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Coleman JL, Jones M, Washington D, Almirol E, Forberg P, Dyer TV, Spieldenner A, Martinez O, Rodriguez-Diaz CE, Parker SD, Schneider JA, Brewer R. Using the Meaningful Involvement of People Living with HIV/AIDS (MIPA) Framework to Assess the Engagement of Sexual Minority Men of Color in the US HIV Response: a Literature Review. J Racial Ethn Health Disparities 2023; 10:2374-2396. [PMID: 36171496 PMCID: PMC10098811 DOI: 10.1007/s40615-022-01417-0] [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: 07/28/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 11/29/2022]
Abstract
Black and Latino sexual minority men (SMM) continue to be disproportionately impacted by HIV. We utilized eight components of the Meaningful Involvement of People Living with HIV/AIDS (MIPA) framework to assess the engagement of Black and Latino SMM. Thirty-six (36) studies were included in the literature review. Forty-two percent of studies were Black SMM-specific, followed by Latino SMM-specific (31%) studies. Twenty-eight percent of studies were conducted among both groups. Most studies (72%) were intervention-related and focused on HIV prevention. The top five most common methods of community engagement were focus groups (39%), followed by interviews (36%), community-based participatory research (14%), the utilization of community advisory boards or peer mentorship (11%), and the establishment of multi-stakeholder coalitions, observations, or surveys (8%). We documented at least 7 MIPA components in 47% of the included studies. Community-based participatory research was more commonly utilized to engage Latino SMM. Researchers were more likely to initiate the engagement across all included studies. Few studies documented how Black and Latino SMM perceived the engagement. Engagement responsiveness was a well-documented MIPA component. In terms of engagement power dynamics, there were several examples of power imbalances, especially among Black SMM-specific studies. The inclusion of Black and Latino SMM had robust impacts on HIV research and interventions. There were limited examples of engagement capacity and maintenance. This is one of the first studies focused on utilizing MIPA to document the engagement of SMM of color. MIPA served as a useful framework for understanding the engagement of SMM of color in the US HIV response. The engagement of SMM of color is critical to reducing health inequities.
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Affiliation(s)
| | - Mickaya Jones
- Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA
| | | | - Ellen Almirol
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, MC 5065, Chicago, IL, 60637, USA
| | | | - Typhanye V Dyer
- Department of Epidemiology and Biostatistics, University of Maryland, College Park, MD, USA
| | - Andrew Spieldenner
- MPact Global, Oakland, CA, USA
- California State University-San Marcos, San Marcos, CA, USA
| | - Omar Martinez
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Carlos E Rodriguez-Diaz
- Department of Prevention and Community Health, George Washington University - Milken Institute School of Public Health, Washington, DC, USA
| | - Sharon D Parker
- North Carolina Agricultural and Technical State University, Greensboro, NC, USA
| | - John A Schneider
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, MC 5065, Chicago, IL, 60637, USA
| | - Russell Brewer
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, MC 5065, Chicago, IL, 60637, USA.
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Status-Neutral Interventions to Support Health Equity for Black Sexual Minority Men. Curr HIV/AIDS Rep 2022; 19:265-280. [PMID: 35794447 DOI: 10.1007/s11904-022-00610-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Status-neutral care, a person-centered approach to healthcare not predicated on HIV serostatus, may improve health equity among Black sexual minority men (BSMM). We reviewed current status-neutral, HIV, and Pre-Exposure Prophylaxis (PrEP) interventions, and coded each for social-ecological focus and use of six approaches: (1) person-centered, (2) anti-stigma, (3) social support, (4) the social determinants of health (SDOH), (5) community engagement, and (6) multi-sectoral partnerships. RECENT FINDINGS We reviewed 25 studies, of which 3 were status-neutral. Nineteen studies utilized person-centered approaches, with several employing BSMM peers. For SDOH, financial incentives and reducing clinic-level barriers to care improved cascade outcomes. Direct text messaging, anti-stigma, social support, community-engagement, and multi-sectoral partnerships also improved outcomes in some studies. Few status-neutral programs exist and additional research is needed to identify key intervention components and mechanisms of influence. Programs targeting SDOH and multiple social-ecological levels offer promise for providing holistic care to BSMM, while addressing HIV prevention and treatment and health equity.
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Cespedes M, Das M, Hojilla JC, Blumenthal J, Mounzer K, Ramgopal M, Hodge T, Torres TS, Peterson C, Shibase S, Elliott A, Demidont AC, Callaghan L, Watson CC, Carter C, Kintu A, Baeten JM, Ogbuagu O. Proactive strategies to optimize engagement of Black, Hispanic/Latinx, transgender, and nonbinary individuals in a trial of a novel agent for HIV pre-exposure prophylaxis (PrEP). PLoS One 2022; 17:e0267780. [PMID: 35657826 PMCID: PMC9165827 DOI: 10.1371/journal.pone.0267780] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/14/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Black and Hispanic/Latinx cisgender men who have sex with men (MSM), transgender women, transgender men, and gender nonbinary (TGNB) individuals have been historically underrepresented in HIV pre-exposure prophylaxis (PrEP) clinical trials. There is an urgent need for ongoing engagement with communities that have been the most impacted by HIV and diverse representation in clinical trials. Here we describe strategic approaches undertaken in the PURPOSE 2 trial to optimize engagement of underrepresented individuals. METHODS AND RESULTS PURPOSE 2 is an ongoing Phase 3 trial evaluating the safety and efficacy of lenacapavir as PrEP in cisgender MSM and TGNB individuals. In PURPOSE 2, we used a multipronged approach aimed at enriching participation of underrepresented individuals. We conducted a review to identify evidence-informed recommendations from literature, engaged with stakeholders, and established the Global Community Advisory and Accountability Group (GCAG) to represent the needs of the community. Insights from stakeholders and GCAG members resulted in an expansion of the study population to include transgender men, gender nonbinary persons, and adolescents, and evaluation of population-specific outcomes. Feedback from stakeholders and GCAG members also informed investigator and site selection; these were selected based on prior experience working with persons from diverse racial, ethnic and gender identities, and estimates of local HIV incidence. Site selection was also expanded to include community-based clinics with services tailored towards Black, Hispanic/Latinx, and TGNB populations. We established a study-wide recruitment goal of 50% Black MSM and 20% Hispanic/Latinx MSM in US sites and 20% transgender women globally. Site-specific recruitment goals were also developed based on local demographics and HIV incidence. Mandatory trainings included Good Participatory Practice guidelines, gender inclusivity, and antiracism. CONCLUSION While further work is needed to achieve equitable representation, the strategies we describe may serve as a framework for future clinical trials. TRIAL REGISTRATION Clinical Trial Number: NCT04925752.
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Affiliation(s)
- Michelle Cespedes
- Division of Infectious Disease, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Moupali Das
- Gilead Sciences, Foster City, CA, United States of America
| | | | - Jill Blumenthal
- Department of Medicine, University of California San Diego, San Diego, CA, United States of America
| | - Karam Mounzer
- Philadelphia FIGHT Community Health Centers, Philadelphia, PA, United States of America
| | - Moti Ramgopal
- Midway Research Center, Fort Pierce, FL, United States of America
| | - Theo Hodge
- Washington Health Institute, Washington, DC, United States of America
| | - Thiago S. Torres
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Charles Peterson
- Department of Medicine, College of Medicine, University of Illinois Chicago, Chicago, IL, United States of America
| | | | - Ayana Elliott
- Gilead Sciences, Foster City, CA, United States of America
| | - A. C. Demidont
- Gilead Sciences, Foster City, CA, United States of America
| | | | | | | | - Alex Kintu
- Gilead Sciences, Foster City, CA, United States of America
| | | | - Onyema Ogbuagu
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, United States of America
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Fusch P, Fusch GE, Hall JA, Walker NA, Booker JM. How to conduct a focus group interview: Tips, strategies, and examples for novice researchers. EDUCATION FOR INFORMATION 2022. [DOI: 10.3233/efi-211520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The focus group interview is a strategy that researchers use across all disciplines from marketing to education and cultural studies. Facilitating a focus group interview is challenging even for experienced researchers. This paper shares the authors’ perspectives on the focus group interview with arguments from the literature along with practical applications. The authors use examples from several of their research studies to discuss a scholarly yet practical approach to plan, conduct, and analyze successful focus groups for the intended audience of doctoral students. In addition to suggestions for facilitating data collection and data analysis for the focus group interview, this paper includes strategies to select the participants, ensure participants show up, engage all the focus group participants, address powerful or authoritative personalities, enhance the synergy of the group, and reach consensus.
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Affiliation(s)
| | - Gene E. Fusch
- Doctor of Business Administration, College of Management and Technology, Walden University, Minneapolis, MN, USA
| | - Janie A. Hall
- Doctor of Business Administration, College of Management and Technology, Walden University, Minneapolis, MN, USA
| | | | - Janet M. Booker
- Doctor of Business Administration, College of Management and Technology, Walden University, Minneapolis, MN, USA
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5
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Kaniuka AR, Zarwell M, Cramer RJ, Quinn K, Broaddus M, Patton A, Walsh JL. Perceptions of HIV Research Participation Among Gay, Bisexual, and Other Men who Have Sex with Men and Transgender and Nonbinary Adults: Results From a Midwest Pride Event. J Empir Res Hum Res Ethics 2021; 17:15-28. [PMID: 34866467 DOI: 10.1177/15562646211062707] [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
Human immunodeficiency virus (HIV) continues to disproportionately affect gay, bisexual, and other men who have sex with men (GBM) and transgender and nonbinary (trans/NB) individuals. This study investigated attitudes toward participation in HIV survey research, guided by Emanuel's framework for ethical clinical research (e.g., risk-benefit ratio, fair participant selection, respect for participants, social value, and collaborative partnership). GBM (n = 294) and trans/NB (n = 86) persons recruited at a Pride event in Milwaukee completed a survey assessing risks and benefits of participation in, and comfort responding to, sexual health surveys. Participants reported few ethical concerns (e.g., privacy and confidentiality), with notable differences by race, sexual orientation and gender identity, and prior research experiences. Implications for HIV research with GBM and trans/NB individuals are discussed.
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Affiliation(s)
- Andrea R Kaniuka
- Department of Public Health Sciences, 14727University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Meagan Zarwell
- Department of Public Health Sciences, 14727University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Robert J Cramer
- Department of Public Health Sciences, 14727University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Katherine Quinn
- Center for AIDS Intervention Research, 356955Medical College of Wisconsin, Milwaukee, WI, USA
| | - Michelle Broaddus
- Center for AIDS Intervention Research, 356955Medical College of Wisconsin, Milwaukee, WI, USA
| | - Alexandra Patton
- Department of Public Health Sciences, 14727University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Jennifer L Walsh
- Center for AIDS Intervention Research, 356955Medical College of Wisconsin, Milwaukee, WI, USA
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Andrasik MP, Broder GB, Wallace SE, Chaturvedi R, Michael NL, Bock S, Beyrer C, Oseso L, Aina J, Lucas J, Wilson DR, Kublin JG, Mensah GA. Increasing Black, Indigenous and People of Color participation in clinical trials through community engagement and recruitment goal establishment. PLoS One 2021; 16:e0258858. [PMID: 34665829 PMCID: PMC8525736 DOI: 10.1371/journal.pone.0258858] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 09/01/2021] [Indexed: 12/03/2022] Open
Abstract
Longstanding social and economic inequities elevate health risks and vulnerabilities for Black, Indigenous and People of Color (BIPOC) communities. Engagement of BIPOC communities in infectious disease research is a critical component in efforts to increase vaccine confidence, acceptability, and uptake of future approved products. Recent data highlight the relative absence of BIPOC communities in vaccine clinical trials. Intentional and effective community engagement methods are needed to improve BIPOC inclusion. We describe the methods utilized for the successful enrollment of BIPOC participants in the U.S. Government (USG)-funded COVID-19 Prevention Network (CoVPN)-sponsored vaccine efficacy trials and analyze the demographic and enrollment data across the efficacy trials to inform future efforts to ensure inclusive participation. Across the four USG-funded COVID-19 vaccine clinical trials for which data are available, 47% of participants enrolled at CoVPN sites in the US were BIPOC. White enrollment outpaced enrollment of BIPOC participants throughout the accrual period, requiring the implementation of strategies to increase diverse and inclusive enrollment. Trials opening later benefitted considerably from strengthened community engagement efforts, and greater and more diverse volunteer registry records. Despite robust fiscal resources and a longstanding collaborative and collective effort, enrollment of White persons outpaced that of BIPOC communities. With appropriate resources, commitment and community engagement expertise, the equitable enrollment of BIPOC individuals can be achieved. To ensure this goal, intentional efforts are needed, including an emphasis on diversity of enrollment in clinical trials, establishment of enrollment goals, ongoing robust community engagement, conducting population-specific trials, and research to inform best practices.
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Affiliation(s)
- Michele P. Andrasik
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Gail B. Broder
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Stephaun E. Wallace
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Richa Chaturvedi
- Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Nelson L. Michael
- Walter Reed Army Institute of Research, Silver Spring, MD, United States of America
| | - Sally Bock
- Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Chris Beyrer
- John’s Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Linda Oseso
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Jasmin Aina
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Jonathan Lucas
- HIV Prevention Trials Network, FHI360, Research Triangle, NC, United States of America
| | - David R. Wilson
- Tribal Health Research Office, National Institutes of Health, Bethesda, MD, United States of America
| | - James G. Kublin
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - George A. Mensah
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States of America
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7
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Morton T, Chege W, Swann E, Senn TE, Cleland N, Renzullo PO, Stirratt MJ. Advancing long-acting and extended delivery HIV prevention and treatment regimens through behavioural science: NIH workshop directions. AIDS 2021; 35:1313-1317. [PMID: 33710013 DOI: 10.1097/qad.0000000000002863] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Tia Morton
- Division of AIDS, National Institute of Allergy and Infectious Disease (NIAID)
| | - Wairimu Chege
- Division of AIDS, National Institute of Allergy and Infectious Disease (NIAID)
| | - Edith Swann
- Division of AIDS, National Institute of Allergy and Infectious Disease (NIAID)
| | - Theresa E Senn
- Division of AIDS Research, National Institute of Mental Health (NIMH), Bethesda, Maryland, USA
| | - Naana Cleland
- Division of AIDS, National Institute of Allergy and Infectious Disease (NIAID)
| | - Philip O Renzullo
- Division of AIDS, National Institute of Allergy and Infectious Disease (NIAID)
| | - Michael J Stirratt
- Division of AIDS Research, National Institute of Mental Health (NIMH), Bethesda, Maryland, USA
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8
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Harkness A, Rogers BG, Balise R, Mayo D, Weinstein ER, Safren SA, Pachankis JE. Who Aren't We Reaching? Young Sexual Minority Men's Non-participation in an HIV-Prevention and Mental Health Clinical Trial. AIDS Behav 2021; 25:2195-2209. [PMID: 33483898 PMCID: PMC8169533 DOI: 10.1007/s10461-020-03148-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 11/29/2022]
Abstract
Despite many successful clinical trials to test HIV-prevention interventions for sexual minority men (SMM), not all SMM are reached by these trials. Identifying factors associated with non-participation in these trials could help to ensure the benefits of research extend to all SMM. Prospective participants in New York City and Miami were screened to determine eligibility for a baseline assessment for a mental health/HIV-prevention trial (N = 633 eligible on screen). Logistic regression and classification and regression tree (CART) analysis identified predictors of non-participation in the baseline, among those who were screened as eligible and invited to participate. Individuals who reported unknown HIV status were more likely to be non-participators than those who reported being HIV-negative (OR = 2.39; 95% CI 1.41, 4.04). In New York City, Latinx SMM were more likely to be non-participators than non-Latinx white SMM (OR = 1.81; 95% CI, 1.09, 2.98). A CART model pruned two predictors of non-participation: knowledge of HIV status and age, such that SMM with unknown HIV status and SMM ages 18-19 were less likely to participate. Young SMM who did not know their HIV status, and thus are more likely to acquire and transmit HIV, were less likely to participate. Additionally, younger SMM (18-19 years) and Latinx SMM in New York City were less likely to participate. The findings suggest the importance of tailored recruitment to ensure HIV-prevention/mental health trials reach all SMM.
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Affiliation(s)
- Audrey Harkness
- Department of Public Health Sciences, University of Miami, Clinical Research Building, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA.
| | - Brooke G Rogers
- Department of Psychology, University of Miami, Miami, FL, USA
| | - Raymond Balise
- Department of Public Health Sciences, University of Miami, Clinical Research Building, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA
| | - Daniel Mayo
- Department of Psychology, University of Miami, Miami, FL, USA
| | | | - Steven A Safren
- Department of Psychology, University of Miami, Miami, FL, USA
| | - John E Pachankis
- Department of Chronic Disease Epidemiology, Social and Behavioral Sciences Division, Yale School of Public Health, Yale University, New Haven, CT, USA
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9
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Jones DL, Salazar AS, Rodriguez VJ, Balise RR, Starita CU, Morgan K, Raccamarich PD, Montgomerie E, Nogueira NF, Barreto Ojeda I, Maddalon M, Rodriguez NLY, Brophy T, Martinez T, Alcaide ML. Severe Acute Respiratory Syndrome Coronavirus 2: Vaccine Hesitancy Among Underrepresented Racial and Ethnic Groups With HIV in Miami, Florida. Open Forum Infect Dis 2021; 8:ofab154. [PMID: 34621912 PMCID: PMC8083672 DOI: 10.1093/ofid/ofab154] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 03/23/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and human immunodeficiency virus (HIV) disproportionally affect underrepresented ethnoracial groups in the United States. Medical mistrust and vaccine hesitancy will likely impact acceptability of SARS-CoV-2 vaccines. This study examined SARS-CoV-2 vaccine hesitancy among underrepresented ethnoracial groups with HIV and identified factors that may reduce vaccine uptake. METHODS We conducted a cross-sectional study of adults ≥18 years of age with HIV residing in Miami, Florida. Participants were invited to participate in the ACTION (A Comprehensive Translational Initiative on Novel Coronavirus) cohort study. A baseline survey was administered from April to August 2020 and followed by a coronavirus disease 2019 (COVID-19) vaccine hesitancy survey from August to November 2020. The COVID-19 vaccine hesitancy survey was adapted from the Strategic Advisory Group of Experts survey. Comparisons by race and ethnicity were performed using the Freedman-Haltmann extension of the Fisher exact test. RESULTS A total of 94 participants were enrolled; mean age was 54.4 years, 52% were female, 60% were Black non-Latinx, and 40% were non-Black Latinx. Black non-Latinx participants were less likely to agree that vaccinations are important for health when compared to non-Black Latinx (67.8% vs 92.1%, P = .009), less likely to agree that vaccines are effective in preventing disease (67.8% vs 84.2%, P = .029), less likely to believe that vaccine information is reliable and trustworthy (35.7% vs 71.1%, P = .002), and less likely to believe vaccines were unnecessary because COVID-19 would disappear soon (11% vs 21%, P = .049). CONCLUSIONS Medical mistrust, vaccine hesitancy, and negative sentiments about SARS-CoV-2 vaccines are prevalent among underrepresented ethnoracial groups with HIV, particularly Black non-Latinx. Targeted strategies to increase vaccine uptake in this population are warranted.
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Affiliation(s)
- Deborah L Jones
- Department of Psychiatry and Behavioral Sciences,
University of Miami Miller School of Medicine, Miami,
Florida, USA
| | - Ana S Salazar
- Division of Infectious Diseases, Department of Medicine,
University of Miami Miller School of Medicine, Miami,
Florida, USA
| | | | - Raymond R Balise
- Division of Biostatistics, Department of Public Health
Sciences, University of Miami Miller School of Medicine,
Miami, Florida, USA
| | - Claudia Uribe Starita
- Division of Infectious Diseases, Department of Medicine,
University of Miami Miller School of Medicine, Miami,
Florida, USA
| | - Kristiana Morgan
- Division of Biostatistics, Department of Public Health
Sciences, University of Miami Miller School of Medicine,
Miami, Florida, USA
- University of Miami Miller School of
Medicine, Miami, Florida, USA
| | - Patricia D Raccamarich
- Division of Infectious Diseases, Department of Medicine,
University of Miami Miller School of Medicine, Miami,
Florida, USA
| | - Emily Montgomerie
- Division of Infectious Diseases, Department of Medicine,
University of Miami Miller School of Medicine, Miami,
Florida, USA
| | - Nicholas Fonseca Nogueira
- Division of Infectious Diseases, Department of Medicine,
University of Miami Miller School of Medicine, Miami,
Florida, USA
| | - Irma Barreto Ojeda
- Division of Infectious Diseases, Department of Medicine,
University of Miami Miller School of Medicine, Miami,
Florida, USA
| | - Marissa Maddalon
- University of Miami School of Nursing and Health
Studies, Miami, Florida, USA
| | - Nicolle L Yanes Rodriguez
- Department of Psychiatry and Behavioral Sciences,
University of Miami Miller School of Medicine, Miami,
Florida, USA
| | - Theodora Brophy
- University of Miami Miller School of
Medicine, Miami, Florida, USA
| | - Thais Martinez
- University of Miami Miller School of
Medicine, Miami, Florida, USA
| | - Maria L Alcaide
- Division of Infectious Diseases, Department of Medicine,
University of Miami Miller School of Medicine, Miami,
Florida, USA
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10
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Parchem B, Molock SD. Brief report: Identified barriers and proposed solutions for recruiting young Black sexual minority men in HIV-related research. J Adolesc 2021; 87:1-5. [PMID: 33429132 DOI: 10.1016/j.adolescence.2020.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/13/2020] [Accepted: 12/21/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Young Black sexual minority men represent a high priority population for HIV prevention research yet the existing literature is not proportional to the current health disparity observed. The challenge of engaging this intersectional population in research on a stigmatized topic likely contributes to the dearth of literature. METHODS This brief report examines the current recruitment strategies for engaging sexual minority men in HIV-related research and identifies individual and system-level barriers that contribute to the underrepresentation of Black sexual minority men in HIV-related research. Qualitative data is integrated from Project HATCH (Helping African American Teens Combat HIV), an ongoing recruitment effort of 14-21-year-old Black sexual minority men in Washington D.C., United States. RESULTS Identified barriers to recruiting young Black sexual minority men include cultural stigma, mistrust of research institutions, the 'coming out' process for queer youth, assent procedures for youth, and others. CONCLUSIONS We propose several solutions for recruitment including geospatial technology, social media, and community spaces of trust (i.e., churches and schools). Additional larger scale solutions include destigmatizing youths' sexuality and prioritizing the advancement of Black scholars in academia and research endeavors.
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Affiliation(s)
- Benjamin Parchem
- Department of Psychological and Brain Sciences, George Washington University, 2125 G St NW, Washington, DC, 20052, USA.
| | - Sherry Davis Molock
- Department of Psychological and Brain Sciences, George Washington University, 2125 G St NW, Washington, DC, 20052, USA
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11
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Maragh-Bass AC, Gamble T, El-Sadr WM, Hanscom B, Tolley EE. Exploring individual-level barriers to HIV medication adherence among men who have sex with men in the HIV Prevention Trials Network (HPTN 065) study. AIDS Care 2020; 33:1404-1413. [PMID: 33025791 DOI: 10.1080/09540121.2020.1828799] [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: 10/23/2022]
Abstract
African-American men who have sex with men (MSM) with HIV are more likely to have unsuppressed viral load than other racial/ethnic groups. HPTN 065 Study, completed in 2015, consisted of five interconnected study components conducted at clinics in Bronx, New York and Washington, D.C. Participants completed surveys with questions related to socio-demographic factors and individual-level HIV medication adherence barriers, such as forgetting doses or fear of taking medications in front of others. Descriptive analyses and ordinal logistic regression with robust standard errors were conducted. Fifty-seven per cent of participants (N = 359) were African-American (57.1%) and roughly 40% had no more than a high school education. Mean age was 48 years. Overall, MSM with viral load suppression identified fewer individual-level barriers to adherence (p < .01) and individuals with depressive symptoms identified a greater number of barriers to adherence (p < .01). Compared to African-Americans, white MSM had a lower likelihood of identifying barriers to adherence (p < .05). Findings suggest that individual-level barriers to HIV medication adherence are common among MSM, irrespective of time since diagnosis and viral suppression. Race-specific interventions which address intersectional stigma are needed to improve health outcomes among African-American MSM, who bear much of the burden of poor HIV outcomes in the United States.
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Affiliation(s)
| | | | - Wafaa M El-Sadr
- ICAP at Columbia University, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Brett Hanscom
- HIV Prevention Trials Network Statistical Center for HIV AIDS Research and Prevention, University of Washington Seattle, Seattle, WA, USA
| | - Elizabeth E Tolley
- FHI 360, Behavioral, Epidemiological, and Clinical Sciences, Durham, NC, USA
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12
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Bass SB, D’Avanzo P, Alhajji M, Ventriglia N, Trainor A, Maurer L, Eisenberg R, Martinez O. Exploring the Engagement of Racial and Ethnic Minorities in HIV Treatment and Vaccine Clinical Trials: A Scoping Review of Literature and Implications for Future Research. AIDS Patient Care STDS 2020; 34:399-416. [PMID: 32931317 PMCID: PMC10722429 DOI: 10.1089/apc.2020.0008] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
HIV disproportionately impacts US racial and ethnic minorities but they participate in treatment and vaccine clinical trials at a lower rate than whites. To summarize barriers and facilitators to this participation we conducted a scoping review of the literature guided by the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Studies published from January 2007 and September 2019 were reviewed. Thirty-one articles were identified from an initial pool of 325 records using three coders. All records were then assessed for barriers and facilitators and summarized. Results indicate that while racial and ethnic minority participation in these trials has increased over the past 10 years, rates still do not proportionately reflect their burden of HIV infection. While many of the barriers mirror those found in other disease clinical trials (e.g., cancer), HIV stigma is a unique and important barrier to participating in HIV clinical trials. Recommendations to improve recruitment and retention of racial and ethnic minorities include training health care providers on the importance of recruiting diverse participants, creating interdisciplinary research teams that better represent who is being recruited, and providing culturally competent trial designs. Despite the knowledge of how to better recruit racial and ethnic minorities, few interventions have been documented using these strategies. Based on the findings of this review, we recommend that future clinical trials engage community stakeholders in all stages of the research process through community-based participatory research approaches and promote culturally and linguistically appropriate recruitment and retention strategies for marginalized populations overly impacted by HIV.
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Affiliation(s)
- Sarah Bauerle Bass
- Risk Communication Laboratory, Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
| | - Paul D’Avanzo
- Risk Communication Laboratory, Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
| | - Mohammed Alhajji
- Risk Communication Laboratory, Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
| | - Nicole Ventriglia
- Fox Chase Cancer Center, Risk Assessment Program, Philadelphia, Pennsylvania, USA
| | - Aurora Trainor
- Risk Communication Laboratory, Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
| | - Laurie Maurer
- Tennessee Department of Health, HIV/STD/Viral Hepatitis Section, Nashville, Tennessee, USA
| | | | - Omar Martinez
- School of Social Work, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
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Mayer KH, Agwu A, Malebranche D. Barriers to the Wider Use of Pre-exposure Prophylaxis in the United States: A Narrative Review. Adv Ther 2020; 37:1778-1811. [PMID: 32232664 PMCID: PMC7467490 DOI: 10.1007/s12325-020-01295-0] [Citation(s) in RCA: 210] [Impact Index Per Article: 52.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Indexed: 01/01/2023]
Abstract
Antiretroviral pre-exposure prophylaxis (PrEP) to prevent HIV transmission was first approved by the US Food and Drug Administration in 2012. Despite correlations of decreases in new HIV infections being greatest where PrEP has been deployed, the uptake of PrEP is lagging, particularly among populations with disproportionate HIV burden. This narrative review seeks to identify individual and systemic barriers to PrEP usage in the USA. A comprehensive search of recent literature uncovered a complex array of structural, social, clinical, and behavioral barriers, including knowledge/awareness of PrEP, perception of HIV risk, stigma from healthcare providers or family/partners/friends, distrust of healthcare providers/systems, access to PrEP, costs of PrEP, and concerns around PrEP side effects/medication interactions. Importantly, these barriers may have different effects on specific populations at risk. The full potential of PrEP for HIV prevention will not be realized until these issues are addressed. Strategies to achieve this goal should include educational interventions, innovative approaches to delivery of HIV care, financial support, and destigmatization of PrEP and PrEP users. Until then, PrEP uptake will continue to be suboptimal, particularly among those who need it most.
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Affiliation(s)
- Kenneth H Mayer
- The Fenway Institute and Harvard Medical School, Boston, MA, USA.
| | - Allison Agwu
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Horvath KJ, MacLehose RF, Martinka A, DeWitt J, Hightow-Weidman L, Sullivan P, Amico KR. Connecting Youth and Young Adults to Optimize Antiretroviral Therapy Adherence (YouTHrive): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e11502. [PMID: 31364601 PMCID: PMC6691670 DOI: 10.2196/11502] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/01/2018] [Accepted: 10/04/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Despite intensive efforts to engage people living with HIV in the United States, less than half of the youth aged 13 to 24 years achieve viral suppression. There is a clear and continued need for innovative behavioral programs that support optimizing adherence among young persons with HIV. OBJECTIVE There are 3 phases of this project. Phase 1 involves conducting focus groups to obtain feedback from youth about an existing technology-based antiretroviral therapy (ART) adherence intervention. Phase 2 will be used to conduct beta testing with youth to refine and finalize the YouTHrive (YT) intervention. Phase 3 is a randomized controlled trial (RCT) to test the efficacy of the YT intervention among youth living with HIV (YLWH). METHODS In phase 1, we will conduct 6 focus groups with approximately 8 youths (aged 15-19 years) and young adults (aged 20-24 years), each in 3 US cities to obtain (1) feedback from YLWH about the look and feel and content of an existing adult-focused Web-based ART adherence intervention and (2) suggestions for adapting the intervention for YLWH similar to themselves. Phase 2 will involve updating the existing intervention to include features and functionality recommended by YLWH in phase 1; it will conclude with beta testing with 12 participants to gain feedback on the overall design and ensure proper functionality and ease of navigation. For phase 3, we will enroll 300 YLWH in 6 US cities (Atlanta, Chicago, Houston, New York City, Philadelphia, and Tampa) into a 2-arm prospective RCT. Participants will be randomized 1:1 to YT intervention or control group. The randomization sequence will be stratified by city and use random permuted blocks of sizes 2 and 4. Participants randomized to the control condition will view a weekly email newsletter on topics related to HIV, with the exception of ART adherence, for 5 months. Participants randomized to the YT intervention condition will be given access to the YT site for 5 months. Study assessments will occur at enrollment and 5, 8, and 11 months post enrollment. The primary outcome that will be assessed is sustained viral load (VL), defined as the proportion of participants in each study arm who have suppressed VL at both the 5- and 11-month assessment; the secondary outcome that will be assessed is suppressed VL at both the 5- and 11-month assessment between drug-using and nondrug-using participants assigned to the YT intervention arm. RESULTS Participant recruitment began in May 2017 for phase 1 of the study. The data collection for aim 3 is anticipated to end in April 2020. CONCLUSIONS The efficacy trial of the YT intervention will help to fill gaps in understanding the efficacy of mobile interventions to improve ART adherence among at-risk populations. TRIAL REGISTRATION ClinicalTrials.gov NCT03149757; https://clinicaltrials.gov/ct2/show/NCT03149757 (Archived by WebCite at http://www.webcitation.org/73pw57Cf1). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/11502.
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Affiliation(s)
- K J Horvath
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - R F MacLehose
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - A Martinka
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - J DeWitt
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - L Hightow-Weidman
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - P Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - K R Amico
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
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Implementation of a Socio-structural Demonstration Project to Improve HIV Outcomes Among Young Black Men in the Deep South. J Racial Ethn Health Disparities 2019; 6:775-789. [PMID: 30793253 DOI: 10.1007/s40615-019-00576-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 01/31/2019] [Accepted: 02/12/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND We describe the background, rationale, intervention components, and formative results of a demonstration project aimed to ameliorate five socio-structural barriers to HIV services for young Black men aged 18-29 living with and at risk for HIV in Louisiana. METHODS The interventions and activities consisted of (1) five person-centered approaches to enhance linkage to HIV services and improve socio-economic outcomes; (2) the implementation of systematic mystery shopping tests to document instances of housing discrimination; (3) the development and implementation of a multi-prong communications campaign to increase knowledge about the signs of housing discrimination and community resources among young Black men who have sex with men (YBMSM); (4) the integration of HIV/STI services and lesbian, gay, bisexual, and trans (LGBT)-inclusive events on Historically Black Colleges and Universities (HBCUs); and (5) the development of a safe space for YBMSM. A multi-method approach was used to evaluate the outcomes of the different interventions. RESULTS The majority (62%) of participants living with HIV were linked to HIV care and 49% had achieved viral suppression. More than 40% of participants were employed during the project. Thirty-seven percent (37%) of the mystery shopping tests showed definite or possible signs of housing discrimination. The housing campaign's duration was limited with unknown long-term impact among YBMSM. Fifteen cases of syphilis were identified during two HBCU events. A safe space was specifically created for YBMSM at a community-based organization. CONCLUSION Multi-component holistic health interventions are needed to improve HIV outcomes and curb the high HIV rates among young Black men, particularly YBMSM in the United States and the Deep South.
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16
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Day S, Blumberg M, Vu T, Zhao Y, Rennie S, Tucker JD. Stakeholder engagement to inform HIV clinical trials: a systematic review of the evidence. J Int AIDS Soc 2018; 21 Suppl 7:e25174. [PMID: 30334358 PMCID: PMC6192899 DOI: 10.1002/jia2.25174] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 07/20/2018] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Stakeholder engagement is an essential component of HIV clinical trials. We define stakeholder engagement as an input by individuals or groups with an interest in HIV clinical trials to inform the design or conduct of said trials. Despite its value, stakeholder engagement to inform HIV clinical trials has not been rigorously examined. The purpose of our systematic review is to examine stakeholder engagement for HIV clinical trials and compare it to the recommendations of the UNAIDS/AVAC Good Participatory Practice (GPP) guidelines. METHODS We used the PRISMA checklist and identified English language studies describing stakeholder engagement to inform HIV clinical trials. Four databases (PubMed, Ovid, CINAHL and Web of Science) and six journals were searched, with additional studies identified using handsearching and expert input. Two independent reviewers examined citations, abstracts and full texts. Data were extracted on country, engagement methods, stakeholder types and purpose of stakeholder engagement. Based on the GPP guidelines, we examined how frequently stakeholder engagement was conducted to inform clinical trial research question development, protocol development, recruitment, enrolment, follow-up, results and dissemination. RESULTS AND DISCUSSION Of the 917 citations identified, 108 studies were included in the analysis. Forty-eight studies (44.4%) described stakeholder engagement in high-income countries, thirty (27.8%) in middle-income countries and nine (8.3%) in low-income countries. Fourteen methods for stakeholder engagement were identified, including individual (e.g. interviews) and group (e.g. community advisory boards) strategies. Thirty-five types of stakeholders were engaged, with approximately half of the studies (60; 55.6%) engaging HIV-affected community stakeholders (e.g. people living with HIV, at-risk or related populations of interest). We observed greater frequency of stakeholder engagement to inform protocol development (49 studies; 45.4%) and trial recruitment (47 studies; 43.5%). Fewer studies described stakeholder engagement to inform post-trial processes related to trial results (3; 2.8%) and dissemination (11; 10.2%). CONCLUSIONS Our findings identify important directions for future stakeholder engagement research and suggestions for policy. Most notably, we found that stakeholder engagement was more frequently conducted to inform early stages of HIV clinical trials compared to later stages. In order to meet recommendations established in the GPP guidelines, greater stakeholder engagement across all clinical trial stages is needed.
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Affiliation(s)
- Suzanne Day
- Institute for Global Health and Infectious DiseasesUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Meredith Blumberg
- Institute for Global Health and Infectious DiseasesUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Thi Vu
- Institute for Global Health and Infectious DiseasesUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Yang Zhao
- University of North Carolina – Project ChinaGuangzhouChina
| | - Stuart Rennie
- Department of Social MedicineUniversity of North Carolina at Chapel HillChapel HillNCUSA
- Center for BioethicsUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Joseph D. Tucker
- Institute for Global Health and Infectious DiseasesUniversity of North Carolina at Chapel HillChapel HillNCUSA
- University of North Carolina – Project ChinaGuangzhouChina
- School of MedicineUniversity of North Carolina at Chapel HillChapel HillNCUSA
- Faculty of Infectious DiseasesLondon School of Hygiene and Tropical MedicineLondonUK
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Wheeler DP, Lucas J, Wilton L, Nelson LE, Hucks‐Ortiz C, Watson CC, Hutchinson C, Mayer KH, Kuo I, Magnus M, Beauchamp G, Shoptaw S, Emel LM, Chen YQ, Hightow‐Weidman L, Fields SD. Building effective multilevel HIV prevention partnerships with Black men who have sex with men: experience from HPTN 073, a pre-exposure prophylaxis study in three US cities. J Int AIDS Soc 2018; 21 Suppl 7:e25180. [PMID: 30334600 PMCID: PMC6193312 DOI: 10.1002/jia2.25180] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 08/06/2018] [Indexed: 11/28/2022] Open
Affiliation(s)
| | | | - Leo Wilton
- Department of Human DevelopmentState University of New York at BinghamtonBinghamtonNYUSA
- Faculty of HumanitiesUniversity of JohannesburgJohannesburgSouth Africa
| | - LaRon E Nelson
- School of NursingUniversity of RochesterRochesterNYUSA
- Centre for Urban Health SolutionsLi Ka Shing Knowledge InstituteSt. Michael's HospitalTorontoONCanada
| | | | | | | | - Kenneth H Mayer
- The Fenway InstituteFenway HealthBostonMAUSA
- Harvard Medical SchoolBostonMAUSA
- Beth Israel Deaconess Medical CenterBostonMAUSA
| | - Irene Kuo
- Department of Epidemiology and BiostatisticsMilken Institute School of Public HealthGeorge Washington UniversityWashingtonDCUSA
| | - Manya Magnus
- Department of Epidemiology and BiostatisticsMilken Institute School of Public HealthGeorge Washington UniversityWashingtonDCUSA
| | - Geetha Beauchamp
- Statistical Center for HIV/AIDS Research & Prevention (SCHARP)Vaccine and Infectious Disease Division (VIDD)Fred Hutchinson Cancer Research CenterSeattleWAUSA
| | - Steven Shoptaw
- Department of Family MedicineDavid Geffen School of MedicineUniversity of California Los Angeles (UCLA)Los AngelesCAUSA
| | | | - Ying Q Chen
- Fred Hutchinson Cancer Research CenterSeattleWAUSA
| | - Lisa Hightow‐Weidman
- Division of Infectious DiseasesUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Sheldon D Fields
- School of Health ProfessionsNew York Institute of TechnologyNorthern BoulevardNYUSA
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18
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Matthews DD. Leveraging a Legacy of Activism: Black Lives Matter and the Future of HIV Prevention for Black MSM. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2018; 30:208-212. [PMID: 29969303 DOI: 10.1521/aeap.2018.30.3.208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This year marks the 30th anniversary of AIDS Education and Prevention. As we approach the United Nations goal of ending the AIDS epidemic by 2030, it is a useful time to reflect on and learn from history. In the United States, no such endeavor can be successful without addressing the specific context of Black men who have sex with men. In this commentary I highlight factors that led us to a state in which Black MSM represent approximately a quarter of all people living with HIV in the United States. I also look back at the power of activism during the beginning of the HIV epidemic. Using Black Lives Matter as a contemporary framework, I highlight natural linkages between activism 30 years ago, its incarnation and relationship to public health today, and its promise as the way forward in achieving the elimination of AIDS for Black MSM by 2030.
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Affiliation(s)
- Derrick D Matthews
- Department of Infectious Diseases and Microbiology, Center for LGBT Health Research, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
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Clement ME, Okeke NL, Munn T, Hunter M, Alexis K, Corneli A, Seña AC, McGee K, McKellar MS. Partnerships Between a University-Affiliated Clinic and Community-Based Organizations to Reach Black Men Who Have Sex With Men for PrEP Care. J Acquir Immune Defic Syndr 2018; 77:e25-e27. [PMID: 29084043 PMCID: PMC5762394 DOI: 10.1097/qai.0000000000001577] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Meredith E Clement
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC
- Duke Clinical Research Institute, Durham, NC
| | - Nwora L Okeke
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC
| | | | | | - Kareem Alexis
- Triangle Empowerment Center, Durham, NC
- Duke University School of Medicine, Durham, NC
| | - Amy Corneli
- Duke Clinical Research Institute, Durham, NC
- Division of General Internal Medicine, Duke University Medical Center, Durham, NC
| | - Arlene C Seña
- Durham County Health Department, Durham, NC
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, NC
| | - Kara McGee
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC
| | - Mehri S McKellar
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC
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20
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Wilson PA, Valera P, Martos AJ, Wittlin NM, Muñoz-Laboy MA, Parker RG. Contributions of Qualitative Research in Informing HIV/AIDS Interventions Targeting Black MSM in the United States. JOURNAL OF SEX RESEARCH 2016; 53:642-54. [PMID: 26241373 PMCID: PMC4740277 DOI: 10.1080/00224499.2015.1016139] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This article presents a systematic review of qualitative studies focusing on human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) among Black men who have sex with men (BMSM) in the United States. We reviewed studies that were published between 1980 and 2014. Qualitative methods employed in the studies reviewed include in-depth interviews, focus groups, participant observation, and ethnography. We searched several databases (PubMed, PsychINFO, JSTOR, ERIC, Sociological Abstracts, and Google Scholar) for relevant articles using the following broad terms: "Black men" "Black gay/bisexual" or "Black men who have sex with men," and "qualitative" and/or "ethnography." We include 70 studies in this review. The key themes observed across studies were (1) heterogeneity, (2) layered stigma and intersectionality, (3) risk behaviors, (4) mental health, (5) resilience, and (6) community engagement. The review suggests that sexual behavior and HIV-status disclosure, sexual risk taking, substance use, and psychological well-being were contextually situated. Interventions occurring at multiple levels and within multiple contexts are needed to reduce stigma within the Black community. Similarly, structural interventions targeting religious groups, schools, and health care systems are needed to improve the health outcomes among BMSM. Community engagement and using community-based participatory research methods may facilitate the development and implementation of culturally appropriate HIV/AIDS interventions targeting BMSM.
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Affiliation(s)
- Patrick A. Wilson
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY U.S.A
| | - Pamela Valera
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY U.S.A
| | - Alexander J. Martos
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY U.S.A
| | - Natalie M. Wittlin
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY U.S.A
| | - Miguel A. Muñoz-Laboy
- College of Health Professions and Social Work, Temple University, Philadelphia, PA, U.S.A
| | - Richard G. Parker
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY U.S.A
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Rubincam C, Lacombe-Duncan A, Newman PA. Taking culture seriously in biomedical HIV prevention trials: a meta-synthesis of qualitative studies. Expert Rev Vaccines 2015; 15:331-47. [PMID: 26560332 DOI: 10.1586/14760584.2016.1118349] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A substantial gap exists between widespread acknowledgement of the importance of incorporating cultural sensitivity in biomedical HIV prevention trials and empirical evidence to guide the operationalization of cultural sensitivity in these trials. We conducted a systematic literature search and qualitative meta-synthesis to explore how culture is conceptualized and operationalized in global biomedical HIV prevention trials. Across 29 studies, the majority (n = 17) were conducted in resource-limited settings. We identified four overarching themes: (1) semantic cultural sensitivity - challenges in communicating scientific terminology into local vernaculars; (2) instrumental cultural sensitivity - understanding historical experiences to guide tailoring of trial activities; (3) budgetary, logistical, and personnel implications of operationalizing cultural sensitivity; and (4) culture as an asset. Future investigations should address how sociocultural considerations are operationalized across the spectrum of trial preparedness, implementation, and dissemination in particular sociocultural contexts, including intervention studies and evaluations of the effectiveness of methods used to operationalize culturally sensitive practices.
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Affiliation(s)
- Clara Rubincam
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
| | - Ashley Lacombe-Duncan
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
| | - Peter A Newman
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
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Kaufman MR, Cornish F, Zimmerman RS, Johnson BT. Health behavior change models for HIV prevention and AIDS care: practical recommendations for a multi-level approach. J Acquir Immune Defic Syndr 2014; 66 Suppl 3:S250-8. [PMID: 25007194 PMCID: PMC4536982 DOI: 10.1097/qai.0000000000000236] [Citation(s) in RCA: 167] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Despite increasing recent emphasis on the social and structural determinants of HIV-related behavior, empirical research and interventions lag behind, partly because of the complexity of social–structural approaches. This article provides a comprehensive and practical review of the diverse literature on multi-level approaches to HIV-related behavior change in the interest of contributing to the ongoing shift to more holistic theory, research, and practice. It has the following specific aims: (1) to provide a comprehensive list of relevant variables/factors related to behavior change at all points on the individual–structural spectrum, (2) to map out and compare the characteristics of important recent multi-level models, (3) to reflect on the challenges of operating with such complex theoretical tools, and (4) to identify next steps and make actionable recommendations. Using a multi-level approach implies incorporating increasing numbers of variables and increasingly context-specific mechanisms, overall producing greater intricacies. We conclude with recommendations on how best to respond to this complexity, which include: using formative research and interdisciplinary collaboration to select the most appropriate levels and variables in a given context; measuring social and institutional variables at the appropriate level to ensure meaningful assessments of multiple levels are made; and conceptualizing intervention and research with reference to theoretical models and mechanisms to facilitate transferability, sustainability, and scalability.
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Affiliation(s)
- Michelle R Kaufman
- *Johns Hopkins University Bloomberg School of Public Health, Center for Communication Programs, Baltimore, MD; †Department of Methodology, London School of Economics and Political Science, London, UK; ‡University of Missouri-St. Louis, College of Nursing; and §Department of Psychology, University of Connecticut and Center for Health, Intervention, and Prevention, Storrs CT
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