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Al Meslamani AZ, Abdel-Qader DH, Kassem AB, Al Mazrouei N. Disparities in drug safety practices in developing nations: focusing on underlying factors and implications for global health. Expert Opin Drug Saf 2024; 23:393-397. [PMID: 38436276 DOI: 10.1080/14740338.2024.2326488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/29/2024] [Indexed: 03/05/2024]
Affiliation(s)
- Ahmad Z Al Meslamani
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
| | | | - Amira B Kassem
- Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy, Damanhour University, Damanhour, Egypt
| | - Nadia Al Mazrouei
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, United Arab Emirates
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2
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Flores Sanchez JM, Kai J. Coloniality and contagion: COVID-19 and the disposability of women of color in feminized labor sectors. GENDER WORK AND ORGANIZATION 2022; 30:GWAO12913. [PMID: 36712911 PMCID: PMC9874415 DOI: 10.1111/gwao.12913] [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: 06/25/2021] [Revised: 04/25/2022] [Accepted: 08/24/2022] [Indexed: 02/01/2023]
Abstract
Grounded in the historical conditions of epidemics intertwined with state power, we examine the factors that contribute to women of color's high proximity to contagion. We build on significant contributions to scholarship on the racial and sexual politics of work and the colonial history of contagion to argue that colonialism is key in the state's weaponization of illness against entire populations. This is crucial to decipher how women of color in feminized labor sectors, in our case, cleaning services and nursing, confront death during the COVID-19 pandemic. This transforms readers' understanding of governmentality within public health crizes and the roles of colonial state institutions in administering death in raced, gendered, and classed ways. We conclude that future studies focused on pandemics, labor, race, and gender must account for the ways in which colonialism positions feminized workers as fungible in structures of response to mass crizes.
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Affiliation(s)
- José M. Flores Sanchez
- Department of Women's, Gender, and Sexuality StudiesSUNY Stony BrookStony BrookNew YorkUSA
| | - Jade Kai
- Department of Women's, Gender, and Sexuality StudiesSUNY Stony BrookStony BrookNew YorkUSA
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3
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Kompella S, Ikekwere J, Alvarez C, Rutkofsky IH. A Retrospective Analysis on Risk Factors for 30-day Readmission Rates in Patients Living With HIV and Severe Major Depression Disorder. Cureus 2021; 13:e15894. [PMID: 34249581 PMCID: PMC8249039 DOI: 10.7759/cureus.15894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2021] [Indexed: 02/01/2023] Open
Abstract
Background Major depression disorder (MDD) is the most common psychiatric comorbidity in patients living with HIV (PLWHIV). The prevalence rate of MDD is higher in PLWHIV in comparison to the general population. In our study, we focus specifically on the 30-day readmission rate of PLWHIV and severe major depression. Methods The Health Care Agency (HCA) databank was used to conduct a retrospective study on PLWHIV and severe MDD. Keywords such as HIV, severe MDD, CD4, viral load were used to identify the data. 30-day readmission rate is studied in PLWHIV and severe MDD (N=143). Variables such as age, sex, gender, adherence to antiretroviral medications, cluster of differentiation 4 (CD4), and viral load were studied in this population. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria were used to diagnose severe MDD in PLWHIV. An antiretroviral therapy (ART) medication list was used to analyze adherence in this population group. Geographical locations were identified using urbanization codes. Results Logistic regression analysis for the 30-day readmission rate in PLWHIV was found to be higher in the older age group (p<0.01). Caucasian population (p<0.01) and rural areas (p<0.01), ART non-adherence (p<0.05), and severe major depression were also found to be significant in this population (p<0.01). Conclusion As more patients live longer with HIV/AIDS, it gives rise to illnesses such as anxiety, depression, and cognitive impairment. Thus, it is important to identify severe depression in PLWHIV since it can have an impact on rates of hospitalization, morbidity/mortality, and the financial burden, specifically within 30-days of discharge.
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Affiliation(s)
| | - Joseph Ikekwere
- Psychiatry/Addiction, University of Illinois at Chicago, Chicago, USA
| | - Clara Alvarez
- Psychiatry, Aventura Hospital and Medical Center, Aventura, USA
| | - Ian H Rutkofsky
- Psychiatry, Aventura Hospital and Medical Center, Aventura, USA
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4
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Jones BE, Ferguson A. Black and gay: A historical perspective of black gay men. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2020. [DOI: 10.1080/19359705.2020.1798683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Billy E. Jones
- Department of Psychiatry, NYU Grossman School of Medicine, New York, USA
| | - Alfonso Ferguson
- College of Education and Human Services, Montclair State University, Montclair, New Jersey, USA
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5
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Bonett S, Meanley S, Stevens R, Brawner B, Bauermeister J. The Role of Networks in Racial Disparities in HIV Incidence Among Men Who Have Sex with Men in the United States. AIDS Behav 2020; 24:2781-2796. [PMID: 31980994 PMCID: PMC7222153 DOI: 10.1007/s10461-020-02798-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Network factors have been proposed as potential drivers of racial disparities in HIV among Black and Latino men who have sex with men (MSM). This review aimed to synthesize the extant literature on networks and racial disparities in HIV among MSM and identify potential directions for future research. We searched databases for peer-reviewed articles published between January 1, 2008 and July 1, 2018. Articles were included if the sample was comprised primarily of racial/ethnic minority MSM and measured one or more network characteristics. (n = 25). HIV prevalence in networks, social support, and structural barriers were linked to disparities in HIV for Black MSM. Future research should focus on intervention development around social support and other strategies for risk reduction within networks. Given the contribution of structural factors to racial/ethnic HIV disparities, network-level interventions should be paired with policies that improve access to housing, jobs, and education for MSM.
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Affiliation(s)
- Stephen Bonett
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Suite 222L, Philadelphia, PA, 19104, USA.
| | - Steven Meanley
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Suite 222L, Philadelphia, PA, 19104, USA
| | - Robin Stevens
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Suite 222L, Philadelphia, PA, 19104, USA
| | - Bridgette Brawner
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Suite 222L, Philadelphia, PA, 19104, USA
| | - José Bauermeister
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Suite 222L, Philadelphia, PA, 19104, USA
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6
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Harp KLH, Bunting AM. The Racialized Nature of Child Welfare Policies and the Social Control of Black Bodies. SOCIAL POLITICS 2020; 27:258-281. [PMID: 32714000 PMCID: PMC7372952 DOI: 10.1093/sp/jxz039] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Black women are disproportionately involved in the child welfare system. This state-level intervention occurs at two levels-a higher likelihood of being (i) screened for drug use during pregnancy and (ii) reported to child welfare authorities after delivery. Consequently, they face further enmeshment in state-systems, including custody loss and lower reunification odds. Using evidence from the past forty years of research and media reports, we argue that systemic forces and policies largely contribute to racial disproportionality in the child welfare system, and assert this state intervention serves as a mechanism to control black reproduction.
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Affiliation(s)
- Kathi L H Harp
- Department of Health Management and Policy, University of Kentucky College of Public Health, Lexington, KY, USA
| | - Amanda M Bunting
- Department of Sociology, University of Kentucky, Lexington, KY, USA
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7
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Smoyer AB, Madera JE, Blankenship KM. Older Adults' Lived Experience of Incarceration. JOURNAL OF OFFENDER REHABILITATION 2019; 58:220-239. [PMID: 31680760 PMCID: PMC6823991 DOI: 10.1080/10509674.2019.1582574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Amy B Smoyer
- Department of Social Work, Southern Connecticut State University, 101 Farnham Ave, #108, New Haven, CT 06515
| | | | - Kim M Blankenship
- Department of Sociology, American University, 4400 Massachusetts Ave, NW, Washington DC, 20016-8072 (USA), ,
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8
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Tempalski B, Cooper HLF, Kelley ME, Linton SL, Wolfe ME, Chen YT, Ross Z, Des Jarlais DC, Friedman SR, Williams LD, Semaan S, DiNenno E, Wejnert C, Broz D, Paz-Bailey G. Identifying Which Place Characteristics are Associated with the Odds of Recent HIV Testing in a Large Sample of People Who Inject Drugs in 19 US Metropolitan Areas. AIDS Behav 2019; 23:318-335. [PMID: 29971735 PMCID: PMC6318077 DOI: 10.1007/s10461-018-2217-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This exploratory analysis investigates relationships of place characteristics to HIV testing among people who inject drugs (PWID). We used CDC's 2012 National HIV Behavioral Surveillance (NHBS) data among PWID from 19 US metropolitan statistical areas (MSAs); we restricted the analytic sample to PWID self-reporting being HIV negative (N = 7477). Administrative data were analyzed to describe the 1. Sociodemographic Composition; 2. Economic disadvantage; 3. Healthcare Service/Law enforcement; and 4. HIV burden of the ZIP codes, counties, and MSAs where PWID lived. Multilevel models tested associations of place characteristics with HIV testing. Fifty-eight percent of PWID reported past-year testing. MSA-level per capita correctional expenditures were positively associated with recent HIV testing among black PWID, but not white PWID. Higher MSA-level household income and imbalanced sex ratios (more women than men) in the MSA were associated with higher odds of testing. HIV screening for PWID is suboptimal (58%) and needs improvement. Identifying place characteristics associated with testing among PWID can strengthen service allocation and interventions in areas of need to increase access to HIV testing.
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Affiliation(s)
- Barbara Tempalski
- Institute for Infectious Disease Research, National Development and Research Institutes (NDRI), Inc., 71 West 23rd Street, 4th Fl, New York, NY, 10010, USA.
| | - Hannah L F Cooper
- Rollins School of Public Health at Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Mary E Kelley
- Rollins School of Public Health at Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Sabriya L Linton
- Rollins School of Public Health at Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Mary E Wolfe
- Rollins School of Public Health at Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Yen-Tyng Chen
- Rollins School of Public Health at Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Zev Ross
- ZevRoss SpatialAnalysis, 120 N Aurora St, Suite 3A, Ithaca, NY, 14850, USA
| | - Don C Des Jarlais
- Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, 39 Broadway, Suite 530, New York, NY, 10006, USA
| | - Samuel R Friedman
- Institute for Infectious Disease Research, National Development and Research Institutes (NDRI), Inc., 71 West 23rd Street, 4th Fl, New York, NY, 10010, USA
| | - Leslie D Williams
- Institute for Infectious Disease Research, National Development and Research Institutes (NDRI), Inc., 71 West 23rd Street, 4th Fl, New York, NY, 10010, USA
| | - Salaam Semaan
- Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS E-46, Atlanta, GA, 30333, USA
| | - Elizabeth DiNenno
- Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS E-46, Atlanta, GA, 30333, USA
| | - Cyprian Wejnert
- Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS E-46, Atlanta, GA, 30333, USA
| | - Dita Broz
- Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS E-46, Atlanta, GA, 30333, USA
| | - Gabriela Paz-Bailey
- Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS E-46, Atlanta, GA, 30333, USA
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Kutnick AH, Leonard NR, Gwadz MV. "Like I Have No Choice": A Qualitative Exploration of HIV Diagnosis and Medical Care Experiences While Incarcerated and Their Effects. Behav Med 2019; 45:153-165. [PMID: 31343965 PMCID: PMC6730550 DOI: 10.1080/08964289.2019.1591338] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
It is estimated that one in six Black and Latino adult persons living with HIV (PLWH) spend time in correctional institutions each year. Yet after release, PLWH of color evidence poor HIV health outcomes across the HIV care continuum. This study, guided by an ecological approach and Critical Race Theory, sought to understand the lived experiences of socioeconomically disadvantaged PLWH of color who received an HIV diagnosis and/or medical care while incarcerated, and the ways in which those experiences influenced engagement in medical care after release. Drawn from a larger study in Brooklyn, NY, in 2013-2016, a subset of 28 participants who received in-depth qualitative interviews were purposively sampled for a secondary analysis of participants who received an HIV diagnosis and/or medical care while incarcerated. Using an Interpretive Phenomenological Analysis, we found participant's experiences were shaped by longstanding mistrust of the medical establishment. While incarcerated, lack of autonomy, substandard medical care, and poor social support exacerbated medical mistrust and avoidance of HIV medical care long after release. Engagement in HIV medical care and treatment were also impacted by a dynamic interplay of factors including substance use, prolonged periods of denial, poverty, and repeated bouts of incarceration. Given that experiences of HIV diagnosis and medical care while incarcerated have long-ranging, adverse effects, we argue that a better understanding of the ways in which PLWH of color experience HIV diagnosis and medical care while incarcerated may serve to inform intervention efforts within correctional institutions to improve HIV health outcomes.
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Affiliation(s)
- Alexandra H. Kutnick
- Center for Drug Use and HIV/HCV Research, NYU Global College of Public Health, New York University, New York, NY, USA
| | - Noelle R. Leonard
- Center for Drug Use and HIV/HCV Research, NYU Global College of Public Health, New York University, New York, NY, USA,Silver School of Social Work, New York University, New York, NY, USA
| | - Marya V. Gwadz
- Center for Drug Use and HIV/HCV Research, NYU Global College of Public Health, New York University, New York, NY, USA,Silver School of Social Work, New York University, New York, NY, USA
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10
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Abstract
To determine smoking behaviors, quit attempts, and cessation preferences among incarcerated smokers, a cross-sectional survey was given to a sample of inmates from three state prison facilities in the United States. A majority of Black smokers (62%) identified as smokers, and 38% identified as ex-smokers, as compared to 46.4 percent of smokers (and 53.6% of ex-smokers) in the non-Black group. There were significant differences in the number of cigarettes smoked per day with non-Black smokers smoking one pack (M = 20.44, standard deviation = 15.86) than Black smokers (M = 14.49, standard deviation = 13.43; t = -2.50, p = 0.014). Smoking cessation interventions are needed to reduce smoking during incarceration.
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Affiliation(s)
- Pamela Valera
- Rutgers School of Public Health, The State University of New Jersey, NJ, USA
| | - Andrea Reid
- Rutgers School of Public Health, The State University of New Jersey, NJ, USA
| | - Nicholas Acuna
- Rutgers School of Public Health, The State University of New Jersey, NJ, USA
| | - Daniel Mackey
- Lake Erie College of Osteopathic Medicine (LECOM), PA, USA
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11
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Keene DE, Smoyer AB, Blankenship KM. Stigma, housing and identity after prison. THE SOCIOLOGICAL REVIEW 2018; 66:799-815. [PMID: 32855574 PMCID: PMC7449251 DOI: 10.1177/0038026118777447] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Existing research suggests that individuals who are released from prison face considerable challenges in obtaining access to safe, stable, and affordable places to live and call home. This article draws on repeated qualitative interviews (conducted every 6 months over a period of 3 years) with 44 formerly incarcerated individuals, to understand how these individuals experience the search for a home after their prison release. The interviews show that the quest for a home is central to participants' reintegration projects as they seek to establish themselves as 'decent' and economically self-sufficient citizens, and shed stigmatized identities associated with incarceration, poverty, homelessness, and place. Interviews also suggest that their quest for a home is an arduous one as they encounter numerous barriers to housing arising from both structural and interpersonal forms of incarceration stigma. Somewhat paradoxically, the challenges that they face in accessing housing seem to hinder their ability to shed the stigmatized identities associated with their incarceration. Ultimately, the narratives presented here show how stigma can restrict access to a valuable material and symbolic resource (housing), resulting in ongoing stigmatization, and contributing to the enduring and discrediting mark of incarceration. In this way, the study illustrates how stigma that is enacted by both individuals and the state, that is embodied in place, and that is internalized and managed by stigmatized individuals themselves, can work to reproduce power and serve as justification for inequality.
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12
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Mahaffey C, Stevens-Watkins D, Knighton JS. Psychosocial Determinants of Health among Incarcerated Black Women: A Systematic Literature Review. J Health Care Poor Underserved 2018; 27:45-70. [PMID: 27133512 DOI: 10.1353/hpu.2016.0059] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Black women are disproportionately incarcerated and experience worse health outcomes compared with White and Hispanic women. This systematic literature review aims to identify the major psychosocial determinants of health and service utilization among incarcerated Black women. The ecological model for health behavior was used to frame the literature presented and explain how individual, interpersonal, and societal factors affect health. Nineteen articles met inclusion criteria for this review. Psychosocial factors were identified at each level, including mental health problems (individual); sexual behavior (interpersonal); and dysfunctional/negative relationships (community). The factors interact in a dynamic relationship that influences the health and service utilization of Black women. Future research should examine within-group differences to highlight the unique needs and culture within the Black community in the context of psychosocial determinants. This synthesis of relevant studies can serve to inform change in correctional policies, practices, and help reduce health disparities.
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13
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Myers JJ, Kang Dufour MS, Koester KA, Morewitz M, Packard R, Monico Klein K, Estes M, Williams B, Riker A, Tulsky J. The Effect of Patient Navigation on the Likelihood of Engagement in Clinical Care for HIV-Infected Individuals Leaving Jail. Am J Public Health 2018; 108:385-392. [PMID: 29345992 DOI: 10.2105/ajph.2017.304250] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To compare the effectiveness of patient navigation-enhanced case management in supporting engagement in HIV care upon release from jail relative to existing services. METHODS We randomized 270 HIV-infected individuals to receive navigation-enhanced case management for 12 months or standard case management for 90 days following release from jail between 2010 and 2013. Participants were interviewed at 2, 6, and 12 months after release. We abstracted medical data from jail and city health records. RESULTS Patient navigation-enhanced case management resulted in greater linkage to care within 30 days of release (odds ratio [OR] = 2.15; 95% confidence interval [CI] = 1.23, 3.75) and consistent retention over 12 months (OR = 1.95; 95% CI = 1.11, 3.46). Receipt of treatment for substance use disorders in jail also resulted in early linkage (OR = 4.06; 95% CI = 1.93, 8.53) and retention (OR = 2.52; 95% CI = 1.21, 5.23). Latinos were less likely to be linked to (OR = 0.35; 95% CI = 0.14, 0.91) or retained in (OR = 0.28; 95% CI = 0.09, 0.82) HIV care. CONCLUSIONS Patient navigation supports maintaining engagement in care and can mitigate health disparities, and should become the standard of care for HIV-infected individuals leaving jail.
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Affiliation(s)
- Janet J Myers
- Janet J. Myers, Mi-Suk Kang Dufour, Kimberly A. Koester, Rebecca Packard, Brie Williams, and Jacqueline Tulsky are with University of California, San Francisco. Mark Morewitz, Kate Monico Klein, and Milton Estes are with San Francisco Department of Public Health. Alissa Riker is with San Francisco Sheriff's Department
| | - Mi-Suk Kang Dufour
- Janet J. Myers, Mi-Suk Kang Dufour, Kimberly A. Koester, Rebecca Packard, Brie Williams, and Jacqueline Tulsky are with University of California, San Francisco. Mark Morewitz, Kate Monico Klein, and Milton Estes are with San Francisco Department of Public Health. Alissa Riker is with San Francisco Sheriff's Department
| | - Kimberly A Koester
- Janet J. Myers, Mi-Suk Kang Dufour, Kimberly A. Koester, Rebecca Packard, Brie Williams, and Jacqueline Tulsky are with University of California, San Francisco. Mark Morewitz, Kate Monico Klein, and Milton Estes are with San Francisco Department of Public Health. Alissa Riker is with San Francisco Sheriff's Department
| | - Mark Morewitz
- Janet J. Myers, Mi-Suk Kang Dufour, Kimberly A. Koester, Rebecca Packard, Brie Williams, and Jacqueline Tulsky are with University of California, San Francisco. Mark Morewitz, Kate Monico Klein, and Milton Estes are with San Francisco Department of Public Health. Alissa Riker is with San Francisco Sheriff's Department
| | - Rebecca Packard
- Janet J. Myers, Mi-Suk Kang Dufour, Kimberly A. Koester, Rebecca Packard, Brie Williams, and Jacqueline Tulsky are with University of California, San Francisco. Mark Morewitz, Kate Monico Klein, and Milton Estes are with San Francisco Department of Public Health. Alissa Riker is with San Francisco Sheriff's Department
| | - Kate Monico Klein
- Janet J. Myers, Mi-Suk Kang Dufour, Kimberly A. Koester, Rebecca Packard, Brie Williams, and Jacqueline Tulsky are with University of California, San Francisco. Mark Morewitz, Kate Monico Klein, and Milton Estes are with San Francisco Department of Public Health. Alissa Riker is with San Francisco Sheriff's Department
| | - Milton Estes
- Janet J. Myers, Mi-Suk Kang Dufour, Kimberly A. Koester, Rebecca Packard, Brie Williams, and Jacqueline Tulsky are with University of California, San Francisco. Mark Morewitz, Kate Monico Klein, and Milton Estes are with San Francisco Department of Public Health. Alissa Riker is with San Francisco Sheriff's Department
| | - Brie Williams
- Janet J. Myers, Mi-Suk Kang Dufour, Kimberly A. Koester, Rebecca Packard, Brie Williams, and Jacqueline Tulsky are with University of California, San Francisco. Mark Morewitz, Kate Monico Klein, and Milton Estes are with San Francisco Department of Public Health. Alissa Riker is with San Francisco Sheriff's Department
| | - Alissa Riker
- Janet J. Myers, Mi-Suk Kang Dufour, Kimberly A. Koester, Rebecca Packard, Brie Williams, and Jacqueline Tulsky are with University of California, San Francisco. Mark Morewitz, Kate Monico Klein, and Milton Estes are with San Francisco Department of Public Health. Alissa Riker is with San Francisco Sheriff's Department
| | - Jacqueline Tulsky
- Janet J. Myers, Mi-Suk Kang Dufour, Kimberly A. Koester, Rebecca Packard, Brie Williams, and Jacqueline Tulsky are with University of California, San Francisco. Mark Morewitz, Kate Monico Klein, and Milton Estes are with San Francisco Department of Public Health. Alissa Riker is with San Francisco Sheriff's Department
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Nasrullah M, Frazier E, Fagan J, Hardnett F, Skarbinski J. The association of recent incarceration and health outcomes among HIV-infected adults receiving care in the United States. Int J Prison Health 2017; 12:135-44. [PMID: 27548016 DOI: 10.1108/ijph-04-2016-0010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose The purpose of this paper is to describe factors associated with incarceration as well as the association between recent incarceration and HIV-related sexual risk behaviors, access to insurance, healthcare utilization (emergency department (ED) and hospital use), antiretroviral therapy (ART) prescription, and viral suppression. Design/methodology/approach Using 2009-2010 data from a cross-sectional, nationally representative three-stage sample of HIV-infected adults receiving care in the USA, the authors assessed the demographic characteristics, healthcare utilization, and clinical outcomes of HIV-infected persons who had been recently incarcerated (detention for>24 hours in the past year) using bivariate analyses. The authors used multivariable logistic regression to examine associations of recent incarceration with insurance status as well as clinical and behavioral outcomes. Findings An estimated 22,949 (95 percent confidence interval (CI) 19,062-26,836) or 5.4 percent (CI: 4.7-6.1) of all HIV-infected persons receiving care were recently incarcerated. Factors associated with recent incarceration were age <50 years, being a smoker, having high school diploma or less, being homeless, income at or below the poverty guidelines, having a geometric mean of CD4 count <500 cells/ μL, and using drugs in the past 12 months. Results from multivariable modeling indicated that incarcerated persons were more likely to use ED services, and to have been hospitalized, and less likely to have achieved viral suppression. Originality/value Recent incarceration independently predicted worse health outcomes and greater use of emergency services among HIV-infected adults currently in HIV care. Options to improve the HIV continuum of care, including pre-enrollment for healthcare coverage and discharge planning, may lead to better health outcomes for HIV-infected inmates post-release.
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Affiliation(s)
| | - Emma Frazier
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer Fagan
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Felicia Hardnett
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jacek Skarbinski
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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15
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Groves AK, Zhan W, Del Río-González AM, Rosenberg A, Blankenship KM. Dual Incarceration and Condom Use in Committed Relationships. AIDS Behav 2017; 21:3549-3556. [PMID: 28194588 DOI: 10.1007/s10461-017-1720-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Incarceration fractures relationship ties and has been associated with unprotected sex. Relationships where both individuals have a history of incarceration (dual incarceration) may face even greater disruption and involve more unprotected sex than relationships where only one individual has been incarcerated. We sought to determine whether dual incarceration is associated with condom use, and whether this association varies by relationship type. Data come from 499 sexual partnerships reported by 210 individuals with a history of incarceration. We used generalized estimating equations to examine whether dual incarceration was associated with condom use after controlling for individual and relationship characteristics. Interaction terms between dual incarceration and relationship commitment were also examined. Among currently committed relationships, dual incarceration was associated with inconsistent condom use (AOR: 4.33; 95% CI 1.02, 18.45). Dual incarceration did not affect condom use in never committed relationships. Reducing incarcerations may positively impact committed relationships and subsequently decrease HIV-related risk.
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Affiliation(s)
- Allison K Groves
- Department of Community Health and Prevention, Drexel Dornsife School of Public Health, 416 Nesbitt Hall, Drexel University 3215 Market Street, Philadelphia, PA, USA.
| | - WeiHai Zhan
- Connecticut Department of Children and Families, Hartford, CT, USA
| | | | | | - Kim M Blankenship
- Department of Sociology, Center on Health, Risk and Society, American University, Washington, DC, USA
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Nowotny KM, Rogers RG, Boardman JD. Racial disparities in health conditions among prisoners compared with the general population. SSM Popul Health 2017; 3:487-496. [PMID: 28824953 PMCID: PMC5558461 DOI: 10.1016/j.ssmph.2017.05.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
This paper compares black-white health disparities among prisoners to disparities in the noninstitutionalized community to provide a more complete portrait of the nation’s heath. We use data from the 2004 Survey of Inmates in State and Federal Correctional Facilities and the 2002 and 2004 National Health and Nutrition Examination Survey for incarcerated and noninstitutionalized adult (aged 18–65) men and women, respectively. Health disparities between black and white male prisoners based on self-reported prevalence are similar to disparities in the general population for hypertension and diabetes but significantly reduced for kidney problems and stroke. Health disparities between black and white female prisoners are similar to disparities in the general population for obesity but significantly reduced for hypertension, diabetes, heart problems, kidney problems, and stroke. Our study reveals that prisoners report far worse health profiles than non-prisoners but there is differential health selection into prison for whites and blacks, and population health estimates for adult black men in particular underreport the true health burden for U.S. adults. Our findings highlight the importance of incorporating prison populations in demographic and public health analyses. Inmates have poorer health overall than the noninstitutionalized population, but more so for white women demonstrating a differential health selection into prison. Health problems increase when inmates are included in national health statistics, especially for black men. U.S. health statistics may underestimate the health of the nation with potential consequences for understanding racial health disparities. Properly characterizing population health and health disparities requires the inclusion of incarcerated adults in mainstream epidemiologic studies.
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Affiliation(s)
- Kathryn M. Nowotny
- University of Miami, Department of Sociology 5202 University Drive, Merrick Building, Rm 120, Coral Gables, FL 33146 USA
- Corresponding author.
| | - Richard G. Rogers
- University of Colorado Boulder, Department of Sociology & Institute of Behavioral Science, 1440 15th Street, Boulder, CO 80309-0483 USA
| | - Jason D. Boardman
- University of Colorado Boulder, Department of Sociology & Institute of Behavioral Science, 1440 15th Street, Boulder, CO 80309-0483 USA
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Schneider JA, Lancki N, Schumm P. At the intersection of criminal justice involvement and sexual orientation: Dynamic networks and health among a population-based sample of young Black men who have sex with men. SOCIAL NETWORKS 2017; 51:73-87. [PMID: 29062165 PMCID: PMC5650246 DOI: 10.1016/j.socnet.2017.04.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Mass incarceration of young Black men has a significant impact on their network composition and stability that, in turn, may have major implications for health and well-being. A sub-group of young Black men with criminal justice involvement (CJI) identify as gay, bisexual or are non-identified men who have sex with men (hereafter MSM). This paper focuses on the potential effects of CJI on the composition of Black MSM social and sexual networks, their stability over time, and concomitant health and social outcomes. We use data from the UConnect study, a population-based cohort of young Black MSM 16-29 years of age (n=618) selected using respondent-driven sampling in Chicago from 2013-2016. Both confidant and sexual network name generators and interpreters were administered at 9-month intervals over three waves of data collection. Ego and dyadic-level data were collected on behaviors prevalent among MSM and including factors associated with network CJI, network stability, and health outcomes. Generalized Structural Equation Models (GSEM) were utilized to determine the relationship between CJI network composition, network stability and behaviors prevalent among young Black MSM and their networks. In the UConnect cohort, 46% had at least once been detained, arrested or spent time in jail or prison. In addition, 20% of participants reported incident CJI over the study period. Respondents with a history of CJI were significantly more likely to have CJI homophily in their confidant and sexual networks. Multivariate analyses demonstrate that the association between one's history of CJI, housing instability and drug use is partially explained by one's network CJI. In addition, a higher prevalence of network CJI is associated with increased turnover in the confidant network, and this network instability is also related to important health and social outcomes. This analysis describes the networks of criminal justice involved men among a representative sample of young Black MSM and demonstrates the relationship between CJI network homophily, network stability and their impact on several key health and social outcomes relevant to this population.
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Affiliation(s)
- J A Schneider
- Department of Medicine, University of Chicago
- Department of Public Health Sciences, University of Chicago
- Chicago Center for HIV Elimination, University of Chicago
| | - N Lancki
- Department of Medicine, University of Chicago
- Chicago Center for HIV Elimination, University of Chicago
| | - P Schumm
- Department of Public Health Sciences, University of Chicago
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18
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Pouget ER. Social determinants of adult sex ratios and racial/ethnic disparities in transmission of HIV and other sexually transmitted infections in the USA. Philos Trans R Soc Lond B Biol Sci 2017; 372:20160323. [PMID: 28760764 PMCID: PMC5540863 DOI: 10.1098/rstb.2016.0323] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2017] [Indexed: 11/12/2022] Open
Abstract
In Black population centres in the USA, adult sex ratios (ASRs) are strongly female-biased primarily due to high male incarceration and early mortality rates. I explore the system of social determinants that shape these ASRs, and describe their apparent consequences. Evidence suggests that female-biased ASRs play a role, along with racial residential segregation, to increase mixing between core and peripheral members of sexual networks, facilitating transmission of human immunodeficiency virus and other sexually transmitted infections. Unique historical factors underlie Black male incarceration and mortality rates in the USA, making comparisons with other groups or other countries challenging.This article is part of the themed issue 'Adult sex ratios and reproductive decisions: a critical re-examination of sex differences in human and animal societies'.
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Affiliation(s)
- Enrique Rodriguez Pouget
- Center for Policing Equity at John Jay College of Criminal Justice, 524 West 59th Street, Room 6.63.14, New York, NY 10019, USA
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19
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Valera P, McClernon FJ, Burkholder G, Mugavero MJ, Willig J, O'Cleirigh C, Cropsey KL. A Pilot Trial Examining African American and White Responses to Algorithm-Guided Smoking Cessation Medication Selection in Persons Living with HIV. AIDS Behav 2017; 21:1975-1984. [PMID: 27942999 DOI: 10.1007/s10461-016-1634-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Algorithm-based treatments (AT) may be an effective clinical tool to aid HIV clinicians in prescribing pharmacotherapy to increase smoking cessation among people living with HIV (PLWH). Initial results from AT indicated significant increases in abstinence self-efficacy and medication utilization and declines in cigarettes smoked per day across time. Given historical racial disparities, it is unclear if both African Americans and White smokers would benefit equally from this type of intervention. Thus, the aim of this study was to examine racial differences in response to AT guided smoking cessation for African American and White smokers living with HIV. One hundred PLWH smokers (n = 100) were randomized to receive either AT guided smoking cessation or Treatment as Usual (TAU) which consisted of instructing participants to talk to a provider about smoking cessation assistance when ready to make a quit attempt. Participants were African American (75%) and White (25%) and majority men (71%) who had never been married (56%). African Americans smoked fewer cigarettes and were more likely to smoke mentholated cigarettes compared to White smokers at baseline. African Americans increased their use of other tobacco products (cigars/cigarillos) over time relative to White smokers. A significant interaction between race and quit goal was observed, with White smokers who reported complete abstinence as their goal having higher quit rates, while African Americans who reported a goal other than complete abstinence demonstrating higher quit rates. The increased use of cigars/cigarillos during quit attempts as well as having a goal other than complete abstinence should be considered when applying algorithm based interventions for PLWH African American smokers.
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Affiliation(s)
- Pamela Valera
- Division of Social Solutions and Services Research, The Nathan Kline Institute for Psychiatric Research and Department of Psychiatry, New York University School of Medicine, 140 Old Orangeburg Rd, Orangeburg, NY, 10962, USA
| | - F Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Addiction Division, Duke University School of Medicine, 2628 Erwin Rd, Durham, NC, 27707, USA
| | - Greer Burkholder
- Department of Internal Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, 1900 University Boulevard, THT 229, Birmingham, AL, 35294, USA
| | - Michael J Mugavero
- Department of Internal Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, 1900 University Boulevard, THT 229, Birmingham, AL, 35294, USA
| | - James Willig
- Department of Internal Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, 1900 University Boulevard, THT 229, Birmingham, AL, 35294, USA
| | - Conall O'Cleirigh
- Department of Psychiatry, Behavioral Medicine, Massachusetts General Hospital/Harvard Medical School, 1 Bowdoin Square, Boston, MA, 02114, USA
| | - Karen L Cropsey
- Department of Psychiatry & Behavioral Neurobiology, University of Alabama at Birmingham, 1720 2nd Ave S., Birmingham, AL, 35294-0017, USA.
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20
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Mitchell MM, Nguyen TQ, Maragh-Bass AC, Isenberg SR, Beach MC, Knowlton AR. Patient-Provider Engagement and Chronic Pain in Drug-Using, Primarily African American Persons Living with HIV/AIDS. AIDS Behav 2017; 21:1768-1774. [PMID: 27787673 DOI: 10.1007/s10461-016-1592-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Among disadvantaged persons living with HIV/AIDS (PLHIV), patient-provider engagement, which has been defined as patient-provider relationships that promote the use of health care services and are characterized by active listening and supportive decision making, has been associated with antiretroviral therapy (ART) maintenance and viral suppression. However, chronic pain, depression, and substance use, all of which are prevalent in this population, can reduce the quality of patient-provider engagement. We hypothesized a model in which chronic pain, depression, and substance use would be associated with poorer patient-provider engagement, which would be positively associated with adherence, with the latter associated positively with viral suppression. We analyzed data from the BEACON study, which included surveys from 383 PLHIV who were primarily African American, on ART, and had histories of drug use. Due to six missing cases on the chronic pain variable, we used data from 377 respondents in a structural equation model. Chronic pain and depressive symptoms were significantly associated with poorer patient-provider engagement, while substance use was associated with better engagement. Patient-provider engagement in turn was associated with better ART adherence, which was associated with higher viral suppression. Results suggest the role of chronic pain in poor patient-physician engagement in this population, which has potential implications for quality of HIV patient care and health outcomes. Findings suggest the need for attention to patient-provider engagement in PLHIV.
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Affiliation(s)
- Mary M Mitchell
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry St., 2nd Floor, Baltimore, MD, 21205, USA.
| | - Trang Q Nguyen
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Allysha C Maragh-Bass
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry St., 2nd Floor, Baltimore, MD, 21205, USA
| | - Sarina R Isenberg
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry St., 2nd Floor, Baltimore, MD, 21205, USA
| | | | - Amy R Knowlton
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 745, Baltimore, MD, 21205, USA
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21
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Cornelius T, Kershaw T. Perception of partner sexual history: Effects on safe-sex intentions. Health Psychol 2017; 36:704-712. [PMID: 28318276 DOI: 10.1037/hea0000474] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Sexual intercourse is a dyadic activity, and intentions to engage in safe sex vary across partners. Because pregnant and newly parenting adolescents and young adults are at high risk for sexually transmitted infections (STIs), it is important to understand sexual decision-making in this population. METHOD This cross-sectional study examined how participants' own risk behavior and their partners' risk behavior influence perceptions of partner risk, and the impact of risk perceptions on condom use intentions and monogamy intentions in 296 pregnant adolescent and young adult couples (MAgeFemale = 18.71 years; MAgeMale = 21.33 years). RESULTS Participants' behavior and their partners' behavior both related to increased perceptions of partner risk. Male participants' perceptions were more strongly influenced by female partners' behavior than participants' own behavior. Perceiving a partner as having a history of more risk behaviors trended toward a negative relationship with condom use intentions and monogamy intentions. For females, more previous sex partners related negatively to condom use intentions and positively to monogamy intentions. Having a male partner with more previous sex partners related positively to condom use intentions and monogamy intentions. CONCLUSIONS Perceptions of partner risk did not significantly relate to condom use intentions and monogamy intentions, however, trends suggest that risk perception could reflect similarity bias and ongoing risk engagement. Differences in partner perception by gender suggest that females may communicate more openly about risks. Interventions to reduce STI transmission in couples should work to interrupt trajectories of risky behavior and enhance risk communication. (PsycINFO Database Record
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Affiliation(s)
- Talea Cornelius
- Department of Psychological Sciences, University of Connecticut
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22
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Bernard CL, Brandeau ML, Humphreys K, Bendavid E, Holodniy M, Weyant C, Owens DK, Goldhaber-Fiebert JD. Cost-Effectiveness of HIV Preexposure Prophylaxis for People Who Inject Drugs in the United States. Ann Intern Med 2016; 165:10-19. [PMID: 27110953 PMCID: PMC5118181 DOI: 10.7326/m15-2634] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The total population health benefits and costs of HIV preexposure prophylaxis (PrEP) for people who inject drugs (PWID) in the United States are unclear. OBJECTIVE To evaluate the cost-effectiveness and optimal delivery conditions of PrEP for PWID. DESIGN Empirically calibrated dynamic compartmental model. DATA SOURCES Published literature and expert opinion. TARGET POPULATION Adult U.S. PWID. TIME HORIZON 20 years and lifetime. INTERVENTION PrEP alone, PrEP with frequent screening (PrEP+screen), and PrEP+screen with enhanced provision of antiretroviral therapy (ART) for individuals who become infected (PrEP+screen+ART). All scenarios are considered at 25% coverage. OUTCOME MEASURES Infections averted, deaths averted, change in HIV prevalence, discounted costs (in 2015 U.S. dollars), discounted quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. RESULTS OF BASE-CASE ANALYSIS PrEP+screen+ART dominates other strategies, averting 26 700 infections and reducing HIV prevalence among PWID by 14% compared with the status quo. Achieving these benefits costs $253 000 per QALY gained. At current drug prices, total expenditures for PrEP+screen+ART could be as high as $44 billion over 20 years. RESULTS OF SENSITIVITY ANALYSIS Cost-effectiveness of the intervention is linear in the annual cost of PrEP and is dependent on PrEP drug adherence, individual transmission risks, and community HIV prevalence. LIMITATION Data on risk stratification and achievable PrEP efficacy levels for U.S. PWID are limited. CONCLUSION PrEP with frequent screening and prompt treatment for those who become infected can reduce HIV burden among PWID and provide health benefits for the entire U.S. population, but, at current drug prices, it remains an expensive intervention both in absolute terms and in cost per QALY gained. PRIMARY FUNDING SOURCE National Institute on Drug Abuse.
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Affiliation(s)
- Cora L. Bernard
- From Stanford University, Stanford, and Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Margaret L. Brandeau
- From Stanford University, Stanford, and Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Keith Humphreys
- From Stanford University, Stanford, and Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Eran Bendavid
- From Stanford University, Stanford, and Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Mark Holodniy
- From Stanford University, Stanford, and Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Christopher Weyant
- From Stanford University, Stanford, and Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Douglas K. Owens
- From Stanford University, Stanford, and Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Jeremy D. Goldhaber-Fiebert
- From Stanford University, Stanford, and Veterans Affairs Palo Alto Health Care System, Palo Alto, California
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23
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Arentoft A, Van Dyk K, Thames AD, Thaler NS, Sayegh P, Hinkin CH. HIV-transmission-related risk behavior in HIV+ African American men: Exploring biological, psychological, cognitive, and social factors. JOURNAL OF HIV/AIDS & SOCIAL SERVICES 2016; 15:299-318. [PMID: 28713225 PMCID: PMC5509347 DOI: 10.1080/15381501.2016.1166092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To identify factors associated with HIV-transmission-related risk behavior among HIV+ African American men. METHOD We examined biological, psychological, cognitive, and social factors and recent HIV-transmission-related risk behavior (i.e., needle sharing, unprotected sex, exchange sex) among a sample of HIV+ African American men. RESULTS A binary logistic regression showed that individuals under age 50 (OR=4.2), with clinically-elevated masochism scores (OR=3.9) on the Millon Clinical Multiaxial Inventory-III (MCMI-III), current substance abuse/dependence (OR=2.6), and higher sensation-seeking (OR=1.3) were more likely to report recent risk behavior. CONCLUSIONS Reducing substance use, addressing self-defeating attitudes, and improving self-control may be avenues for future prevention and intervention research among HIV+ African American men engaging in HIV-transmission-related risk behavior.
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Affiliation(s)
- Alyssa Arentoft
- Department of Psychology, California State University, Northridge, Northridge, California
| | - Kathleen Van Dyk
- Department of Psychiatry & Biobehavioral Sciences, University of California-Los Angeles, Los Angeles, California
| | - April D. Thames
- Department of Psychiatry & Biobehavioral Sciences, University of California-Los Angeles, Los Angeles, California
| | - Nicholas S. Thaler
- Department of Psychiatry & Biobehavioral Sciences, University of California-Los Angeles, Los Angeles, California
| | - Philip Sayegh
- Department of Psychiatry & Biobehavioral Sciences, University of California-Los Angeles, Los Angeles, California
| | - Charles H. Hinkin
- Department of Psychiatry & Biobehavioral Sciences, University of California-Los Angeles, Los Angeles, California
- Department of Psychology, West Los Angeles VA Healthcare Center, Los Angeles, California
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24
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Male Incarceration Rates and Rates of Sexually Transmitted Infections: Results From a Longitudinal Analysis in a Southeastern US City. Sex Transm Dis 2016; 42:324-8. [PMID: 25970309 DOI: 10.1097/olq.0000000000000268] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In the United States, rates of certain sexually transmitted infections (STIs) are increasing. Contextual factors seem to play an important role in shaping STI transmission dynamics. This longitudinal study explores the relationship between one contextual determinant of health (the male incarceration rate) and rates of newly diagnosed STIs in census tracts in Atlanta, GA. METHODS The sample consisted of all census tracts in Atlanta (n = 946). Annual data on STI diagnoses were drawn from the Georgia surveillance system for 2005 to 2010; annual male incarceration data were drawn from the Georgia Department of Corrections for 2005 to 2010; and data on potential confounders were drawn from the US Census. Multivariable growth models were used to examine the association between the male incarceration rate and rates of newly diagnosed STIs, controlling for covariates. RESULTS Census tracts with higher baseline male incarceration rates had a higher baseline rate of newly diagnosed STIs. Census tracts with increasing male incarceration rates experienced a more rapid increase in their rate of newly diagnosed STIs. Census tracts with medium and high baseline male incarceration rates experienced a decrease in their rate of newly diagnosed STIs over time. CONCLUSIONS The present study strengthens the evidence that male incarceration rates have negative consequences on sexual health outcomes, although the relationship may be more nuanced than originally thought. Future multilevel research should explore individual sexual risk behaviors and networks in the context of high male incarceration rates to better understand how male incarceration shapes rates of STIs.
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25
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Knowlton AR, Nguyen TQ, Robinson AC, Harrell PT, Mitchell MM. Pain Symptoms Associated with Opioid Use among Vulnerable Persons with HIV: An exploratory study with implications for palliative care and opioid abuse prevention. J Palliat Care 2016; 31:228-33. [PMID: 26856123 DOI: 10.1177/082585971503100404] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Current or former injection drug users with human immunodeficiency virus (HIV) are at high risk for pain, which adversely affects their quality of life and may increase their risk for illicit drug use or relapse. We explored associations between pain symptoms and substance use among injection-drug-using study participants with HIV who had histories of heroin use. Using generalized estimating equations and controlling for prior substance use, we found that pain in each six-month period was associated with the use of heroin and prescription opioids, but not the use of nonopioid drugs or alcohol. Routine clinical assessment and improved management of pain symptoms may be needed for persons with HIV and a history of injection drug use, particularly those with chronic pain, for whom there is increased risk for heroin use.
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26
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Zaller ND, Patry EJ, Bazerman LB, Noska A, Kuo I, Kurth A, Beckwith CG. A Pilot Study of Rapid Hepatitis C Testing in Probation and Parole Populations in Rhode Island. J Health Care Poor Underserved 2016; 27:214-23. [PMID: 27133520 PMCID: PMC10916330 DOI: 10.1353/hpu.2016.0049] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Hepatitis C virus (HCV) affects between five and seven million individuals in the United States and chronic infection can lead to liver disease, cirrhosis, and hepatocellular carcinoma. Probation/parole offices are a novel setting for rapid HCV testing, providing outreach to populations at increased risk for HCV infection and/or transmitting HCV to others. While some correctional facilities offer HCV testing, many individuals who present to probation/parole offices are never or briefly incarcerated and may not access medical services. We conducted a rapid HCV testing pilot at probation/parole offices in Rhode Island. Overall, 130 people accepted rapid HCV testing, of whom 12 had reactive tests. Only four of these individuals presented to a community-based clinic for confirmatory testing, despite being offered a monetary incentive. Identifying and addressing barriers to HCV confirmatory testing and follow-up care is critical to increasing the uptake of HCV care and treatment in this vulnerable population.
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27
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Rowell-Cunsolo TL, El-Bassel N, Hart CL. Black Americans and Incarceration: A Neglected Public Health Opportunity for HIV Risk Reduction. J Health Care Poor Underserved 2016; 27:114-130. [PMID: 27763462 PMCID: PMC5111428 DOI: 10.1353/hpu.2016.0011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Black Americans are incarcerated at disproportionate rates, largely due to racial differences in the application of drug laws. Human immunodeficiency virus (HIV) prevalence rates among Black Americans are also disproportionately high. Moreover, availability of and access to HIV prevention services in correctional settings are limited. Recognizing that Blacks are at an elevated risk of contracting HIV, and that incarceration worsens health outcomes, this paper addresses the importance of implementing comprehensive prison-based HIV programs and prevention interventions to improve the health of this vulnerable population. In the absence of a vaccine, prevention interventions can serve as an effective method of systematically addressing HIV-related health disparities. Prevention strategies offered within correctional settings provide a unique opportunity to engage a high-risk population when its members may be receptive to behavior modification.
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Affiliation(s)
| | - Nabila El-Bassel
- Social Intervention Group, Columbia University School of Social Work, New York, NY
| | - Carl L. Hart
- Departments of Psychology and Psychiatry, Columbia University, New York, NY
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28
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Miller PK, Broman CL. Racial-ethnic differences in sexual risk behaviors: The role of substance use. JOURNAL OF BLACK SEXUALITY AND RELATIONSHIPS 2016; 3:25-43. [PMID: 29201951 PMCID: PMC5710830 DOI: 10.1353/bsr.2016.0020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This research investigates the impact adolescent substance use has on adult sexual risk behaviors within racial-ethnic groups. Previous research has found support for this relationship, but often relies on concurrent measures of substance use and sexual risk behavior meaning that the causal direction of this relationship may be unclear. The data for this study come from the National Longitudinal Survey of Adolescent to Adult Health (Add Health), a nationally representative survey that followed respondents from adolescence in 1994 to adulthood in 2008. Results show that substance use correlates with sexual risk behavior, but the impact varies by race-ethnicity.
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29
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Michel L, Lions C, Van Malderen S, Schiltz J, Vanderplasschen W, Holm K, Kolind T, Nava F, Weltzien N, Moser A, Jauffret-Roustide M, Maguet O, Carrieri PM, Brentari C, Stöver H. Insufficient access to harm reduction measures in prisons in 5 countries (PRIDE Europe): a shared European public health concern. BMC Public Health 2015; 15:1093. [PMID: 26507505 PMCID: PMC4624386 DOI: 10.1186/s12889-015-2421-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 10/16/2015] [Indexed: 01/13/2023] Open
Abstract
Background Prisoners constitute a high-risk population, particularly for infectious diseases. The aim of this study was to estimate the level of infectious risk in the prisons of five different European countries by measuring to what extent the prison system adheres to WHO/UNODC recommendations. Methods Following the methodology used in a previous French survey, a postal/electronic questionnaire was sent to all prisons in Austria, Belgium, Denmark and Italy to collect data on the availability of several recommended HIV-HCV prevention interventions and HBV vaccination for prisoners. A score was built to compare adherence to WHO/UNODC recommendations (considered a proxy of environmental infectious risk) in those 4 countries. It ranged from 0 (no adherence) to 12 (full adherence). A second score (0 to 9) was built to include data from a previous French survey, thereby creating a 5-country comparison. Results A majority of prisons answered in Austria (100 %), France (66 %) and Denmark (58 %), half in Belgium (50 %) and few in Italy (17 %), representing 100, 74, 89, 47 and 23 % coverage of the prison populations, respectively. Availability of prevention measures was low, with median adherence scores ranging from 3.5 to 4.5 at the national level. These results were confirmed when using the second score which included France in the inter-country comparison. Overall, the adherence score was inversely associated with prison overpopulation rates (p = 0.08). Conclusions Using a score of adherence to WHO/UNODC recommendations, the estimated environmental infectious risk remains extremely high in the prisons of the 5 European countries assessed. Public health strategies should be adjusted to comply with the principle of equivalence of care and prevention with the general community.
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Affiliation(s)
- Laurent Michel
- Inserm U1178, Paris, France. .,Univ Paris-Sud and Univ Paris Descartes, UMRS1178, Paris, France. .,Centre Pierre Nicole, French Red Cross, Paris, France.
| | - Caroline Lions
- Inserm U912 (SESSTIM), Marseille, France. .,Univ Aix Marseille, IRD, UMR-S912, Marseille, France. .,ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France.
| | | | - Julie Schiltz
- Department of Special Education, Ghent University, Ghent, Belgium.
| | | | - Karina Holm
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark.
| | - Torsten Kolind
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark.
| | | | | | | | | | | | - Patrizia M Carrieri
- Inserm U912 (SESSTIM), Marseille, France. .,Univ Aix Marseille, IRD, UMR-S912, Marseille, France. .,ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France.
| | | | - Heino Stöver
- University of Applied Sciences, Frankfurt, Germany.
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Kerr JC, Valois RF, Siddiqi A, Vanable P, Carey MP, DiClemente RJ, Romer D, Brown LK, Farber NB, Salazar LF. Neighborhood Condition and Geographic Locale in Assessing HIV/STI Risk Among African American Adolescents. AIDS Behav 2015; 19:1005-13. [PMID: 25108404 DOI: 10.1007/s10461-014-0868-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Although region and neighborhood condition's effect on HIV/sexually transmitted infection (STI) risk has been studied separately, there is little research examining their interplay. African American adolescents (n = 1,602) from four matched cities in the Northeastern and Southeastern US completed Audio Computer Assisted Self-Interviews and submitted biospecimen samples to detect Sexually Transmitted Infections (chlamydia, gonorrhea, and trichomonas). Logistic and negative binomial regressions determined HIV/STI risk differences by region, neighborhood stress, and stress-region dyads. Northeastern participants demonstrated lower HIV/STI risk while participants from higher stress neighborhoods exhibited greater risk. Relationships between neighborhood condition and ever having anal sex (p < 0.01), anal condom use (p < 0.05), and number of anal partners (p < 0.05) were significant in the Northeast only. Participants in unstressed Northeastern neighborhoods were less likely to have vaginal sex than those in comparable Southeastern neighborhoods (p < 0.05). Participants in unfavorable Northeastern neighborhoods had fewer anal partners than participants in comparable Southeastern neighborhoods (p < 0.01). In concert, neighborhood and region differentially affect HIV/STI risk.
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Affiliation(s)
- Jelani C Kerr
- Department of Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA,
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Taylor TN, Joseph M, Henny KD, Pinto AR, Agbetor F, Camilien B, Williams KM, Browne RC, White M, Gousse Y, Brown H, Taylor RD, Wilson TE. Perceptions of HIV Risk and Explanations of Sexual Risk Behavior Offered by Heterosexual Black Male Barbershop Patrons in Brooklyn, NY. JOURNAL OF HEALTH DISPARITIES RESEARCH AND PRACTICE 2015; 7:1-25. [PMID: 25699198 PMCID: PMC4331027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
To describe HIV risk factors among adult heterosexual Black men recruited from four barbershops located in high HIV seroprevalent neighborhoods of Brooklyn, NY. Data on HIV-risk related behaviors and other characteristics were collected from barbershop clients. All participants (n=60) completed brief risk assessments; and a subset (n=22) also completed focus groups and/or individual interviews. Of the subset of 22 men, 68% were US born, 59% had been in jail/prison, 32% were unemployed; and during the 3 months before the interviews, 68% reported at least two partners and 45% reported unprotected vaginal or anal sex with two or more women. Emergent themes included: 1) the psychological function of multiple partnerships; 2) calculated risk taking regarding condom use; 3) the role of emotional attachment and partner trust in condom use; 4) low perceived HIV risk and community awareness; and 5) lack of relationship between HIV testing and safer sex practices. Interventions among heterosexual Black men should focus not only on increasing HIV awareness and reducing sexual risk, but also on contextual and interpersonal factors that influence sexual risk.
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Haley DF, Golin CE, Farel CE, Wohl DA, Scheyett AM, Garrett JJ, Rosen DL, Parker SD. Multilevel challenges to engagement in HIV care after prison release: a theory-informed qualitative study comparing prisoners' perspectives before and after community reentry. BMC Public Health 2014; 14:1253. [PMID: 25491946 PMCID: PMC4295310 DOI: 10.1186/1471-2458-14-1253] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 11/17/2014] [Indexed: 01/28/2023] Open
Abstract
Background Although prison provides the opportunity for HIV diagnosis and access to in-prison care, following release, many HIV-infected inmates experience clinical setbacks, including nonadherence to antiretrovirals, elevations in viral load, and HIV disease progression. HIV-infected former inmates face numerous barriers to successful community reentry and to accessing healthcare. However, little is known about the outcome expectations of HIV-infected inmates for release, how their post-release lives align with pre-release expectations, and how these processes influence engagement in HIV care following release from prison. Methods We conducted semi-structured interviews (24 pre- and 13 post-release) with HIV-infected inmates enrolled in a randomized controlled trial of a case management intervention to enhance post-release linkage to care. Two researchers independently coded data using a common codebook. Intercoder reliability was strong (kappa = 0.86). We analyzed data using Grounded Theory methodology and Applied Thematic Analysis. We collected and compared baseline sociodemographic and behavioral characteristics of all cohort participants who did and did not participate in the qualitative interviews using Fisher’s Exact Tests for categorical measures and Wilcoxon rank-sum tests for continuous measures. Results Most participants were heterosexual, middle-aged, single, African American men and women with histories of substance use. Substudy participants were more likely to anticipate living with family/friends and needing income assistance post-release. Most were taking antiretrovirals prior to release and anticipated needing help securing health benefits and medications post-release. Before release, most participants felt confident they would be able to manage their HIV. However, upon release, many experienced intermittent or prolonged periods of antiretroviral nonadherence, largely due to substance use relapse or delays in care initiation. Substance use was precipitated by stressful life experiences, including stigma, and contact with drug-using social networks. As informed by the Social Cognitive Theory and HIV Stigma Framework, findings illustrate the reciprocal relationships among substance use, experiences of stigma, pre- and post-release environments, and skills needed to engage in HIV care. Conclusion These findings underscore the need for comprehensive evidence-based interventions to prepare inmates to transition from incarceration to freedom, particularly those that strengthen linkage to HIV care and focus on realities of reentry, including stigma, meeting basic needs, preventing substance abuse, and identifying community resources.
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Affiliation(s)
- Danielle F Haley
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, 1518 Clifton Rd,, NE Atlanta, GA 30322, USA.
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Davey-Rothwell MA, Villarroel MA, Grieb SD, Latkin CA. Norms, attitudes, and sex behaviors among women with incarcerated main partners. J Urban Health 2013; 90:1151-65. [PMID: 22872432 PMCID: PMC3853167 DOI: 10.1007/s11524-012-9749-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Incarceration has been extensively linked with HIV and sexually transmitted infections (STIs). While a great deal of attention has been given to the risk behaviors of people who have been incarcerated, examination of the behaviors of partners of incarcerated individuals is also needed to understand the direct and indirect links between incarceration and HIV and to identify prevention avenues. In the present study, we hypothesize that incarceration is associated with risk behavior through attitudes and norms. The purpose of this paper is: (1) to describe the attitudes and norms about sexual behaviors that women have when a sexual partner is incarcerated; and (2) to examine the association between attitudes and norms with the behavior of having other sex partners while a main partner is incarcerated. In our sample (n = 175), 50 % of women reported having other sex partners while their partner was incarcerated. Our findings show that attitudes, descriptive norms (i.e., norms about what other people do), and injunctive norms (i.e., norms about what others think is appropriate) were associated with having other partners. Interventions designed for couples at pre- and post-release from prison are needed to develop risk reduction plans and encourage HIV/STI testing prior to their reunion.
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Affiliation(s)
- Melissa A Davey-Rothwell
- Department of Health, Behavior and Society, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, 21205, USA,
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Fu JJ, Herme M, Wickersham JA, Zelenev A, Althoff A, Zaller ND, Bazazi AR, Avery AK, Porterfield J, Jordan AO, Simon-Levine D, Lyman M, Altice FL. Understanding the revolving door: individual and structural-level predictors of recidivism among individuals with HIV leaving jail. AIDS Behav 2013; 17 Suppl 2:S145-55. [PMID: 24037440 DOI: 10.1007/s10461-013-0590-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Incarceration, particularly when recurrent, can significantly compromise the health of individuals living with HIV. Despite this, the occurrence of recidivism among individuals with HIV has been little examined, particularly among those leaving jail, who may be at especially high risk for return to the criminal justice system. We evaluated individual- and structural-level predictors of recidivism and time to re-incarceration in a cohort of 798 individuals with HIV leaving jail. Nearly a third of the sample experienced at least one re-incarceration event in the 6 months following jail release. Having ever been diagnosed with a major psychiatric disorder, prior homelessness, having longer lifetime incarceration history, having been charged with a violent offense for the index incarceration and not having health insurance in the 30 days following jail release were predictive of recidivism and associated with shorter time to re-incarceration. Health interventions for individuals with HIV who are involved in the criminal justice system should also target recidivism as a predisposing factor for poor health outcomes. The factors found to be associated with recidivism in this study may be potential targets for intervention and need to be further explored. Reducing criminal justice involvement should be a key component of efforts to promote more sustainable improvements in health and well-being among individuals living with HIV.
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Affiliation(s)
- Jeannia J Fu
- Section of Infectious Diseases, AIDS Program, Department of Internal Medicine, Yale School of Medicine, 135 College Street, Suite 323, New Haven, CT, 06510, USA,
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Pacek LR, Malcolm RJ, Martins SS. Race/ethnicity differences between alcohol, marijuana, and co-occurring alcohol and marijuana use disorders and their association with public health and social problems using a national sample. Am J Addict 2013; 21:435-44. [PMID: 22882394 DOI: 10.1111/j.1521-0391.2012.00249.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Alcohol and marijuana are commonly used and misused in the United States, both singly and together. Despite this, few studies examine their co-occurring use and the corresponding association with public health and other problems. Moreover, there is a lack of investigation into differences in these associations on the basis of race/ethnicity. METHODS The present study estimated the frequency of alcohol use disorder, marijuana use disorder, and co-occurring alcohol and marijuana use disorder and their associated public health and social problems in Whites, African Americans, and Hispanics. This cross-sectional study included 13,872 individuals and used data from the 2005-2007 National Survey on Drug Use and Health. Frequency was calculated and multinomial regression was used to assess associations between substance use disorder and psychosocial, adverse consequences such as history of being arrested, substance use treatment, and sexually transmitted infection. RESULTS Alcohol use disorder was comparable between, and most prevalent among, Whites and Hispanics compared to African Americans, whereas marijuana use disorder was greatest among African Americans compared to other race/ethnicities. Co-occurring alcohol and marijuana use disorders were most prevalent for African Americans versus Whites and Hispanics, and similar in Whites and Hispanics. In general, major depressive episode was more prevalent for respondents with co-occurring use disorders or single marijuana use disorders. However, race/ethnicity differences in associations between substance use disorder and psychosocial correlates and adverse consequences were observed. CONCLUSIONS Findings have implications for race/ethnicity appropriate integrated prevention and treatment of single and co-occurring use disorders and psychiatric comorbidities.
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Affiliation(s)
- Lauren R Pacek
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, USA.
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Green TC, Pouget ER, Harrington M, Taxman FS, Rhodes AG, OʼConnell D, Martin SS, Prendergast M, Friedmann PD. Limiting options: sex ratios, incarceration rates, and sexual risk behavior among people on probation and parole. Sex Transm Dis 2012; 39:424-30. [PMID: 22592827 PMCID: PMC3575024 DOI: 10.1097/olq.0b013e318254c81a] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND To investigate how incarceration may affect risk of acquiring HIV and other sexually transmitted infections, we tested associations of ex-offenders' sexual risk behavior with the male-female sex ratio and the male incarceration rate. METHODS Longitudinal data from 1287 drug-involved persons on probation and parole as part of the Criminal Justice Drug Abuse Treatment Studies were matched by county of residence with population factors, and stratified by race/ethnicity and gender. Generalized estimating equations assessed associations of having unprotected sex with a partner who had HIV risk factors, and having >1 sex partner in the past month. RESULTS Among non-Hispanic black men and women, low sex ratios were associated with greater risk of having unprotected sex with a risky partner (adjusted relative risk [ARR] = 1.76, 95% confidence interval [CI] = 1.29, 2.42; ARR = 2.48, 95% CI = 1.31, 4.73, respectively). Among non-Hispanic black and non-Hispanic white (NHW) women, low sex ratios were associated with having >1 sex partner (ARR = 2.00, 95% CI = 1.02, 3.94; ARR = 1.71, 95% CI = 1.06, 2.75, respectively). High incarceration rates were associated with greater risk of having a risky partner for all men (non-Hispanic black: ARR = 2.14, 95% CI = 1.39, 3.30; NHW: ARR = 1.39, 95% CI: 1.05, 1.85; Hispanic: ARR = 3.99, 95% CI = 1.55, 10.26) and having >1 partner among NHW men (ARR = 1.92, 95% CI = 1.40, 2.64). CONCLUSIONS Low sex ratios and high incarceration rates may influence the number and risk characteristics of sex partners of ex-offenders. HIV-prevention policies and programs for ex-offenders could be improved by addressing structural barriers to safer sexual behavior.
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Affiliation(s)
- Traci C Green
- Division of General Internal Medicine, Rhode Island Hospital/Brown Medical School, Providence, RI 02903, USA.
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Green TC, McGowan SK, Yokell MA, Pouget ER, Rich JD. HIV infection and risk of overdose: a systematic review and meta-analysis. AIDS 2012; 26:403-17. [PMID: 22112599 PMCID: PMC3329893 DOI: 10.1097/qad.0b013e32834f19b6] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Drug overdose is a common cause of non-AIDS death among people with HIV and the leading cause of death for people who inject drugs. People with HIV are often exposed to opioid medications during their HIV care experience; others may continue to use illicit opioids despite their disease status. In either situation, there may be a heightened risk for nonfatal or fatal overdose. The potential mechanisms for this elevated risk remain controversial. We systematically reviewed the literature on the HIV-overdose association, meta-analyzed results, and investigated sources of heterogeneity, including study characteristics related to hypothesize biological, behavioral, and structural mechanisms of the association. Forty-six studies were reviewed, 24 of which measured HIV status serologically and provided data quantifying an association. Meta-analysis results showed that HIV seropositivity was associated with an increased risk of overdose mortality (pooled risk ratio 1.74, 95% confidence interval 1.45, 2.09), although the effect was heterogeneous (Q = 80.3, P < 0.01, I(2) = 71%). The wide variability in study designs and aims limited our ability to detect potentially important sources of heterogeneity. Causal mechanisms considered in the literature focused primarily on biological and behavioral factors, although evidence suggests structural or environmental factors may help explain the greater risk of overdose among HIV-infected drug users. Gaps in the literature for future research and prevention efforts as well as recommendations that follow from these findings are discussed.
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Affiliation(s)
- Traci C Green
- Lifespan/Tufts/Brown Center for AIDS Research, Providence, RI, USA.
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Grieb SMD, Davey-Rothwell M, Latkin CA. Concurrent sexual partnerships among urban African American high-risk women with main sex partners. AIDS Behav 2012; 16:323-33. [PMID: 21538086 DOI: 10.1007/s10461-011-9954-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To determine correlates of concurrent sexual partnerships among high-risk low-income urban African American women, survey responses of 337 women who had main sexual partners for over 6 months and reported high-risk behaviors were analyzed; 142 of these women also reported other sexual partnerships within the past 90 days. Unadjusted analyses showed that concurrency was significantly associated with relationship status, sexual debut, forced sex, incarceration of self and partners, depression, drug use, known or suspected partner nonmonogamy, and partner drug use. Age of sexual debut, relationship status, and indicators of problem drug use remained significantly associated with concurrency when controlling for individual factors, and only indicators of problem drug use and known or suspected partner nonmonogamy remained significantly associated with concurrency when also controlling for partner characteristics. Our results suggest the presence of extensive sexual networks within this population and document the need for interventions that address drug abuse and partnership instability. Moreover, the strong association between concurrency and perceptions of partners' nonmonogamy suggest the need for intervention to target men and women in this core group.
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Abstract
Although racial and ethnic minorities are more likely to be involved with the criminal justice system than whites in the U.S.A., critical scientific gaps exist in our understanding of the relationship between the criminal justice system and the persistence of racial/ethnic health disparities. Individuals engaged with the criminal justice system are at risk for poor health outcomes. Furthermore, criminal justice involvement may have direct or indirect effects on health and health care. Racial/ethnic health disparities may be exacerbated or mitigated at several stages of the criminal justice system. Understanding and addressing the health of individuals involved in the criminal justice system is one component of a comprehensive strategy to reduce population health disparities and improve the health of our urban communities.
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Abstract
Social stability is an understudied construct in public health that offers a useful framework for understanding social disadvantage across multiple domains. This study investigated prevalence and patterns of cooccurrence among a hypothesized set of social stability characteristics (housing, residential transition, employment, income, incarceration, and partner relationship), evaluated the possibility of underlying subgroups of social stability, and investigated the association between social stability and health outcomes. Data were from comprehensive interviews with primarily African-American low income urban women and their female social network members (n = 635) in Baltimore. Analysis included exploratory statistics, latent class analysis, and latent class regression accounting for clustered data using Stata and Mplus software. Social stability characteristics cooccurred in predictable directions, but with heterogeneity. Respondents had an average of three stability characteristics (S.D.: 1.4). Latent class analysis identified two classes of social stability: low (25%) and high (75%), with the higher class less likely to experience each of the included indicators. In controlled models, higher social stability was significantly correlated with social network characteristics and neighborhood integration. Higher social stability was independently associated with reduced risk of chronic illness (AOR: 0.54, 95% C.I.: 0.31, 0.94), mental illness history (AOR: 0.24, 95% CI: 0.15, 0.39), and current depressive symptoms (AOR: 0.35, 95% C.I.: 0.22, 0.57). The current set of social stability characteristics appears to represent a single construct with identifiable underlying subgroups and associated health disparities. Findings suggest a need for comprehensive policies and programs that address structural determinants of cooccurring social disadvantage and help to mitigate the likely spiral effect of instability experiences.
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Affiliation(s)
- Danielle German
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry St., 2nd floor, Baltimore, MD 21215, USA.
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Abstract
This study evaluated a cumulative and syndromic relationship among commonly co-occurring vulnerabilites (homelessness, incarceration, low-income, residential transition) in association with HIV-related risk behaviors among 635 low-income women in Baltimore. Analysis included descriptive statistics, logistic regression, latent class analysis and latent class regression. Both methods of assessing multidimensional instability showed significant associations with risk indicators. Risk of multiple partners, sex exchange, and drug use decreased significantly with each additional domain. Higher stability class membership (77%) was associated with decreased likelihood of multiple partners, exchange partners, recent drug use, and recent STI. Multidimensional social vulnerabilities were cumulatively and synergistically linked to HIV risk behavior. Independent instability measures may miss important contextual determinants of risk. Social stability offers a useful framework to understand the synergy of social vulnerabilities that shape sexual risk behavior. Social policies and programs aiming to enhance housing and overall social stability are likely to be beneficial for HIV prevention.
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Vadiee M. The quest for multi-sectoral HIV/AIDS prevention in Central and Eastern Europe and why it matters. HIV & AIDS REVIEW 2011. [DOI: 10.1016/j.hivar.2011.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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Ropelewski LR, Mancha BE, Hulbert A, Rudolph AE, Martins SS. Correlates of risky injection practices among past-year injection drug users among the US general population. Drug Alcohol Depend 2011; 116:64-71. [PMID: 21227602 PMCID: PMC3090520 DOI: 10.1016/j.drugalcdep.2010.11.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Revised: 11/16/2010] [Accepted: 11/20/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND With an estimated 1 million active injection drug users (IDUs), injection drug use continues to be a public health concern in the United States. Risky injection practices have been associated with the transmission of HIV, Hepatitis B and C, as well as other skin and soft tissue infections. METHODS We used data from 463 respondents, aged 18 and older, who were past-year IDUs in the 2005-2008 National Survey of Drug Use and Health (NSDUH). We investigated correlates of risky injection behavior among these recent IDUs. RESULTS Older age (≥ 35 versus 18-25) was associated with reusing one's own needle at last injection (aOR=1.80 [1.02-3.17], as were past year heroin (aOR=2.59 [1.18-5.66]) and cocaine injection (aOR=2.17 [1.13-4.15]). Past year crack cocaine use was positively associated with not cleaning needles with bleach (aOR=2.18 [1.10-4.33]). Past year cocaine injection was associated with obtaining needles in a risky manner (aOR=2.29 [1.23-4.25]). Methamphetamine injection was associated with obtaining needles in less risky ways (aOR=0.41 [0.20-0.84]). CONCLUSION Our findings indicate that some IDUs are continuing to engage in high risk injection behaviors. The identification of potential at-risk populations of IDUs may have implications for harm reduction interventions and HIV prevention programs.
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Affiliation(s)
- Lauren R Ropelewski
- Johns Hopkins University Bloomberg School of Public Health, Department of Mental Health, Baltimore, MD 21205, USA.
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Wiewel EW, Hanna DB, Begier EM, Torian LV. High HIV prevalence and diagnosis rates in New York City black men. J Community Health 2011; 36:141-9. [PMID: 20574776 DOI: 10.1007/s10900-010-9291-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We sought to identify population and subpopulation disparities in rates of HIV diagnosis and prevalence among black males 13 years and older in New York City. We used population-based data from the New York City HIV/AIDS surveillance registry and US Census 2000 to calculate HIV prevalence in 2006 and HIV diagnosis rates in 2007. Black males were the largest demographic group of new HIV diagnoses (n = 1,161, 33%) and persons living with HIV/AIDS in New York City (n = 24,294, 29%) and had the highest diagnosis rates (1.7 per 1,000 population) and prevalence (3.7%). Prevalence and diagnosis rates among black males were higher in higher-poverty neighborhoods than in lower-poverty neighborhoods (p < 0.01). However, very high prevalence (19.3%) was found among black males in three adjacent Manhattan neighborhoods with relatively low poverty rates, and where overall diagnosis rates among black males (7.4 per 1,000) and proportions attributable to men who have sex with men (60.0%) were high. HIV-related disparities exist not only between black males and other groups but also within black males. Success addressing the citywide HIV epidemic will be linked to success in the various portions of this highly affected, heterogeneous population.
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Affiliation(s)
- Ellen W Wiewel
- HIV Epidemiology and Field Services Program, Bureau of HIV/AIDS Prevention and Control, New York City Department of Health and Mental Hygiene, 346 Broadway, Room 706, CN44, New York, NY 10013, USA.
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Staton-Tindall M, Havens JR, Oser CB, Burnett MC. Substance Use Prevalence in Criminal Justice Settings. HANDBOOK OF EVIDENCE-BASED SUBSTANCE ABUSE TREATMENT IN CRIMINAL JUSTICE SETTINGS 2011. [DOI: 10.1007/978-1-4419-9470-7_6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Freudenberg N. HIV in the epicenter of the epicenter: HIV and drug use among criminal justice populations in New York City, 1980-2007. Subst Use Misuse 2011; 46:159-70. [PMID: 21303236 DOI: 10.3109/10826084.2011.521460] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
During the 1990s, some of the highest rates of HIV infection in the United States were found among inmates in the New York City jail and prisons systems. This article traces the history of drug use and HIV infection among populations incarcerated in New York City jails and New York State prisons between 1980 and 2007. It describes and analyzes the policies and programs that were initiated to respond to these epidemics and assesses the lessons learned from almost three decades of experience with HIV among populations in New York's correctional facilities.
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Affiliation(s)
- Nicholas Freudenberg
- School of Public Health, Hunter College, City University of New York, New York, New York 10010, USA.
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Stockman JK, Strathdee SA. HIV among people who use drugs: a global perspective of populations at risk. J Acquir Immune Defic Syndr 2010; 55 Suppl 1:S17-22. [PMID: 21045594 PMCID: PMC3059238 DOI: 10.1097/qai.0b013e3181f9c04c] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article examines the epidemiology of HIV among selected subgroups of drug users around the world who are "most at risk"--men who have sex with men, female sex workers, prisoners, and mobile populations. The underlying determinants of HIV infection among these populations include stigma, physical and sexual violence, mental illness, social marginalization, and economic vulnerability. HIV interventions must reach beyond specific risk groups and individuals to address the micro-level and macro-level determinants that shape their risk environments. Public health interventions that focus on the physical, social, and health policy environments that influence HIV risk-taking in various settings are significantly more likely to impact the incidence of HIV and other blood-borne and sexually transmitted infections across larger population groups.
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Affiliation(s)
- Jamila K Stockman
- Department of Medicine, Division of Global Public Health, University of California San Diego, La Jolla, CA 92093-0507, USA
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Harawa NT, Sweat J, George S, Sylla M. Sex and condom use in a large jail unit for men who have sex with men (MSM) and male-to-female transgenders. J Health Care Poor Underserved 2010; 21:1071-87. [PMID: 20693745 DOI: 10.1353/hpu.0.0349] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Few data are available on factors contributing to sexual activity and condom use in custody settings, particularly among self-identified sexual minority prisoners. To address this gap, we undertook a study of sexual behavior and condom use of 101 randomly-selected men who have sex with men (MSM) and male-to-female transgender inmates in a segregated Los Angeles jail unit that has weekly condom access. Most survey participants (53%) reported anal sex during custody. Although 65% of these reported using condoms, 75% also reported having sex without condoms. Qualitative interviews (n=17) indicate a wide range of reasons for participating in protected and unprotected sex during custody, the use of cues within the custody environment to assess potential partners' HIV status, and support for increased condom availability. Findings also indicate that high-risk sex occurs frequently in this unit and that condom distribution likely prevents a substantial amount of related HIV/STD risk.
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Kennedy DP, Wenzel SL, Tucker JS, Green HD, Golinelli D, Ryan GW, Beckman R, Zhou A. Unprotected sex of homeless women living in Los Angeles county: an investigation of the multiple levels of risk. AIDS Behav 2010; 14:960-73. [PMID: 19876728 DOI: 10.1007/s10461-009-9621-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This research uses multi-level modeling to investigate the context of unprotected sex of homeless women. Based on interviews with 429 randomly selected women living in temporary shelter settings in Los Angeles, this project investigates multiple levels of influence on unprotected sex with particular partners. Previous studies have investigated condom use of homeless women primarily at the individual level. This project investigates unprotected sex at the level of the partnership, the individual woman, and her social network. Homeless women who believe in the efficacy of condoms to prevent HIV infection, believe that they have low susceptibility to HIV and have a greater proportion of their non-sex partner social network ties with whom they speak about HIV are less likely to engage in unprotected sex. Women are more likely to engage in risky sexual behavior in relationships in which they have high commitment to their partner and experience physical violence.
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Wang EA, Green J. Incarceration as a key variable in racial disparities of asthma prevalence. BMC Public Health 2010; 10:290. [PMID: 20509891 PMCID: PMC2889869 DOI: 10.1186/1471-2458-10-290] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Accepted: 05/28/2010] [Indexed: 11/10/2022] Open
Abstract
Background Despite the disproportionate incarceration of minorities in the United States, little data exist investigating how being incarcerated contributes to persistent racial/ethnic disparities in chronic conditions. We hypothesized that incarceration augments disparities in chronic disease. Methods Using data from the New York City Health and Nutrition Examination Study, a community-based survey of 1999 adults, we first estimated the association between having a history of incarceration and the prevalence of asthma, diabetes, hypertension using propensity score matching methods. Propensity scores predictive of incarceration were generated using participant demographics, socioeconomic status, smoking, excessive alcohol and illicit drug use, and intimate partner violence. Among those conditions associated with incarceration, we then performed mediation analysis to explore whether incarceration mediates racial/ethnic disparities within the disease. Results Individuals with a history of incarceration were more likely to have asthma compared to those without (13% vs. 6%, p < 0.05) and not more likely to have diabetes or hypertension, after matching on propensity scores. Statistical mediation analysis revealed that increased rates of incarceration among Blacks partially contribute to the racial disparity in asthma prevalence. Conclusion Having been incarcerated may augment racial disparities in asthma among NYC residents. Eliminating health disparities should include a better understanding of the role of incarceration and criminal justice policies in contributing to these disparities.
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Affiliation(s)
- Emily A Wang
- Section of General Medicine, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.
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