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Augostini P, Bradley ELP, Raphael BH, Secor WE. In Vitro Testing of Trichomonas vaginalis Drug Susceptibility: Evaluation of Minimal Lethal Concentrations for Metronidazole and Tinidazole That Correspond With Treatment Failure. Sex Transm Dis 2023; 50:370-373. [PMID: 36849257 PMCID: PMC10175203 DOI: 10.1097/olq.0000000000001788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/15/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND The only drugs approved by the US Food and Drug Administration for oral treatment of trichomoniasis belong to the 5-nitroimidazole group. Most individuals infected with Trichomonas vaginalis can be cured with a standard treatment of metronidazole or tinidazole, but it is estimated that more than 159,000 people fail treatment each year. Although a minimal lethal concentration (MLC) corresponding to treatment failure has been reported for metronidazole, the MLC for tinidazole associated with treatment failure has not been determined. We conducted a study using T. vaginalis isolates from women with reported treatment success or failure to determine these values. METHODS We measured MLCs of 47 isolates obtained from women who had failed metronidazole treatment, 33 isolates from women who had failed tinidazole treatment, and 48 isolates from women successfully cured with metronidazole. The cutoff was calculated as the 95th percentile of MLCs of susceptible isolates for each drug. RESULTS Our data confirmed that the MLC previously associated with metronidazole treatment failure is ≥50 μg/mL and identified the MLC associated with tinidazole treatment failure as ≥6.3 μg/mL. For metronidazole, the agreement between laboratory result and treatment outcome was 93.7%; for tinidazole, this agreement was 88.9%. CONCLUSIONS The T. vaginalis susceptibility assay is useful for determining whether 5-nitroimidazole treatment failure in persons with trichomoniasis can be attributed to drug resistance. These results are useful for establishing interpretive guidance of test results, and MLC levels can help guide appropriate patient treatment.
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Affiliation(s)
- Peter Augostini
- From the Laboratory Science and Diagnostics Branch, Division of Parasitic Disease and Malaria, Centers for Disease Control and Prevention
| | | | - Brian H. Raphael
- From the Laboratory Science and Diagnostics Branch, Division of Parasitic Disease and Malaria, Centers for Disease Control and Prevention
| | - W. Evan Secor
- From the Laboratory Science and Diagnostics Branch, Division of Parasitic Disease and Malaria, Centers for Disease Control and Prevention
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DiClemente RJ, Rosenbaum JE, Rose ES, Sales JM, Brown JL, Renfro TL, Bradley ELP, Davis TL, Capasso A, Wingood GM, Liu Y, West SG, Hardin JW, Bryan AD, Feldstein Ewing SW. Horizons and Group Motivational Enhancement Therapy: HIV Prevention for Alcohol-Using Young Black Women, a Randomized Experiment. Am J Prev Med 2021; 60:629-638. [PMID: 33678517 DOI: 10.1016/j.amepre.2020.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 10/11/2020] [Accepted: 11/23/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Black women are at disproportionately greater risk for HIV and sexually transmitted infections than women of other ethnic/racial backgrounds. Alcohol use may further elevate the risk of HIV/sexually transmitted infection acquisition and transmission. STUDY DESIGN A random-assignment parallel-group comparative treatment efficacy trial was conducted with random assignment to 1 of 3 conditions. SETTING/PARTICIPANTS The sample comprised 560 Black or African American women aged 18-24 years who reported recent unprotected vaginal or anal sex and recent alcohol use. Participants were recruited from community settings in Atlanta, Georgia, from January 2012 to February 2014. INTERVENTION A Group Motivational Enhancement Therapy module was designed to complement a Centers for Disease Control and Prevention-designated evidence-based intervention (Horizons) to reduce sexual risk behaviors, alcohol use, and sexually transmitted infections, with 3 comparison groups: (1) Horizons + Group Motivational Enhancement Therapy intervention, (2) Horizons + General Health Promotion intervention, and (3) enhanced standard of care. MAIN OUTCOME MEASURES Outcome measures included safe sex (abstinence or 100% condom use); condom nonuse; proportion of condom use during sexual episodes; incident chlamydia, gonorrhea, and trichomonas infections; and problematic alcohol use measured by Alcohol Use Disorders Identification Test score. Treatment effects were estimated using an intention-to-treat protocol‒generalized estimating equations with logistic regression for binomial outcomes and Poisson regression for count outcomes. Analyses were conducted between October 2018 and October 2019. RESULTS Participants assigned to Horizons + Group Motivational Enhancement Therapy had greater odds of safe sex (AOR=1.45, 95% CI=1.04, 2.02, p=0.03), greater proportion of condom use (AOR=1.68, 95% CI=1.18, 2.41, p=0.004), and lower odds of condom nonuse (AOR=0.57, 95% CI=0.38, 0.83, p=0.004). Both interventions had lower odds of problematic alcohol use (Horizons: AOR=0.57, 95% CI=0.39, 0.85, p=0.006; Horizons + Group Motivational Enhancement Therapy: AOR=0.61, 95% CI=0.41, 0.90, p=0.01). CONCLUSIONS Complementing an evidence-based HIV prevention intervention with Group Motivational Enhancement Therapy may increase safer sexual behaviors and concomitantly reduce alcohol use among young Black women who consume alcohol. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov NCT01553682.
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Affiliation(s)
- Ralph J DiClemente
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, New York
| | - Janet E Rosenbaum
- Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, New York.
| | - Eve S Rose
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Jessica M Sales
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Jennifer L Brown
- Department of Psychology, University of Cincinnati, Cincinnati, Ohio; Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Tiffaney L Renfro
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Erin L P Bradley
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia; Department of Public Health, Agnes Scott College, Decatur, Georgia
| | - Teaniese L Davis
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia; Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta, Georgia
| | - Ariadna Capasso
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, New York
| | - Gina M Wingood
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York City, New York
| | - Yu Liu
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, Texas
| | - Stephen G West
- Department of Psychology, Arizona State University, Tempe, Arizona
| | - James W Hardin
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Angela D Bryan
- Department of Psychology and Neuroscience, University of Colorado, Boulder, Colorado
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McCree DH, Chesson H, Bradley ELP, Williams A, Gant Z, Geter A. Exploring Changes in Racial/Ethnic Disparities of HIV Diagnosis Rates Under the "Ending the HIV Epidemic: A Plan for America" Initiative. Public Health Rep 2020; 135:685-690. [PMID: 32762633 DOI: 10.1177/0033354920943526] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Racial/ethnic disparities in HIV diagnosis rates remain despite the availability of effective treatment and prevention tools in the United States. In 2019, President Trump announced the "Ending the HIV Epidemic: A Plan for America" (EHE) initiative to reduce new HIV infections in the United States at least 75% by 2025 and at least 90% by 2030. The objective of this study was to show the potential effect of the EHE initiative on racial/ethnic disparities in HIV diagnosis rates at the national level. METHODS We used 2017 HIV diagnoses data from the Centers for Disease Control and Prevention National HIV Surveillance System. We developed a counterfactual scenario to determine changes in racial/ethnic disparities if the 2017 HIV diagnosis rates were reduced by 75% in the geographic regions targeted by the EHE initiative. We used 4 measures to calculate results: rate ratio, population-attributable proportion (PAP), Gini coefficient, and Index of Disparity. RESULTS The relative measures of racial/ethnic disparity decreased by 9%-21% in the EHE scenario compared with the 2017 HIV diagnoses data. The largest decrease was in the Hispanic/Latino:white rate ratio (-20.6%) and in the black:white rate ratio (-18.2%). The PAP measure decreased by 11.5%. The absolute versions of the Index of Disparity (unweighted and weighted) were approximately 50% lower in the EHE scenario than in the 2017 HIV diagnoses data. CONCLUSIONS EHE efforts could reduce but will not eliminate racial/ethnic disparities in HIV diagnosis rates. Efforts to address racial/ethnic disparities should continue, and innovative approaches, specifically those that focus on social and structural factors, should be developed and implemented for populations that are disproportionately affected by HIV in the United States.
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Affiliation(s)
- Donna Hubbard McCree
- 1242 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Harrell Chesson
- 1242 Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Erin L P Bradley
- 17215 Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Zanetta Gant
- 1242 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Angelica Geter
- 17215 Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention, Atlanta, GA, USA
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McCree DH, Beer L, Fugerson AG, Tie Y, Bradley ELP. Social and Structural Factors Associated with Sustained Viral Suppression Among Heterosexual Black Men with Diagnosed HIV in the United States, 2015-2017. AIDS Behav 2020; 24:2451-2460. [PMID: 32020509 DOI: 10.1007/s10461-020-02805-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This paper describes sociodemographic, sexual risk behavior, and clinical care factors associated with sustained viral suppression (SVS) among heterosexual Black men with diagnosed HIV in the US. Sample was 968 men, 2015-2017 cycles of Medical Monitoring Project. We used prevalence ratios and a multivariable logistic regression model to identify independent predictors of SVS. About 9% of sexually active men had sex that carries a risk of HIV transmission. Nearly 2/3 lived at or below the poverty level, 13% were under or uninsured, 1/4 experienced food insecurity and 15% reported recent homelessness. About 26% were not engaged in HIV care, 8% not currently taking antiretroviral therapy (ART) and 59% had SVS. Among men taking ART, care engagement and adherence were the only significant independent predictors of SVS. Efforts to increase VS should focus on increasing ART use, care engagement, and ART adherence, and include strategies that address the social and structural factors that influence them.
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Affiliation(s)
- Donna Hubbard McCree
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Linda Beer
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Yunfeng Tie
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Erin L P Bradley
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
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5
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Bradley ELP, Lanier Y, Ukuku Miller AM, Brawner BM, Sutton MY. Successfully Recruiting Black and Hispanic/Latino Adolescents for Sexually Transmitted Infection and HIV Prevention Research. J Racial Ethn Health Disparities 2019; 7:36-44. [PMID: 31520322 DOI: 10.1007/s40615-019-00631-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 08/10/2019] [Accepted: 08/15/2019] [Indexed: 11/29/2022]
Abstract
Disparities in rates of sexually transmitted infections (STIs) and HIV between Black/African American and Hispanic/Latino adolescents and their white counterparts are well documented. Researchers may encounter notable challenges recruiting Black/African American and Hispanic/Latino adolescents for sexual risk reduction studies. In this article, we present information to assist with planning, implementing, and evaluating recruitment and retention strategies. We also provide practical examples of challenges and solutions from three STI/HIV epidemiologic or prevention intervention studies with different study purposes and populations. Researchers can use this information to aid proposal development, create or refine a recruitment/retention protocol before implementation, and troubleshoot challenges during implementation.
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Affiliation(s)
- Erin L P Bradley
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, 1600 Clifton Road NE, MS E-45, Atlanta, GA, 30329, USA.
| | - Yzette Lanier
- New York University Rory Meyers College of Nursing, 433 First Ave, Room 406, New York, NY, 10003, USA
| | - Afekwo M Ukuku Miller
- Department of Health Promotion and Physical Education, Kennesaw State University, 290 Kennesaw State University Road, MD 0301, Kennesaw, GA, 30144, USA
| | - Bridgette M Brawner
- Department of Family and Community Health, University of Pennsylvania School of Nursing, 418 Curie Blvd., Room 419, Philadelphia, PA, 19104-4217, USA
| | - Madeline Y Sutton
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, 1600 Clifton Road NE, MS E-45, Atlanta, GA, 30329, USA.,Department of Obstetrics and Gynecology, Morehouse School of Medicine, 720 Westview Dr, Atlanta, GA, 30310, USA
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6
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Bradley ELP, Frazier EL, Carree T, Hubbard McCree D, Sutton MY. Psychological and social determinants of health, antiretroviral therapy (ART) adherence, and viral suppression among HIV-positive black women in care. AIDS Care 2019; 31:932-941. [PMID: 31056924 DOI: 10.1080/09540121.2019.1612022] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Black women are disproportionately affected by HIV, accounting for 61% of women diagnosed in 2016. Black women with HIV are less likely to be adherent to antiretroviral therapy (ART) and virally suppressed compared to women of other racial/ethnic groups. We analyzed 2013-2014 data from 1703 black women patients in the Centers for Disease Control and Prevention's Medical Monitoring Project to examine whether select psychological and social determinants of health (SDH) factors were associated with ART adherence and viral suppression. We calculated weighted estimates and used multivariable logistic regression with adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) to examine correlates of ART adherence and viral suppression. Women who had not been incarcerated in the past 12 months (aPR = 1.24; CI: 1.04-1.48) and had not experienced discrimination in a health care setting since their HIV diagnosis (aPR = 1.06; 1.00-1.11) were slightly more likely to be adherent to ART. Women who lived above the federal poverty level were more likely to be virally suppressed during the past 12 months (aPR = 1.09; CI: 1.01-1.18). More research is warranted to identify the best strategies to create health care settings that encourage black women's HIV care engagement, and to address other key SDH and/or psychological factors.
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Affiliation(s)
- Erin L P Bradley
- a Division of HIV/AIDS Prevention , Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Emma L Frazier
- a Division of HIV/AIDS Prevention , Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Tamara Carree
- a Division of HIV/AIDS Prevention , Centers for Disease Control and Prevention , Atlanta , GA , USA.,b ICF Corporation , Atlanta , GA , USA
| | - Donna Hubbard McCree
- a Division of HIV/AIDS Prevention , Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Madeline Y Sutton
- a Division of HIV/AIDS Prevention , Centers for Disease Control and Prevention , Atlanta , GA , USA.,c Department of Obstetrics and Gynecology , Morehouse School of Medicine , Atlanta , GA , USA
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7
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Elmore K, Bradley ELP, Lima AC, Khalil GM, Obi-Tabot E, Gant Z, Dean HD, McCree DH. Trends in Geographic Rates of HIV Diagnoses Among Black Females in the United States, 2010-2015. J Womens Health (Larchmt) 2018; 28:410-417. [PMID: 30526269 DOI: 10.1089/jwh.2017.6868] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND HIV diagnoses among females in the United States declined 22% from 2010 to 2015, including a 27% decline in diagnoses among black females. Despite this progress, disparities persist. Black females accounted for 60% of new HIV diagnoses among females in 2015. Geographic disparities also exist. This article describes geographic differences in HIV diagnoses among black females in the United States, from 2010 to 2015. MATERIALS AND METHODS We examined HIV surveillance data from 2010 to 2015 to determine in which geographic areas decreases or increases in HIV diagnoses occurred. We used data from the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention's (NCHHSTP) AtlasPlus to calculate percent changes in HIV diagnosis rates by geographic region for black females ≥13 years of age. RESULTS The number of new HIV diagnoses declined 27% among black females from 2010 to 2015. The highest rates of HIV diagnosis per 100,000 population of black females, from 2010 to 2015, were in the Northeast and the South. In 2015, five of the eight states reporting the highest rates of HIV diagnosis (i.e., the highest quartile) were in the South. CONCLUSIONS HIV diagnosis rates decreased nationally among black females, but the decreases were not uniform within regions or across the United States. Some states experienced increases, and black females in the South and Northeast remain disproportionately affected. Additional research is needed to ascertain factors associated with the increases to continue progress toward reducing HIV-related disparities among females in the United States.
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Affiliation(s)
- Kim Elmore
- 1 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Erin L P Bradley
- 1 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Ashley C Lima
- 1 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - George M Khalil
- 1 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Estella Obi-Tabot
- 2 Division of Disease Prevention , Virginia Department of Health, Richmond, Virginia
| | - Zanetta Gant
- 1 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Hazel D Dean
- 3 National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Donna Hubbard McCree
- 1 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia
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Bradley ELP, Geter A, Lima AC, Sutton MY, Hubbard McCree D. Effectively Addressing Human Immunodeficiency Virus Disparities Affecting US Black Women. Health Equity 2018; 2:329-333. [PMID: 30460333 PMCID: PMC6243214 DOI: 10.1089/heq.2018.0038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Black women have disproportionately higher rates of human immunodeficiency virus (HIV) infection, and low percentages being linked to care and becoming virally suppressed, compared with women of other races/ethnicities. To date, few evidence-based HIV prevention and care interventions tailored for black women exist. We highlight three essential factors to consider in designing culturally and gender-appropriate studies to address HIV-related disparities affecting black women: (1) social determinants of HIV risk, (2) determinants of equity, and (3) perceptions of black women's sexuality. Synergy between a strong evidence base and developing strong partnerships could accelerate progress toward HIV-related health equity for black women.
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Affiliation(s)
- Erin L P Bradley
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Angelica Geter
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ashley C Lima
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Madeline Y Sutton
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Donna Hubbard McCree
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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Bradley ELP, Hoover KW. Improving HIV Preexposure Prophylaxis Implementation for Women: Summary of Key Findings From a Discussion Series with Women's HIV Prevention Experts. Womens Health Issues 2018; 29:3-7. [PMID: 30292440 DOI: 10.1016/j.whi.2018.08.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 08/10/2018] [Accepted: 08/14/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Erin L P Bradley
- Division of HIV/AIDS Prevention, National Centers for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
| | - Karen W Hoover
- Division of HIV/AIDS Prevention, National Centers for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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- Division of HIV/AIDS Prevention, National Centers for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Bradley ELP, Vidot DC, Gaul Z, Sutton MY, Pereyra M. Acceptability of oral rapid HIV testing at dental clinics in communities with high HIV prevalence in South Florida. PLoS One 2018; 13:e0196323. [PMID: 29702677 PMCID: PMC5922539 DOI: 10.1371/journal.pone.0196323] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 04/11/2018] [Indexed: 11/19/2022] Open
Abstract
Background Expanding HIV screening for populations at risk necessitates testing in nontraditional settings. We assessed HIV testing in dental clinics in South Florida, an urban area with the highest rates of HIV diagnoses in the United States in 2015. Aims We explored patients’ acceptance of oral HIV rapid tests administered by dental providers and identified reasons for accepting or declining HIV testing. Methods During 2014 and 2015, dentists and hygienists at two federally qualified health center (FQHC) dental clinics who serve racial/ethnic minority patient populations in South Florida were trained to administer oral HIV rapid tests as a part of a routine dental visit. Patients presenting for dental services were offered a rapid HIV test and brief survey regarding their demographics, HIV testing history and behaviors. Results We enrolled 600 patients (median age = 43 years; IQR: 29–56 years), 45% non-Hispanic black and 35% Hispanic/Latino, 83% graduated high school, and 50% unemployed. Most (85%) accepted oral HIV rapid testing (none tested HIV-positive); 14% had never been tested for HIV. The most common reasons for testing were a desire to know HIV status (56%) and free testing (54%). Among 93 (15%) patients who declined testing, 58% were tested recently and 31% felt confident that they were HIV-negative; however, 74 (80%) who declined testing said they would feel comfortable discussing HIV prevention with their dentist. Additionally, 290 of 600 patients (48%) reported condomless vaginal or anal sex in the past 6 months. Further, among 119 patients who had condomless sex with an HIV-positive partner and/or one whose HIV status was unknown, 98 (82%) accepted the oral HIV test. Conclusion Dental clinics may provide expanded opportunities for oral HIV rapid testing and conversations about HIV prevention in high HIV prevalence communities.
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Affiliation(s)
- Erin L. P. Bradley
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
- * E-mail:
| | - Denise C. Vidot
- School of Nursing and Health Studies, University of Miami, Miami, FL, United States of America
| | | | - Madeline Y. Sutton
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Margaret Pereyra
- Sociomedical Sciences at the Columbia University Medical Center, Columbia University, New York, NY, United States of America
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Bradley ELP, Sutton MY, Cooks E, Washington-Ball B, Gaul Z, Gaskins S, Payne-Foster P. Developing FAITHH: Methods to Develop a Faith-Based HIV Stigma-Reduction Intervention in the Rural South. Health Promot Pract 2018; 19:730-740. [PMID: 29383967 DOI: 10.1177/1524839917754044] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Human immunodeficiency virus (HIV) disproportionately affects Blacks/African Americans, particularly those residing in the southern United States. HIV-related stigma adversely affects strategies to successfully engage people in HIV education, prevention, and care. Interventions targeting stigma reduction are vital as additional tools to move toward improved outcomes with HIV prevention and care, consistent with national goals. Faith institutions in the South have been understudied as partners in HIV stigma-reduction efforts, and some at-risk, Black/African American communities are involved with southern faith institutions. We describe the collaborative effort with rural, southern faith leaders from various denominations to develop and pilot test Project Faith-based Anti-stigma Initiative Towards Healing HIV/AIDS (FAITHH), an HIV stigma-reduction intervention that built on strategies previously used with other nonrural, Black/African American faith communities. The eight-module intervention included educational materials, myth-busting exercises to increase accurate HIV knowledge, role-playing, activities to confront stigma, and opportunities to develop and practice delivering a sermon about HIV that included scripture-based content and guidance. Engaging faith leaders facilitated the successful tailoring of the intervention, and congregation members were willing participants in the research process in support of increased HIV awareness, prevention, and care.
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Affiliation(s)
- Erin L P Bradley
- 1 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Madeline Y Sutton
- 1 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eric Cooks
- 2 University of Alabama, Tuscaloosa, AL, USA
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Payne-Foster P, Bradley ELP, Aduloju-Ajijola N, Yang X, Gaul Z, Parton J, Sutton MY, Gaskins S. Testing our FAITHH: HIV stigma and knowledge after a faith-based HIV stigma reduction intervention in the Rural South. AIDS Care 2017; 30:232-239. [PMID: 29119799 DOI: 10.1080/09540121.2017.1371664] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Eliminating racial/ethnic HIV disparities requires HIV-related stigma reduction. African-American churches have a history of addressing community concerns, including health issues, but may also contribute to stigma. We developed and pilot tested a faith-based, anti-stigma intervention with 12 African-American churches in rural Alabama. We measured HIV-related stigma held by 199 adults who participated in the intervention (individual-level) and their perception of stigma among other congregants (congregational-level). Analyses of pre- and post-assessments using a linear mixed model showed the anti-stigma intervention group reported a significant reduction in individual-level stigma compared with the control group (mean difference: -.70 intervention vs. -.16 control, adjusted p < .05). Findings suggest African-American churches may be poised to aid HIV stigma-reduction efforts.
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Affiliation(s)
- Pamela Payne-Foster
- a Department of Community Medicine and Population Health , College of Community Health Sciences, University of Alabama , Tuscaloosa , AL , USA
| | - Erin L P Bradley
- b Division of HIV Prevention , Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Natasha Aduloju-Ajijola
- c Department of Biomedical and Health Informatics, School of Medicine , University of Missouri-Kansas City , Kansas City , Missouri , USA
| | - Xin Yang
- d Department of Information Systems, Statistics, and Management Science , Culverhouse College of Commerce and Business Administration, University of Alabama , Tuscaloosa , AL , USA
| | - Zaneta Gaul
- b Division of HIV Prevention , Centers for Disease Control and Prevention , Atlanta , GA , USA.,e Public Health Analyst , ICF , Atlanta , GA , USA
| | - Jason Parton
- d Department of Information Systems, Statistics, and Management Science , Culverhouse College of Commerce and Business Administration, University of Alabama , Tuscaloosa , AL , USA
| | - Madeline Y Sutton
- b Division of HIV Prevention , Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Susan Gaskins
- f Capstone College of Nursing, University of Alabama , Tuscaloosa , AL , USA
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Mercer Kollar LM, Davis TL, Monahan JL, Samp JA, Coles VB, Bradley ELP, Sales JM, Comer SK, Worley T, Rose E, DiClemente RJ. Do As I Say: Using Communication Role-Plays to Assess Sexual Assertiveness Following an Intervention. Health Educ Behav 2016; 43:691-698. [PMID: 27164847 DOI: 10.1177/1090198116630528] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sexual risk reduction interventions are often ineffective for women who drink alcohol. The present study examines whether an alcohol-related sexual risk reduction intervention successfully trains women to increase assertive communication behaviors and decrease aggressive communication behaviors. Women demonstrated their communication skills during interactive role-plays with male role-play partners. Young, unmarried, and nonpregnant African American women (N = 228, ages 18-24) reporting unprotected vaginal or anal sex and greater than three alcoholic drinks in the past 90 days were randomly assigned to a control, a sexual risk reduction, or a sexual and alcohol risk reduction (NLITEN) condition. Women in the NLITEN condition significantly increased assertive communication behavior compared to women in the control condition, yet use of aggressive communicative behaviors was unchanged. These data suggest assertive communication training is an efficacious component of a sexual and alcohol risk reduction intervention. Public health practitioners and health educators may benefit from group motivational enhancement therapy (GMET) training and adding a GMET module to existing sexual health risk reduction interventions. Future research should examine GMET's efficacy in combination with other evidence-based interventions within other populations and examine talking over and interrupting one's sexual partner as an assertive communication behavior within sexual health contexts.
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Affiliation(s)
| | - Teaniese L Davis
- Morehouse College, Atlanta, GA, USA.,Emory University, Atlanta, GA, USA
| | | | | | | | | | | | | | | | - Eve Rose
- Emory University, Atlanta, GA, USA
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14
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Bradley ELP, Elifson KW, Sales JM, DiClemente RJ. The Power of Partners: A Qualitative Study of the Dissonance between African-American Females’ Interest in Practicing Secondary Abstinence and Continued Sexual Activity. Health (London) 2014. [DOI: 10.4236/health.2014.613191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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15
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Bradley ELP, Sales JM, Murray CC, DiClemente RJ. Examining interest in secondary abstinence among young African American females at risk for HIV or STIs. Health Educ Res 2012; 27:1120-8. [PMID: 22722781 PMCID: PMC3498603 DOI: 10.1093/her/cys068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Accepted: 04/13/2012] [Indexed: 06/01/2023]
Abstract
Sexually active African American females are at increased risk for acquiring HIV or STIs. However, some reduce their risk by abstaining from sex for various periods of time following initiation, a practice known as secondary abstinence. Although this may be a valuable mechanism for reducing HIV or STI rates in this population, little is known about those interested in secondary abstinence. Baseline data were obtained from a sample of African American adolescent females, ages 14-20 years, prior to participation in an HIV-risk reduction intervention trial (N = 701). Differences in individual-level and interpersonal-level factors, as well as sociodemographic variables were examined between participants who reported strong interest in secondary abstinence and those who did not. 144 (20.5%) participants reported strong interest in secondary abstinence. Young women with strong interest in abstinence had higher odds of reporting a history of STIs and feeling negative emotions following sex because of their religious beliefs. They also had higher odds of believing their partner may be interested in abstaining and being less invested in their relationship with their main partner. Additionally, adolescents reported less interpersonal stress and more social support. African American females who are interested in practicing secondary abstinence and those who are not differ in their sexual health education needs. Findings from this study characterizing young women interested in secondary abstinence can help researchers provide more targeted health education by identifying those who may be more responsive to abstinence-promoting messages.
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Affiliation(s)
- Erin L P Bradley
- Rollins School of Public Health at Emory University, Atlanta, GA 30322, USA.
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16
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Bradley ELP, Sales JM, Elifson KW, DiClemente RJ. Motivations for Secondary Abstinence Among African American Females at Risk for HIV/Sexually Transmitted Infections. Journal of Black Psychology 2012. [DOI: 10.1177/0095798412454678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Some sexually experienced African American females abstain from sexual activity for various reasons and periods of time following sexual debut (secondary abstinence), reducing their risk of HIV/sexually transmitted infection (STI) acquisition. However, few studies have sought to understand secondary abstinence motivations. Furthermore, the scope of existing knowledge may be limited by the quantitative approaches employed. Thus, the purpose of this qualitative study was to investigate secondary abstinence motivations among African American females using a grounded theory approach. Interviews were conducted with 20 young women, aged 18 to 23 years, who recently completed a sexual risk–reduction intervention. Motivations for secondary abstinence not identified in previous studies included feeling used for sex, partner infidelity, and abuse or sexual assault. Also, young women were motivated to abstain to focus on improving certain aspects of their lives. Other motivations similar to those previously identified included not being married or in a committed relationship, separation from one’s partner, and STI and pregnancy experiences or fears. Insight from this investigation can be used to improve measurement of motivations and to develop and refine HIV/STI interventions for this population.
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17
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Salazar LF, Bradley ELP, Younge SN, Daluga NA, Crosby RA, Lang DL, DiClemente RJ. Applying ecological perspectives to adolescent sexual health in the United States: rhetoric or reality? Health Educ Res 2010; 25:552-562. [PMID: 20007196 PMCID: PMC2912548 DOI: 10.1093/her/cyp065] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Accepted: 11/04/2009] [Indexed: 05/28/2023]
Abstract
This study sought to determine the perspective taken toward understanding adolescent sexual risk behaviors and related biological outcomes (i.e. pregnancy, sexually transmitted diseases) since 1990. We content analyzed 324 abstracts representing observational research published between January 1990 and December 2007 for inclusion of ecological (environmental) factors, level of analysis, sample composition and type of behavioral and biological outcomes. A majority (95%) of studies included individual characteristics; half were void of any environmental factors. Of those including environmental factors, 27% included familial, 23% community, 13% relational and 3% societal factors. Most (80%) were positioned at the individual level of analysis. Samples were diverse (43%) and of mixed gender (71%). Biomarkers of sexually transmitted diseases (7.5%) or pregnancy outcomes (2%) were rare. Ecological inclusion was not related to year of publication. Despite the rhetoric highlighting, the importance of an ecological perspective in understanding adolescent sexual risk behavior, much published research, excludes environmental influences.
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Affiliation(s)
- Laura F Salazar
- Department of Behavioral Sciences.ealth Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
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