and sexually transmitted infections (STIs) in the US. We sought to identify factors facilitating continued conversations - social reinforcement - surrounding HIV/STI prevention among this subgroup. Participants were recruited in Chicago from 2018 to 2019 from community health spaces. Participants provided information about themselves (level 2) and ⩽5 confidants (level 1). We used multinomial multilevel modeling to identify associations with HIV/STI prevention conversation frequency. A total of 370 participants provided information on 987 confidants (mean = 2.6). We found significantly positive associations between having biweekly or more often HIV/STI prevention conversations and a confidant being a kin family member, older by 15 years or more, racially homophilous, and emotionally close. Future interventions should harness social networks by including components that consider racial homophily, respect for elders, and strong ties, in addition to applying kin family systems interventions approaches and decreasing stigma surrounding HIV/STIs.
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Affiliation(s)
- Cho-Hee Shrader
- ICAP at Columbia University, 60 Haven Ave B120, New York, NY, United States of America.
- Department of Epidemiology, Mailman School of Public Health, New York, NY, United States of America.
| | - Duncan Dt
- Department of Epidemiology, Mailman School of Public Health, New York, NY, United States of America
| | - R Driver
- Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, NY, United States of America
- New York State Psychiatric Institute, HIV Center for Clinical and Behavioral Studies, New York, NY, United States of America
| | - Y-T Chen
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, United States of America
| | - J Knox
- Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, NY, United States of America
- New York State Psychiatric Institute, HIV Center for Clinical and Behavioral Studies, New York, NY, United States of America
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - K Bond
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, United States of America
| | - E R Weinstein
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America
| | - M Durrell
- Department of Medicine, University of Chicago, Chicago, IL, United States of America
- Department of Public Health Sciences, University of Chicago, Chicago, IL, United States of America
| | - H Hanson
- Department of Medicine, University of Chicago, Chicago, IL, United States of America
- Department of Public Health Sciences, University of Chicago, Chicago, IL, United States of America
| | - R Eavou
- Department of Medicine, University of Chicago, Chicago, IL, United States of America
- Department of Public Health Sciences, University of Chicago, Chicago, IL, United States of America
| | - W C Goedel
- Department of Epidemiology, Brown University, Providence, RI, United States of America
| | - J A Schneider
- Department of Medicine, University of Chicago, Chicago, IL, United States of America
- Department of Public Health Sciences, University of Chicago, Chicago, IL, United States of America
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3
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McKinney-Prupis E, Chiu YCJ, Grov C, Tsui EK, Duke SI. Psychosocial and Health-Related Behavioral Outcomes of a Work Readiness HIV Peer Worker Training Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4322. [PMID: 36901333 PMCID: PMC10001842 DOI: 10.3390/ijerph20054322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/22/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Targeted work readiness training is an important approach to help people living with HIV (PLHIV) to overcome their unique barriers to work, while addressing social determinants of health needs. This study assesses the psychosocial impacts of a work readiness training and internship program among HIV peer workers in New York City. From 2014 through 2018, 137 PLHIV completed the training program, and 55 individuals completed both the training and the six-month peer internship. Depression, HIV internalized stigma, self-esteem, HIV medication adherence, patient self-advocacy, and safer sex communication apprehension were used as outcome measures. Paired t-tests were performed to determine if significant score changes occurred at the individual level before and after each training. Our results show that participating in the peer worker training program significantly decreased depression and internalized HIV stigma, and significantly increased self-esteem, medication adherence, and patient self-advocacy. The study underscores that peer worker training programs are important tools to improve not only the work readiness of PLHIV, but also psychosocial and health outcomes. Implications for HIV service providers and stakeholders are discussed.
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Affiliation(s)
| | | | - Christian Grov
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY 10017, USA
| | - Emma K. Tsui
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY 10017, USA
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Leblanc NM, Mitchell JW, Bond KT, Juarez Cuellar A, Vil NMS, McMahon J. Perspectives on a Couples-Based, e-Health HIV Prevention Toolkit Intervention: A Qualitative Dyadic Study with Black, Heterosexual Couples in New York State. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2625-2640. [PMID: 35639220 PMCID: PMC10688541 DOI: 10.1007/s10508-021-02270-8] [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] [Received: 01/31/2021] [Revised: 12/11/2021] [Accepted: 12/17/2021] [Indexed: 05/11/2023]
Abstract
Web-based technology provides an unparalleled opportunity to increase access and uptake of couples-based HIV prevention interventions. e-Health HIV prevention interventions for US Black heterosexual couples have largely been understudied. To address this gap, we applied the Assessment Phase of the ADAPT-ITT Framework to investigate Black heterosexual couples' perspectives on an existing e-Health, couples-based HIV prevention intervention. Applying a qualitative descriptive approach, joint dyadic interviews were conducted with 28 Black heterosexual couples from three jurisdictions in New York State. Content dyadic analysis revealed three descriptive categories: perspectives of the toolkit intervention (sub-codes: perceived relevance, reactions to core components), recommendations to enhance intervention relevancy (sub-codes: tailoring to relationship type, adding new content), and lasting intervention considerations (sub-codes: toolkit usability and language use). Overall, couples found the toolkit intervention content and usability acceptable and reflected on its potential to build sexual and relationship health. Couples recommended to enhance toolkit adaptability for varied couple's motivation and types re-consider terms like sexual agreements, and include content to facilitate communication regarding sensitive topics (e.g., childhood sexual trauma, co-parenting, family planning) and other issues that may have more relevance to the experience of US Black persons (i.e., wealth building).
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Affiliation(s)
- Natalie M Leblanc
- School of Nursing, University of Rochester, 601 Elmwood Ave., Rochester, NY, 14624, USA.
| | - Jason W Mitchell
- Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Keosha T Bond
- City College of New York, CUNY School of Medicine, New York City, NY, USA
| | | | - Noelle M St Vil
- School of Social Work, University at Buffalo, Buffalo, NY, USA
| | - James McMahon
- School of Nursing, University of Rochester, 601 Elmwood Ave., Rochester, NY, 14624, USA
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Abubakari GM, Smith MDR, Boyd DT, Ramos SR, Johnson C, Benavides JL, Threats M, Allen JL, Quinn CR. Assessing Different Types of HIV Communication and Sociocultural Factors on Perceived HIV Stigma and Testing among a National Sample of Youth and Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1003. [PMID: 35055823 PMCID: PMC8776079 DOI: 10.3390/ijerph19021003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/08/2022] [Accepted: 01/14/2022] [Indexed: 11/17/2022]
Abstract
In the United States, racial/ethnic and sexual youth and young adults (YYA) of color are disproportionately affected by HIV. Subsequently, YYA experience HIV stigma and engage in increased risk behaviors and reduced HIV testing. HIV communication has been identified as a potential buffer to HIV stigma, resulting in health-seeking behaviors, such as HIV testing. In this study, we respond to a meaningful gap in the literature by examining different types of HIV communication and their impact on HIV stigma and HIV testing in a diverse sample of YYA. We analyzed secondary data from the Kaiser Family Foundation National Survey of Teens and Young Adults on HIV/AIDS. A 40-question, web-based survey was conducted with 1437 youth (ages 15-24). Recruitment included a dual sampling method from households with: (1) listed phone numbers, (2) unlisted phone numbers, (3) telephones, (4) no telephone, and (5) only cell phone access. The purpose of the survey was to establish participants' HIV knowledge, communication, experiences, and testing behaviors. Findings suggested an association between intimate-partner HIV communication, increased HIV testing, and reduced HIV stigma. We also identified differentials in HIV testing and stigma based on gender, income, age, and sexual minority status, explained by HIV communication. Further research is needed that examines ways to use intimate-partner HIV communication to reduce stigma and increase HIV testing among YYA of different sociodemographic characteristics and sexual orientations.
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Affiliation(s)
- Gamji M’Rabiu Abubakari
- School of Public Health, Yale University, New Haven, CT 06510, USA;
- Center for Interdisciplinary Research on AIDS (CIRA), School of Public Health, Yale University, New Haven, CT 06510, USA; (S.R.R.); (M.T.)
| | | | - Donte T. Boyd
- Center for Interdisciplinary Research on AIDS (CIRA), School of Public Health, Yale University, New Haven, CT 06510, USA; (S.R.R.); (M.T.)
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA; (J.L.B.); (C.R.Q.)
| | - S. Raquel Ramos
- Center for Interdisciplinary Research on AIDS (CIRA), School of Public Health, Yale University, New Haven, CT 06510, USA; (S.R.R.); (M.T.)
- School of Nursing, Yale University, Orange, CT 06477, USA
| | - Courtney Johnson
- Ryan Chelsea-Clinton Community Health Center, New York, NY 10036, USA;
| | - Juan L. Benavides
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA; (J.L.B.); (C.R.Q.)
| | - Megan Threats
- Center for Interdisciplinary Research on AIDS (CIRA), School of Public Health, Yale University, New Haven, CT 06510, USA; (S.R.R.); (M.T.)
- School of Communication and Information, Rutgers University, New Brunswick, NJ 08901, USA
| | - Junior L. Allen
- School of Social Work, Wayne State University, Detroit, MI 48202, USA;
| | - Camille R. Quinn
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA; (J.L.B.); (C.R.Q.)
- Kirwan Institute for the Study of Race and Ethnicity, The Ohio State University, Columbus, OH 43201, USA
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