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Obidoa C, Thompson PO, Thitsa M, Martin CF, Katner H. Socio-ecologic Correlates of HIV/AIDS-Related Sexual Risk Behavior of African American Emerging Adults. AIDS Behav 2023; 27:3392-3400. [PMID: 37027071 DOI: 10.1007/s10461-023-04055-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 04/08/2023]
Abstract
There is growing evidence showing that patterns of individual sexual risk behaviors are insufficient in explaining the disproportionate HIV/AIDS burden borne by African Americans. Instead, dynamic features of social, economic, political, and geographic contexts play a more determining role. However, not enough studies have examined the impact of multi-level factors including neighborhood-level influences on HIV/AIDS sexual risk among African American emerging adults using a socio-ecologic perspective. Anchored on the socio-ecologic framework, this study examines the collective role of relevant socio-ecologic determinants of sexual risk-taking among African American emerging adults. Results from both bivariate and multivariate analyses revealed that individual and neighborhood-level variables were significantly associated with sexual risk in our study population partially confirming the hypothesis of the study. Male gender, educational attainment, and neighborhood social disorder were the strongest predictors of sexual risk. Our findings contribute to the vast literature on sexual risk behavior patterns of young adults, and increasing evidence demonstrating the role of contextual factors as stronger predictors of sexual risk and HIV infection among at-risk youth. Our findings, however, underscore the need for further research on the pathways of HIV socio-behavioral vulnerability in this demographic group.
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Affiliation(s)
- Chinekwu Obidoa
- Department of International & Global Studies, Mercer University, 1501 Mercer University Drive, Macon, GA, 31207, USA.
| | - Peter Onah Thompson
- Department of Government & Justice Studies, Appalachian State University, 350K Anne Belk Hall, Boone, USA
| | - Makhin Thitsa
- Department of Electrical & Computer Engineering, Mercer University, 1501 Mercer University Drive, Macon, GA, 31207, USA
| | - Clyde F Martin
- Paul Whitfield Horn Professor Emeritus, Texas Tech University, Lubbock, USA
| | - Harold Katner
- Division of Infectious Diseases, Department of Internal Medicine, Mercer University School of Medicine, Macon, GA, USA
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2
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Hoff L, Scheidell JD, Mazumdar M, Feelemyer J, Dyer TV, Turpin RE, Cleland CM, Caniglia EC, Remch M, Brewer R, Hucks-Ortiz C, Irvine NM, Mayer KH, Khan MR. The associations of incarceration and depression with healthcare experiences and utilization among Black men who have sex with men in HPTN 061. AIDS Care 2022; 34:1169-1178. [PMID: 34384304 PMCID: PMC8837705 DOI: 10.1080/09540121.2021.1966695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 08/03/2021] [Indexed: 01/26/2023]
Abstract
Associations of incarceration with healthcare access and utilization among Black sexual minority men (BSMM) and differences in association among those with and without pre-incarceration symptoms of depression were measured. Secondary analysis using survey data from the longitudinal cohort HIV Prevention Trials Network 061 study was conducted among 1553 BSMM from six major U.S. cities from 2009 to 2011. We used modified log-binomial regression with robust standard errors to estimate associations of incarceration (reported at 6 month follow-up) on next six-month healthcare utilization and access (reported at the 12 month follow-up). We tested the significance of baseline depressive symptoms by incarceration interaction and reported differences in associations when observed. Participants with a history of incarceration were more likely to have depressive symptoms at baseline compared to those without. Recent incarceration was associated with almost twice the risk of mistrust in healthcare providers and emergency room utilization. Among men reporting depressive symptoms, a history of incarceration was associated with almost tripled risk of reporting providers do not communicate understandably. Among those with depression, one in five reported a missed visit regardless of incarceration status.
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Affiliation(s)
- Lee Hoff
- SUNY Downstate Medical Center School of Public Health, New York, NY
- New York University Grossman School of Medicine, Department of Population Health, New York, NY
| | - Joy D Scheidell
- New York University Grossman School of Medicine, Department of Population Health, New York, NY
| | - Medha Mazumdar
- New York University Grossman School of Medicine, Department of Population Health, New York, NY
| | - Jonathan Feelemyer
- New York University Grossman School of Medicine, Department of Population Health, New York, NY
| | - Typhanye V Dyer
- University of Maryland School of Public Health, Department of Epidemiology and Biostatistics, College Park, MD
| | - Rodman E Turpin
- University of Maryland School of Public Health, Department of Epidemiology and Biostatistics, College Park, MD
| | - Charles M Cleland
- New York University Grossman School of Medicine, Department of Population Health, New York, NY
| | - Ellen C Caniglia
- New York University Grossman School of Medicine, Department of Population Health, New York, NY
| | - Molly Remch
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, NC
| | - Russell Brewer
- University of Chicago, Department of Medicine, Chicago, IL
| | | | - Natalia M Irvine
- New York University Grossman School of Medicine, Department of Population Health, New York, NY
| | | | - Maria R Khan
- New York University Grossman School of Medicine, Department of Population Health, New York, NY
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3
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Maiorana A, Kegeles SM, Brown S, Williams R, Arnold EA. Substance use, intimate partner violence, history of incarceration and vulnerability to HIV among young Black men who have sex with men in a Southern US city. CULTURE, HEALTH & SEXUALITY 2021; 23:37-51. [PMID: 31944158 PMCID: PMC7363521 DOI: 10.1080/13691058.2019.1688395] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 10/30/2019] [Indexed: 05/23/2023]
Abstract
In this longitudinal qualitative study we explored the lived experiences of young Black men who have sex with men in Dallas, Texas in relation to methamphetamine use, intimate partner violence and a history of incarceration as syndemic conditions that may contribute to their risk of transmitting or acquiring HIV. We conducted a total of 106 interviews (four repeat interviews every six months) with a cohort of 30 participants. Some reported condomless sex and no discussion about condom use or HIV status with sexual partners. Fifteen participants reported that they were living with HIV. Methamphetamine use contributed to participants' unstable housing, job loss, destructive relationships and HIV risk. One third of participants reported a history of intimate partner violence. About half had a history of incarceration resulting from intimate partner violence, substance use/dealing and/or other activities. Post-release, having a criminal record limited job opportunities and impacted financial stability. Consequently, some men engaged in survival work involving HIV risk (sex work, organising/participating in sex parties). Methamphetamine use, intimate partner violence and incarceration may constitute syndemic conditions that increase young Black men who have sex with men's risk for HIV acquisition and transmission. HIV prevention interventions must address syndemics and include structural factors and the wider social environment.
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Affiliation(s)
- Andres Maiorana
- Center for AIDS Prevention Studies, University of
California, San Francisco, CA, USA
| | - Susan M. Kegeles
- Center for AIDS Prevention Studies, University of
California, San Francisco, CA, USA
| | - Stephen Brown
- Community, Prevention, and Intervention Unit, University of Texas, Southwestern
| | - Robert Williams
- Center for AIDS Prevention Studies, University of
California, San Francisco, CA, USA
| | - Emily A. Arnold
- Center for AIDS Prevention Studies, University of
California, San Francisco, CA, USA
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Mahaffey CC, Stevens-Watkins D, Burlew AK, Moody MD, Wheeler PB, Thrasher S. Evaluating the Feasibility of Implementing an HIV Prevention Intervention for Incarcerated African American Men: Lessons Learned From a Pilot Study. Health Promot Pract 2020; 21:822-830. [PMID: 31958976 DOI: 10.1177/1524839919896786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This pilot study evaluated the feasibility of implementing an evidence-based, culturally adapted HIV intervention with substance-using African American men in a prison setting. We recruited 60, soon-to-be released African American male prisoners from a larger study (N = 211) to be randomly selected for participation in the group-based HIV intervention, Real Men Are Safe-Culturally Adapted (REMAS-CA). Participants who were not selected for participation in the intervention received standard Centers for Disease Control and Prevention HIV prevention counseling education, provided during participant assessment in the larger study. Nearly all of the participants who were selected to participate (87%) completed the REMAS-CA intervention. To examine feasibility, data were collected about any revisions made to the HIV intervention components for the prison setting, time needed to implement the program in full, details of implementing the intervention to ensure participation and maintain retention, and participant perception of the intervention. Revisions to the intervention included reducing the number of sessions from five to three, modifying the protocol language based on the setting, and removing six activities deemed inappropriate and/or unallowable by the prison officials. The cultural considerations and intervention, overall, were well received by the participants. However, several revisions made specific to the prison and its administration could affect the potential effectiveness of the intervention. Future research is needed to determine the effectiveness of REMAS-CA among this community.
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Affiliation(s)
| | - Danelle Stevens-Watkins
- University of Kentucky, Lexington, KY, USA.,Center on Drug and Alcohol Research, Lexington, KY, USA
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Johnson K, Gilbert L, Hunt T, Wu E, Metsch L, Goddard-Eckrich D, Richards S, Tibbetts R, Rowe JC, Wainberg ML, El-Bassel N. The effectiveness of a group-based computerized HIV/STI prevention intervention for black women who use drugs in the criminal justice system: study protocol for E-WORTH (Empowering African-American Women on the Road to Health), a Hybrid Type 1 randomized controlled trial. Trials 2018; 19:486. [PMID: 30201039 PMCID: PMC6131955 DOI: 10.1186/s13063-018-2792-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 07/06/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This paper describes the study protocol of a hybrid type I randomized controlled trial that evaluates the effectiveness and cost-effectiveness of implementing Empowering African-American Women on the Road to Health (E-WORTH), an Afrocentric, group-based, computerized human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention intervention for controlled substance-using black women in community corrections settings in New York City. METHODS/DESIGN We provide an overview of E-WORTH's hybrid type I design, which is guided by the Consolidated Framework for Implementation Research (CFIR). E-WORTH combines HIV/STI and intimate partner violence (IPV) prevention components and tests the comparative effectiveness of E-WORTH and streamlined HIV testing versus streamlined HIV testing alone in decreasing biologically confirmed HIV and STI incidence, sexual risk, and IPV, as well as in improving access to HIV and STI prevention services and care. DISCUSSION This paper provides an overview of E-WORTH's intervention protocol and serves as a framework for using hybrid type I designs, guided by the CFIR conceptual framework, to evaluate HIV/STI and IPV prevention interventions in community corrections settings. We discuss how E-WORTH's hybrid type I design advances implementation science through its effectiveness and cost-effectiveness aims as well as through a mixed-methods study that evaluates multilevel theory-driven factors (structural, organizational, staffing, and client) guided by the CFIR that influences the implementation of E-WORTH in a criminal justice setting. This study also addresses the novel challenges and opportunities of implementing an intervention that targets specific racial subgroup(s) in a community corrections setting that services all populations, implementing a group-based intervention with technological components in such settings, and employing community-based participatory research strategies to guide recruitment and retention efforts. TRIAL REGISTRATION ClinicalTrials.gov, NCT02391233 . Registered on 17 March 2015.
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Affiliation(s)
- Karen Johnson
- University of Alabama School of Social Work, Little Hall, 670 Bonner Drive, Tuscaloosa, AL 35401 USA
- Columbia University School of Social Work, Social Intervention Group, 1255 Amsterdam Avenue, New York, NY 10027 USA
| | - Louisa Gilbert
- University of Alabama School of Social Work, Little Hall, 670 Bonner Drive, Tuscaloosa, AL 35401 USA
| | - Timothy Hunt
- University of Alabama School of Social Work, Little Hall, 670 Bonner Drive, Tuscaloosa, AL 35401 USA
| | - Elwin Wu
- University of Alabama School of Social Work, Little Hall, 670 Bonner Drive, Tuscaloosa, AL 35401 USA
| | - Lisa Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032 USA
| | - Dawn Goddard-Eckrich
- University of Alabama School of Social Work, Little Hall, 670 Bonner Drive, Tuscaloosa, AL 35401 USA
- Social Intervention Group, Columbia University Teacher’s College, 1255 Amsterdam Avenue, New York, NY 10027 USA
| | - Stanley Richards
- The Fortune Society, 625 West 140th Street, New York, NY 10031 USA
| | - Rick Tibbetts
- New York City Department of Probation, 210 Joralemon Street, Brooklyn, NY 11201 USA
| | - Jessica C. Rowe
- Center for Teaching and Learning, Columbia University, Lewisohn Hall, 2970 Broadway #603, New York, NY 10027 USA
| | - Milton L. Wainberg
- Columbia University / New York State Psychiatric Institute, 1051 Riverside Drive, #24, New York, NY 10032 USA
| | - Nabila El-Bassel
- University of Alabama School of Social Work, Little Hall, 670 Bonner Drive, Tuscaloosa, AL 35401 USA
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Juarez-Cuellar A, Chang YP. HIV Testing in Urban Transgender Individuals: A Descriptive Study. Transgend Health 2017; 2:151-155. [PMID: 29159309 PMCID: PMC5685202 DOI: 10.1089/trgh.2016.0047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
HIV testing is considered the initial component of HIV eradication strategies. This study aimed to describe HIV testing in urban, transgender individuals in western New York. The study uses HIV testing intake data from a sample of self-identified transgender males and females volunteering for an HIV test at a community-based healthcare organization. Transgender individuals with some characteristics were found to have more HIV tests including female gender, black, HIV status (positive), a history of incarceration, sex worker, housing situation, and self-referral. The findings can be used to tailor future interventions to encourage HIV testing in transgender populations.
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Affiliation(s)
- Adrian Juarez-Cuellar
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, New York
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, New York
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Bose S. Demographic and spatial disparity in HIV prevalence among incarcerated population in the US: A state-level analysis. Int J STD AIDS 2017; 29:278-286. [PMID: 28776462 DOI: 10.1177/0956462417724586] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to explore empirically the presence of any spatial and demographic disparity in the Human Immunodeficiency Virus (HIV) infection rate among the prison inmates across 48 states in the US and compare the results for 2000 and 2010. HIV infection is a severe health issue for incarcerated populations in the US. In 2010, the rate of diagnosed HIV infection among inmates in state and federal prisons was five times more than the nonincarcerated population. The National Prisoner Statistics database was used to find the demographic disparities in HIV prevalence rate based on incarceration rate, gender, race/ethnicity, the proportion of non-US citizens, and proportion of population below 18 years. State-level spatial mapping, Pearson correlation coefficient, and Moran's I statistic (univariate and bivariate) were computed based on these demographic characteristics using QGIS and Geoda software. There was a statistically significant pattern of spatial disparity in overall, male and female HIV infection rates across the state prisoners, with South and South-Eastern states facing a higher risk of infection. There was also statistically significant bivariate spatial association of HIV infection rate with the covariates: whites (negative), blacks (positive), non-US citizen (positive), and prisoners under age 18 years (positive) for both 2000 and 2010. There was a statistically significant higher HIV infection rate among the female prisoners in comparison to the male prisoners. It is of prime importance to examine the state-level disparities in HIV infection rate based on place and demographics. This is because evaluating the spatial pattern will help in accessing the relevant local information and provide federal agencies with better knowledge to target interventions and prevention programs toward the subgroup of the population at higher risk and help in controlling and reducing HIV infection prevalence.
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Affiliation(s)
- Srimoyee Bose
- School of Public Health, Georgia State University, Atlanta, GA, USA
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