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Hatch MA, Laschober TC, Paschen-Wolff M, Ertl MM, Nelson CM, Wright L, Lancaster C, Feaster DJ, Forrest D, Hankey C, Monger M, Fegley JP, Irving R, Young C, Rose J, Spector A, Dresser L, Moran L, Jelstrom E, Tross S. PrEP for people who use opioids: A NIDA clinical trials network survey study in Southern U.S. cities where HIV incidence is high. Drug Alcohol Depend 2024; 257:111133. [PMID: 38447393 DOI: 10.1016/j.drugalcdep.2024.111133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND People who use opioids (PWUO) are at increased risk for HIV. Pre-exposure prophylaxis (PrEP) is effective but underutilized as HIV prevention among PWUO. This study examined predictors of willingness to take daily oral PrEP and long-acting injectable (LAI) PrEP among PWUO across eight Southern urban cities with high HIV incidence. METHODS HIV-negative PWUO (N = 308) seeking services in community-based programs participated in this cross-sectional survey study. Measures included demographics, sexual risk behavior, substance use frequency, and awareness of and willingness to take oral and injectable PrEP. Data were analyzed using mixed-effects models. RESULTS Willingness to take daily oral and LAI PrEP was moderately high (69.16% and 62.02%, respectively). Half had heard of PrEP, but only 4% had ever taken it. Only education and condomless vaginal sex predicted willingness to take oral PrEP. Only education predicted willingness to take LAI PrEP. Polysubstance use was prevalent, with substantial proportions of PWUO reporting frequent use of injection drugs (opioids or stimulants, 79.5%), non-injection opioids (73.3%), non-injection stimulants (71.1%), cannabis (62.6%), and hazardous drinking (29.6%). About 20% reported past-year condomless anal sex, and one-third reported past-year condomless vaginal sex. CONCLUSIONS PWUO in this study were amenable to PrEP, particularly in light of education and condomless vaginal sex. Careful consideration for matching PrEP messaging to the PWUO audience is needed. PrEP promotion should expand beyond men who have sex with men to include groups such as these predominantly heterosexual, polysubstance-using PWUO with HIV risk who were open to both formulations of PrEP.
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Affiliation(s)
- Mary A Hatch
- University of Washington Addictions, Drug & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, Seattle, WA 98185, USA.
| | - Tanja C Laschober
- University of Washington Addictions, Drug & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, Seattle, WA 98185, USA
| | - Margaret Paschen-Wolff
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center at New York State Psychiatric Institute, New York, NY 10032, USA
| | - Melissa M Ertl
- University of Minnesota-Twin Cities, Department of Psychology, Minneapolis, MN 55455, USA
| | - C Mindy Nelson
- University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL 33136, USA
| | - Lynette Wright
- University of Washington Addictions, Drug & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, Seattle, WA 98185, USA
| | - Chloe Lancaster
- University of South Florida, Department of Leadership, Policy, and Lifelong Learning, Tampa, FL 33620, USA
| | - Daniel J Feaster
- University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL 33136, USA
| | - David Forrest
- University of Miami, Department of Anthropology, Coral Gables, FL, USA
| | - Colby Hankey
- Aspire Health Partners, HIV Services, Orlando, FL 32804, USA
| | - Mauda Monger
- My Brother's Keeper, 710 Avignon Dr, Ridgeland, MS 39157, USA
| | - Joshua P Fegley
- CrescentCare, 330 Tulane Ave, 1st Floor, New Orleans, LA 70119, USA
| | - Rhonda Irving
- Capitol Area Reentry Program, Baton Rouge, LA 70807, USA
| | - Cynthia Young
- Capitol Area Reentry Program, Baton Rouge, LA 70807, USA
| | - Juliana Rose
- Gateway Community Services, Research Department, Jacksonville, FL, USA
| | - Anya Spector
- Stella and Charles Guttman Community College, City University of New York, New York, NY, USA
| | | | - Landhing Moran
- Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892, USA
| | | | - Susan Tross
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality, and Health, Department of Psychiatry, New York State Psychiatric Institute and Columbia University, New York, NY 10032, USA
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Burns PA, Anyimukwu C, Omondi AA, Monger M, Ward L, Poteat T. Health-care providers' perspectives on an HIV patient navigation training to improve uptake of PrEP among Black sexual minority men. Health Educ Res 2023:7158390. [PMID: 37159000 DOI: 10.1093/her/cyad005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/28/2022] [Accepted: 01/27/2023] [Indexed: 05/10/2023]
Abstract
This article examines implementational factors associated with an HIV patient navigation training intervention for health care professionals working with Black sexual minority men to improve access to and uptake of HIV prevention services among Black MSM. Utilizing qualitative analysis to better understand healthcare professionals' perceptions of the training program, we conducted a thematic content analysis based on constructs from Professional Network and Reach Model-Systems Model Approach (PNRSMA) framework. Data analysis revealed four major themes: 1) Knowledge and skill building, 2) Novel and Innovation, 3) Barriers to Implementation, and 4) Recommendations and Future Directions. Implementation factors such as appropriate facilitators, content, mode of delivery, learning strategies, and understanding structural barriers were important to training success. Participants highlighted innovation strategies such as the use of social media and interactive communication (e.g. role-playing and bi-directional communication) enhanced learning and skill-building. The expansion of training to include other affected groups such as women and bisexual individuals and increasing the duration of the training emerged as areas for improvement and effectiveness. Our analysis of an HIV patient navigation training revealed important findings to improve the implementation process to increase uptake of PrEP and other HIV prevention, care and treatment services.
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Affiliation(s)
- Paul A Burns
- John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 North State Street, TR202-09, Jackson, MS 39216, USA
| | - Chizoba Anyimukwu
- Jackson State University, College of Health Sciences, School of Public Health, 1400 John R. Lynch St, Jackson, MS 39217, USA
| | - Angela A Omondi
- Jackson State University, College of Health Sciences, School of Public Health, 1400 John R. Lynch St, Jackson, MS 39217, USA
| | - Mauda Monger
- MLM Center for Health Education and Equity Consulting Services, LLC, Jackson, MS 39216, USA
| | - Lori Ward
- John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 North State Street, TR202-09, Jackson, MS 39216, USA
| | - Tonia Poteat
- School of Medicine, University of North Carolina-Chapel Hill, 321 S. Columbia Street, Chapel Hill, NC 27599, USA
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Willie TC, Knight D, Baral SD, Chan PA, Kershaw T, Mayer KH, Stockman JK, Adimora AA, Monger M, Mena LA, Philllips KA, Nunn A. Where's the "Everyday Black Woman"? An intersectional qualitative analysis of Black Women's decision-making regarding HIV pre-exposure prophylaxis (PrEP) in Mississippi. BMC Public Health 2022; 22:1604. [PMID: 35999528 PMCID: PMC9396836 DOI: 10.1186/s12889-022-13999-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 08/11/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Black cisgender women in the U.S. South bear a disproportionate burden of HIV compared to cisgender women in other racial and ethnic groups and in any other part of the US. Critical to decreasing new HIV infections is the improved delivery of pre-exposure prophylaxis (PrEP) for Black cisgender women as it remains underutilized in 2021. Informed by intersectionality, the study sought to characterize the sociostructural influences on Black cisgender women's deliberations about PrEP within the context of interlocking systems of oppression including racism, sexism, and classism. METHODS Six focus groups were conducted with 37 Black women residing in Jackson, Mississippi. This sample was purposively recruited to include Black cisgender women who were eligible for PrEP but had never received a PrEP prescription. RESULTS Six themes were identified as concerns during PrEP deliberation among Black women: 1) limited PrEP awareness, 2) low perceived HIV risk, 3) concerns about side effects, 4) concerns about costs, 5) limited marketing, and 6) distrust in the healthcare system. Three themes were identified as facilitators during PrEP deliberations: 1) women's empowerment and advocacy, 2) need for increased PrEP-specific education, and 3) the positive influence of PrEP-engaged women's testimonials. Black women shared a limited awareness of PrEP exacerbated by the lack of Black women-specific marketing. Opportunities to support Black women-specific social marketing could increase awareness and knowledge regarding PrEP's benefits and costs. Black women also shared their concerns about discrimination in healthcare and distrust, but they felt that these barriers may be addressed by patient testimonials from PrEP-engaged Black women, empowerment strategies, and directly addressing provider biases. CONCLUSIONS An effective response to PrEP implementation among Black women in the South requires developing programs to center the needs of Black women and carry out active strategies that prioritize peer advocacy while reinforcing positive and mitigating negative influences from broader social and historical contexts.
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Affiliation(s)
- Tiara C Willie
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA.
| | - Deja Knight
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Stefan D Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Philip A Chan
- Department of Medicine, Brown University, 222 Richmond St, Providence, RI, 02903, USA
| | - Trace Kershaw
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06510, USA
| | - Kenneth H Mayer
- Harvard Medical School and Harvard T H Chan School of Public Health, Harvard University, 25 Shattuck St, Boston, MA, 02115, USA
| | - Jamila K Stockman
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Adaora A Adimora
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, 170 Rosenau Hall, CB#7400, 135 Dauer Drive, Chapel Hill, NC, 27599-7400, USA
| | - Mauda Monger
- MLM Center for Health Education and Equity Consulting Services, 123-A Hwy 80 East #258, Clinton, MS, 39056, USA
| | - Leandro A Mena
- Department of Medicine, University of Mississippi Medical Center, 2500 N State St, Jackson, MS, 39216, USA
| | - Karlye A Philllips
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA
| | - Amy Nunn
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, 121 S Main St, Providence, RI, 02903, USA
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Willie TC, Sharpless L, Monger M, Kershaw TS, Mahoney WB, Stockman JK. Enhancing domestic violence advocates' ability to discuss HIV pre-exposure prophylaxis (PrEP): Feasibility and acceptability of an educational intervention. Womens Health (Lond) 2022; 18:17455065211070548. [PMID: 35001751 PMCID: PMC8744168 DOI: 10.1177/17455065211070548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/15/2021] [Accepted: 12/14/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Survivors of intimate partner violence are at elevated risk for HIV acquisition, yet there is limited research on the best strategies to optimize biomedical HIV prevention, such as pre-exposure prophylaxis among this population. Domestic violence agencies are critical collaborating partners and function as potential entry points into HIV prevention services for survivors; however, limited knowledge regarding HIV prevention has been an important barrier to advocate-led discussions. This study aimed to develop, implement, and evaluate an HIV prevention intervention for domestic violence advocates. SETTING A nonrandomized, group-based intervention with pre-intervention, immediate post-intervention, and 3-month post-intervention periods were conducted with multiple domestic violence agencies in Mississippi. METHODS Overall, 25 domestic violence advocates participated in the two-session intervention. Surveys were administered to assess pre-exposure prophylaxis knowledge, self-efficacy, subjective norms, and willingness to provide HIV prevention services to intimate partner violence survivors. Generalized estimating equations were conducted to assess change in behavioral outcomes over time. RESULTS Compared to pre-intervention, there were significant increases at immediate and 3-month post-intervention in advocates' intervention acceptability, pre-exposure prophylaxis knowledge, and self-efficacy to provide HIV prevention information, discuss pre-exposure prophylaxis eligibility criteria, assist pre-exposure prophylaxis-engaged clients, and initiate pre-exposure prophylaxis counseling. CONCLUSION This group-based intervention enhanced domestic violence advocates' acceptability, pre-exposure prophylaxis knowledge, and self-efficacy to offer HIV care information, discuss pre-exposure prophylaxis eligibility, assist pre-exposure prophylaxis-engaged survivors, and initiate pre-exposure prophylaxis counseling with intimate partner violence survivors. Efforts should focus on training domestic violence advocates in HIV prevention care for survivors and also include these agencies in collaborative strategies to reduce HIV incidence.
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Affiliation(s)
- Tiara C Willie
- Department of Mental Health, Johns
Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Laurel Sharpless
- Department of Social and Behavioral
Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Mauda Monger
- MLM Center for Health Education and
Equity Consulting Services, Jackson, MS, USA
| | - Trace S Kershaw
- Department of Social and Behavioral
Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Wendy B Mahoney
- Mississippi Coalition Against Domestic
Violence, Jackson, MS, USA
| | - Jamila K Stockman
- Division of Infectious Diseases and
Global Public Health, Department of Medicine, University of California San Diego, La
Jolla, CA, USA
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Willie TC, Monger M, Nunn A, Kershaw T, Stockman JK, Mayer KH, Chan PA, Adimora AA, Mena LA, Knight D, Philllips KA, Baral SD. "PrEP's just to secure you like insurance": a qualitative study on HIV pre-exposure prophylaxis (PrEP) adherence and retention among black cisgender women in Mississippi. BMC Infect Dis 2021; 21:1102. [PMID: 34702165 PMCID: PMC8549215 DOI: 10.1186/s12879-021-06786-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/12/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Pre-exposure prophylaxis (PrEP) has the potential to reduce transmission of HIV among Black cisgender women in the Southern United States (U.S.); however, national data suggests that PrEP initiation is lowest in the South and among Black women compared to other U.S. regions and white women. This study applied intersectionality and PrEP multilevel resilience frameworks to assess how socio-structural and clinical contexts shaped PrEP persistence among Black cisgender women in Mississippi. METHODS Semi-structured interviews were conducted with eight Black cisgender women in Jackson, Mississippi. This sample was purposively recruited to include PrEP-initiated Black cisgender women. RESULTS Six themes identified that shaped PrEP care among Black cisgender women: (1) internal assets, (2) sole responsibility to HIV prevention, (3) added protection in HIV serodifferent relationships, (4) financial issues, (5) trust and distrust in the medical system, and (6) side effects. Black cisgender women reported that PrEP persistence increased control over their sexual health, reduced anxiety about HIV, and promoted self-care. Black cisgender women also indicated that medication assistance programs increased PrEP affordability resulting in continued persistence. CONCLUSIONS In addition to preventing HIV, PrEP may yield secondary positive impacts on the health and relationships of Black cisgender women. However, very few Black cisgender women in the South are using PrEP given intersectional barriers and thus necessitates adaptive strategies to support PrEP initiation and persistence. Efforts aimed at increasing the coverage of PrEP among Black cisgender women should consider implementation strategies responsive to lived realities of Black women.
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Affiliation(s)
- Tiara C Willie
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Mauda Monger
- MLM Center for Health Education and Equity Consulting Services, Jackson, MS, USA
| | - Amy Nunn
- Department of Psychiatry, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Medicine, The Miriam Hospital, Providence, RI, USA
- School of Public Health, Brown University, Providence, RI, USA
| | - Trace Kershaw
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, USA
| | - Jamila K Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Kenneth H Mayer
- Harvard Medical School and Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Philip A Chan
- Department of Psychiatry, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Medicine, The Miriam Hospital, Providence, RI, USA
| | - Adaora A Adimora
- Department of Medicine, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- School of Medicine, and Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Leandro A Mena
- Department of Medicine, University of Mississippi Medical Center, Jackson, USA
| | - Deja Knight
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Karlye A Philllips
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Stefan D Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
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Burns PA, Omondi AA, Monger M, Ward L, Washington R, Sims Gomillia CE, Bamrick-Fernandez DR, Anyimukwu C, Mena LA. Meet Me Where I Am: An Evaluation of an HIV Patient Navigation Intervention to Increase Uptake of PrEP Among Black Men Who Have Sex with Men in the Deep South. J Racial Ethn Health Disparities 2021; 9:103-116. [PMID: 33403654 DOI: 10.1007/s40615-020-00933-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 09/01/2020] [Revised: 11/02/2020] [Accepted: 11/24/2020] [Indexed: 11/29/2022]
Abstract
The southern region of the USA is the epicenter of the HIV epidemic. HIV disproportionately affects African Americans, particularly Black men who have sex with men (Black MSM). Given the alarming rates of new infections among Black MSM, there is an urgent need for culturally competent healthcare professionals who are trained to address the unique needs and barriers to uptake and adherence to HIV prevention, care, and treatment services. Utilizing a mixed method research approach, we conducted a process evaluation of Meet Me Where I Am, a 6-month, 6-session HIV/AIDS patient navigation training program for healthcare professionals and patient navigators working in organizations that provide HIV services to residents of central Mississippi, an area with high incidence and prevalence rates of HIV. A self-administered questionnaire after each session was given to participants to assess the acceptability, quality, and translational aspects of the training program. The overall positive feedback on the MMWIA training reflects the program's acceptability and feasibility. Participants found that the training was effective in providing the necessary knowledge and skills to deliver patient-centered HIV prevention-related navigation services. A majority (67%) of participants indicated that they felt they could apply the lessons learned within their healthcare settings to improve access to HIV prevention, care, and treatment services. If we are to reduce racial and ethnic disparities in HIV/AIDS, there is a critical need for culturally appropriate training programs designed to improve the ability of healthcare professionals and health systems to deliver culturally competent HIV prevention, care, and treatment services.
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Affiliation(s)
- Paul A Burns
- John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 North State Street, TR202-09, Jackson, MS, 39216, USA.
| | - Angela A Omondi
- John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 North State Street, TR202-09, Jackson, MS, 39216, USA.,School of Public Health, Department of Behavioral and Environmental Health, Jackson, State University, Jackson, MS, 39217, USA
| | - Mauda Monger
- MLM Center for Health Education and Equity Consulting Services, LLC, Jackson, MS, 39216, USA
| | - Lori Ward
- John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 North State Street, TR202-09, Jackson, MS, 39216, USA
| | - Rodney Washington
- John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 North State Street, TR202-09, Jackson, MS, 39216, USA
| | - Courtney E Sims Gomillia
- John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 North State Street, TR202-09, Jackson, MS, 39216, USA
| | - Daniel R Bamrick-Fernandez
- John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 North State Street, TR202-09, Jackson, MS, 39216, USA
| | - Chizoba Anyimukwu
- John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 North State Street, TR202-09, Jackson, MS, 39216, USA.,School of Public Health, Department of Behavioral and Environmental Health, Jackson, State University, Jackson, MS, 39217, USA
| | - Leandro A Mena
- John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 North State Street, TR202-09, Jackson, MS, 39216, USA
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Melvin SC, Wiggins C, Burse N, Thompson E, Monger M. The Role of Public Health in COVID-19 Emergency Response Efforts From a Rural Health Perspective. Prev Chronic Dis 2020; 17:E70. [PMID: 32701430 PMCID: PMC7380288 DOI: 10.5888/pcd17.200256] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
As the country responds to coronavirus disease 2019 (COVID-19), the role of public health in ensuring the delivery of equitable health care in rural communities has not been fully appreciated. The impact of such crises is exacerbated in rural racial/ethnic minority communities. Various elements contribute to the problems identified in rural areas, including a declining population; economic stagnation; shortages of physicians and other health care providers; a disproportionate number of older, poor, and underinsured residents; and high rates of chronic illness. This commentary describes the challenges faced by rural communities in addressing COVID-19, with a focus on the issues faced by southeastern US states. The commentary will also address how the COVID-19 Community Vulnerability Index may be used as a tool to identify communities at heightened risk for COVID-19 on the basis of 6 clearly defined indicators.
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Affiliation(s)
- Sandra C Melvin
- Institute for the Advancement of Minority Health, 215 Katherine Dr, Flowood, MS 39232.
| | - Corey Wiggins
- Mississippi State Conference of the NAACP, Jackson, Mississippi
| | | | | | - Mauda Monger
- MLM Center for Health Education and Equity Consulting Services, LLC, Jackson, Mississippi
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Nunn A, Parker S, McCoy K, Monger M, Bender M, Poceta J, Harvey J, Thomas G, Johnson K, Ransome Y, Sutten Coats C, Chan P, Mena L. African American Clergy Perspectives About the HIV Care Continuum: Results From a Qualitative Study in Jackson, Mississippi. Ethn Dis 2018; 28:85-92. [PMID: 29725192 DOI: 10.18865/ed.28.2.85] [Citation(s) in RCA: 7] [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] [Indexed: 11/18/2022] Open
Abstract
Mississippi has some of the most pronounced racial disparities in HIV infection in the country; African Americans comprised 37% of the Mississippi population but represented 80% of new HIV cases in 2015. Improving outcomes along the HIV care continuum, including linking and retaining more individuals and enhancing adherence to medication, may reduce the disparities faced by African Americans in Mississippi. Little is understood about clergy's views about the HIV care continuum. We assessed knowledge of African American pastors and ministers in Jackson, Mississippi about HIV and the HIV care continuum. We also assessed their willingness to promote HIV screening and biomedical prevention technologies as well as efforts to enhance linkage and retention in care with their congregations. Four focus groups were conducted with 19 African American clergy. Clergy noted pervasive stigma associated with HIV and believed they had a moral imperative to promote HIV awareness and testing; they provided recommendations on how to normalize conversations related to HIV testing and treatment. Overall, clergy were willing to promote and help assist with linking and retaining HIV positive individuals in care but knew little about how HIV treatment can enhance prevention or new biomedical technologies such as pre-exposure prophylaxis (PrEP). Clergy underscored the importance of building coalitions to promote a collective local response to the epidemic. The results of this study highlight important public health opportunities to engage African American clergy in the HIV care continuum in order to reduce racial disparities in HIV infection.
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Affiliation(s)
- Amy Nunn
- Center for Health Equity Research, School of Public Health, Brown University, Providence, Rhode Island
| | - Sharon Parker
- Department of Sociology and Social Work, North Carolina Agriculture and Technology State University, Greensboro, North Carolina
| | - Katryna McCoy
- University of Washington Bothell, School of Nursing & Health Studies, Bothell, Washington
| | - Mauda Monger
- University of Mississippi Medical Center, Jackson, Mississippi
| | - Melverta Bender
- University of Mississippi Medical Center, Jackson, Mississippi
| | - Joanna Poceta
- Center for Health Equity Research, School of Public Health, Brown University, Providence, Rhode Island
| | - Julia Harvey
- Center for Health Equity Research, School of Public Health, Brown University, Providence, Rhode Island
| | - Gladys Thomas
- Center for Health Equity Research, School of Public Health, Brown University, Providence, Rhode Island
| | - Kendra Johnson
- Mississippi State Department of Health, Jackson, Mississippi
| | - Yusuf Ransome
- Yale School of Public Health, New Haven, Connecticut
| | - Cassandra Sutten Coats
- Center for Health Equity Research, School of Public Health, Brown University, Providence, Rhode Island
| | - Phil Chan
- Warren Alpert Medical School of Brown University, Providence, Rhode Island.,The Miriam Hospital, Providence, Rhode Island
| | - Leandro Mena
- University of Mississippi Medical Center, Jackson, Mississippi
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9
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Monger M. Stigma: barrier to quality of life and health care. HIV Clin 2011; 23:1-5. [PMID: 27027126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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10
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Abstract
X-Linked hypophosphatemic rickets (XLH) is an X-linked dominant disorder that is secondary to renal phosphate wasting. Affected individuals frequently present the following characteristics: short stature, lower-extremity deformity, bone pain, dental abscesses, enthesopathy, rickets, and osteomalacia. Since the disorder is characterized by evident phenotypic abnormalities, we hypothesized that there would be a high degree of knowledge about the disease in affected kindreds. Thus, we constructed a six-page, self-administered questionnaire to determine whether family members are, in fact, aware of their disease and properly diagnosed and treated. We also designed the survey to determine rates of symptoms thought to be associated with rickets/osteomalacia in a population with a lower referral bias than is usually seen in tertiary care centers. We administered the questionnaire to 234 study subjects (57 affected) who were members of one of three large kindreds. Although 62% of affected individuals knew they had some problem with their bones, only 22.6% were told by a physician that they had rickets or osteomalacia. This apparent lack of awareness occurred in spite of 61.1% of affected subjects complaining of bone or joint problems to their personal physician. Indeed, of those patients who had persistent complaints, only 34.5% were told they had rickets or osteomalacia. Only one patient was taking phosphate and vitamin D.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M J Econs
- Department of Medicine, Duke University Medical Center, Durham, NC 27710
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11
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Monger M, Wachsmuth C. An ED nursing documentation tool and the process of planned change. J Emerg Nurs 1986; 12:370-7. [PMID: 3540409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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