1
|
Vitsupakorn S, Pierce N, Ritchwood TD. Cultural interventions addressing disparities in the HIV prevention and treatment cascade among Black/African Americans: a scoping review. BMC Public Health 2023; 23:1748. [PMID: 37679765 PMCID: PMC10485990 DOI: 10.1186/s12889-023-16658-9] [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: 10/17/2022] [Accepted: 08/30/2023] [Indexed: 09/09/2023] Open
Abstract
Culture is an important determinant of HIV risk and protective behaviors; yet, we know little about how it is integrated in HIV interventions. This scoping review characterizes the integration of culture in HIV prevention and treatment interventions focused on Black/African Americans. We searched MEDLINE, PsycINFO, CINAHL, and Google Scholar for peer-reviewed manuscripts published between July 1, 2011, and June 28, 2021. Twenty-five interventions were identified, with 96% focused on prevention. Most (40%) targeted men who have sex with men or transgender women. Only three were grounded in cultural theory. Although all interventions were labeled "culturally based," only two explicitly defined culture. Moreover, there was much diversity regarding the ways in which interventions integrated cultural elements, with some conflating race/ethnicity with culture. To improve uptake and HIV-related outcomes, interventions integrating culture are greatly needed. Additionally, HIV interventions purporting to be "culturally based" must include basic information to support rigor and reproducibility.
Collapse
Affiliation(s)
| | - Nia Pierce
- College of Humanities and Social Sciences, North Carolina State University, Raleigh, NC, USA
| | - Tiarney D Ritchwood
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
| |
Collapse
|
2
|
Nyman J, Tornivuori A, Salanterä S, Barroso T, Parisod H. Systematic review of digital interventions to support refusal self-efficacy in child and adolescent health promotion. Health Promot Int 2022; 37:6722695. [PMID: 36166268 DOI: 10.1093/heapro/daac085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Refusal self-efficacy protects against risky health behavior. Digital interventions have the potential to support self-efficacy due to the enactive experience provided by digital technologies. The aim of this systematic literature review was to evaluate the evidence of digital interventions to support refusal self-efficacy in child and adolescent health promotion. Following the Cochrane Collaboration guidelines, five electronic databases were searched from 2009 to 2020. The studies were assessed by two independent reviewers according to the eligibility criteria. Eligible studies were included in the review, assessed for risk of bias, synthesized narratively and assessed for evidence quality with the GRADE approach. Twenty-three studies, that examined 18 different interventions, were included in the review. The interventions included various digital elements as means to support the child and adolescent refusal self-efficacy (e.g. games, videos, feedback and activities for regulating feelings). The interventions improving refusal self-efficacy were more often used at home setting and addressed the four sources of self-efficacy with different digital elements regardless of intervention duration and intensity. Although the results on intervention effects varied and the evidence quality remained low, the overall evidence concerning these interventions was encouraging. Based on the subgroup analysis, the results were mainly encouraging among girls. When these interventions are implemented in health promotion, their benefits and weaknesses need to be considered comprehensively. The results provide information for designing and developing digital interventions to support child and adolescent refusal self-efficacy. Further research with larger sample sizes and more rigorous study designs is needed to strengthen the evidence of these interventions.
Collapse
Affiliation(s)
- Johanna Nyman
- Department of Nursing Science, FI-20014, University of Turku
| | - Anna Tornivuori
- Department of Nursing Science, FI-20014, University of Turku.,Turku University Hospital, Health Village, Turku, Finland
| | - Sanna Salanterä
- Department of Nursing Science, FI-20014, University of Turku.,Turku University Hospital, Turku, Finland
| | - Teresa Barroso
- Nursing School of Coimbra, Rua 5 de Outubro, Apartado 7001, 3046-851 Coimbra, Portugal
| | - Heidi Parisod
- Department of Nursing Science, FI-20014, University of Turku.,Nursing Research Foundation sr (NRF), Asemamiehenkatu 2, 00520 Helsinki, Finland
| |
Collapse
|
3
|
Nguyen CJ, Pham C, Jackson AM, Ellison NLK, Sinclair KI. Online Food Security Discussion Before and During the COVID-19 Pandemic in Native Hawaiian and Pacific Islander Community Groups and Organizations: Content Analysis of Facebook Posts. Asian Pac Isl Nurs J 2022; 6:e40436. [PMID: 36212246 PMCID: PMC9528231 DOI: 10.2196/40436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022] Open
Abstract
Background The Native Hawaiian and Pacific Islander (NHPI) population experiences disproportionately higher rates of food insecurity, which is a risk factor for cardiometabolic diseases such as cardiovascular disease, type 2 diabetes, obesity, and hypertension, when compared to white individuals. Novel and effective approaches that address food insecurity are needed for the NHPI population, particularly in areas of the continental United States, which is a popular migration area for many NHPI families. Social media may serve as an opportune setting to reduce food insecurity and thus the risk factors for cardiometabolic diseases among NHPI people; however, it is unclear if and how food insecurity is discussed in online communities targeting NHPI individuals. Objective The objective of this study was to characterize the quantity, nature, and audience engagement of messages related to food insecurity posted online in community groups and organizations that target NHPI audiences. Methods Publicly accessible Facebook pages and groups focused on serving NHPI community members living in the states of Washington or Oregon served as the data source. Facebook posts between March and June 2019 (before the COVID-19 pandemic) and from March to June 2020 (during the COVID-19 pandemic) that were related to food security were identified using a set of 36 related keywords. Data on the post and any user engagement (ie, comments, shares, or digital reactions) were extracted for all relevant posts. A content analytical approach was used to identify and quantify the nature of the identified posts and any related comments. The codes resulting from the content analysis were described and compared by year, page type, and engagement. Results Of the 1314 nonduplicated posts in the 7 relevant Facebook groups and pages, 88 were related to food security (8 in 2019 and 80 in 2020). The nature of posts was broadly classified into literature-based codes, food assistance (the most common), perspectives of food insecurity, community gratitude and support, and macrolevel contexts. Among the 88 posts, 74% (n=65) had some form of engagement, and posts reflecting community gratitude and support or culture had more engagement than others (mean 19.9, 95% CI 11.2-28.5 vs mean 6.1, 95% CI 1.7-10.4; and mean 26.8, 95% CI 12.7-40.9 vs mean 5.3, 95% CI 3.0-7.7, respectively). Conclusions Food security–related posts in publicly accessible Facebook groups targeting NHPI individuals living in Washington and Oregon largely focused on food assistance, although cultural values of gratitude, maintaining NHPI culture, and supporting children were also reflected. Future work should capitalize on social media as a potential avenue to reach a unique cultural group in the United States experiencing inequitably high rates of food insecurity and risk of cardiometabolic diseases.
Collapse
Affiliation(s)
- Cassandra Jean Nguyen
- Institute for Research and Education to Advance Community Health Washington State University Seattle, WA United States
| | - Christian Pham
- Elson S Floyd College of Medicine Washington State University Spokane, WA United States
| | - Alexandra M Jackson
- Institute for Research and Education to Advance Community Health Washington State University Seattle, WA United States
| | | | - Ka Imi Sinclair
- Institute for Research and Education to Advance Community Health Washington State University Seattle, WA United States
| |
Collapse
|
4
|
Akankunda S, Nambi Najjuma J, Tayebwa S, Byamugisha B, Ariho S, Bahati R. The Role of Mass Media Campaigns in Improving Adherence to Antiretroviral Therapy Among Adolescents Living with HIV in Southwestern Uganda. HIV AIDS (Auckl) 2022; 14:397-407. [PMID: 36039117 PMCID: PMC9419725 DOI: 10.2147/hiv.s375789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 08/17/2022] [Indexed: 11/23/2022] Open
Abstract
Background Methods Results Conclusion
Collapse
Affiliation(s)
- Sandra Akankunda
- Faculty of Nursing and Health Sciences, Bishop Stuart University, Mbarara, Uganda
| | | | - Sandra Tayebwa
- Faculty of Nursing and Health Sciences, Bishop Stuart University, Mbarara, Uganda
| | - Benjamen Byamugisha
- Faculty of Nursing and Health Sciences, Bishop Stuart University, Mbarara, Uganda
| | - Sabastian Ariho
- Faculty of Nursing and Health Sciences, Bishop Stuart University, Mbarara, Uganda
| | - Ronald Bahati
- Faculty of Nursing and Health Sciences, Bishop Stuart University, Mbarara, Uganda
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Correspondence: Ronald Bahati, Bishop Stuart University, Faculty of Nursing and Health Sciences, P. o Box 09, Mbarara City, Uganda, Tel +256701512551, Email
| |
Collapse
|
5
|
Jones J, Knox J, Meanley S, Yang C, Lounsbury DW, Huang TT, Bauermeister J, Gonzalez-Hernandez G, Frye V, Grov C, Patel V, Baral SD, Sullivan PS, Schwartz SR. Explorations of the Role of Digital Technology in HIV-Related Implementation Research: Case Comparisons of Five Ending the HIV Epidemic Supplement Awards. J Acquir Immune Defic Syndr 2022; 90:S226-S234. [PMID: 35703775 PMCID: PMC9204781 DOI: 10.1097/qai.0000000000002983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 02/22/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The use of digital technology in HIV-related interventions and implementation strategies is increasing. Whether the use of technology is to directly improve patient outcomes (ie, part of the intervention) or as part of the strategy to implement interventions has important implications. In this article, we present 5 case studies of projects that feature the use of technology in HIV-related implementation research to identify and describe challenges specific to technology-based implementation research about study design, outcome measurement, implementing in an evolving technology landscape, and equity. METHODS For each case study, we identified the technological components, classified the components as intervention or implementation strategy, and identified implications for measuring performance and ensuring equity. The Exploration, Preparation, Implementation, and Sustainment framework was used to identify the research stage of each project. RESULTS Technology is being leveraged across a diverse array of implementation strategies to promote Ending the HIV Epidemic in the United States. The case studies were primarily in the exploration and preparation phases of implementation, yet technology played a different role in each project- developing educational materials, mass media to recruit participants or distribute evidence-based campaigns, providing training, guiding tailoring, and implementing novel methods to democratize intervention development. DISCUSSION Technology can play multiple roles in HIV-related implementation research projects, including serving as the intervention, being leveraged within implementation strategies, or both. We identified multiple considerations across projects that should be taken into account when measuring success and planning for equitable and sustained impact.
Collapse
Affiliation(s)
- Jeb Jones
- Department of Epidemiology, Emory University
| | - Justin Knox
- Department of Psychiatry, Columbia University Irving Medical Center
| | - Steven Meanley
- Department of Family and Community Health, University of Pennsylvania School of Nursing
| | - Cui Yang
- Department of Health, Behavior and Society, Johns Hopkins School of Public Health
| | - David W Lounsbury
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine
| | - Terry T Huang
- Center for Systems and Community Design, Graduate School of Public Health and Health Policy, City University of New York
| | - Jose Bauermeister
- Department of Family and Community Health, University of Pennsylvania School of Nursing
| | | | | | - Christian Grov
- Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy, City University of New York
| | - Viraj Patel
- Department of Medicine, Division of General Internal Medicine, Montefiore Health System
| | - Stefan D Baral
- Department of Epidemiology, Johns Hopkins School of Public Health
| | | | | |
Collapse
|
6
|
Chandler R, Ross H, Guillaume D. Innovative perception analysis of HIV prevention messaging for black women in college: a proof of concept study. BMC Public Health 2022; 22:1255. [PMID: 35752799 PMCID: PMC9233782 DOI: 10.1186/s12889-022-13564-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 06/01/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Black women in college are disproportionately affected by HIV, but have not been a population of focus for HIV prevention campaigns. This study used content from a preexisting HIV media campaign to assess its relevancy and acceptability among Black women in college. METHODS Media viewing and listening sessions were convened with Black women enrolled at an HBCU (n = 10) using perception analyzer technology-hardware and software tools that are calibrated to gather and interpret continuous, in-the-moment feedback. Matched pre-and-post-test responses from focus groups were obtained from the perception analyzer data. Descriptive statistics and t-tests were used to characterize the data. RESULTS Students were more likely to personally identify with media content that included profound statements, along with memorable people and actors [95% CI: 1.38, 2.27]. In over half of the vignettes, participants reported that content representing students' society, culture, or interests was missing. CONCLUSIONS HIV prevention media campaigns may offer potential in increasing HIV awareness and risk perceptions; further research is needed to evaluate optimal content tailoring for both cultural and climate relevancy.
Collapse
Affiliation(s)
- Rasheeta Chandler
- grid.189967.80000 0001 0941 6502Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA USA
| | - Henry Ross
- grid.16416.340000 0004 1936 9174Center for Community Practice, University of Rochester, Rochester, NY USA
| | - Dominique Guillaume
- grid.189967.80000 0001 0941 6502Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA USA ,grid.21107.350000 0001 2171 9311School of Nursing, Johns Hopkins University, Baltimore, MD USA
| |
Collapse
|
7
|
Perry EW, Culbreth R, Self-Brown S, Gilmore AK, Kasirye R, Musuya T, Ndetei D, Swahn MH. Violence Exposure, Self-Reported Mental Health Concerns and Use of Alcohol and Drugs for Coping among Youth in the Slums of Kampala, Uganda. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2022; 53:83-110. [PMID: 38577222 PMCID: PMC10989775 DOI: 10.1080/00207411.2022.2073755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study aimed to a) compute the prevalence of violence exposure types, polyvictimization, and self-reported depression, anxiety, and using substances to cope among youth ages 12 to 18 years living on the streets or in the slums of Kampala, Uganda, (b) examine the independent associations among orphan status, violence exposure types, and self-reported mental health concerns, and c) explore the association between polyvictimization and mental health concerns. Data are from a 2014 cross-sectional survey of service-seeking youth ages 12 to 18 years (N = 1134) in Kampala, Uganda. Violence exposure types explored in this study were: witnessing family physical violence, direct physical abuse by a parent, any rape history, and physical dating violence. We used descriptive statistics and multivariable logistic regression to test study objectives. Over half of the sample (60.5%) reported experiencing at least one type of violence exposure; many youth endorsed self-reported depression (57.8%), anxiety (76.8%), and substance use to cope (37.0%). Exposure to violence was associated with higher odds for self-reported depression, anxiety, and using substances to cope. These findings underscore the urgent need to implement evidence-based interventions among this young, underserved population and their families to prevent violence, improve mental health outcomes, and promote resilience.
Collapse
Affiliation(s)
| | - Rachel Culbreth
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA USA
| | | | - Amanda K Gilmore
- School of Public Health, National Center for Sexual Violence Prevention, Georgia State University, Atlanta, GA USA
| | | | - Tina Musuya
- Center for Domestic Violence Prevention, Kampala, Uganda
| | - David Ndetei
- Department of Psychiatry, University of Nairobi, Africa Mental Health Foundation, Nairobi, Kenya
| | - Monica H Swahn
- Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA USA, School of Public Health, Georgia State University, Atlanta, GA USA
| |
Collapse
|
8
|
Ligo VAC, Chang CM, Yi H. Contested solidarity and vulnerability in social media-based public responses to COVID-19 policies of mobility restrictions in Singapore: a qualitative analysis of temporal evolution. BMC Public Health 2021; 21:2232. [PMID: 34879835 PMCID: PMC8652376 DOI: 10.1186/s12889-021-12316-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 11/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mobility restriction is the most effective measure to control the spread of infectious disease at its early stage, especially if a cure and vaccine are not available. When control of the coronavirus disease 2019 (COVID-19) required strong precautionary measures, lockdowns were necessarily implemented in countries around the globe. Public health risk communication about the justification and scope of a lockdown was challenging as it involved a conflict between solidarity and individual liberty and a trade-off between various values across groups with different socioeconomic statuses. In the study, we examined public responses to the government-announced "circuit breaker" (a local term for lockdown) at four-time points in Singapore: (1) entry, (2) extension, (3) exit of lockdown 'phase 1' and (4) entry of lockdown 'phase 2'. METHODS We randomly collected 100 comments from the relevant articles on new organisations' Facebook and Instagram pages and conducted preliminary coding. Later, additional random 20 comments were collected to check the data saturation. Content analysis was focused on identifying themes that emerged from the responses across the four-time points. RESULTS At the entry, public support for the lockdown was prevalent; yet most responses were abstract with uncertainty. At six weeks of lockdown, initial public responses with uncertainty turned into salient narratives of their lived experiences and hardship with lockdown and unmasking of societal weaknesses caused by COVID-19. At the entry to phase 2, responses were centred on social-economic impact, disparity, and lockdown burnout with the contested notion of continuing solidarity. A temporal pattern was seen in the rationalisation of the lockdown experience from trust, anxiety, attribution of pandemic and lockdown, blaming of non-compliant behaviours, and confusion. CONCLUSIONS The findings indicated a temporal evolution of public responses from solidarity, attribution of the sustained pandemic, increasing ambiguity towards strong precautionary measures, concerns about economic hardship and mental well-being to worsened social vulnerability, where the government's restrictive policies were questioned with anxiety and confusion. Public health risk communication in response to COVID-19 should be transparent and address health equity and social justice to enhance individual and collective responsibility in protecting the public from the pandemic.
Collapse
Affiliation(s)
- Val Alvern Cueco Ligo
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Cheng Mun Chang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Huso Yi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
| |
Collapse
|
9
|
Holloway IW, Garner A, Tan D, Ochoa AM, Santos GM, Howell S. Associations Between Physical Distancing and Mental Health, Sexual Health and Technology Use Among Gay, Bisexual and Other Men Who Have Sex With Men During the COVID-19 Pandemic. JOURNAL OF HOMOSEXUALITY 2021; 68:692-708. [PMID: 33528316 DOI: 10.1080/00918369.2020.1868191] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Physical distancing measures, designed to limit the spread of COVID-19, have been implemented globally. We sought to understand how physical distancing impacts gay, bisexual and other men who have sex with men (GBMSM), a group disproportionately affected by poor health outcomes. A cross-sectional online survey on Hornet, a networking application (N = 10,079), measured sociodemographics, physical distancing, mental health outcomes, and sexual behavior. Nearly two-thirds of participants (63%) reported only leaving their home for essentials. Those who practiced physical distancing were more likely to feel anxious (aOR = 1.37), feel lonely (aOR = 1.36), to report their sex life being impacted (aOR = 2.95), and less likely to be satisfied with their current sex life (aOR = 0.76). Those who practiced physical distancing were more likely to use social technologies to stay in touch with others. Risk reduction and telehealth opportunities may alleviate health challenges for GBMSM in the COVID-19 era.
Collapse
Affiliation(s)
- Ian W Holloway
- Department of Social Welfare, UCLA Luskin School of Public Affairs , Los Angeles, California, USA
- Gay Sexuality and Social Policy Initiative, UCLA Luskin School of Public Affairs , Los Angeles, California, USA
| | - Alex Garner
- Gay Sexuality and Social Policy Initiative, UCLA Luskin School of Public Affairs , Los Angeles, California, USA
- Hornet Social Network , Los Angeles, California, USA
| | - Diane Tan
- Department of Health Policy and Management, UCLA Fielding School of Public Health , Los Angeles, California, USA
| | - Ayako Miyashita Ochoa
- Department of Social Welfare, UCLA Luskin School of Public Affairs , Los Angeles, California, USA
| | - Glen Milo Santos
- Community Health Systems Department, University of California San Francisco , San Francisco, California, USA
- San Francisco Department of Public Health, Center of Public Health Research , San Francisco, California, USA
| | - Sean Howell
- LGBT Foundation , San Francisco, California, USA
| |
Collapse
|
10
|
Diress GA, Ahmed M, Linger M. Factors associated with discriminatory attitudes towards people living with HIV among adult population in Ethiopia: analysis on Ethiopian demographic and health survey. SAHARA J 2020; 17:38-44. [PMID: 33357027 PMCID: PMC7759280 DOI: 10.1080/17290376.2020.1857300] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Extensive discriminatory attitudes in a population can affect people’s willingness to be tested for Human Immunodeficiency Virus (HIV), their initiation of antiretroviral therapy, social support as well as the quality of life of people infected with HIV. This study aimed to assess factors associated with discriminatory attitudes towards people living with HIV/AIDS (PLWHA). Secondary data analysis was conducted using data from the 2016 Ethiopia Demographic Health Survey. A total of 26,623 adult populations were included. Multivariable logistic regression analysis was conducted to identify factors associated with discriminatory attitudes. The proportion of participants having discriminatory attitudes towards PLWHA was 93.8% among men and 64.5% among women. This study revealed that rural residence, no formal education, lack of media access, not previously tested for HIV and lack of comprehensive HIV knowledge increase the odds of having discriminatory attitudes. In conclusion, there is a high-level discriminatory attitude towards PLWHA. Improvement in HIV-related knowledge and dealing with wrong perceptions and myths are extremely vital to reduce discriminatory attitudes towards HIV-infected people. Information, education and communication programmes need to intensify its educational campaigns to dispel these misconceptions.
Collapse
Affiliation(s)
- Gedefaw Alen Diress
- Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Mohammed Ahmed
- Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Melese Linger
- Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| |
Collapse
|
11
|
Perry EW, Culbreth R, Swahn M, Kasirye R, Self-Brown S. Psychological Distress Among Orphaned Youth and Youth Reporting Sexual Exploitation in Kampala, Uganda. CHILDREN AND YOUTH SERVICES REVIEW 2020; 119:105587. [PMID: 33363296 PMCID: PMC7755130 DOI: 10.1016/j.childyouth.2020.105587] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Psychological distress is a priority health issue in low- and middle-income countries; however, it is inadequately addressed among vulnerable youth living in extremely underserved communities (i.e., on the streets and in the slums) who are at a high risk of experiencing adversity. The purpose of this study was to compute the prevalence of self-reported psychological distress among youth living in the slums of Kampala, Uganda, and examine how orphan status and commercial sexual exploitation (CSE) are related to youth psychological distress. Analyses are based on a 2014 cross-sectional survey of service-seeking youth (N = 1134) in Kampala, Uganda. Bivariate and multivariable multinomial regression analyses were used to determine associations between orphan status, sexual exploitation, and psychological distress (defined as experiencing the following proxy variables for more complex psychopathology: hopelessness and/or worry). Among all youth participants, 83.2% (n = 937) reported at least one type of psychological distress; 51.3% (n = 578) reported experiencing both types. The reported prevalence of any type of psychological distress was highest among youth who reported experiencing sexual exploitation (91.2%), double orphans (90.0%), and single orphans (83.8%); however, a high prevalence (76.7%) of any type of distress was also found among youth who reported both parents alive. Experiencing both types of distress was associated with being a double orphan (adjusted odds ratio [AOR] = 2.92, 95% confidence interval [CI] = [1.77, 4.81]), reporting CSE (AOR = 2.71, 95% CI = [1.67, 4.41]), and increased age (AOR = 1.31, 95% CI = [1.20, 1.44]). Psychological distress is prevalent among all youth living in the slums of Kampala and is independently associated with being a double orphan and experiencing CSE. These findings underscore the urgent need to intervene with all youth who reside in this particular underserved community, especially those who have lost both parents, and to prevent CSE among this vulnerable, underserved population.
Collapse
Affiliation(s)
| | - Rachel Culbreth
- Department of Respiratory Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA, USA
| | - Monica Swahn
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | | | | |
Collapse
|
12
|
Haas SM, Perazzo JD, Ruffner AH, Lyons MS. Exploring Current Stereotypes and Norms Impacting Sexual Partner HIV-Status Communication. HEALTH COMMUNICATION 2020; 35:1376-1385. [PMID: 31257927 DOI: 10.1080/10410236.2019.1636340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study sought to explore HIV-related stereotypes and norms that impact HIV-status communication with potential sexual partners. A series of focus groups and in-depth interviews were conducted (N = 59) with HIV-positive and HIV-negative MSM (75%) and Heterosexuals (25%). Findings indicate that HIV stereotypes and stigma remain as barriers to HIV-status discussion. Differences also emerged across groups: 1) HIV-negative MSM were more likely to report engaging in HIV-status communication, 2) HIV-positive MSM described inconsistent HIV-status communication and reported concealing their status at times, and 3) Heterosexuals reported being least likely to engage in HIV-status communication; often using the blanket question "Are you clean?" to encompass all STIs and avoiding direct HIV-status discussion. Overall, findings indicate that many HIV stereotypes and stigma-related communication norms persist that discourage discussion of sexual partners' HIV-status prior to sexual activity.
Collapse
|
13
|
Kerr J, Ayangeakaa S, Combs R, Harris L, Sears J, Northington T, Burton K, Sterrett-Hong E, Parker K, Krigger K. Community-Informed Development of a Campaign to Increase HIV Pre-exposure Prophylaxis (PrEP) Awareness Among African-American Young Adults. J Racial Ethn Health Disparities 2020; 8:901-911. [PMID: 32869211 DOI: 10.1007/s40615-020-00848-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
Abstract
Pre-exposure prophylaxis (PrEP) for HIV prevention can help reduce racial/ethnic HIV disparities in the USA. However, the benefits of PrEP have not been equally distributed across races. Community-informed, culturally tailored media has the potential to increase PrEP awareness and acceptability among vulnerable African-American populations. More research is needed to identify media preferences around PrEP for these groups in order to optimize effectiveness of health messaging. This study details the development of a community-informed multimedia (print, digital, Internet radio, website, social media) campaign to increase PrEP awareness among African-American young adults (age 18-29 years). Eleven focus groups with African-American young adults and a community advisory board informed the intervention. Focus group participants expressed concerns with PrEP safety, efficacy, accessibility, the universality of HIV vulnerability, and representation. Campaign elements were then developed based on this feedback. Future studies should examine the effectiveness of culturally tailored multimedia PrEP campaigns.
Collapse
Affiliation(s)
- Jelani Kerr
- Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA.
| | - Suur Ayangeakaa
- Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA
| | - Ryan Combs
- Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA
| | - Lesley Harris
- Kent School of Social Work, University of Louisville, Louisville, KY, USA
| | - Jeanelle Sears
- Department of Human Services, Bowling Green State University, Bowling Green, OH, USA
| | | | - Kelsey Burton
- Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA
| | - Emma Sterrett-Hong
- Kent School of Social Work, University of Louisville, Louisville, KY, USA
| | | | - Karen Krigger
- School of Medicine, University of Louisville, Louisville, KY, USA
| |
Collapse
|
14
|
Karlsson CJ, Rowlett J. Decisions and disease: a mechanism for the evolution of cooperation. Sci Rep 2020; 10:13113. [PMID: 32753581 PMCID: PMC7403384 DOI: 10.1038/s41598-020-69546-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/13/2020] [Indexed: 01/01/2023] Open
Abstract
In numerous contexts, individuals may decide whether they take actions to mitigate the spread of disease, or not. Mitigating the spread of disease requires an individual to change their routine behaviours to benefit others, resulting in a 'disease dilemma' similar to the seminal prisoner's dilemma. In the classical prisoner's dilemma, evolutionary game dynamics predict that all individuals evolve to 'defect.' We have discovered that when the rate of cooperation within a population is directly linked to the rate of spread of the disease, cooperation evolves under certain conditions. For diseases which do not confer immunity to recovered individuals, if the time scale at which individuals receive accurate information regarding the disease is sufficiently rapid compared to the time scale at which the disease spreads, then cooperation emerges. Moreover, in the limit as mitigation measures become increasingly effective, the disease can be controlled; the number of infections tends to zero. It has been suggested that disease spreading models may also describe social and group dynamics, indicating that this mechanism for the evolution of cooperation may also apply in those contexts.
Collapse
Affiliation(s)
- Carl-Joar Karlsson
- Department of Mathematical Sciences, Chalmers University of Technology and The University of Gothenburg, 41296, Gothenburg, Sweden
| | - Julie Rowlett
- Department of Mathematical Sciences, Chalmers University of Technology and The University of Gothenburg, 41296, Gothenburg, Sweden.
| |
Collapse
|
15
|
Zullig KJ, Valois RF, Hobbs GR, Romer D, Brown LK, DiClemente RJ, Vanable PA. Does Initiating Vaginal Sexual Intercourse During a Safer Sex Media Campaign Influence Life Satisfaction Among African American Adolescents? J Adolesc Health 2020; 67:40-45. [PMID: 31771924 DOI: 10.1016/j.jadohealth.2019.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 09/03/2019] [Accepted: 09/03/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE Addressing adolescent sexual risk behaviors in the STI/HIV prevention literature is well documented; however, intervention impacts on life satisfaction are relatively unexplored. This study is a secondary analysis of data (N = 1,658) from a randomized, multisite, multilevel safer sex media campaign (Project iMPPACS) analyzing life satisfaction across baseline and follow-up data collected from 2006 to 2008 among participants (mean age 15.08 years) who reported never having had vaginal sex at baseline (n = 787). METHODS Participants were separated into groups based on whether they reported having vaginal sex (yes/no) at baseline. Then taking into account the nested study design and controlling for confounders, a mixed model repeated measures analysis of variance assessed whether differences in mean total life satisfaction (LS) were associated across time in the media and nonmedia study conditions separately by gender. RESULTS A significant interaction between time and media condition was detected (p = .039) where mean total LS increased +.065 units from baseline (M = 5.364) to last contact in media cities and decreased -.084 units from baseline (M = 5.557) to last contact in nonmedia cities when controlling for the effect of initiating vaginal sex. No significant differences in LS at baseline were observed between media and nonmedia intervention cities. Results by gender suggest most positive change in LS was observed for females with mixed findings for males. CONCLUSIONS Although Project iMPPACS was not designed with the intent on improving participants' life satisfaction, results advance the LS literature by demonstrating a temporal sequence for sexual risk taking and LS over time.
Collapse
Affiliation(s)
- Keith J Zullig
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, West Virginia.
| | - Robert F Valois
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, Columbia, South Carolina
| | - Gerald R Hobbs
- Department of Statistics, West Virginia University, Morgantown, West Virginia
| | - Daniel Romer
- Adolescent Communication Institute, Public Policy Center, Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Larry K Brown
- The Centers for Behavioral & Preventive Medicine, The Miriam Hospital and Brown University, Providence, Rhode Island
| | - Ralph J DiClemente
- Department of Social & Behavioral Sciences, College of Global Public Health, New York University, New York, New York
| | - Peter A Vanable
- Department of Psychology, Center for Health & Behavior, Syracuse University, Syracuse, New York
| |
Collapse
|
16
|
Get Yourself Tested Goes to High School: Adapted Sexually Transmitted Disease Prevention Campaign and Associated Student Use of Clinic Sexually Transmitted Disease Testing Services. Sex Transm Dis 2020; 46:383-388. [PMID: 31095101 DOI: 10.1097/olq.0000000000000983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND In an attempt to increase high school students' sexually transmitted disease (STD) testing rates, the Centers for Disease Control and Prevention's Division of Adolescent and School Health partnered with ICF and Chicago Public Schools to adapt and implement the "GYT: Get Yourself Tested" health marketing campaign for a high school. METHODS Clinic record data and student retrospective self-report surveys (n = 193) tested for differences between the GYT intervention school and a comparison school on a number of outcomes, including human immunodeficiency virus and STD testing. RESULTS Clinic record data showed that testing increased significantly more for the intervention than the comparison school during the GYT implementation period (B, 2.9; SE, 1.1, P < 0.05). Furthermore, the odds of being tested at the referral clinic were more than 4 times (odds ratio, 4.4) as high for students in the campaign school than for those in the comparison school (95% confidence interval, 2.3-8.2). Survey data did not show increased self-reported testing but, more students in the GYT school (92.7%) were aware of where to receive free, low-cost, or affordable human immunodeficiency virus and STD testing than students in the comparison school (76.0%; P < 0.01). Among sexually experienced students (n = 142), significantly more from the campaign school reported that they intended to test for STDs in the next 3 months (48.4% strongly agree and 33.2% agree) compared with those at the comparison school (27.4% strongly agree and 32.9% agree; P < 0.05). CONCLUSIONS Our pilot suggests that a student-led GYT campaign in high schools may successfully increase STD testing of students. Although some of the findings from this pilot evaluation are promising, they are limited, and broader implementation and evaluation is needed. Future evaluation efforts can include more rigorous study designs, multiple schools or districts, longer campaign and evaluation across an entire school or calendar year, or in combination with other school-based testing strategies like a mass school-based screening event.
Collapse
|
17
|
Valois RF, Kerr JC, Carey MP, Brown LK, Romer D, DiClemente RJ, Vanable PA. Neighborhood Stress and Life Satisfaction: Is there a Relationship for African American Adolescents? APPLIED RESEARCH IN QUALITY OF LIFE 2020; 15:273-296. [PMID: 32042351 PMCID: PMC7009313 DOI: 10.1007/s11482-018-9679-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 11/09/2018] [Indexed: 06/10/2023]
Abstract
This study identified associations between perceived neighborhood stress and adolescents' perceptions of life satisfaction. African American adolescents aged 13-18 (n=1,658) from four matched, mid-sized cities in the northeastern and southeastern USA, completed a self-report questionnaire using an audio computer-assisted self-interview (ACASI). Analyses examined relationships between perceived neighborhood stress and perceived life satisfaction, while controlling for socioeconomic status (SES). Life satisfaction was found to be related to neighborhood stress for both males and females, with variability in neighborhood stress characteristics and in the magnitude of associations by gender. Further research should identify the particular characteristics of youth and specific aspects of adolescent life satisfaction associated with perceived neighborhood stress to develop community-based and culturally-sensitive quality of life improvement/health promotion programs.
Collapse
Affiliation(s)
- Robert F Valois
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, Department of Family & Preventive Medicine, School of Medicine, University of South Carolina, Columbia, SC 29208 USA 803-917-5844 or 803-781-8302
| | - Jelani C Kerr
- Department of Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY 40202
| | - Michael P Carey
- Miriam Hospital and Brown University, Centers for Behavioral & Preventive Medicine, Providence, RI, 02903 USA
| | - Larry K Brown
- Miriam Hospital and Brown University, Centers for Behavioral & Preventive Medicine, Providence, RI, 02903 USA
| | - Daniel Romer
- Adolescent Communication Institute, Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Ralph J DiClemente
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY 10003 USA
| | - Peter A Vanable
- Department of Psychology, Center for Health and Behavior, Syracuse University, Syracuse, NY 13244 USA
| |
Collapse
|
18
|
Rouffiac AE, Whiteley L, Brown L, Mena L, Craker L, Healy M, Haubrick K. A Mobile Intervention to Improve Uptake of Pre-Exposure Prophylaxis for Southern Black Men Who Have Sex With Men: Protocol for Intervention Development and Pilot Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e15781. [PMID: 32130196 PMCID: PMC7059079 DOI: 10.2196/15781] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/22/2019] [Accepted: 11/22/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The uptake of pre-exposure prophylaxis (PrEP) has been slow for young black men who have sex with men (BMSM) living in the southern United States. This is a significant issue because 8 of the 10 states with the highest rates of new HIV infections are in the South. Jackson, Mississippi (MS), the site of this project, has the second highest AIDS diagnosis rate in the nation and the highest rate of HIV infection for young, urban BMSM. This study will develop and test an engaging, interactive, and cost-effective mobile messaging intervention to improve engagement in PrEP care for BMSM aged 18 to 35 years living in Jackson, MS. OBJECTIVE The goals of this mixed methods study are to (1) conduct qualitative interviews with young BMSM in Jackson, MS, to understand individual, community, and structural barriers affecting engagement in PrEP-related care, (2) assemble a PrEP mobile messaging intervention that includes text messages with publicly available internet content (websites and YouTube videos) that provide factual information, motivational materials, and behavioral skills related to PrEP and HIV prevention, and (3) evaluate the preliminary efficacy of the intervention in a randomized controlled study with PrEP-eligible BMSM receiving care in STI/HIV testing clinics in Jackson, MS. METHODS This research protocol will be conducted in 2 phases. A development phase will involve in-depth interviews (n=30) with PrEP-eligible BMSM who receive care in STI/HIV testing clinics in MS. These interviews will allow researchers to select the texted material that will be sent out during the intervention. The second phase will consist of an unblinded, small, randomized controlled trial among 66 new participants to examine the preliminary efficacy of the intervention compared with enhanced standard of care (ESC) on attendance at a PrEP services appointment (the first step in initiating PrEP care) and receipt of a PrEP prescription, based on self-report and electronic medical records. The free, publicly available material will be sent to PrEP-eligible BMSM in 8 to 16 interactive text messages over 4 weeks. Study assessments will occur at enrollment and at 4- and 16-weeks postenrollment and can be completed online or in person. All participants will be recruited from a local clinic. RESULTS Institutional review board approval was received on January 16, 2017, and research activities, subsequently, began in February 2018. Recruitment for the study concluded in November 2019. In total, 65 participants were randomized with 33 being assigned to the intervention and 32 to ESC. Collection of follow-up data is ongoing. CONCLUSIONS This PrEP mobile messaging intervention aims to increase uptake of PrEP by BMSM in the southern United States. This intervention uses interactive, tailored text messaging and appealing free Web content (publicly accessible educational websites and YouTube videos) to promote linkage to PrEP care and increase HIV preventative behaviors. A cost-effective PrEP mobile messaging intervention has great potential to improve information about PrEP, improve motivation to use PrEP, and decrease stigma and structural barriers that often prevent engagement in PrEP-related medical care. TRIAL REGISTRATION ClinicalTrials.gov NCT03308097; https://clinicaltrials.gov/ct2/show/NCT03308097. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/15781.
Collapse
Affiliation(s)
- Anne-Emilie Rouffiac
- Young Adult Behavioral Health Program, Rhode Island Hospital, Providence, RI, United States
| | - Laura Whiteley
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Larry Brown
- Young Adult Behavioral Health Program, Rhode Island Hospital, Providence, RI, United States
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Leandro Mena
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, MS, United States
- Division of Infectious Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, United States
| | - Lacey Craker
- Young Adult Behavioral Health Program, Rhode Island Hospital, Providence, RI, United States
| | - Meredith Healy
- Young Adult Behavioral Health Program, Rhode Island Hospital, Providence, RI, United States
| | - Kayla Haubrick
- Young Adult Behavioral Health Program, Rhode Island Hospital, Providence, RI, United States
| |
Collapse
|
19
|
Zullig KJ, Valois RF, Hobbs GR, Kerr JC, Romer D, Carey MP, Brown LK, DiClemente RJ, Vanable PA. Can a Multilevel STI/HIV Prevention Strategy for High Risk African American Adolescents Improve Life Satisfaction? JOURNAL OF HAPPINESS STUDIES 2020; 21:417-436. [PMID: 33828410 PMCID: PMC8023228 DOI: 10.1007/s10902-019-00084-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Addressing adolescent sexual risk behaviors in the STI/HIV prevention literature is well documented; however, impacts from interventions on life satisfaction are relatively unexplored. This study examined data (n = 1658) from a randomized, multi-site, multi-level STI/HIV prevention intervention trial (Project iMPAACS) to determine whether increased protective and reduced sexual risk-taking behaviors associated with STI/HIV would also improve self-reported life satisfaction. Taking into account the nested study design and controlling for confounders, a mixed model ANOVA was performed where Total mean life satisfaction scores were analyzed at baseline and 3, 6, 12, and 18 months post-recruitment. Significance levels of 0.05 were used to determine significance and η 2 was used to assess effect size. We hypothesized that as intervention participants engaged in the intentional activity associated with increasing protective behaviors and reducing sexual risk-taking behaviors associated with STI/HIV, life satisfaction reports would also improve over the course of the intervention. A significant main effect for sex was detected (F = 5.19, p = .02, η 2 = .03), along with three interactions: between experimental condition and media intervention (F = 7.96, p = .005, η 2= .04); experimental condition, sex, and media intervention (F = 6.51, p = .01, η 2 = .04); and experimental condition, sex, assessment point, and media intervention (F = 3.23, p = .01, η 2 = .02). With the exception of the control condition, female life satisfaction reports improved from baseline assessments to 18-months post-recruitment, whereas male reports decreased. Project iMPPACS was not designed with the intent on improving participants' life satisfaction. However, study results suggest incorporating strategies to address subjective well-being into future adolescent STI/HIV risk-reduction interventions is beneficial for females and additional research is necessary for males.
Collapse
Affiliation(s)
- Keith J. Zullig
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 9190-26506, USA
| | - Robert F. Valois
- Department of Health Promotion, Education and Behavior, Department of Family and Preventive Medicine, Schools of Public Health and Medicine, University of South Carolina, Columbia, SC 29208, USA
| | - Gerald R. Hobbs
- Department of Statistics, West Virginia University, Morgantown, WV 26506, USA
| | - Jelani C. Kerr
- Department of Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY 40202, USA
| | - Daniel Romer
- Public Policy Center, Annenberg School for Communication, Adolescent Communication Institute, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael P. Carey
- The Centers for Behavioral and Preventive Medicine, The Miriam Hospital and Brown University, Providence, RI, USA
| | - Larry K. Brown
- The Centers for Behavioral and Preventive Medicine, The Miriam Hospital and Brown University, Providence, RI, USA
| | - Ralph J. DiClemente
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY 10012, USA
| | - Peter A. Vanable
- Department of Psychology, Center for Health and Behavior, Syracuse University, Syracuse, NY, USA
| |
Collapse
|
20
|
Kerr J, Harris L, Glass E, Golden T, Crawford T. "I Shall Live and Not Die": Using Monologues Based on the Experiences of Older African Americans Living With HIV to Address HIV-Related Stigma Among African Americans in Louisville, Kentucky. FAMILY & COMMUNITY HEALTH 2020; 43:257-263. [PMID: 32658028 DOI: 10.1097/fch.0000000000000268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Remediating racial/ethnic HIV inequities necessitates addressing HIV-related stigma. Arts- and media-based approaches demonstrate potential for effective knowledge translation and HIV-related stigma reduction. This study employs 5 monologues portraying lived experiences of older African Americans living with HIV to do this. Monologues were developed on the basis of qualitative research, actors performed them for live and online audiences, and surveys were distributed to gauge their potential for raising awareness about HIV-related stressors, reducing HIV-related stigma, and entertainment value. Monologues may also foster HIV testing. More scholarship should integrate arts-based knowledge translation with HIV education. Future efforts should focus on scaling this approach.
Collapse
Affiliation(s)
- Jelani Kerr
- Department of Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences (Drs Kerr and Golden), Kent School of Social Work (Dr Harris), and Department of Comparative Humanities, School of Arts of Sciences (Ms Glass), University of Louisville, Louisville, Kentucky; and Department of Population and Public Health Sciences, Boonshoft School of Medicine, Wright State University, Dayton, Ohio (Dr Crawford)
| | | | | | | | | |
Collapse
|
21
|
Ransome Y, Bogart LM, Kawachi I, Kaplan A, Mayer KH, Ojikutu B. Area-level HIV risk and socioeconomic factors associated with willingness to use PrEP among Black people in the U.S. South. Ann Epidemiol 2019; 42:33-41. [PMID: 31899083 PMCID: PMC7056502 DOI: 10.1016/j.annepidem.2019.11.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/25/2019] [Accepted: 11/28/2019] [Indexed: 02/02/2023]
Abstract
Purpose: In the United States (U.S.), southern states have the highest HIV incidence. Uptake of pre-exposure prophylaxis (PrEP) has been slow among Black people, particularly in the South. We know little about how area-level HIV risk influences one's willingness to use PrEP. Methods: 169 Black participants across 142 ZIP codes in the South completed the 2016 National Survey on HIV in the Black Community. We performed log-binomial regression to estimate the prevalence risk associated with residing in the upper 25th percentile of increases in new HIV diagnosis (2014–2015) within ZIP code and an individual's willingness to use PrEP, adjusting for individual and area-level covariates. Results: Participants were 68% female, mean age of 36 years, and 24% willing to use PrEP. Among the ZIP codes, 23% were within Atlanta, GA. The median increase in new HIV diagnoses was 25 per 100,000 population from 2014 to 2015 (IQR, 14–49). Participants living in ZIP codes within the upper 25th (compared-to-lower 75th) percentile of new HIV diagnoses were more willing to use PrEP (adjusted prevalence ratio (aPR) = 2.02, 95% CI = 1.06–3.86, P = .03). Area-level socioeconomic factors attenuated that association (aPR = 1.63, 95% CI = 0.78–3.39, P = .19). Conclusions: Area-level factors may influence PrEP uptake among Black people in the South.
Collapse
Affiliation(s)
- Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT.
| | - Laura M Bogart
- Pardee RAND Graduate School, RAND Corporation, Santa Monica, CA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Anna Kaplan
- Cambridge Public Health Department, Cambridge, MA
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, MA; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Boston, MA
| | - Bisola Ojikutu
- Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA
| |
Collapse
|
22
|
Rogers BG, Whiteley L, Haubrick KK, Mena LA, Brown LK. Intervention Messaging About Pre-Exposure Prophylaxis Use Among Young, Black Sexual Minority Men. AIDS Patient Care STDS 2019; 33:473-481. [PMID: 31682168 DOI: 10.1089/apc.2019.0139] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Approximately 1.1 million individuals in the United States are living with HIV/AIDS. HIV disproportionately affects young, black men who have sex with men (YBMSM). Recent biomedical advances, including the use of antiretroviral therapy as pre-exposure prophylaxis (PrEP), hold promise for preventing HIV infections. However, PrEP uptake remains slow among those most at-risk. To develop and test an intervention to address HIV disparities in YBMSM, we conducted qualitative interviews with 29 YBMSM from Jackson, Mississippi, to learn more about their views of PrEP. Twenty-nine PrEP-eligible YBMSM were enrolled and participated in either semistructured interviews or focus groups. They were asked about PrEP use, messaging, and promotion. Data were coded based on an iteratively developed coding scheme and entered into NVivo to facilitate thematic analysis. Our analysis identified the following three main themes: (1) the role of setting, context, and stigma in health care, (2) targeted PrEP messaging is further stigmatizing, and (3) recommendations for PrEP messaging and care. YBMSM in our sample felt highly stigmatized in their current environment and felt that PrEP messaging targeting YBMSM only enhanced their sense of marginalization. They concluded that broad and inclusive messaging would be just as relevant and cause less stigma. Our findings were somewhat surprising, as several prior studies benefited from using targeted materials to engage YBMSM in HIV prevention and PrEP uptake. The study's location may explain this difference in findings, which suggests the importance of considering local conditions and opinions when developing interventions for HIV prevention among minority populations.
Collapse
Affiliation(s)
- Brooke G. Rogers
- Department of Psychiatry, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Laura Whiteley
- Department of Psychiatry, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Kayla K. Haubrick
- Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island
| | - Leandro A. Mena
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, Mississippi
- Division of Infectious Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Larry K. Brown
- Department of Psychiatry, Warren Alpert Medical School, Brown University, Providence, Rhode Island
- Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island
| |
Collapse
|
23
|
Foley JD, Vanable PA, Brown LK, Carey MP, DiClemente RJ, Romer D, Valois RF. Depressive symptoms as a longitudinal predictor of sexual risk behaviors among African-American adolescents. Health Psychol 2019; 38:1001-1009. [PMID: 31380687 PMCID: PMC6800787 DOI: 10.1037/hea0000780] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Understanding individual level factors associated with sexual risk behaviors among African-American adolescents remains an important public health priority. The current secondary data analysis examined the longitudinal association between a baseline assessment of depressive symptoms and sexual risk behaviors reported 6 months later; the purpose was to determine whether the association of depressive symptoms to risky sex varies as a function of gender. A secondary aim was to examine self-efficacy for sex refusal and condom use assessed at a 3-month follow-up as mediators of the depressive symptoms-sexual risk relationship. METHODS The sample consisted of 782 sexually active African-American adolescents (Mage = 15.3 years, SD = 1.08; 54% female) recruited to participate in a sexual health intervention trial. Data analyses focused on vaginal sex, and outcomes included: (a) sexual activity with 2 or more partners in the previous 3 months; (b) the relative frequency of condom use in the previous 3 months; (c) noncondom use at last occasion of sex; and (d) positive sexually transmitted infection (STI) screening. RESULTS Depressive symptoms predicted sex with 2 more partners for female participants, but no other risk markers for the sample as a whole. However, there was a significant indirect effect of depressive symptoms on condomless sex via decreased condom use self-efficacy for both male and female adolescents. CONCLUSIONS These findings have important implications for HIV/STI prevention, in which behavioral interventions may benefit from modules that include a focus on the influence of mood on self-efficacy for safer sex practices. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Collapse
|
24
|
Valois RF, Zullig KJ, Brown LK, Carey MP, Vanable PA, Romer D, DiClemente RJ. Is the Brief Multidimensional Student's Life Satisfaction Scale Valid and Reliable for African American Adolescents? AMERICAN JOURNAL OF HEALTH EDUCATION 2019; 50:344-355. [PMID: 32983312 PMCID: PMC7518648 DOI: 10.1080/19325037.2019.1662348] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 04/29/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Health promotion/education strive to promote healthful conditions that improve quality of life1 based on the perceptions of those whose lives are affected.2-4 Though health promotion/education might have instrumental value in reducing risks for premature morbidity and mortality, their ultimate value lies in contributions to quality of life.1 Life satisfaction (LS) has been defined as an individual's assessment of their quality of life based upon personal criteria5,6 and linked to adolescent health risk behaviors7,8 and developmental assets.9. PURPOSE We investigated the psychometrics of the Brief Multidimensional Students' Life Satisfaction Scale [BMSLSS] with an adolescent sample of African Americans (N=1,658) from four mid-sized cities in the United States (US). Reliability and validity of the BMSLSS has not been determined for samples of exclusively African American adolescents. METHODS Data analysis included calculating mean ratings, standard deviations and effect sizes (Cohen's d) and inspecting the scale's internal structure, reliability, and relationships to other variables. RESULTS Evidence of internal structure, internal consistency reliability, and hypothesized relationships to other variables for participants were determined. TRANSLATION TO HEALTH EDUCATION PRACTICE The BMSLSS is a useful indicator of LS for research and health education assessment purposes among African American adolescents where brevity of psychometric measures is imperative.
Collapse
Affiliation(s)
- Robert F Valois
- Department of Health Promotion, Education & Behavior, Department of Family & Preventive Medicine, Schools of Public Health and Medicine, University of South Carolina, Columbia, SC 29208 USA
| | - Keith J Zullig
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506 USA
| | - Larry K Brown
- Miriam Hospital and Brown University, Centers for Behavioral & Preventive Medicine, Providence, RI, 02903 USA
| | - Michael P Carey
- Miriam Hospital and Brown University, Centers for Behavioral & Preventive Medicine, Providence, RI, 02903 USA
| | - Peter A Vanable
- Department of Psychology, Center for Health and Behavior, Syracuse University, Syracuse, NY 13244 USA
| | - Daniel Romer
- Adolescent Communication Institute, Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Ralph J DiClemente
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY 10003 USA
| |
Collapse
|
25
|
Swahn MH, Culbreth R, Salazar LF, Tumwesigye NM, Kasirye R. Psychosocial correlates of self-reported HIV among youth in the slums of Kampala. BMC Public Health 2019; 19:1176. [PMID: 31455348 PMCID: PMC6712737 DOI: 10.1186/s12889-019-7480-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 08/13/2019] [Indexed: 11/10/2022] Open
Abstract
Background Human immunodeficiency virus (HIV) rates are high in Uganda (6.7%), and rates are especially high among at-risk groups such as youth living in the slums of Kampala, Uganda. The objective of this study was to assess the psychosocial correlates, particularly alcohol use, associated with HIV among youth living in the slums of Kampala, Uganda. Methods Analyses are based on cross-sectional survey data collected in Spring of 2014. Participants comprised a convenience sample (N = 1134) of urban service-seeking youth living on the streets or in the slums, 12–18 years of age who were participating in a Uganda Youth Development Link drop-in center (56.1% female and 43.9% male). Chi-Square Tests were used to determine differences in the proportions of alcohol use patterns between self-reported HIV-positive and HIV-negative youth. Bivariate and multivariable logistic regression were conducted to determine the associated risk factors with self-reported HIV. Institutional Review Board approvals were obtained from the Georgia State University and the Uganda National Council for Science and Technology. Results Among the total sample of youth (N = 1103), 10.5% (n = 116) reported being HIV-positive. There were statistically significant differences between HIV-positive and HIV-negative youth on ever living on the streets (χ2 =10.14, df = 1, p = 0.002), past 12-month alcohol use (χ2 =16.38, df = 1, p < .0001), ever having sexual intercourse (χ2 =14.52, df = 1, p = 0.0001), ever engaging in sex work (χ2 =13.19, df = 1, p = 0.0003), inconsistent condom use in the past 3 months (χ2 =5.03, df = 1, p = 0.03), and ever being raped (χ2 =15.29, df = 1, p < 0.0001). A higher percentage of HIV-positive youth were classified as problem drinkers, defined by the CAGE scores (21.6% vs. 13.9%, respectively). In the multivariable analysis, previously being raped (OR: 1.70; 95% CI: 1.02, 2.83) and alcohol use without problem drinking (OR: 2.14; 95% CI: 1.24, 3.69) was associated with HIV. Conclusion Youth living in the slums of Kampala, Uganda have a high prevalence of HIV. These youth are in dire need of interventions which address both alcohol use behaviors and sexual risk behaviors to reduce further complications of their existing health conditions, including HIV.
Collapse
Affiliation(s)
- Monica H Swahn
- Department of Population Health Sciences, School of Public Health, Georgia State University, P.O. Box 3984, Atlanta, GA, 30302-3984, USA.
| | - Rachel Culbreth
- Department of Respiratory Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, P.O. Box 3995, Atlanta, GA, 30302-3995, USA
| | - Laura F Salazar
- Department of Population Health Sciences, School of Public Health, Georgia State University, P.O. Box 3984, Atlanta, GA, 30302-3984, USA
| | - Nazarius M Tumwesigye
- Department of Epidemology and Biostatistics, School of Public Health, Makerere University, PO Box 7062, Kampala, Uganda
| | - Rogers Kasirye
- Uganda Youth Developmental Link, P.O. Box 12659, Kampala, Uganda
| |
Collapse
|
26
|
Dunne EM, Norris AL, Romer D, DiClemente RJ, Vanable PA, Valois RF, Brown LK, Carey MP. Problem Solving Reduces Sexual Risk Associated with Sensation Seeking, Substance Use, and Depressive Symptoms Among African-American Adolescents. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2019; 28:113-118. [PMID: 32952380 PMCID: PMC7500528 DOI: 10.1080/1067828x.2019.1610679] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE African-American adolescents experience higher rates of sexually transmitted infections (STIs) compared to same-age Caucasian peers. Substance use, sensation seeking, and depression have all been linked to risky sexual practices. Theory suggests that problem-solving skills may help to buffer against these risk factors. METHOD To test this hypothesis, we used data from African-American adolescents (N = 1018; M age = 16.7, SD = 1.1; 58% female) who participated in a prevention trial. RESULTS Nearly half of the sample (47%) reported lifetime marijuana use, while 13% reported drug use prior to most recent sexual encounter. Sexual sensation seeking was directly associated with drug use prior to sex (β = 1.13, b = 0.13,
SE = 0.02, p < .001) and lower problem-solving skills (β = -0.08, b = -0.06,
SE = 0.02, p = .01). Problem-solving skills were associated with drug use prior to sex (β = 0.92, b = -0.08, SE = 0.03, p = .004), such that those with greater problem-solving skills were less likely to report drug use prior to most recent sex. Lastly, problem solving skills mediated the association between sexual sensation seeking and drug use prior to sex, though the effect was small (β = 0.01, 95% CI: .001, .01). CONCLUSIONS Problem-solving skills can have a protective influence on risky behavior for adolescents. Future research might examine the utility of strengthening problem-solving skills in order to reduce STI/HIV risk among African American adolescents.
Collapse
Affiliation(s)
- Eugene M. Dunne
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
- Alpert Medical School, Brown University, Providence, RI
| | - Alyssa L. Norris
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
- Alpert Medical School, Brown University, Providence, RI
| | - Daniel Romer
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA
| | | | | | - Robert F. Valois
- Schools of Public Health and Medicine, University of South Carolina, Columbia, SC
| | | | - Michael P. Carey
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
- Alpert Medical School, Brown University, Providence, RI
- Brown University School of Public Health, Providence, RI
| |
Collapse
|
27
|
Wand H, Reddy T. Population-level impact of information sources on HIV testing uptake in South Africa: gender and age disparities. Int J STD AIDS 2019; 30:756-764. [PMID: 31072280 DOI: 10.1177/0956462419840859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In South Africa, mass media and interpersonal communication sources have been used extensively to increase awareness of human immunodeficiency virus (HIV)/AIDS. A sub-population of 10,565 black Africans who participated in the 2011–2012 household survey was analysed. Overall compared to men, a higher proportion of women had ever been tested for HIV (76% versus 60%). In age-specific analysis, men and women aged 25–49 years were more likely to be ever been tested compared to the youngest (<25 years) and the oldest age groups (50+ years). More than 80% of the study population was exposed to mass media tools, while exposure to interpersonal information sources was less common (16–72%). Among adolescents, 37% (men) and 41% (women) of the HIV tests were collectively associated with exposure to interpersonal programmes, while mass media tools had substantial contributions on HIV testing rates among the older individuals. Information sources to promote HIV/AIDS awareness should be tailored to reduce age–gender disparities.
Collapse
Affiliation(s)
- Handan Wand
- 1 Kirby Institute, University of New South Wales, Kensington, Australia
| | - Tarylee Reddy
- 2 Biostatistics Unit, South African Medical Research Council, Durban, South Africa
| |
Collapse
|
28
|
Norris AL, Brown LK, DiClemente RJ, Valois RF, Romer D, Vanable PA, Carey MP. African-American sexual minority adolescents and sexual health disparities: An exploratory cross-sectional study. J Natl Med Assoc 2018; 111:302-309. [PMID: 30514572 DOI: 10.1016/j.jnma.2018.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 11/06/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE To better understand sexual health disparities among African-American sexual minority adolescents. METHODS African-American adolescents (N = 1120; mean age = 15.24 years) were recruited from 4 cities (Columbia, SC; Macon, GA; Providence, RI; Syracuse, NY) to a larger trial. The current analyses used data from the 18-month follow-up when adolescents reported on their sexual partnerships, condom use knowledge, self-efficacy and outcome expectancies for condom use, sexual risk behavior, and STI testing history. RESULTS Compared with heterosexual adolescents, sexual minority adolescents reported more concerns about potential relationship harms resulting from safer sex negotiation. Sexual minority adolescents were also more likely to engage in riskier sexual behaviors, with females reporting more sexual partners and drug use prior to sex, and males reporting inconsistent condom use and higher rates of HIV. CONCLUSIONS African-American sexual minority adolescents evidence disparities in sexual risk behavior and STI history that appear to result from interpersonal and relationship concerns. These concerns need to be targeted in sexual health interventions for sexual minority adolescents.
Collapse
Affiliation(s)
- Alyssa L Norris
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University Providence, RI, 02912, USA; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Coro East, Suite 309, Providence, RI, 02903, USA.
| | - Larry K Brown
- Department of Psychiatry, Rhode Island Hospital, Brown University, Providence, RI, 02903, USA
| | - Ralph J DiClemente
- Department of Social & Behavioral Sciences, College of Global Public Health, New York University, New York, NY, 10012, USA
| | - Robert F Valois
- Emory Center for AIDS Research, 1518 Clifton Rd, NE, Ste 8050, Atlanta, GA, 30322, USA; Arnold School of Public Health, Discovery 534A, 915 Greene Street, University of South Carolina, Columbia, SC, 29201, USA
| | - Daniel Romer
- Annenberg Public Policy Center, 202 S. 36th ST, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Peter A Vanable
- Department of Psychology, 430 Huntington Hall, Syracuse University, Syracuse, NY, 13244, USA
| | - Michael P Carey
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University Providence, RI, 02912, USA; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Coro East, Suite 309, Providence, RI, 02903, USA; Department of Behavioral and Social Sciences, Brown University, Providence, RI, 02903, USA
| |
Collapse
|
29
|
Asamoah CK, Asamoah BO, Agardh A. A generation at risk: a cross-sectional study on HIV/AIDS knowledge, exposure to mass media, and stigmatizing behaviors among young women aged 15-24 years in Ghana. Glob Health Action 2018. [PMID: 28621223 PMCID: PMC5496072 DOI: 10.1080/16549716.2017.1331538] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
HIV/AIDS stigmatizing behaviors are a huge barrier to early detection and treatment of individuals with the AIDS virus. HIV/AIDS stigma and related consequences are debilitating, especially for vulnerable populations. This study sought to assess whether young women's HIV/AIDS knowledge levels and exposure to mass media (television and radio) have an influence on their stigmatizing behaviors and role as agents of stigma towards individuals living with HIV and AIDS. The data used for this study originated from the Ghana Multiple Indicator Cluster Survey 2011. Binary and multiple (stepwise) logistic regression analyses were used to examine the associations between HIV/AIDS knowledge, frequency of exposure to mass media, and HIV/AIDS stigmatizing behaviors among young women aged 15-24 years in Ghana. Of the 3573 young women, 80% of 15-19-year-olds and 76% of 20-24-year-olds had at least one stigmatizing behavior towards persons living with HIV/AIDS (PLHA). Young women with increased knowledge regarding HIV/AIDS and frequent exposure to mass media (television and radio) had lesser tendency to stigmatize or act as agents of stigma towards PLHA (proportion with at least one stigmatizing behavior per subgroup - HIV/AIDS knowledge: those with highest knowledge score 579 [70.1%], those with lowest knowledge score 28 [90.3%]; mass media: those with daily exposure 562 [73.4%], those not exposed at all 249 [89.2%]). There was a graded negative 'exposure-response' association between the ranked variables: HIV/AIDS knowledge, mass media, and HIV/AIDS stigmatizing behaviors. The significant inverse association between HIV/AIDS knowledge, frequency of exposure to mass media, and HIV/AIDS stigmatizing behaviors persisted even after adjusting for all other covariates in the multiple logistic regression models. It is extremely important to increase HIV/AIDS-related knowledge and reduce stigma among young women in Ghana through targeted HIV/AIDS factual knowledge transfer. The use of mass media for communication of issues regarding HIV/AIDS, its mode of transmission, and associated stigma should be emphasized among women in Ghana.
Collapse
Affiliation(s)
- Charity Konadu Asamoah
- a International Master Programme in Public Health, Faculty of Medicine , Lund University , Malmö , Sweden
| | - Benedict Oppong Asamoah
- b Social Medicine and Global Health, Department of Clinical Sciences , Lund University , Malmö , Sweden
| | - Anette Agardh
- b Social Medicine and Global Health, Department of Clinical Sciences , Lund University , Malmö , Sweden
| |
Collapse
|
30
|
Care continuum entry interventions: seek and test strategies to engage persons most impacted by HIV within the United States. AIDS 2018; 32:407-417. [PMID: 29381558 DOI: 10.1097/qad.0000000000001733] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
: The current review re-conceptualizes seek and test strategies, particularly given the changing importance of HIV testing as care continuum entry for persons irrespective of their HIV status. Care continuum entry advances previous seek and test strategies for client engagement with two next-generation functions: use of testing to engage (or re-engage) HIV negative clients in preexposure prophylaxis (PrEP) care; and testing individuals who may already be known positives for care continuum re-entry. We review existing seek and test strategies for most impacted community members with a goal of optimizing care continuum entry as we move towards HIV transmission elimination. These strategies are context, sub-group, community and epidemic-specific. This review is timely, given the initiation of routine PrEP care, which shifts and broadens our conceptualization of care continuum entry triggered by the HIV testing event. In addition, as the epidemic becomes more concentrated, focusing on re-engagement of HIV-infected persons becomes increasingly important given that transmission events involve both those acutely and newly infected as well as the large numbers who may not be virally suppressed. We start with examination of routine testing in healthcare settings, emphasizing its potential role in re-engagement for persons out of care. Subsequently, we describe risk-based testing to identify key populations. We then review network-based approaches and their impact on the epidemic. We close with future directions for individual and combination care continuum entry strategies most relevant to elimination of HIV transmission in the United States.
Collapse
|
31
|
Roberts M, Lobo R, Sorenson A. Evaluating the Sharing Stories youth theatre program: an interactive theatre and drama-based strategy for sexual health promotion among multicultural youth. Health Promot J Austr 2017; 28:30-36. [PMID: 27346537 DOI: 10.1071/he15096] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 04/18/2016] [Indexed: 11/23/2022] Open
Abstract
Issue addressed Rates of sexually transmissible infections among young people are high, and there is a need for innovative, youth-focused sexual health promotion programs. This study evaluated the effectiveness of the Sharing Stories youth theatre program, which uses interactive theatre and drama-based strategies to engage and educate multicultural youth on sexual health issues. The effectiveness of using drama-based evaluation methods is also discussed. Methods The youth theatre program participants were 18 multicultural youth from South East Asian, African and Middle Eastern backgrounds aged between 14 and 21 years. Four sexual health drama scenarios and a sexual health questionnaire were used to measure changes in knowledge and attitudes. Results Participants reported being confident talking to and supporting their friends with regards to safe sex messages, improved their sexual health knowledge and demonstrated a positive shift in their attitudes towards sexual health. Drama-based evaluation methods were effective in engaging multicultural youth and worked well across the cultures and age groups. Conclusions Theatre and drama-based sexual health promotion strategies are an effective method for up-skilling young people from multicultural backgrounds to be peer educators and good communicators of sexual health information. Drama-based evaluation methods are engaging for young people and an effective way of collecting data from culturally diverse youth. So what? This study recommends incorporating interactive and arts-based strategies into sexual health promotion programs for multicultural youth. It also provides guidance for health promotion practitioners evaluating an arts-based health promotion program using arts-based data collection methods.
Collapse
Affiliation(s)
- Meagan Roberts
- Sexual Health and Blood-borne Virus Program, Department of Health, 227 Stubbs Terrace, Shenton Park, WA 6008, Australia
| | - Roanna Lobo
- Collaboration of Evidence, Research and Impact in Public Health, Curtin University, GPO Box U1987, WA 6845, Australia
| | - Anne Sorenson
- Southern Edge Arts, PO Box 1367, Albany, WA 6331, Australia
| |
Collapse
|
32
|
Hood KB, Shook NJ, Belgrave FZ. "Jimmy Cap Before You Tap": Developing Condom Use Messages for African American Women. JOURNAL OF SEX RESEARCH 2017; 54:651-664. [PMID: 27136298 DOI: 10.1080/00224499.2016.1168351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study examined which characteristics of persuasive communications are most effective in changing African American women's condom use attitudes. Focus groups were convened with 40 African American women (Mage = 25.54, SD = 4.67) to assess their opinions on current effective strategies used to promote condom use among their peers. Participants discussed effective characteristics of messaging campaigns (i.e., source, message type, channel) and how these could be used in future prevention messages. Findings revealed that making messages that are fun, catchy, and informative, delivered frequently through social media, TV, or radio by a peer or celebrity would be perceived as most effective in changing young African American women's attitudes. Other themes that emerged were that condom use is more strongly associated with pregnancy prevention than HIV prevention and that sexual partners were perceived to have negative condom use attitudes. Recommendations centered on increasing exposure of HIV prevention messages by placing messages on the Internet and including a funny phrase or jingle in the message so that it is easy to remember and could potentially serve as a conversation starter for discussing safe sex with partners.
Collapse
Affiliation(s)
| | | | - Faye Z Belgrave
- c Center for Cultural Experiences in Prevention , Virginia Commonwealth University
| |
Collapse
|
33
|
Valois RF, Zullig KJ, Revels AA. Aggressive and Violent Behavior and Emotional Self-Efficacy: Is There a Relationship for Adolescents? THE JOURNAL OF SCHOOL HEALTH 2017; 87:269-277. [PMID: 28260243 DOI: 10.1111/josh.12493] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 06/25/2016] [Accepted: 11/24/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND In this cross-sectional study we explored relationships between aggressive and violent behaviors and emotional self-efficacy (ESE) in a statewide sample of public high school adolescents in South Carolina (N = 3836). METHODS The US Centers for Disease Control and Prevention Youth Risk Behavior Survey items on aggressive and violent behavior items and an adolescent ESE scale were used. Logistic regression analyses and multivariate models constructed separately, revealed significant race by sex findings. RESULTS Results suggest that carrying a weapon to school (past 30 days) and being threatened or injured with a gun, knife, or club at school (past 12 months) were significantly associated (p < .05) with reduced ESE for specific race/sex groups. CONCLUSIONS Results have implications for school- and community-based mental health services and social and emotional learning and aggression/violence prevention programs for adolescents. Measures of ESE as a component of comprehensive assessments of adolescent mental health, social and emotional learning and aggressive/violent behaviors in fieldwork, research, and program-evaluation efforts should be considered.
Collapse
Affiliation(s)
- Robert F Valois
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, Department of Family & Preventive Medicine, School or Medicine, University of South Carolina, Columbia, SC 29208
| | - Keith J Zullig
- Department of Social & Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506
| | - Asa A Revels
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208
| |
Collapse
|
34
|
Chandler-Coley R, Ross H, Ozoya O, Lescano C, Flannigan T. Exploring Black College Females' Perceptions Regarding HIV Prevention Message Content. JOURNAL OF HEALTH COMMUNICATION 2017; 22:102-110. [PMID: 28098500 PMCID: PMC5596455 DOI: 10.1080/10810730.2016.1252817] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Media messages can facilitate the delivery of accurate information related to HIV and sexually transmitted infection. This study's purpose was to examine preexisting media campaigns from the iMPPACS study to assess age-, gender-, and culturally appropriate components identified by African American females who attend historically Black colleges/universities. In 3 separate focus group sessions, 31 Black female college students (M age = 20) viewed 4 vignettes and heard 3 audio-only clips, then ranked and commented on them based on perceived satisfaction with HIV prevention content and appropriateness of delivery. Conventional qualitative analysis using NVivo software was performed until saturation of content was achieved and themes derived. Six major themes emerged and were designated as (a) social media; (b) mirror image; (c) visually dynamic advertisements; (d) the real world; (e) people, place, things; and (f) HIV knowledge. Visually stimulating content (i.e., graphics) was found to be most appealing in marketing HIV prevention, with brief monologue/dialogue from scenarios that resemble daily life. Socially and culturally relevant HIV prevention messages are important to Black college female students. Participants recommended creating short audiovisual messages that encompass familiar contexts like dorm rooms and appealing graphics for HIV health promotion messages, such as emojis. Future audio-only prevention advertisements for this population should use recognizable voices (e.g., celebrities). Finally, messaging should be promoted on open and closed circuit social media platforms.
Collapse
Affiliation(s)
| | - Henry Ross
- a Nell Hodgson School of Nursing , Emory University , Atlanta , Georgia , USA
| | - Oluwatobi Ozoya
- b College of Public Health and Global Health , University of South Florida , Tampa , Florida , USA
| | - Celia Lescano
- c Department of Mental Health Law and Policy , University of South Florida , Tampa , Florida , USA
| | | |
Collapse
|
35
|
Health Communication and Social Marketing Campaigns for Sexually Transmitted Disease Prevention and Control: What Is the Evidence of their Effectiveness? Sex Transm Dis 2016; 43:S83-101. [PMID: 26779691 DOI: 10.1097/olq.0000000000000286] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite the ubiquity of sex in the media, a culture of silence surrounds sexual health in the United States, serving as a barrier to sexually transmitted disease (STD) prevention, testing, and treatment. Campaigns can increase STD-related knowledge, communication, and protective behaviors. This review assesses the effectiveness of STD prevention and testing campaigns in the United States to inform the field on their use as a strategy for affecting behavior change. METHODS A comprehensive literature search was conducted to identify original research articles, published between 2000 and 2014, which report on US media campaigns promoting community- or population-level STD testing or prevention behaviors and are evaluated for impact on one or more behavioral outcomes. Titles and abstracts were independently reviewed by 2 researchers. RESULTS The review yielded 26 articles representing 16 unique STD testing and/or prevention campaigns. Most campaigns were developed using formative research and social marketing or behavioral theory. Most campaigns (68.75%) used posttest-only or pretest-posttest designs without comparison groups for evaluation; only 5 campaigns used control groups, and these proved challenging (i.e., achieving necessary exposure and avoiding contamination). Nearly all campaigns found differences between exposed and unexposed individuals on one or more key behavioral outcomes. Several campaigns found dose-response relationships. Among evaluations with uncontaminated control groups whose campaigns achieved sufficient exposure, sustained campaign effects were observed among targeted populations. CONCLUSIONS Current findings suggest that campaigns can impact targeted STD-related behaviors and add to the evidence that greater exposure is associated with greater behavior change.
Collapse
|
36
|
Sunguya BF, Munisamy M, Pongpanich S, Yasuoka J, Jimba M. Ability of HIV Advocacy to Modify Behavioral Norms and Treatment Impact: A Systematic Review. Am J Public Health 2016; 106:e1-8. [PMID: 27310343 PMCID: PMC4940638 DOI: 10.2105/ajph.2016.303179] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND HIV advocacy programs are partly responsible for the global community's success in reducing the burden of HIV. The rising wave of the global burden of noncommunicable diseases (NCDs) has prompted the World Health Organization to espouse NCD advocacy efforts as a possible preventive strategy. HIV and NCDs share some similarities in their chronicity and risky behaviors, which are their associated etiology. Therefore, pooled evidence on the effectiveness of HIV advocacy programs and ideas shared could be replicated and applied during the conceptualization of NCD advocacy programs. Such evidence, however, has not been systematically reviewed to address the effectiveness of HIV advocacy programs, particularly programs that aimed at changing public behaviors deemed as risk factors. OBJECTIVES To determine the effectiveness of HIV advocacy programs and draw lessons from those that are effective to strengthen future noncommunicable disease advocacy programs. SEARCH METHODS We searched for evidence regarding the effectiveness of HIV advocacy programs in medical databases: PubMed, The Cumulative Index to Nursing and Allied Health Literature Plus, Educational Resources and Information Center, and Web of Science, with articles dated from 1994 to 2014. Search criteria. The review protocol was registered before this review. The inclusion criteria were studies on advocacy programs or interventions. We selected studies with the following designs: randomized controlled design studies, pre-post intervention studies, cohorts and other longitudinal studies, quasi-experimental design studies, and cross-sectional studies that reported changes in outcome variables of interest following advocacy programs. We constructed Boolean search terms and used them in PubMed as well as other databases, in line with a population, intervention, comparator, and outcome question. The flow of evidence search and reporting followed the standard Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. DATA COLLECTION AND ANALYSIS We selected 2 outcome variables (i.e., changing social norms and a change in impact) out of 6 key outcomes of advocacy interventions. We assessed the risk of bias for all selected studies by using the Cochrane risk-of-bias tool for randomized studies and using the Risk of Bias for Nonrandomized Observational Studies for observational studies. We did not grade the collective quality of evidence because of differences between the studies, with regard to methods, study designs, and context. Moreover, we could not carry out meta-analyses because of heterogeneity and the diverse study designs; thus, we used a narrative synthesis to report the findings. MAIN RESULTS A total of 25 studies were eligible, of the 1463 studies retrieved from selected databases. Twenty-two of the studies indicated a shift in social norms as a result of HIV advocacy programs, and 3 indicated a change in impact. We drew 6 lessons from these programs that may be useful for noncommunicable disease advocacy: (1) involving at-risk populations in advocacy programs, (2) working with laypersons and community members, (3) working with peer advocates and activists, (4) targeting specific age groups and asking support from celebrities, (5) targeting several, but specific, risk factors, and (6) using an evidence-based approach through formative research. Author conclusions. HIV advocacy programs have been effective in shifting social norms and facilitating a change in impact. PUBLIC HEALTH IMPLICATIONS The lessons learned from these effective programs could be used to improve the design and implementation of future noncommunicable disease advocacy programs.
Collapse
Affiliation(s)
- Bruno F Sunguya
- Bruno F. Sunguya is with the School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania, and the Department of Community and Global Health, The University of Tokyo, Japan. Murallitharan Munisamy is with the College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand, and the London School of Hygiene and Tropical Medicine and the London School of Economics and Political Sciences, London, England. Sathirakorn Pongpanich is with the College of Public Health Sciences, Chulalongkorn University. Junko Yasuoka and Masamine Jimba are with the Department of Community and Global Health at the University of Tokyo
| | - Murallitharan Munisamy
- Bruno F. Sunguya is with the School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania, and the Department of Community and Global Health, The University of Tokyo, Japan. Murallitharan Munisamy is with the College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand, and the London School of Hygiene and Tropical Medicine and the London School of Economics and Political Sciences, London, England. Sathirakorn Pongpanich is with the College of Public Health Sciences, Chulalongkorn University. Junko Yasuoka and Masamine Jimba are with the Department of Community and Global Health at the University of Tokyo
| | - Sathirakorn Pongpanich
- Bruno F. Sunguya is with the School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania, and the Department of Community and Global Health, The University of Tokyo, Japan. Murallitharan Munisamy is with the College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand, and the London School of Hygiene and Tropical Medicine and the London School of Economics and Political Sciences, London, England. Sathirakorn Pongpanich is with the College of Public Health Sciences, Chulalongkorn University. Junko Yasuoka and Masamine Jimba are with the Department of Community and Global Health at the University of Tokyo
| | - Junko Yasuoka
- Bruno F. Sunguya is with the School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania, and the Department of Community and Global Health, The University of Tokyo, Japan. Murallitharan Munisamy is with the College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand, and the London School of Hygiene and Tropical Medicine and the London School of Economics and Political Sciences, London, England. Sathirakorn Pongpanich is with the College of Public Health Sciences, Chulalongkorn University. Junko Yasuoka and Masamine Jimba are with the Department of Community and Global Health at the University of Tokyo
| | - Masamine Jimba
- Bruno F. Sunguya is with the School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania, and the Department of Community and Global Health, The University of Tokyo, Japan. Murallitharan Munisamy is with the College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand, and the London School of Hygiene and Tropical Medicine and the London School of Economics and Political Sciences, London, England. Sathirakorn Pongpanich is with the College of Public Health Sciences, Chulalongkorn University. Junko Yasuoka and Masamine Jimba are with the Department of Community and Global Health at the University of Tokyo
| |
Collapse
|
37
|
Dai X, Xiang L, Li T, Bai Z. Cancer Hallmarks, Biomarkers and Breast Cancer Molecular Subtypes. J Cancer 2016; 7:1281-94. [PMID: 27390604 PMCID: PMC4934037 DOI: 10.7150/jca.13141] [Citation(s) in RCA: 247] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 05/19/2016] [Indexed: 12/13/2022] Open
Abstract
Breast cancer is a complex disease encompassing multiple tumor entities, each characterized by distinct morphology, behavior and clinical implications. Besides estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2, novel biomarkers have shown their prognostic and predictive values, complicating our understanding towards to the heterogeneity of such cancers. Ten cancer hallmarks have been proposed by Weinberg to characterize cancer and its carcinogenesis. By reviewing biomarkers and breast cancer molecular subtypes, we propose that the divergent outcome observed from patients stratified by hormone status are driven by different cancer hallmarks. 'Sustaining proliferative signaling' further differentiates cancers with positive hormone receptors. 'Activating invasion and metastasis' and 'evading immune destruction' drive the differentiation of triple negative breast cancers. 'Resisting cell death', 'genome instability and mutation' and 'deregulating cellular energetics' refine breast cancer classification with their predictive values. 'Evading growth suppressors', 'enabling replicative immortality', 'inducing angiogenesis' and 'tumor-promoting inflammation' have not been involved in breast cancer classification which need more focus in the future biomarker-related research. This review novels in its global view on breast cancer heterogeneity, which clarifies many confusions in this field and contributes to precision medicine.
Collapse
Affiliation(s)
- Xiaofeng Dai
- National Engineering Laboratory for Cereal Fermentation Technology, School of Biotechnology, Jiangnan University, Wuxi, Jiangsu, P.R.China
| | - Liangjian Xiang
- National Engineering Laboratory for Cereal Fermentation Technology, School of Biotechnology, Jiangnan University, Wuxi, Jiangsu, P.R.China
| | - Ting Li
- National Engineering Laboratory for Cereal Fermentation Technology, School of Biotechnology, Jiangnan University, Wuxi, Jiangsu, P.R.China
| | - Zhonghu Bai
- National Engineering Laboratory for Cereal Fermentation Technology, School of Biotechnology, Jiangnan University, Wuxi, Jiangsu, P.R.China
| |
Collapse
|
38
|
Agu J, Lobo R, Crawford G, Chigwada B. Migrant Sexual Health Help-Seeking and Experiences of Stigmatization and Discrimination in Perth, Western Australia: Exploring Barriers and Enablers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13050485. [PMID: 27187423 PMCID: PMC4881110 DOI: 10.3390/ijerph13050485] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 04/25/2016] [Accepted: 05/03/2016] [Indexed: 11/26/2022]
Abstract
Increasing HIV notifications amongst migrant and mobile populations to Australia is a significant public health issue. Generalizations about migrant health needs and delayed or deterred help-seeking behaviors can result from disregarding the variation between and within cultures including factors, such as drivers for migration and country of birth. This study explored barriers and enablers to accessing sexual health services, including experiences of stigma and discrimination, within a purposive sample of sub-Saharan African, Southeast Asian, and East Asian migrants. A qualitative design was employed using key informant interviews and focus group discussions. A total of 45 people with ages ranging from 18 to 50 years, participated in focus group discussions. Common barriers and enablers to help seeking behaviors were sociocultural and religious influence, financial constraints, and knowledge dissemination to reduce stigma. Additionally, common experiences of stigma and discrimination were related to employment and the social and self-isolation of people living with HIV. Overcoming barriers to accessing sexual health services, imparting sexual health knowledge, recognizing variations within cultures, and a reduction in stigma and discrimination will simultaneously accelerate help-seeking and result in better sexual health outcomes in migrant populations.
Collapse
Affiliation(s)
- Josephine Agu
- School of Public Health, Curtin University, Kent Street, Bentley, Western Australia 6102, Australia.
| | - Roanna Lobo
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Kent Street, Bentley, Western Australia 6102, Australia.
| | - Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Kent Street, Bentley, Western Australia 6102, Australia.
| | - Bethwyn Chigwada
- HepatitisWA (Inc.), 134 Aberdeen Street, Northbridge, Western Australia 6003, Australia.
| |
Collapse
|
39
|
Barth A, Schmälzle R, Hartung FM, Renner B, Schupp HT. How Target and Perceiver Gender Affect Impressions of HIV Risk. Front Public Health 2015; 3:223. [PMID: 26501048 PMCID: PMC4593940 DOI: 10.3389/fpubh.2015.00223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 09/18/2015] [Indexed: 11/30/2022] Open
Abstract
Background People do not use condoms consistently but instead rely on intuition to identify sexual partners high at risk for human immunodeficiency virus (HIV) infection. The present study examined gender differences of intuitive impressions about HIV risk. Methods Male and female perceivers evaluated portraits of unacquainted male and female targets regarding their risk for HIV, trait characteristics (trust, responsibility, attractiveness, valence, arousal, and health), and willingness for interaction. Results Male targets were perceived as more risky than female targets for both perceiver genders. Furthermore, male perceivers reported higher HIV risk perception for both male and female targets than female perceivers. Multiple regression indicated gender differences in the association between person characteristics and HIV risk. In male targets, only trustworthiness predicts HIV risk. In female targets, however, HIV risk is related to trustworthiness, attractiveness, health, valence (for male perceivers), and arousal (for female perceivers). Conclusion The present findings characterize intuitive impressions of HIV risk and reveal differences according to both target and perceiver gender. Considering gender differences in intuitive judgments of HIV risk may help devise effective strategies by shifting the balance from feelings of risk toward a more rational mode of risk perception and the adoption of effective precautionary behaviors.
Collapse
Affiliation(s)
- Alexander Barth
- Department of Psychology, University of Konstanz , Konstanz , Germany
| | - Ralf Schmälzle
- Department of Psychology, University of Konstanz , Konstanz , Germany
| | | | - Britta Renner
- Department of Psychology, University of Konstanz , Konstanz , Germany
| | - Harald T Schupp
- Department of Psychology, University of Konstanz , Konstanz , Germany
| |
Collapse
|
40
|
Valois RF, Kerr JC, Hennessy M, DiClemente RJ, Brown LK, Carey MP, Vanable PA, Farber NB, Salazar LF, Romer D. Perceived Difficulty of Performing Selected HIV/AIDS Preventive Behaviors and Life Satisfaction: Is there a Relationship for African American Adolescents? AIDS Behav 2015; 19:1288-97. [PMID: 25227680 PMCID: PMC4363292 DOI: 10.1007/s10461-014-0900-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Research on the relationship between adolescent health risk behaviors, sexual risk behaviors in particular, and perceived life satisfaction is emerging. Some researchers suggest that life satisfaction has been a neglected component of adolescent health research. African American adolescents aged 13-18 (n = 1,658) from four matched, mid-sized cities in the northeastern and southeastern USA, completed a self-report questionnaire via Audio Computer Assisted Self-Interview. Analyses were conducted to examine relationships between perceived difficulty in performing HIV/AIDS preventive behavior and perceived life satisfaction, while controlling for socioeconomic status. Results suggest that perceived life satisfaction is related to perceived difficulty in performing HIV/AIDS preventive behaviors, for both males and females, with variability in the magnitude of associations by gender. Further research is necessary to identify the particular characteristics of youth and specific aspects of adolescent life satisfaction associated with perceived difficulty in performing HIV/AIDS preventive behavior to develop gender-appropriate and culturally-sensitive quality of life/health promotion programs.
Collapse
Affiliation(s)
- Robert F Valois
- Health Promotion, Education & Behavior, Family & Preventive Medicine, Schools of Public, Health and Medicine, University of South Carolina, 915 Green Street, Discovery 1 Building, Room 534, Columbia, SC, 29208, USA,
| | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Kerr JC, Valois RF, Siddiqi A, Vanable P, Carey MP, DiClemente RJ, Romer D, Brown LK, Farber NB, Salazar LF. Neighborhood Condition and Geographic Locale in Assessing HIV/STI Risk Among African American Adolescents. AIDS Behav 2015; 19:1005-13. [PMID: 25108404 DOI: 10.1007/s10461-014-0868-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Although region and neighborhood condition's effect on HIV/sexually transmitted infection (STI) risk has been studied separately, there is little research examining their interplay. African American adolescents (n = 1,602) from four matched cities in the Northeastern and Southeastern US completed Audio Computer Assisted Self-Interviews and submitted biospecimen samples to detect Sexually Transmitted Infections (chlamydia, gonorrhea, and trichomonas). Logistic and negative binomial regressions determined HIV/STI risk differences by region, neighborhood stress, and stress-region dyads. Northeastern participants demonstrated lower HIV/STI risk while participants from higher stress neighborhoods exhibited greater risk. Relationships between neighborhood condition and ever having anal sex (p < 0.01), anal condom use (p < 0.05), and number of anal partners (p < 0.05) were significant in the Northeast only. Participants in unstressed Northeastern neighborhoods were less likely to have vaginal sex than those in comparable Southeastern neighborhoods (p < 0.05). Participants in unfavorable Northeastern neighborhoods had fewer anal partners than participants in comparable Southeastern neighborhoods (p < 0.01). In concert, neighborhood and region differentially affect HIV/STI risk.
Collapse
Affiliation(s)
- Jelani C Kerr
- Department of Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA,
| | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Xiao Z, Li X, Lin D, Tam CC. Mass Media and HIV/AIDS Prevention Among Female Sex Workers in Beijing, China. JOURNAL OF HEALTH COMMUNICATION 2015; 20:1095-1106. [PMID: 25950448 PMCID: PMC6277979 DOI: 10.1080/10810730.2015.1018575] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The current study aimed to identify the sources of HIV prevention information for female sex workers in Beijing and assess the associations between levels of mass media exposure of HIV/AIDS prevention information and HIV/AIDS knowledge as well as condom use-related attitudes, beliefs, and behaviors. Cross-sectional data were collected from 359 female sex workers in Beijing, China. Chi-square tests and one-way ANOVA tests were employed. Female sex workers sampled in Beijing were more likely to obtain HIV/AIDS prevention information from television and street posters than radio and the Internet. However, a higher level of exposure to and a lasting impression on online information were significantly associated with a higher level of condom use self-efficacy and more consistent condom use among the participants. Exposure to HIV/AIDS prevention information delivered by radio, street posters, and the Internet was found to be associated with sexual communication about HIV or condom use with sexual partners. Overall, this study provides preliminary evidence of the utility of various mass media outlets in delivering HIV/AIDS prevention information among female sex workers in China. Future studies are needed to systematically examine the effectiveness of mass media-based prevention education on HIV/AIDS related attitudes and behaviors among female sex workers and other populations in China.
Collapse
Affiliation(s)
- Zhiwen Xiao
- a Valenti School of Communication , University of Houston , Houston , Texas , USA
| | | | | | | |
Collapse
|
43
|
Kerr JC, Valois RF, DiClemente RJ, Carey MP, Stanton B, Romer D, Fletcher F, Farber N, Brown LK, Vanable PA, Salazar LF, Juzang I, Fortune T. The effects of a mass media HIV-risk reduction strategy on HIV-related stigma and knowledge among African American adolescents. AIDS Patient Care STDS 2015; 29:150-6. [PMID: 25738952 DOI: 10.1089/apc.2014.0207] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
HIV-related stigma undermines HIV prevention, testing, and treatment. Multipronged risk-reduction strategies may reduce stigma among African American adolescents. To test the effectiveness of a risk-reduction strategy in addressing stigma, 1613 African American adolescents from four mid-sized cities participated in a randomized control trial. Participants received a sexual-risk reduction [Focus on Youth (FOY)] or general health curriculum [Promoting Health Among Teens (PHAT)]. Two cities received a culturally-tailored media intervention. Participants completed baseline, 3-, 6-, and 12-month surveys to measure HIV-related stigma and knowledge. Analysis of covariance tested for stigma and knowledge differences by media city status and curriculum/media city status (PHAT media vs. PHAT non-media, FOY media vs. FOY non-media; FOY media vs. PHAT media; FOY non-media vs. PHAT non-media) at each measurement. Hierarchical linear modeling (HLM) determined stigma and knowledge differences over time. Media participants demonstrated greater HIV-related knowledge (p<0.10) at 6 months and lower stigma at 3 months (p<0.10). FOY media participants had lower 3-month (p<0.05) and 12-month (p<0.10) stigma scores than non-media FOY participants. FOY media and non-media participants had greater knowledge than PHAT for all intervals after baseline. FOY media had lower stigma than PHAT media after baseline for all intervals after baseline. HLM indicated greater knowledge slopes for the media group (p<0.05). FOY media participants had greater knowledge slopes (p<0.05) relative to non-media FOY participants and media PHAT participants (p<0.01). A combination of a HIV risk-reduction curriculum and culturally-tailored media demonstrated some effectiveness in reducing stigma. Future use of media in HIV-prevention should include and evaluate effects on stigma.
Collapse
Affiliation(s)
- Jelani C. Kerr
- Department of Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky
| | - Robert F. Valois
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Family and Preventive Medicine, School of Medicine, University of South Carolina, Columbia, South Carolina
| | - Ralph J. DiClemente
- Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Michael P. Carey
- Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island
| | - Bonita Stanton
- Wayne State University, Department of Pediatrics, Detroit, Michigan
| | - Daniel Romer
- Annenberg Public Policy Center, College of Arts and Sciences, Pennsylvania, Pennsylvania
| | - Faith Fletcher
- Community Health Sciences Division, University of Illinois at Chicago, Chicago, Illinois
| | - Naomi Farber
- College of Social Work, University of South Carolina, Columbia, South Carolina
| | - Larry K. Brown
- Department of Psychiatry, Rhode Island Hospital, Brown University, Providence, Rhode Island
| | - Peter A. Vanable
- Department of Psychology, Center for Health & Behavior, Syracuse University, Syracuse, New York
| | - Laura F. Salazar
- Division of Health Promotion and Behavior, Institute of Public Health, Georgia State University, Atlanta, Georgia
| | - Ivan Juzang
- Motivational Educational Entertainment, Philadelphia, Pennsylvania
| | - Thierry Fortune
- Motivational Educational Entertainment, Philadelphia, Pennsylvania
| |
Collapse
|
44
|
Zullig KJ, Teoli DA, Valois RF. Emotional self-efficacy and alcohol and tobacco use in adolescents. JOURNAL OF DRUG EDUCATION 2015; 44:51-66. [PMID: 25721321 DOI: 10.1177/0047237915573526] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study examined relationships between emotional self-efficacy (ESE) and alcohol and tobacco use in a statewide sample of public high school adolescents (n = 2,566). The Center for Disease Control Youth Risk Behavior Survey and an adolescent ESE scale were utilized. Logistic regression analyses indicated the presence of any significant race by gender associations between lower ESE and alcohol and tobacco use. Results suggest that alcohol and cigarette use was significantly associated (p ≤ .05) with lower levels of ESE for certain race/gender groups. Results have implications for school- and community-based mental health services and substance use prevention/education programs for adolescents. Measures of ESE as a component of comprehensive assessments of adolescent mental health in fieldwork, research, and substance abuse prevention/education program evaluation efforts should be considered.
Collapse
Affiliation(s)
- Keith J Zullig
- Department of Social & Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Dac A Teoli
- School of Medicine, University of Pittsburgh, PA, USA
| | - Robert F Valois
- Department of Health Promotion, Education, & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA Department of Family & Preventive Medicine, School of Medicine, University of South Carolina, Columbia, SC, USA
| |
Collapse
|
45
|
Robinson MN, Tansil KA, Elder RW, Soler RE, Labre MP, Mercer SL, Eroglu D, Baur C, Lyon-Daniel K, Fridinger F, Sokler LA, Green LW, Miller T, Dearing JW, Evans WD, Snyder LB, Kasisomayajula Viswanath K, Beistle DM, Chervin DD, Bernhardt JM, Rimer BK. Mass media health communication campaigns combined with health-related product distribution: a community guide systematic review. Am J Prev Med 2014; 47:360-71. [PMID: 25145620 DOI: 10.1016/j.amepre.2014.05.034] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 05/05/2014] [Accepted: 05/28/2014] [Indexed: 11/26/2022]
Abstract
CONTEXT Health communication campaigns including mass media and health-related product distribution have been used to reduce mortality and morbidity through behavior change. The intervention is defined as having two core components reflecting two social marketing principles: (1) promoting behavior change through multiple communication channels, one being mass media, and (2) distributing a free or reduced-price product that facilitates adoption and maintenance of healthy behavior change, sustains cessation of harmful behaviors, or protects against behavior-related disease or injury. EVIDENCE ACQUISITION Using methods previously developed for the Community Guide, a systematic review (search period, January 1980-December 2009) was conducted to evaluate the effectiveness of health communication campaigns that use multiple channels, including mass media, and distribute health-related products. The primary outcome of interest was use of distributed health-related products. EVIDENCE SYNTHESIS Twenty-two studies that met Community Guide quality criteria were analyzed in 2010. Most studies showed favorable behavior change effects on health-related product use (a median increase of 8.4 percentage points). By product category, median increases in desired behaviors ranged from 4.0 percentage points for condom promotion and distribution campaigns to 10.0 percentage points for smoking-cessation campaigns. CONCLUSIONS Health communication campaigns that combine mass media and other communication channels with distribution of free or reduced-price health-related products are effective in improving healthy behaviors. This intervention is expected to be applicable across U.S. demographic groups, with appropriate population targeting. The ability to draw more specific conclusions about other important social marketing practices is constrained by limited reporting of intervention components and characteristics.
Collapse
Affiliation(s)
- Maren N Robinson
- Community Guide Branch, Division of Epidemiology, Analysis and Library Services, Center for Surveillance, Epidemiology and Laboratory Services , CDC, Atlanta
| | - Kristin A Tansil
- Community Guide Branch, Division of Epidemiology, Analysis and Library Services, Center for Surveillance, Epidemiology and Laboratory Services , CDC, Atlanta
| | - Randy W Elder
- Community Guide Branch, Division of Epidemiology, Analysis and Library Services, Center for Surveillance, Epidemiology and Laboratory Services , CDC, Atlanta.
| | - Robin E Soler
- Community Guide Branch, Division of Epidemiology, Analysis and Library Services, Center for Surveillance, Epidemiology and Laboratory Services , CDC, Atlanta
| | - Magdala P Labre
- Community Guide Branch, Division of Epidemiology, Analysis and Library Services, Center for Surveillance, Epidemiology and Laboratory Services , CDC, Atlanta
| | - Shawna L Mercer
- Community Guide Branch, Division of Epidemiology, Analysis and Library Services, Center for Surveillance, Epidemiology and Laboratory Services , CDC, Atlanta
| | - Dogan Eroglu
- Office of Associate Director of Communications, Office of the Director, CDC, Atlanta
| | - Cynthia Baur
- Office of Associate Director of Communications, Office of the Director, CDC, Atlanta
| | - Katherine Lyon-Daniel
- Office of Associate Director of Communications, Office of the Director, CDC, Atlanta
| | - Fred Fridinger
- Office of Associate Director of Communications, Office of the Director, CDC, Atlanta
| | - Lynn A Sokler
- Office of Associate Director of Communications, Office of the Director, CDC, Atlanta
| | | | - Therese Miller
- Agency for Healthcare Research and Quality, Rockville, MD
| | | | | | | | | | - Diane M Beistle
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta
| | | | | | - Barbara K Rimer
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina
| | | |
Collapse
|
46
|
Kerr JC, Valois RF, Diclemente RJ, Fletcher F, Carey MP, Romer D, Vanable PA, Farber N. HIV-related stigma among African-American youth in the Northeast and Southeast US. AIDS Behav 2014; 18:1063-7. [PMID: 24402690 DOI: 10.1007/s10461-013-0687-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
HIV-related stigma inhibits optimal HIV prevention and treatment among African-Americans. Regional differences in HIV/AIDS prevalence may be related to stigma among young African-Americans. Baseline data (N = 1,606) from an HIV prevention intervention were used to investigate regional differences in HIV-related stigma and knowledge among African-American adolescents in four midsized cities in the Northeastern and Southeastern US. Analyses indicated greater HIV-related stigma among adolescents from the Southeast relative to adolescents from the Northeast (F = 22.23; p < 0.0001). Linear regression indicated a negative relationship between HIV stigma and HIV knowledge (b = -0.65; p < 0.0001). Addressing HIV/AIDS in high prevalence locales should include efforts to reduce HIV-related stigma.
Collapse
Affiliation(s)
- Jelani C Kerr
- Department of Sociology, Anthropology, and Criminology, University of Windsor, 401 Sunset Ave, CHS 50-1, Windsor, ON, N9B 3P4, USA,
| | | | | | | | | | | | | | | |
Collapse
|
47
|
DiClemente RJ, Jackson JM. Towards an integrated framework for accelerating the end for the global HIV epidemic among young people. SEX EDUCATION 2014; 14:609-621. [PMID: 25197260 PMCID: PMC4153437 DOI: 10.1080/14681811.2014.901214] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
For decades the HIV epidemic has exacted an enormous toll worldwide. However, trend analyses have discerned significant declines in the overall prevalence of HIV over the last two decades. More recently, advances in biomedical, behavioural, and structural interventions offer considerable promise in the battle against generalised epidemics. Despite advances in the prevention of transmission and new infections, morbidity and mortality of HIV among young people remains a considerable concern for individuals, couples, families, communities, practitioners, and policy makers around the globe. To accelerate the end of the global HIV epidemic among young people, we must merge existing efficacious interventions with more novel, cost-effective implementation strategies to develop integrated, multilevel combination interventions. The benefits of conceptualising the HIV epidemic more broadly and adopting ecological frameworks for the development of HIV prevention programmes are critical.
Collapse
Affiliation(s)
- Ralph J. DiClemente
- Department of Behavioral Sciences & Health Education, Center for AIDS Research, Prevention Sciences & Epidemiology Core, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | |
Collapse
|
48
|
Ugarte WJ, Högberg U, Valladares E, Essén B. Assessing knowledge, attitudes, and behaviors related to HIV and AIDS in Nicaragua: A community-level perspective. SEXUAL & REPRODUCTIVE HEALTHCARE 2013; 4:37-44. [DOI: 10.1016/j.srhc.2012.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 10/31/2012] [Accepted: 11/01/2012] [Indexed: 10/27/2022]
|
49
|
HIV prevention interventions for adolescents and young adults: what about the needs of gay and bisexual males? AIDS Behav 2013; 17:1082-95. [PMID: 22460226 DOI: 10.1007/s10461-012-0178-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
While rates of HIV infection among gay/bisexual male adolescents have been increasing in the U.S., there has not been a commensurate increase in the development of HIV prevention interventions targeted specifically for this population. This editorial review examines primary HIV prevention interventions published in peer-reviewed journals between 1991 and 2010 in order to explore the differential focus on heterosexual versus gay/bisexual male adolescents/young adults. Of the 92 articles reviewed, only 5 (5.44 %) included interventions that addressed gay/bisexual sexual orientation or same-gender sexual activity. HIV prevention interventions developed for adolescents/young adults in the U.S. are not targeting those at highest risk of infection. Recommendations for addressing this gap are discussed.
Collapse
|
50
|
Tyler KA, Melander LA. Individual and Social Network Sexual Behavior Norms of Homeless Youth at High Risk for HIV Infection. CHILDREN AND YOUTH SERVICES REVIEW 2012; 34:2481-2486. [PMID: 23162182 PMCID: PMC3496415 DOI: 10.1016/j.childyouth.2012.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Although previous research shows that homeless youth engage in numerous risky sexual behaviors, little is known about whether or not specific rules govern this conduct within their social networks and how group norms influence subsequent sexual actions. The current study utilizes 19 in-depth interviews with homeless youth to investigate different elements of their sexual behavior. Findings reveal that their decision to have sex generally depends on chemistry and physical appearance whereas a potential partner's risky sexual history and heavy substance use discourages youth from engaging in sex. Both males and females discuss condom usage as it relates to unknown sexual history, availability, pregnancy, and the prevention of sexually transmitted infections (STIs). Sixteen homeless youth indicate that they do not discuss safe sex practices with their partners or social network members.
Collapse
Affiliation(s)
| | - Lisa A. Melander
- Kansas State University, Department of Sociology, Anthropology, and Social Work
| |
Collapse
|