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Town MA, Freeman I, Cool RJ, Klein CH. The HIV Environmental Riskscape: The Roles of HIV Sexual Risk and Resilience Factors among Black Men Who Have Sex with Men: Findings from the Real Talk Project. AIDS Behav 2024:10.1007/s10461-024-04418-8. [PMID: 38900312 DOI: 10.1007/s10461-024-04418-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2024] [Indexed: 06/21/2024]
Abstract
Black and African American men who have sex with men (Black MSM) experience the greatest proportion of new HIV infections in the United States. To address this challenge, a better understanding of the HIV environment riskscape including both risk and resilience factors is warranted among Black MSM. Research indicates that stress is associated with increased HIV sexual risk behaviors. Further, behavioral factors such as serosorting and community level factors including social support and community connection are resilience factors that protect against risk behaviors. The present study examines whether everyday stress is associated with HIV sexual risk behavior, as well as the role of risk and resilience factors among 125 Black MSM recruited in the Real Talk study. The Real Talk project examined the relationships between resilience, HIV risk behaviors, and HIV prevention strategy among a sample of Black MSM. Using generalized estimating equations, our results indicate a positive association between everyday stress and engaging in condomless anal intercourse only after adjusting for risk, resilience, and correlate variables. Similarly, having multiple sex partners and using substances during sex also show positive associations with condomless anal intercourse. Resilience factors of engaging in serosorting and being connected to both the Black and gay communities were negatively associated with condomless anal intercourse. Future prevention research and programming should focus on both risk and resilience factors to mitigate new HIV infections among Black MSM.
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Affiliation(s)
- Matthew Alan Town
- School of Social Work, Portland State University, 1800 SW 6th Ave, Portland, OR, 97201, USA.
| | - Ilana Freeman
- Oregon Health and Sciences University, Portland, OR, USA
| | - Ronnie James Cool
- Respiratory Therapy Program, Concorde Career College, Portland, OR, USA
| | - Charles H Klein
- Department of Anthropology, Portland State University, Portland, OR, USA
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2
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Whitfield DL, Miller RS, Escobar-Viera CG, Mammadli T, Brown AL, Gordon JD, Chandler C. Effects of internalised racism and internalised homophobia on sexual behaviours among black gay and bisexual men in the USA: a systematic review protocol. BMJ Open 2023; 13:e070969. [PMID: 37524550 PMCID: PMC10391786 DOI: 10.1136/bmjopen-2022-070969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
INTRODUCTION Black gay and bisexual men are overburdened by HIV in the USA. While the socioecological model has been applied to understand potential mechanisms of HIV acquisition among black gay and bisexual men, there is mixed evidence on the impact of internalised stigma on HIV risk among this population. This systematic review protocol paper outlines the systematic review being conducted to determine the relationship between internalised racism, internalised homophobia and engagement in sexual behaviour, which puts individuals at risk for HIV infection. METHODS AND ANALYSIS For the review, we will conduct a systematic review of the literature, summarise and critique published scholarly literature on the associations between forms of internalised stigma and sexual behaviours among black gay and bisexual men. We will conduct a systematic search of published qualitative and quantitative research studies published during and after 1993. The searches will be conducted in Ovid Medline, Ovid APA PsycInfo and EBSCO SocINDEX databases. Studies will be included if they were conducted in the USA, with samples that comprised African American/black cisgender gay, bisexual, queer and other men who have sex with men, measured internalised racism and/or internalised homophobia, and assessed sexual behaviour risk for HIV acquisition. ETHICS AND DISSEMINATION No ethical approval will be required for this review. We will report our findings using the guidelines outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Findings of this review may offer new opportunities to study internalised mechanisms impacting outcomes and to identify research gaps and spur additional queries in the group most disproportionately impacted by HIV.
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Affiliation(s)
| | - Rebekah S Miller
- Health Sciences Library System, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - César G Escobar-Viera
- Department of Psychiatry and Behavioral and Community Health Systems, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Tural Mammadli
- School of Social Work, University of Maryland, Baltimore, Maryland, USA
| | - Andre L Brown
- Director of Equity, Diversity, and Inclusion, Cuyahoga County Board of Health, Parma, Ohio, USA
| | - Jacob D Gordon
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Cristian Chandler
- Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Public Health, Vanderbilt Center for Health Services Research, Nashville, Tennessee, USA
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3
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Turpin RE, Dangerfield DT, Oke T, Hickson DA. Parental Sexuality Disclosure, Discrimination, and Depression Among Black Sexual Minority Men and Black Transgender Women. FAMILY & COMMUNITY HEALTH 2023; 46:95-102. [PMID: 36799942 PMCID: PMC9942094 DOI: 10.1097/fch.0000000000000360] [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: 06/18/2023]
Abstract
Racial and sexuality-based discrimination can induce depressive symptoms among Black sexual minority men and transgender women (BSMM/BTW). BSMM and BTW who disclose their sexuality to parents may be better prepared to cope with discrimination. We explored the relationship between discrimination and depression among BSMM and BTW and whether parental disclosure modified this relationship. Secondary analysis of The MARI Study was used to test the relationship between discrimination and depression modified by level of disclosure of sexuality to parents among 580 BSMM and BTW in Jackson, Mississippi, and Atlanta, Georgia. Bivariate tests and linear regression models were stratified by sexuality disclosure to parents. Discrimination was associated with greater depression, with significant dose-response modification across levels of disclosure. After adjustment, maximum discrimination scores were associated with depression scores 10.7 units higher among participants with very open disclosure (95% CI, 10.4-11.8), 15.3 units higher among participants with somewhat open disclosure (95% CI, 3.7-26.9), and 19.5 units higher among participants with no disclosure (95% CI, 10.2-26.8). Disclosure of sexuality to supportive parents can substantially benefit the mental health of BSMM and BTW. Future studies should explore intervention approaches to providing social support for BSMM and BTW in unsupportive families.
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Affiliation(s)
- Rodman E Turpin
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia (Dr Turpin); George Washington University, Milken Institute School of Public Health, Washington, District of Columbia (Dr Dangerfield); School of Social Work, University at Buffalo, Buffalo, New York (Mr Oke); and Us Helping Us, People Into Living Inc, Washington, District of Columbia (Drs Hickson and Dangerfield, and Mr Oke)
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Hickson DA, He Y, Odusanya A, Smith AE, Ogunbajo A, Smallwood SW. Psychometric Testing of the Daily Spiritual Experiences Scale (DSES) Among Black Gay, Bisexual, and Other Sexual Minority Men (SMM) and Black Transwomen in the Deep South: The MARI Study. JOURNAL OF RELIGION AND HEALTH 2022; 61:3507-3524. [PMID: 35147863 DOI: 10.1007/s10943-022-01516-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/22/2022] [Indexed: 06/14/2023]
Abstract
Spirituality is a well-established protective psychosocial determinant of health. The current study examined the psychometric properties of the Daily Spiritual Experiences Scale (DSES) among Black gay, bisexual and other sexual minority men (SMM) and Black transwomen (TW) in the Deep South. Data were collected via self-interview technology and analyzed using factor analyses and correlation coefficients. We demonstrated a single-factor structure of the DSES with high internal consistency (Cronbach's α = 0.96). DSES was positively and significantly associated with multiple dimensions of religion, resilience, optimism and social support and not significantly associated with cynicism and anger expressions. Spirituality should be included in HIV prevention, treatment and care strategies focused on Black SMM and Black TW, especially those residing in the Deep South, USA.
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Affiliation(s)
- DeMarc A Hickson
- Us Helping Us, People Into Living Inc., 3636 George Ave NW, Washington, DC, 20010, USA.
| | - Ying He
- Center for Research, Evaluation and Environmental and Policy Change, My Brother's Keeper, Inc., Jackson, MS, USA
| | - Anne Odusanya
- Department of Community Health Behavior and Education, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Adam E Smith
- Department of Mathematics, Tougaloo College, Tougaloo, MS, USA
| | - Adedotun Ogunbajo
- Us Helping Us, People Into Living Inc., 3636 George Ave NW, Washington, DC, 20010, USA
| | - Stacy W Smallwood
- Department of Community Health Behavior and Education, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
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McCartney DJ, Pinheiro TF, Gomez JL, Carvalho PGCD, Veras MA, Mayaud P. Acceptability of self-sampling for etiological diagnosis of mucosal sexually transmitted infections (STIs) among transgender women in a longitudinal cohort study in São Paulo, Brazil. Braz J Infect Dis 2022; 26:102356. [PMID: 35513055 PMCID: PMC9387447 DOI: 10.1016/j.bjid.2022.102356] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/03/2022] [Indexed: 11/28/2022] Open
Abstract
This study conducted among transgender women in São Paulo, Brazil assessed the acceptability and suitability of screening sexually transmitted infections (STIs), such as Chlamydia trachomatis and Neisseria gonorrhoeae, by sampling multiple anatomical sites (i.e. urethral, anorectal, oropharyngeal, and neovaginal), and utilizing self- or provider-collection methods. First, a convenience sample of 23 cohort participants were recruited during a scheduled study visit between October and November 2018. Data collection was through a short investigator-led quantitative survey in Portuguese, and included presentation of investigator-designed, gender-neutral instructional diagrams to guide self-sampling. Three supplemental focus group discussions (FGDs) with a total of 30 participants guided by semi-structured script were conducted in Portuguese between September and October 2019. All participants reported being assigned male sex at birth and self-identified with a feminine gender identity at time of study. All survey respondents (100%; n = 23) indicated willingness to provide samples for STI screening during a future study visit. Preference was for self-collection of urine samples (83%; n = 19), urethral swabs (82%; n = 18), and anorectal swabs (77%; n = 17). A lower preference for self-collection of oropharyngeal swabs (48%; n = 11) was observed. Most respondents (78%; n = 18) indicated that they would not prefer specimens to be collected by a health professional, mainly due to ‘more privacy’ (72%; n = 13). All respondents indicated that they would feel comfortable to provide a self-collected sample based on instructional diagrams shown. In FGDs, although the collection by a health professional was described as a technically safer option for some participants, there was a preference for self-collection to avoid discomfort and embarrassment in exposing the body. Overall, this sub-study suggested acceptability among transgender women of introducing self-sampling for etiological diagnosis of STIs from potential infection sites. Uptake and usability will be explored further in a cross-sectional STI prevalence study of transgender women in Brazil.
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Affiliation(s)
- Daniel Jason McCartney
- London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
| | | | - José Luis Gomez
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil
| | | | - Maria Amélia Veras
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil
| | - Philippe Mayaud
- London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
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Duncan DT, Callander D, Bowleg L, Park SH, Brinkley-Rubinstein L, Theall KP, Hickson DA. Intersectional analysis of life stress, incarceration and sexual health risk practices among cisgender Black gay, bisexual and other men who have sex with men in the Deep South of the US: the MARI Study. Sex Health 2021; 17:38-44. [PMID: 31972125 DOI: 10.1071/sh19062] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 08/05/2019] [Indexed: 11/23/2022]
Abstract
Objectives The purpose of the present study was to examine associations between life stress and incarceration history in relation to sexual health risk practices among a sample of cisgender Black gay, bisexual and other men who have sex with men (MSM) in the Deep South. METHODS Using data from a sample of 355 cisgender Black MSM in Mississippi and Georgia, multivariable logistic regression analyses were conducted to examine associations between life stress and sexual risk practices. In addition, we assessed whether stress may interact with experiences of incarceration to influence sexual health risk practices. RESULTS After controlling for sociodemographic characteristics, stress was associated with some sexual risk practices (e.g. alcohol and drug use during sex and group sex). Further, when an interaction with incarceration was assessed, among participants who had been incarcerated, high compared with low levels of stress were associated with alcohol use during sex (adjusted odds ratio (aOR) 4.59, 95% confidence interval (CI) 2.11-9.99, P < 0.001), drug use during sex (aOR 3.92, 95% CI 1.79-8.60, P < 0.001), condomless sex with casual partners (aOR 2.83, 95% CI 1.31-6.12, P < 0.001), having six or more casual partners (aOR 2.77, 95% CI 1.09-7.06, P = 0.02) and participating in group sex (aOR 5.67, 95% CI 2.07-15.51, P < 0.001). Stress and incarceration produced a dose-response effect for each association; similar associations with stress were not observed among men who had not been incarcerated. CONCLUSIONS Among people with experiences of incarceration, there are several possible ways our findings could be applied practically, including through safer sex and stress management interventions designed specifically for Black MSM following their release.
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Affiliation(s)
- Dustin T Duncan
- Department of Population Health, NYU School of Medicine, New York, NY 10016, USA; and Present address: Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA; and Corresponding author.
| | - Denton Callander
- Department of Population Health, NYU School of Medicine, New York, NY 10016, USA
| | - Lisa Bowleg
- Department of Psychology, Columbian College of Arts and Sciences, George Washington University, Washington, DC 20052, USA
| | - Su Hyun Park
- Department of Population Health, NYU School of Medicine, New York, NY 10016, USA
| | | | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, Tulane University of School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
| | - DeMarc A Hickson
- Center for Research, Evaluation and Environmental and Policy Change, My Brother's Keeper Inc., Jackson, MS 39211, USA; and Us Helping Us, People Into Living, Washington, DC 20010, USA
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Duncan DT, Ransome Y, Park SH, Jackson SD, Kawachi I, Branas CC, Knox J, Al-Ajlouni YA, Mountcastle H, Miles CH, Hickson DA. Neighborhood social cohesion, religious participation and sexual risk behaviors among cisgender black sexual minority men in the southern United States. Soc Sci Med 2021; 279:113913. [PMID: 33991789 PMCID: PMC8336607 DOI: 10.1016/j.socscimed.2021.113913] [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] [Revised: 02/09/2021] [Accepted: 04/05/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Few studies have examined associations between neighborhood social cohesion and sexual risk behaviors among gay, bisexual, and other sexual minority men (SMM), and none have among Black SMM in the southern U.S. The purpose of the current study is to examine associations between neighborhood social cohesion and sexual risk behaviors among Black SMM in the southern U.S., a population heavily impacted by HIV. We also examined whether these relationships are modified by religious participation for Black SMM in the southern U.S. METHODS Data was obtained from the MARI Study, a sample of Black SMM ages 18-66 years, recruited from the Jackson, MS and Atlanta, GA metropolitan areas (n = 354). Neighborhood social cohesion was assessed with a validated 5-item scale. We conducted multivariable regression analyses to examine the association between neighborhood social cohesion with each of the sexual risk behaviors (e.g., condomless sex and drug use before or during sex), controlling for key confounders. We then performed moderation analysis by religious participation (religious attendance and private religiosity). RESULTS Compared to Black SMM with higher perceived neighborhood social cohesion, Black SMM with lower neighborhood social cohesion had increased odds of alcohol use before or during sex (aPR = 1.56; 95% CI = 1.16-2.11) and condomless anal sex with casual partners (aPR = 1.55; 1.03-2.32). However, the magnitude of these associations varied by religious attendance and private religiosity. Black SMM with low religious service attendance had higher risk of alcohol use in the context of sex when perceived neighborhood social cohesion was low; those with high private religiosity had elevated alcohol use in the context of sex when perceived neighborhood social cohesion was low. DISCUSSION Interventions that target connectedness among neighborhood members through community education or mobilization efforts, including the involvement of religious organizations, should be considered for HIV prevention focused on alcohol and condomless sex among Black SMM.
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Affiliation(s)
- Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Su Hyun Park
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Skyler D Jackson
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Charles C Branas
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Justin Knox
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Yazan A Al-Ajlouni
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Hayden Mountcastle
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Caleb H Miles
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
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Denson DJ, Gelaude D, Saul H, Schoua-Glusberg A, Randall LA, Kenward K, Gall E, Hickson D, Schamel J, Frew PM. "To Me, Everybody Is infected": Understanding Narratives about HIV Risk among HIV-negative Black Men Who Have Sex with Men in the Deep South. JOURNAL OF HOMOSEXUALITY 2021; 68:973-992. [PMID: 31794351 PMCID: PMC7266721 DOI: 10.1080/00918369.2019.1694338] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
For black MSM living in the Deep South, the intersection of sexuality, race, and geography impacts HIV risk substantially. Between July and September 2016, we conducted a qualitative study among HIV-negative black MSM in five southern cities in the US with elevated HIV prevalence. Analysis included assessment of interrater reliability, cluster analysis, and descriptive statistics. We enrolled 99 black MSM (mean age: 33.6; SD = 12.8; range: 17-68 years). Four overarching themes emerged: harboring fear of HIV and the internalization of HIV stigma; scrutinizing potential partners to assess riskiness and HIV status; embracing distance and isolation from those perceived as a threat to HIV status; and exhibiting self-efficacy toward HIV prevention and utilizing risk reduction strategies. Future HIV prevention efforts may benefit by balancing risk and deficit based strategies with those that emphasize resilience, address disenfranchisement via structural interventions, and assess and treat inherent trauma(s).
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Affiliation(s)
- Damian J. Denson
- Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia, USA
| | - Deborah Gelaude
- Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia, USA
| | - Heather Saul
- Department of Health, Science, and Human Services, ICF International, Incorporated, Atlanta, Georgia, USA
| | | | - Laura A. Randall
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | | | - Elizabeth Gall
- Division of Health, IMPAQ International, LLC, Columbia, Maryland, USA
| | | | - Jay Schamel
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Paula M. Frew
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
- Hubert Department of Global Health, Emory Rollins School of Public Health, Atlanta, Georgia, USA
- Department of Behavioral Sciences and Health Education, Emory Rollins School of Public Health, Atlanta, Georgia, USA
- Emory Center for AIDS Research, Atlanta, Georgia, USA
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Dangerfield Ii DT, Wylie C, Anderson JN. Conducting Virtual, Synchronous Focus Groups Among Black Sexual Minority Men: Qualitative Study. JMIR Public Health Surveill 2021; 7:e22980. [PMID: 33427671 PMCID: PMC7899800 DOI: 10.2196/22980] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/23/2020] [Accepted: 01/09/2021] [Indexed: 11/25/2022] Open
Abstract
Background Focus groups are useful to support HIV prevention research among US subpopulations, such as Black gay, Black bisexual, and other Black sexual minority men (BSMM). Virtual synchronous focus groups provide an electronic means to obtain qualitative data and are convenient to implement; however, the protocols and acceptability for conducting virtual synchronous focus groups in HIV prevention research among BSMM are lacking. Objective This paper describes the protocols and acceptability of conducting virtual synchronous focus groups in HIV prevention research among BSMM Methods Data for this study came from 8 virtual synchronous focus groups examined in 2 studies of HIV-negative BSMM in US cities, stratified by age (N=39): 2 groups of BSMM ages 18-24 years, 5 groups of BSMM ages 25-34 years, and 1 group of BSMM 35 years and older. Virtual synchronous focus groups were conducted via Zoom, and participants were asked to complete an electronic satisfaction survey distributed to their email via Qualtrics. Results The age of participants ranged from 18 to 44 years (mean 28.3, SD 6.0). All participants “strongly agreed” or “agreed” that they were satisfied participating in an online focus group. Only 17% (5/30) preferred providing written informed consent versus oral consent. Regarding privacy, most (30/30,100%) reported “strongly agree” or “agree” that their information was safe to share with other participants in the group. Additionally, 97% (29/30) reported being satisfied with the incentive. Conclusions Conducting virtual synchronous focus groups in HIV prevention research among BSMM is feasible. However, thorough oral informed consent with multiple opportunities for questions, culturally relevant facilitation procedures, and appropriate incentives are needed for optimal focus group participation.
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Affiliation(s)
- Derek T Dangerfield Ii
- Johns Hopkins School of Nursing, Baltimore, MD, United States.,Us Helping Us, People Into Living, Inc, Washington DC, MD, United States
| | - Charleen Wylie
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Janeane N Anderson
- Department of Health Promotion and Disease Prevention, College of Nursing, University of Tennessee Health Science Center, Memphis, TN, United States
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10
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Russell JS, Hickson DA, Timmins L, Duncan DT. Higher Rates of Low Socioeconomic Status, Marginalization, and Stress in Black Transgender Women Compared to Black Cisgender MSM in The MARI Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042183. [PMID: 33672272 PMCID: PMC7927022 DOI: 10.3390/ijerph18042183] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/08/2021] [Accepted: 02/19/2021] [Indexed: 12/15/2022]
Abstract
Most HIV research combines transgender women who have sex with men (TWSM) with cisgender men who have sex with men (MSM), despite emerging evidence of important differences. Using data from The MARI Study, we compared Black TWSM and Black cisgender MSM on personal and ecological factors. Black TWSM reported more unemployment (71.4% versus 51.4%, p = 0.015), incarceration (52.4% versus 36.0%, p = 0.046), stressful life experiences (median score 135.5 versus 90, p = 0.033), and HIV positivity (66.7% versus 22.9%, p = 0.008). Further research into the causes and consequences of these differences, and regarding TWSM specifically, is needed.
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Affiliation(s)
- Jonathan S. Russell
- Department of Epidemiology and ICAP, Columbia University Mailman School of Public Health, New York, NY 10032, USA
- Correspondence:
| | | | - Liadh Timmins
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA; (L.T.); (D.T.D.)
| | - Dustin T. Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA; (L.T.); (D.T.D.)
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11
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He Y, Dangerfield Ii DT, Fields EL, Dawkins MR, Turpin RE, Johnson D, Browne DC, Hickson DA. Health care access, health care utilisation and sexual orientation disclosure among Black sexual minority men in the Deep South. Sex Health 2020; 17:421-428. [PMID: 33176906 DOI: 10.1071/sh20051] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 09/01/2020] [Indexed: 11/23/2022]
Abstract
Background Black gay, bisexual, and other sexual minority men (BSMM) account for 39.1% of new HIV infections among men who have sex with men and 78.9% of newly diagnosed cases among Black men. Health care access, health care utilisation and disclosing sexuality to providers are important factors in HIV prevention and treatment. This study explored the associations among sexual orientation disclosure, health care access and health care utilisation among BSMM in the Deep South. METHODS Secondary analysis of existing data of a population-based study in Jackson, Mississippi, and Atlanta, Georgia, was conducted among 386 BSMM. Poisson regression models were used to estimate prevalence ratios (PR) between sexual orientation disclosure to healthcare providers, health care access and health care utilisation. RESULTS The mean (±s.d.) age of participants was 30.5 ± 11.2 years; 35.3% were previously diagnosed with HIV and 3.7% were newly diagnosed with HIV. Two-thirds (67.2%) self-identified as homosexual or gay; 70.6% reported being very open about their sexual orientation with their healthcare providers. After adjustment, BSMM who were not open about their sexual orientation had a lower prevalence of visiting a healthcare provider in the previous 12 months than those who were very open with their healthcare provider (PR 0.42; 95% confidence interval 0.18-0.97). CONCLUSION Clinics, hospitals and other healthcare settings should promote affirming environments that support sexuality disclosure for BSMM.
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Affiliation(s)
- Ying He
- My Brother's Keeper, Inc., 407 Orchard Park, Ridgeland, MS 39157, USA
| | - Derek T Dangerfield Ii
- Johns Hopkins School of Nursing, 525 N Wolfe Street, Baltimore, MD 21205, USA; and Us Helping Us, People Into Living, Inc., 3636 Georgia Avenue NW, Washington, DC 20010, USA; and Corresponding author.
| | - Errol L Fields
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, 200 N Wolfe Street, Baltimore, MD 21287, USA
| | - Milton R Dawkins
- My Brother's Keeper, Inc., 407 Orchard Park, Ridgeland, MS 39157, USA; and Department of Psychology, Jackson State University, Jackson, MS 39213, USA
| | - Rodman E Turpin
- School of Public Health, University of Maryland, 4200 Valley Drive #2242, College Park, MD 20742, USA
| | - Damon Johnson
- USA National AIDS and Education Services for Minorities, Inc., 2140 Martin Luther King Jr Drive SW, Atlanta, GA 30310, USA
| | - Dorothy C Browne
- Department of Maternal and Child Health, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; and University of Duy Tan, 254 Nguyen Van Linh, Thanh Khe District, Da Nang, Vietnam
| | - DeMarc A Hickson
- My Brother's Keeper, Inc., 407 Orchard Park, Ridgeland, MS 39157, USA; and Us Helping Us, People Into Living, Inc., 3636 Georgia Avenue NW, Washington, DC 20010, USA
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12
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Abstract
Black men who have sex with men (MSM) are disproportionately burdened by the HIV epidemic. Although there has been an increased focus on reducing HIV prevalence in Black MSM, little attention has been given to how and why Black MSM are able to remain HIV-negative, beyond believing that they are lucky. The purpose of this qualitative study was to explore how Black MSM try to stay HIV-negative. Guided by constructivist grounded theory and a strengths-based approach, we conducted in-depth interviews to explicate how Black MSM demonstrate resilience by staying seronegative amidst high seroprevalence. Results from this study suggest that it is their perceptions of HIV risk that translate into protective strategies that enable them to prevent infection. Our study offers insight into their reasoning processes that guide their efforts to stay HIV-negative.
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Affiliation(s)
- Jagadisa-Devasri Dacus
- HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, New York, NY, USA.
- New York State Psychiatric Institute, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA.
| | - Theo G M Sandfort
- HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, New York, NY, USA
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13
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Dangerfield DT, Johnson D, Hamlin-Palmer S, Browne DC, Mayer KH, Hickson DA. Prevalence and Correlates of Rectal Douching and Enema Use Among Black Sexual Minority Men and Black Transwomen in the Deep South. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1915-1922. [PMID: 32086643 DOI: 10.1007/s10508-019-01605-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 11/30/2019] [Accepted: 12/03/2019] [Indexed: 06/10/2023]
Abstract
HIV/STI disparities are highest among Black sexual minority men (BSMM) and Black transwomen (BTW) in the Deep South. Exploring the prevalence and correlates of rectal douching and enema use could provide insights into risk factors and HIV/STI prevention opportunities among these groups. This study explored the prevalence and correlates of rectal douching and enema using Poisson regression models among 375 BSMM and BTW in Jackson, MS, and Atlanta GA. Approximately 95% reported their gender as male/man; 5.6% self-identified as transwomen. Most reported being single (73.1%) and were unemployed (56.0%); 36.1% were previously diagnosed with HIV. In multivariable models, BSMM and BTW who reported that their typical sexual position during anal sex was "bottom" (aPR = 2.39, 95% CI = 1.48, 3.84) or "versatile" (aPR = 2.46, 95% CI = 1.44, 4.17) had a higher prevalence of rectal douching and enema use than those who reported "top." Deeper understanding of the contexts of rectal douching, enema use, and sexual positioning practices is needed.
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Affiliation(s)
| | | | | | - Dorothy C Browne
- Department of Maternal and Child Health, University of North Carolina, Durham, NC, USA
| | - Kenneth H Mayer
- The Fenway Institute of Fenway Health and the Infectious Disease Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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14
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English D, Hickson DA, Callander D, Goodman MS, Duncan DT. Racial Discrimination, Sexual Partner Race/Ethnicity, and Depressive Symptoms Among Black Sexual Minority Men. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1799-1809. [PMID: 32222852 PMCID: PMC7340340 DOI: 10.1007/s10508-020-01647-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 06/01/2023]
Abstract
Although racial sexual exclusivity among Black gay, bisexual, and other sexual minority men (SMM) is frequently framed as a cause of HIV inequities, little research has examined how these sexual relationships may be driven by and protective against racism. This study examined associations between general racial discrimination, Black sexual exclusivity, sexual racial discrimination, and depressive symptoms among Black SMM. We conducted analyses on cross-sectional self-report data from 312 cisgender Black SMM in the U.S. Deep South who participated in the MARI study. Measures included general racial and sexual identity discrimination, race/ethnicity of sexual partners, sexual racial discrimination, and depressive symptoms. We estimated a moderated-mediation model with associations from discrimination to Black sexual exclusivity, moderated by discrimination target, from Black sexual exclusivity to sexual racial discrimination, and from sexual racial discrimination to depressive symptoms. We tested an indirect effect from racial discrimination to depressive symptoms to examine whether Black sexual exclusivity functioned as an intervening variable in the associations between racial discrimination and depressive symptoms. Results indicated that participants who experienced racial discrimination were more likely to exclusively have sex with Black men. Men with higher Black sexual exclusivity were less likely to experience sexual racial discrimination and, in turn, reported lower depressive symptoms. The indirect pathway from racial discrimination to depressive symptoms through Black sexual exclusivity and sexual racial discrimination was significant. Our results suggest that one of the drivers of sexual exclusivity among Black SMM may be that it helps to protect against the caustic psychological effects of racial discrimination.
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Affiliation(s)
- Devin English
- Rutgers School of Public Health, One Riverfront Plaza, Suite 1020 (10th Floor), Newark, NJ, 07102-0301, USA.
| | | | | | - Melody S Goodman
- New York University College of Global Public Health, New York, NY, USA
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15
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Heidari O, Dangerfield DT, Hickson DA. Sexual risk and sexual healthcare utilization profiles among Black sexual minority men in the U.S. Deep South. AIDS Care 2020; 32:1602-1609. [PMID: 32476446 DOI: 10.1080/09540121.2020.1772455] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Black gay, bisexual, and other Black sexual minority men (BSMM) continue to experience negative health outcomes along the HIV prevention and treatment continuum, especially in the U.S. Deep South. The purpose of this study is to identify sexual risk and healthcare utilization profiles behaviors among BSMM in the Deep South. Guided by the Behavioral Model for Vulnerable Populations, latent class analysis was used to identify sexual risk and healthcare utilization profiles using data from 348 individuals in Jackson, MS and Atlanta, GA. Multinomial logistic regression was used to identify the correlates of class membership. A 3-class solution was identified: Class 1 (Substance using, Low Testers); Class 2 (Condom using testers), and Class 3 (Casual Partner Testers). Class 1 had the highest conditional probabilities of drug (75%) and alcohol (84%) use before sex and the lowest probability of STI and HIV testing. Class 2 had the highest probabilities of condom use and a 65% probability of seeing a healthcare provider. Class 3 had the highest probability of inconsistent condom use and seeing a healthcare provider in the previous 12 months (76%). Findings support the need for targeted interventions tailored to BSMM of different sexual risk and healthcare utilization behaviors.
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Affiliation(s)
- Omeid Heidari
- Johns Hopkins University, School of Nursing, Baltimore, MD, USA
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16
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Duncan DT, Sutton MY, Park SH, Callander D, Kim B, Jeffries WL, Henny KD, Harry-Hernández S, Barber S, Hickson DA. Associations Between Neighborhood Problems and Sexual Behaviors Among Black Men Who Have Sex with Men in the Deep South: The MARI Study. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:185-193. [PMID: 31950381 PMCID: PMC7410008 DOI: 10.1007/s10508-019-01619-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/05/2019] [Accepted: 12/20/2019] [Indexed: 06/10/2023]
Abstract
There is a disproportionately high HIV incidence among Black men who have sex with men (MSM) despite equal or lower levels of HIV risk behaviors compared to White MSM. Due to high levels of racial segregation in the U.S., Black MSM have an elevated likelihood of living in neighborhoods that contain psychosocial stressors, which, in turn, may increase behaviors promoting HIV infection. We examined associations between perceived neighborhood problems and sexual behaviors among Black MSM in the Deep South, a population at highest risk of HIV. Data came from the MARI Study, which included Black MSM ages 18-66 years recruited from the Jackson, MS, and Atlanta, GA, metropolitan areas (n = 377). Participants completed questions about neighborhood problems (e.g., excessive noise, heavy traffic/speeding cars and trash/litter) and sexual behaviors (e.g., condomless sex and drug use before or during sex). We used Poisson's regression model with robust standard errors to estimate the adjusted prevalence ratio (aPR; 95% confidence intervals [CI]) of neighborhood problems (coded as tertiles [tertile 1 = low neighborhood problems, tertile 2 = medium neighborhood problems, tertile 3 = high neighborhood problems] as well as continuously) with sexual behaviors, after adjustment for sociodemographic characteristics and other variables. About one-fourth of the sample reported at least one neighborhood problem, with the most common (31.6%) being no/poorly maintained sidewalks, which indicates an infrastructural problem. In multivariable models, compared to those in the lowest tertile, those reporting more neighborhood problems (tertile 2: aPR = 1.49, 95% CI = 1.04, 2.14 and tertile 3: aPR = 1.53, 95% CI = 1.05, 2.24) reported more drug use before or during sex (p for trend = .027). Neighborhood problems may promote behaviors (e.g., drug use before or during sex) conducive to HIV infection. Structural interventions could improve community infrastructure to reduce neighborhood problems (e.g., no/poorly maintained sidewalks and litter). These interventions may help to reduce HIV incidence among Black MSM in the Deep South.
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Affiliation(s)
- Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 715, New York, NY, 10032, USA.
| | - Madeline Y Sutton
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Su Hyun Park
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 715, New York, NY, 10032, USA
| | - Denton Callander
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 715, New York, NY, 10032, USA
| | - Byoungjun Kim
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 715, New York, NY, 10032, USA
| | - William L Jeffries
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kirk D Henny
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Salem Harry-Hernández
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 715, New York, NY, 10032, USA
| | - Sharrelle Barber
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - DeMarc A Hickson
- Center for Research, Evaluation and Environmental and Policy Change, My Brother's Keeper, Inc, Jackson, MS, USA
- Us Helping Us, People Into Living, Inc, Washington, DC, USA
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17
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Gaines MT, McCree DH, Gaul Z, Henny KD, Hickson DA, Sutton MY. Comparison of Selected Sociodemographic Characteristics and Sexual Risk Behaviors of Black/African American Men Who Have Sex with Men Only and Men Who Have Sex with Men and Women, Southeastern United States, 2013-2016. J Racial Ethn Health Disparities 2019; 7:84-89. [PMID: 31502106 DOI: 10.1007/s40615-019-00636-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/08/2019] [Accepted: 08/29/2019] [Indexed: 12/01/2022]
Abstract
PURPOSE Compare selected sociodemographic and sexual risk characteristics of black/African American (black) men who have sex with men only (MSMO) and men who have sex with men and women (MSMW) in the southeastern United States (the South). METHODS We conducted bivariate and multivariable analyses to explore the sociodemographic characteristics and sexual risk behaviors of 584 MSMW and MSMO in the South. RESULTS MSMW had lesser odds of having a college or graduate degree (aOR = 0.32; 95% CI = 0.19, 0.54) and having > 2 male oral sex partners (aOR = 0.20; 95% CI = 0.08, 0.48) compared to MSMO. MSMW had greater odds of being homeless (aOR = 3.11; 95% CI = 1.80, 5.38) and selecting "top" sexual position (aOR = 1.70; 95% CI = 1.07, 2.72) compared to MSMO. CONCLUSION MSMW in the South experience social and structural factors that may affect their risk for HIV infection. Strategies to address these factors should be considered in prevention and care efforts for this population.
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Affiliation(s)
- Malendie T Gaines
- Oak Ridge Institute for Science and Education, 100 ORAU Way, Oak Ridge, TN, 37830, USA.
| | - Donna Hubbard McCree
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-45, Atlanta, GA, 30333, Georgia
| | - Zaneta Gaul
- ICF, 3 Corporate Square NE, Suite 370, Atlanta, GA, 30329, Georgia
| | - Kirk D Henny
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-45, Atlanta, GA, 30333, Georgia
| | - DeMarc A Hickson
- My Brothers' Keeper, 510 George Street, Suite 100, Jackson, MS, 39202, USA.,Us Helping Us, Inc., 3636 Georgia Avenue NW, Washington, DC, 20010, USA
| | - Madeline Y Sutton
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-45, Atlanta, GA, 30333, Georgia.,Department of Obstetrics and Gynecology, Morehouse School of Medicine, 80 Jesse Hill Jr. Drive SE, Atlanta, GA, 30303, Georgia
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18
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Implementation of a Socio-structural Demonstration Project to Improve HIV Outcomes Among Young Black Men in the Deep South. J Racial Ethn Health Disparities 2019; 6:775-789. [PMID: 30793253 DOI: 10.1007/s40615-019-00576-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 01/31/2019] [Accepted: 02/12/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND We describe the background, rationale, intervention components, and formative results of a demonstration project aimed to ameliorate five socio-structural barriers to HIV services for young Black men aged 18-29 living with and at risk for HIV in Louisiana. METHODS The interventions and activities consisted of (1) five person-centered approaches to enhance linkage to HIV services and improve socio-economic outcomes; (2) the implementation of systematic mystery shopping tests to document instances of housing discrimination; (3) the development and implementation of a multi-prong communications campaign to increase knowledge about the signs of housing discrimination and community resources among young Black men who have sex with men (YBMSM); (4) the integration of HIV/STI services and lesbian, gay, bisexual, and trans (LGBT)-inclusive events on Historically Black Colleges and Universities (HBCUs); and (5) the development of a safe space for YBMSM. A multi-method approach was used to evaluate the outcomes of the different interventions. RESULTS The majority (62%) of participants living with HIV were linked to HIV care and 49% had achieved viral suppression. More than 40% of participants were employed during the project. Thirty-seven percent (37%) of the mystery shopping tests showed definite or possible signs of housing discrimination. The housing campaign's duration was limited with unknown long-term impact among YBMSM. Fifteen cases of syphilis were identified during two HBCU events. A safe space was specifically created for YBMSM at a community-based organization. CONCLUSION Multi-component holistic health interventions are needed to improve HIV outcomes and curb the high HIV rates among young Black men, particularly YBMSM in the United States and the Deep South.
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19
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Duncan DT, Chaix B, Regan SD, Park SH, Draper C, Goedel WC, Gipson JA, Guilamo-Ramos V, Halkitis PN, Brewer R, Hickson DA. Collecting Mobility Data with GPS Methods to Understand the HIV Environmental Riskscape Among Young Black Men Who Have Sex with Men: A Multi-city Feasibility Study in the Deep South. AIDS Behav 2018; 22:3057-3070. [PMID: 29797163 PMCID: PMC6076855 DOI: 10.1007/s10461-018-2163-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
While research increasingly studies how neighborhood contexts influence HIV among gay, bisexual and other men who have sex with men (MSM) populations, to date, no research has used global positioning system (GPS) devices, an innovative method to study spatial mobility through neighborhood contexts, i.e., the environmental riskscape, among a sample of Black MSM. The purpose of this study was to examine the feasibility of collecting two-week GPS data (as measured by a pre- and post-surveys as well as objectively measured adherence to GPS protocol) among a geographically-diverse sample of Black MSM in the Deep South: Gulfport, MS, Jackson, MS, and New Orleans LA (n = 75). GPS feasibility was demonstrated including from survey items, e.g. Black MSM reported high ratings of pre-protocol acceptability, ease of use, and low levels of wear-related concerns. Findings from this study demonstrate that using GPS methods is acceptable and feasible among Black MSM in the Deep South.
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Affiliation(s)
- Dustin T Duncan
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA.
| | - Basile Chaix
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
- Inserm, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Seann D Regan
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Su Hyun Park
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Cordarian Draper
- Center for Research, Evaluation and Environmental & Policy Change, My Brother's Keeper, Inc, Jackson, MS, USA
| | - William C Goedel
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - June A Gipson
- Center for Community-Based Programs, My Brother's Keeper, Inc, Jackson, MS, USA
| | - Vincent Guilamo-Ramos
- Center for Latino Adolescent and Family Health (CLAFH), Silver School of Social Work, New York University, New York, NY, USA
| | - Perry N Halkitis
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University School of Public Health, New Brunswick, NJ, USA
| | - Russell Brewer
- Louisiana Public Health Institute (LPHI), New Orleans, LA, USA
| | - DeMarc A Hickson
- Center for Research, Evaluation and Environmental & Policy Change, My Brother's Keeper, Inc, Jackson, MS, USA
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20
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The Associations of Resilience and HIV Risk Behaviors Among Black Gay, Bisexual, Other Men Who Have Sex with Men (MSM) in the Deep South: The MARI Study. AIDS Behav 2018; 22:1679-1687. [PMID: 28856456 DOI: 10.1007/s10461-017-1881-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Resilience is an understudied intrapersonal factor that may reduce HIV risk among men who have sex with men (MSM). Multivariable Poisson regression models were used to estimate the prevalence ratio (PR) of sexual risk behaviors, HIV prevalence, and history of sexually transmitted infections (STIs) with resilience scores in a population-based study among 364 black MSM in the Deep South. Participants with higher resilience scores had a lower prevalence of condomless anal sex with casual sexual partners in past 12 months (PR = 0.80, p value = 0.001) and during their last sexual encounter (PR = 0.81; p value = 0.009). Resilience was inversely associated with a lower prevalence of condomless anal sex with main sexual partners, participating in a sex party/orgy and having a STI in the past 12 months. Resilience may have a protective effect on HIV among black MSM, especially in the Deep South, and should be further explored in studies with prospective designs.
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Hickson DA, Mena LA, Wilton L, Tieu HV, Koblin BA, Cummings V, Latkin C, Mayer KH. Sexual Networks, Dyadic Characteristics, and HIV Acquisition and Transmission Behaviors Among Black Men Who Have Sex With Men in 6 US Cities. Am J Epidemiol 2017; 185:786-800. [PMID: 28402405 DOI: 10.1093/aje/kww144] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 03/15/2016] [Indexed: 12/24/2022] Open
Abstract
The role of sexual networks in the epidemiology of human immunodeficiency virus (HIV) among black men who have sex with men (MSM) is poorly understood. Using data from 1,306 black MSM in the BROTHERS Study (2009-2010) in the United States, we examined the relationships between multiple sexual dyadic characteristics and serodiscordant/serostatus-unknown condomless sex (SDCS). HIV-infected participants had higher odds of SDCS when having sex at least weekly (odds ratio (OR) = 2.41, 95% confidence interval (CI): 1.37, 4.23) or monthly (OR = 1.94, 95% CI: 1.17, 3.24) versus once to a few times a year. HIV-uninfected participants had higher odds of SDCS with partners met offline at sex-focused venues (OR = 1.79, 95% CI: 1.15, 2.78) versus partners met online. In addition, having sex upon first meeting was associated with higher odds of SDCS (OR = 1.49, 95% CI: 1.21, 1.83) than was not having sex on first meeting, while living/continued communication with sexual partner(s) was associated with lower odds of SDCS (weekly: OR = 0.64, 95% CI: 0.47, 0.85; monthly: OR = 0.60, 95% CI: 0.44, 0.81; yearly: OR = 0.58, 95% CI: 0.39, 0.85) versus discontinued communication. Persons with primary/steady nonprimary partners versus commercial partners had lower odds of SDCS regardless of HIV serostatus. This suggests the need for culturally relevant HIV prevention efforts for black MSM that facilitate communication with sexual partners especially about risk reduction strategies, including preexposure prophylaxis.
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Affiliation(s)
- DeMarc A Hickson
- Department of Epidemiology and Biostatistics, Jackson State University, School of Public Health, Jackson, MS
| | - Leandro A Mena
- Department of Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39213, USA
| | - Leo Wilton
- Department of Human Development, State University of New York at Binghamton, Binghamton, NY, USA
- Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - Hong-Van Tieu
- New York Blood Center and Columbia University Medical Center, New York, NY, USA
| | - Beryl A Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States
| | - Vanessa Cummings
- National Institute of Water and Atmospheric Research (NIWA), Wellington, New Zealand
| | - Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kenneth H Mayer
- Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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22
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Gee S, Skovdal M. Navigating 'riskscapes': The experiences of international health care workers responding to the Ebola outbreak in West Africa. Health Place 2017; 45:173-180. [PMID: 28391128 DOI: 10.1016/j.healthplace.2017.03.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 03/27/2017] [Accepted: 03/28/2017] [Indexed: 10/24/2022]
Abstract
This paper draws on interview data to examine how international health care workers navigated risk during the unprecedented Ebola outbreak in West Africa. It identifies the importance of place in risk perception, including how different spatial localities give rise to different feelings of threat or safety, some from the construction of physical boundaries, and others mediated through aspects of social relations, such as trust, communication and team dynamics. Referring to these spatial localities as 'riskscapes', the paper calls for greater recognition of the role of place in understanding risk perception, and how people navigate risk.
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Affiliation(s)
- Stephanie Gee
- School of Health and Related Research, University of Sheffield, United Kingdom; Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark.
| | - Morten Skovdal
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark
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23
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Truong N, Perez-Brumer A, Burton M, Gipson J, Hickson D. What is in a label? Multiple meanings of 'MSM' among same-gender-loving Black men in Mississippi. Glob Public Health 2016; 11:937-52. [PMID: 26950431 DOI: 10.1080/17441692.2016.1142593] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Men who have sex with men (MSM) and other same-gender-loving (SGL) men continue to be disproportionately affected by HIV and AIDS, particularly among the Black population. Innovative strategies are needed to support the health of this community; however, public health efforts primarily approach MSM as a monolithic population erasing the diverse identities, practices, and sexualities within and beyond this category. To better understand diversity within MSM in a geographic region with the largest proportion of Black Americans in the U.S.A. and among the most heavily affected by the epidemic, the Deep South, we conducted four focus groups (n = 29) with Black men who reported having sex with other men residing in Jackson, Mississippi. Results suggest multiple overlapping usages of MSM as identity and behaviour, reflecting internalisation of behavioural categories and co-creation of identities unique to the Black community. These narratives contribute to the literature by documenting the evolving understandings of the category 'MSM' among Black men to reflect intersections between race, socioeconomic status, sexual behaviour, sexuality, subjectivities, and social context. Findings suggest the current monolithic approach to treating MSM may limit public health efforts in developing effective HIV prevention and promotion programmes targeting SGL Black men in the Deep South.
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Affiliation(s)
- Nhan Truong
- a Institute for Behavioral and Community Health , San Diego State University , San Diego , CA , USA
| | - Amaya Perez-Brumer
- b Department of Sociomedical Sciences , Mailman School of Public Health, Columbia University , New York , NY , USA
| | - Melissa Burton
- c Public Health Program , Jackson State University , Jackson , MS , USA
| | - June Gipson
- d Center for Community-based Programs, My Brother's Keeper, Inc ., Ridgeland , MS , USA
| | - DeMarc Hickson
- e Center for Research, Evaluation, and Environmental and Policy Change, My Brother's Keeper, Inc ., Jackson , MS , USA
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