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Irie WC, Calabrese SK, Mayer KH, Geng EH, Blackstock O, Marcus JL. Social and structural factors associated with interest in HIV preexposure prophylaxis among Black women in the United States. AIDS Care 2024; 36:672-681. [PMID: 38176016 PMCID: PMC10994725 DOI: 10.1080/09540121.2023.2299338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024]
Abstract
In a nationwide sample of cisgender Black women in the US, we assessed the associations between social and structural factors and interest in using HIV preexposure prophylaxis (PrEP). Among 315 respondents, 62.2% were interested in PrEP if it were provided for free. Positive social norms surrounding PrEP, including injunctive norms (perceived social acceptability of PrEP use) and descriptive norms (perceived commonality of PrEP use), were positively associated with interest in using PrEP. Concerns about HIV infection, recently visiting a health care provider, and comfort discussing PrEP with a provider were also positively associated with interest in using PrEP. Anticipating PrEP disapproval from others was negatively associated with interest in PrEP. Although PrEP can promote autonomy and personal discretion, Black women's PrEP-related decisions occur in a complex social environment. Black women may benefit from interventions to promote positive norms and attitudes surrounding PrEP at the community level and empower them in discussions with their providers about PrEP.
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Affiliation(s)
- Whitney C. Irie
- Boston College School of Social Work, Chestnut Hill, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Sarah K. Calabrese
- Department of Psychological and Brain Sciences, George Washington University, Washington, D.C., USA
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, D.C., USA
| | - Kenneth H. Mayer
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA
| | - Elvin H. Geng
- Division of Infectious Diseases, Washington University in St Louis, St. Louis, MO, USA
| | | | - Julia L. Marcus
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
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Sprague C, Brown SM, Simon SE, McMahan LD, Konkle-Parker D. Experience of religion and spirituality among socially marginalised people living with HIV in Mississippi. CULTURE, HEALTH & SEXUALITY 2021; 23:1111-1125. [PMID: 32631148 DOI: 10.1080/13691058.2020.1758345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/16/2020] [Indexed: 06/11/2023]
Abstract
African Americans in Mississippi have the highest HIV-related mortality and poverty rates in the USA, and they tend to be religious. Attitudes toward gender and sexuality are changing, yet few studies have investigated religion and spirituality among special populations living with HIV. Using grounded theory and qualitative methods, we investigated the experience of health and illness of a low-income, socially marginalised population living with HIV in two locations of Mississippi in 2015. In a context of high stigma and HIV-related health disparities, individuals turned, or returned, to religion, church and spirituality as sources of community and strength, which also motivated safer health behaviours. Findings underscore how religion and spirituality are enabling social determinants of health that are under-explored, untapped, potentially culturally acceptable, sustainable interventions at the community-level. We posit, given diminished funding for community-based services, the most significant influence churches could exert is in decreasing HIV stigma. Given the current US plan to end HIV by 2030, with appropriate stakeholder participation, the role of religion, spirituality and clergy could be further amplified via linkage to care providers and the 'normalisation' of the HIV discourse, to address disparities and improve the health of African Americans.
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Affiliation(s)
- Courtenay Sprague
- Department of Conflict Resolution, Human Security & Global Governance, McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, Boston, MA, USA
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Shelley M Brown
- Department of Health Sciences, Sargent College, Boston University, Boston, MA, USA
| | - Sara E Simon
- Department of Conflict Resolution, Human Security & Global Governance, McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, Boston, MA, USA
| | - Lyndsey D McMahan
- Department of Conflict Resolution, Human Security & Global Governance, McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, Boston, MA, USA
| | - Deborah Konkle-Parker
- Department of Medicine, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, MS, USA
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Shaw SA, Mergenova G, El-Bassel N. Religion and HIV Risk Among Male Market Vendors in Kazakhstan. JOURNAL OF RELIGION AND HEALTH 2020; 59:2019-2031. [PMID: 31605265 DOI: 10.1007/s10943-019-00929-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study examines associations between religion and sexual HIV risk among 1342 male migrant and non-migrant market vendors in Kazakhstan. In the multivariate analysis, religious influence was associated with a lower likelihood of having multiple partners. Regular attendance was associated with a lower likelihood of having anal sex with a male partner, but with increased likelihood of having multiple partners. Spending time socially with friends at a mosque or church was associated with lower risk of anal sex with a male partner and lower risk of unprotected sex.
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Affiliation(s)
- Stacey A Shaw
- 2175 JFSB, School of Social Work, Brigham Young University, Provo, UT, 84602, USA.
| | - Gaukhar Mergenova
- Global Health Research Center of Central Asia, Columbia University, Almaty, Kazakhstan
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Bowen DJ, Hyams T, Laurino M, Woolley T, Cohen S, Leppig KA, Jarvik G. Development of FamilyTalk: an Intervention to Support Communication and Educate Families About Colorectal Cancer Risk. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:470-478. [PMID: 30737640 PMCID: PMC6688969 DOI: 10.1007/s13187-019-1484-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
IFamily members of individuals with colorectal cancer (CRC) may be at increased risk of developing the disease. However, the majority of CRC can be prevented through colonoscopy screening and family members may not be aware if they are recommended to pursue earlier screening because of their family history of CRC. As such, tools must be developed to effectively communicate potential changes to the recommended age for colonoscopy screening and other important CRC-related information to family members. We modified and adapted a successful intervention for families with melanoma to be appropriate for families with CRC to increase communication and screening in family members. The multistep process included the following: (1) developing a paper version of the intervention, (2) piloting the paper version among families with CRC, (3) developing the web-based version, and (4) testing the intervention for usability. Qualitative data was collected and analyzed for pilot testing. Usability testing utilized both qualitative and quantitative data. Patients with CRC liked the paper version and had multiple suggestions, including adding a better introduction, sections on genetics and family history, and clearer communication assistance. The web-based tool was well received and improved upon the linear book format with links, better section instructions, and more proactive communication tools for families. These processes produced materials that satisfied individuals from various families with assistance and support for communicating about CRC. Evaluating the effects of the tools in rigorous research projects is the next step.
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Affiliation(s)
- Deborah J Bowen
- Department of Bioethics and Humanities, University of Washington, Box 357120, Seattle, WA, 98195, USA.
| | - Travis Hyams
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - Mercy Laurino
- Genetics and Cancer Prevention Programs, Seattle Cancer Care Alliance, Seattle, WA, USA
| | | | - Stacey Cohen
- Division of Oncology, University of Washington, Seattle, WA, USA
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Gail Jarvik
- Department of Medicine, Division of Medical Genetics, University of Washington, Seattle, WA, USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
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Ransome Y, Bogart LM, Nunn AS, Mayer KH, Sadler KR, Ojikutu BO. Faith leaders' messaging is essential to enhance HIV prevention among black Americans: results from the 2016 National Survey on HIV in the black community (NSHBC). BMC Public Health 2018; 18:1392. [PMID: 30567530 PMCID: PMC6300012 DOI: 10.1186/s12889-018-6301-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 12/04/2018] [Indexed: 11/17/2022] Open
Abstract
Background To investigate whether religious service attendance and faith leaders’ messages about HIV and same-sex relationships are associated with acceptance of HIV prevention strategies. Methods Multivariable Poisson regression assessed whether attending religious services, faith leaders’ messages about HIV and same-sex relationships, and supportiveness of those messages were associated with HIV testing, as well as knowledge of and willingness to use pre-exposure prophylaxis (PrEP) among 868 Black Americans [45% men; M (SD) = 34 (9) years-old] in the 2016 National Survey on HIV in the Black Community, USA. Results Participants who reported attending services monthly and/or hearing faith leaders’ messages that were supportive of same-sex relationships had a significantly higher likelihood of willingness to use PrEP (adjusted Rate Ratio[ARR] = 1.76; 95% confidence interval [CI] = 1.09, 2.48) and aRR = 2.19; 95% CI = 1.35, 3.55, respectively), independent of HIV risk. Homophobia was significantly associated with higher likelihood of being aware of PrEP and testing for HIV testing in the past 12 months. Conclusions Faith leaders’ messaging can influence Black Americans’ perceptions and uptake of HIV prevention strategies. Faith institutions and faith leaders should be involved in designing and disseminating HIV prevention strategies.
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Affiliation(s)
- Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, LEPH, New Haven, CT, 06510, USA.
| | | | - Amy S Nunn
- Brown School of Public Health, Providence, RI, USA
| | - Kenneth H Mayer
- Harvard Medical School and Beth Israel Deaconess Medical Center, and Fenway Health, Boston, MA, USA
| | - Keron R Sadler
- National Association for the Advancement of Colored People (NAACP), Baltimore, MD, USA
| | - Bisola O Ojikutu
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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Mistretta EG, Sloan D, BrintzenhofeSzoc K, Weber KM, Berger A. Testing domains of the healing experiences in all life stressors questionnaire in a cohort of HIV-infected and HIV-uninfected Chicago women. Psychol Res Behav Manag 2017; 10:201-208. [PMID: 28740439 PMCID: PMC5505676 DOI: 10.2147/prbm.s129566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Patients may deal with issues of spiritual and religious meaning when coping with life-threatening or chronic illness. Researchers at the National Institutes of Health have developed the healing experiences in all life stressors (HEALS) questionnaire, an assessment to determine psychosocial spiritual adjustment to healing. Many measures assess religious and spiritual behavior, but there exists a need to capture the meaning of these factors in the process of healing. The instrument consists of spirituality, religion, interpersonal, and intrapersonal domains. This study explores the preliminary partial validation of the spirituality and religion domains of the HEALS against the Ironson–Woods Spirituality and Religiousness Index (IWSR). Methods The abbreviated HEALS, IWSR, and a measure of depression were completed by 205 human immunodeficiency virus (HIV)-infected and HIV-uninfected women from Chicago as part of the Women’s Interagency HIV Study. Total scores on the HEALS and IWSR were correlated using Pearson correlations to examine convergent validity. Total depression scores were analyzed with Pearson correlations to investigate criterion validity. Results Responses between the abbreviated HEALS and IWSR were highly correlated (r=0.74). Similar to other measures of its kind, scores on the HEALS were associated with depressive symptoms. Women with clinically significant depressive symptoms scored significantly lower on the HEALS than women without. No significant differences were found for race, age, education, or HIV status. Conclusion This study is an important step in the future validation of the HEALS. Results suggest that the spirituality and religion domains of the HEALS have good construct validity with the IWSR. After further validation, this measure may provide clinicians and researchers with a unique way to assess psychosocial spiritual healing.
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Affiliation(s)
- Erin G Mistretta
- Pain and Palliative Care Service, National Institutes of Health, Bethesda, MD.,Department of Psychology, Catholic University of America, Washington, DC
| | - Danetta Sloan
- Pain and Palliative Care Service, National Institutes of Health, Bethesda, MD
| | - Karlynn BrintzenhofeSzoc
- School of Social Work, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH
| | - Kathleen M Weber
- HIV Research, Hektoen Institute of Medicine/Cook County Health and Hospitals System, Chicago, IL, USA
| | - Ann Berger
- Pain and Palliative Care Service, National Institutes of Health, Bethesda, MD
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Coughlin SS, Besenyi GM, Bowen D, De Leo G. Development of the Physical activity and Your Nutrition for Cancer (PYNC) smartphone app for preventing breast cancer in women. Mhealth 2017; 3:5. [PMID: 28293621 PMCID: PMC5344121 DOI: 10.21037/mhealth.2017.02.02] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 01/20/2017] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND In the U.S., breast cancer accounts for more cancer deaths in women than any site other than lung cancer. Based upon attributable risks, about 30-35% of breast cancers could potentially be prevented by addressing obesity, physical inactivity, increased alcohol consumption, and carcinogenic exposures such as hormone replacement therapy (HRT). We need methods of reducing women's risks of this disease that are attractive and easy to use, widely accessible to diverse women, and able to be easily amended to account for new research. METHODS The overall objective of this 12-month project is to develop and test a smartphone app to provide women with information about how they can reduce their risk of breast cancer through healthy behaviors such as physical activity, weight management, restricting caloric intake, consuming a healthy diet and proper nutrition, engaging in regular physical activity, and avoiding carcinogenic exposures such as HRT and alcohol. The specific aims are: (I) to develop a smartphone app for breast cancer prevention using a behavioral framework; (II) to ensure interconnectivity with commercially available products (Fitbit device for monitoring physical activity and the LoseIt! smartphone app for monitoring and tracking diet and nutrition); and (III) to ensure that the mHealth intervention is suitable for women with varying levels of health literacy and eHealth literacy. RESULTS The app, referred to as Physical activity and Your Nutrition for Cancer (PYNC), is being coded on an iOS platform. Users will be able to access the breast cancer prevention app using their smartphone or tablet. The app's design will ensure interconnectivity with commercially available products for monitoring and tracking physical activity, caloric intake, diet and nutrition. Using the app, it will be feasible for users to connect and sync their Fitbit and LoseIt! accounts so that information collected about physical activity, caloric intake, diet, and nutrition can be conveniently assessed from one portal. The Fitbit device and app provides reminders and allows users to set physical activity goals. Users will be able to access health education information about breast cancer risk-reduction with attractive graphics and visual displays. CONCLUSIONS Future directions will include testing the efficacy of the mHealth intervention in increasing physical activity, improving diet and nutrition, and weight management through a randomized controlled trial, and widespread dissemination and implementation research.
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Affiliation(s)
- Steven S. Coughlin
- Department of Clinical and Digital Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA, USA
| | - Gina M. Besenyi
- Department of Clinical and Digital Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA, USA
| | - Deborah Bowen
- Department of Bioethics and Humanities, University of Washington School of Medicine, Seattle, WA, USA
| | - Gianluca De Leo
- Department of Clinical and Digital Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA, USA
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