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Quinn KG, Walsh JL, Johnson A, Edwards T, Takahashi L, Dakin A, Bouacha N, Voisin D. Police Violence Experienced by Black Gay and Bisexual Men: The Effects on HIV Care Engagement and Medication Adherence. AIDS Behav 2024; 28:1642-1649. [PMID: 38315300 PMCID: PMC11070282 DOI: 10.1007/s10461-024-04278-2] [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] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
Black men face high rates of police violence, including direct victimization and indirect exposure to or knowledge of harmful policing. This violence can result in death and physical harm, as well as in numerous poor mental health outcomes. There has been little research examining experiences of police violence experienced by Black gay and bisexual men or the effects of police brutality on HIV continuum of care outcomes. To address this important gap, in this exploratory study, we examined the effects of police brutality on engagement in HIV care and adherence to antiretroviral medications. Cross-sectional survey data were collected from 107 Black gay and bisexual men living with HIV. The path analysis showed that men with greater exposure to police violence had increased symptoms of post-traumatic stress disorder and were more likely to have missed HIV care appointments in the past year. Additionally, there was a significant indirect effect of exposure to police violence on missed medication doses via PTSD symptoms.
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Affiliation(s)
- Katherine G Quinn
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin Center for AIDS Intervention Research, 2071 N. Summit Ave, Milwaukee, WI, 53202, USA.
| | - Jennifer L Walsh
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin Center for AIDS Intervention Research, 2071 N. Summit Ave, Milwaukee, WI, 53202, USA
| | - Anthony Johnson
- School of Social Work, Loyola University Chicago, Chicago, IL, USA
| | - Travonne Edwards
- School of Child and Youth Care, Toronto Metropolitan University, Toronto, ON, Canada
| | - Lois Takahashi
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA
| | | | | | - Dexter Voisin
- School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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Voisin DR, Takahashi L, Walsh JL, DiFranceisco W, Johnson A, Dakin A, Bouacha N, Brown K, Quinn KG. An exploratory study of community violence and HIV care engagement among Black gay and bisexual men. AIDS Care 2024:1-8. [PMID: 38648523 DOI: 10.1080/09540121.2024.2331221] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 03/08/2024] [Indexed: 04/25/2024]
Abstract
This study examined the relationship between exposure to community violence and HIV care engagement among 107 Black gay or bisexual men living with HIV in Chicago. Measures assessed the importance of demographic covariates (age, annual income, health insurance status, and years living with HIV), community violence exposures, mental health, social support, in explaining variations in missed doses of antiretroviral therapy (ART) medication and missed HIV care appointments. Results showed that participants who reported higher rates of exposure to community violence were two times more likely to have missed ART doses and HIV care appointments. Participants who reported depression scores were two times more likely to have greater non-ART adherence. Finally, older participants were more likely to report fewer missed ART doses. More research is needed to clarify the mechanisms between age or depression and ART adherence given community violence exposure. Health care providers should screen for depression when attempting to promote better ART adherence and keeping HIV care appointments for Black gay and bisexual men living with HIV. Younger Black gay and bisexual men living with HIV may be more vulnerable than older men for missed ART doses and may require additional screening and follow-up.
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Affiliation(s)
- Dexter R Voisin
- Jack Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Lois Takahashi
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA
| | | | | | - Anthony Johnson
- School of Social Work, Loyola University Chicago, Chicago, IL, USA
| | | | | | - Khalil Brown
- Jack Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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Quinn KG, Walsh JL, DiFranceisco W, Edwards T, Takahashi L, Johnson A, Dakin A, Bouacha N, Voisin DR. The Inherent Violence of Anti-Black Racism and its Effects on HIV Care for Black Sexually Minoritized Men. J Urban Health 2024; 101:23-30. [PMID: 38158546 PMCID: PMC10897081 DOI: 10.1007/s11524-023-00823-x] [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] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
The goal of this study was to examine the effects of racial discrimination, depression, and Black LGBTQ community support on HIV care outcomes among a sample of Black sexually minoritized men living with HIV. We conducted a cross-sectional survey with 107 Black sexually minoritized men living with HIV in Chicago. A path model was used to test associations between racial discrimination, Black LGBTQ community support, depressive symptoms, and missed antiretroviral medication doses and HIV care appointments. Results of the path model showed that men who had experienced more racism had more depressive symptoms and subsequently, missed more doses of HIV antiretroviral medication and had missed more HIV care appointments. Greater Black LGBTQ community support was associated with fewer missed HIV care appointments in the past year. This research shows that anti-Black racism may be a pervasive and harmful determinant of HIV inequities and a critical driver of racial disparities in ART adherence and HIV care engagement experienced by Black SMM. Black LGBTQ community support may buffer against the effects of racial discrimination on HIV care outcomes by providing safe, inclusive, supportive spaces for Black SMM.
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Affiliation(s)
- Katherine G Quinn
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Jennifer L Walsh
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Wayne DiFranceisco
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Travonne Edwards
- School of Child and Youth Care, Toronto Metropolitan University, Toronto, Canada
| | - Lois Takahashi
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA
| | - Anthony Johnson
- School of Social Work, Loyola University Chicago, Chicago, IL, USA
| | | | | | - Dexter R Voisin
- School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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Quinn KG, Edwards T, Johnson A, Takahashi L, Dakin A, Bouacha N, Voisin D. Understanding the impact of police brutality on Black sexually minoritized men. Soc Sci Med 2023; 334:116191. [PMID: 37666095 PMCID: PMC10565611 DOI: 10.1016/j.socscimed.2023.116191] [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] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/06/2023]
Abstract
Young Black gay, bisexual, and other sexually minoritized men (SMM) face high levels of police brutality and other negative, unwarranted encounters with the police. Such interactions have known health consequences. The purpose of this study was to understand the health, mental health, and social consequences of police brutality experienced by young Black SMM. We conducted in-depth interviews with 31 Black, cisgender men, ages of 16-30 and analyzed the data using thematic analysis. Our primary results are summarized in four themes: 1) Police brutality is built into the system and diminishes trust; 2) Videos and social media make visible violence that has long existed; 3) Police brutality contributes to anxiety and other psychosocial effects; and 4) Violence reduces feelings of safety and contributes to avoidance of police. Our results highlight the direct and vicarious police brutality participants are subjected to and sheds light on the effects of such violence on trust, perceived safety, anxiety, and trauma symptoms. Results from this study contribute to the needed public health conversation around police brutality against Black men, specifically shedding light on the experiences of Black SMM.
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Affiliation(s)
- Katherine G Quinn
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Travonne Edwards
- School of Child and Youth Care, Toronto Metropolitan University, Canada
| | - Anthony Johnson
- School of Social Work, Loyola University Chicago, Chicago, IL, USA
| | - Lois Takahashi
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA
| | | | | | - Dexter Voisin
- School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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Quinn KG, Edwards T, Takahashi L, Johnson A, Spector A, Dakin A, Bouacha N, Valadez-Tapia S, Voisin D. "The Fight is Two Times as Hard": A Qualitative Examination of a Violence Syndemic Among Young Black Sexual Minority Men. J Interpers Violence 2023; 38:8162-8186. [PMID: 36803199 PMCID: PMC10714286 DOI: 10.1177/08862605231153891] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Young Black men who have sex with men (YBMSM) are disproportionately impacted by violence, including violence rooted in anti-Black racism, sexual identity bullying, and neighborhood violence rooted in structural racism and inequities. These multiple forms of violence are frequently co-occurring and interactive creating syndemic conditions that can negatively impact HIV care. This qualitative study is based on in-depth interviews with 31 YBMSM, aged 16-30 years, living with HIV in Chicago, IL, to examine how violence has impacted their lives. Using thematic analysis, we identified five themes that reflect how YBMSM experience violence at the intersection of racism, homonegativity, socioeconomic status, and HIV status: (a) the experience of intersectional violence; (b) long histories of violence contributed to hypervigilance, lack of safety, and lack of trust; (c) making meaning of violence and the importance of strength; (d) normalizing violence for survival; and (e) the cyclical nature of violence. Our study highlights how multiple forms of violence can accumulate across an individual's life and contribute to social and contextual situations that further contribute to violence and negatively impact mental health and HIV care.
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Affiliation(s)
- Katherine G. Quinn
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Travonne Edwards
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
| | - Lois Takahashi
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA
| | - Anthony Johnson
- School of Social Work, Loyola University Chicago, Chicago, IL
| | - Antoinette Spector
- Department of Physical Therapy, Rehabilitation Sciences & Technology, University of Wisconsin, Milwaukee, Milwaukee, WI
| | | | | | | | - Dexter Voisin
- School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH
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Stump T, Ethier K, Hirschhorn L, Dakin A, Bouacha N, Freeman A, Bannon J, Gómez W, Moskowitz J, Bouris A. Development of an Implementation Facilitation Strategy to Link Mental Health Screening and eHealth Intervention for Clients in Ryan White-Funded Clinics in Chicago. J Acquir Immune Defic Syndr 2022; 90:S197-S205. [PMID: 35703772 PMCID: PMC9204837 DOI: 10.1097/qai.0000000000002980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND To reduce the impact of depression on people living with HIV, we are implementing a clinic-based behavioral health screener and referral to Optimizing Resilience and Coping with HIV through Internet Delivery, an evidenced-based intervention. We used the Consolidated Framework for Implementation Research to identify contextual barriers and facilitators in advance of implementation. SETTING Sixteen Chicagoland area Ryan White Medical Case Management sites. METHODS We conducted a sequential mixed-methods study with medical case managers and supervisors. Participants completed an online survey assessing Consolidated Framework for Implementation Research domains, scored on a 1 (strongly disagree) to 5 (strongly agree) scale. Survey results informed a purposive sampling frame and interview protocol. Interviews were analyzed by rapid qualitative analysis. RESULTS On average, survey respondents (n = 58) slightly agreed with positive views of team culture, learning climate, and implementation readiness (mean = 3.80-3.87). Potential barriers included intervention complexity (mean = 3.47), needed human resources (mean = 2.71-3.33), and only slight agreement with relative advantage over existing screening/referral systems (mean = 3.09-3.71). Qualitative results (n = 15) identified low advantage for clinics with robust behavioral health systems but strong advantage in clinics without these services. Respondents identified system-wide training and monitoring strategies to facilitate implementation. CONCLUSIONS Ryan White Medical Case Management sites are a generally favorable context for the implementation of the interventions. As illustrated in an implementation research logic model, barriers will be addressed through deploying strategies proposed to impact clinic- and individual-level outcomes, including electronic prompts (reduce complexity), training on Optimizing Resilience and Coping with HIV through Internet Delivery as a complement to other behavioral health services (increase relative advantage), and feedback during implementation (strengthen rewards/incentives).
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Affiliation(s)
- Tammy Stump
- Northwestern University Feinberg School of Medicine, University of Illinois – Chicago
| | - Kristen Ethier
- University of Chicago Crown Family School of Social Work, Policy and Practice, University of Illinois – Chicago
| | - Lisa Hirschhorn
- Northwestern University Feinberg School of Medicine, University of Illinois – Chicago
| | - Andrea Dakin
- AIDS Foundation Chicago, University of Illinois – Chicago
| | - Nora Bouacha
- AIDS Foundation Chicago, University of Illinois – Chicago
| | - Angela Freeman
- Northwestern University Feinberg School of Medicine, University of Illinois – Chicago
| | - Jacqueline Bannon
- Northwestern University Feinberg School of Medicine, University of Illinois – Chicago
| | - Walter Gómez
- Jane Addams College of Social Work, University of Illinois – Chicago
| | - Judith Moskowitz
- Northwestern University Feinberg School of Medicine, University of Illinois – Chicago
| | - Alida Bouris
- University of Chicago Crown Family School of Social Work, Policy and Practice, University of Illinois – Chicago
- Chicago Center for HIV Elimination
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Jamoussi A, Abdallah M, Hamzaoui S, Bouacha N, Bouslama K, Harmel A, Ennafaa M, M’Rad S, Ben Dridi M. Une hypertension artérielle pulmonaire révélant une maladie de Basedow. Rev Med Interne 2008. [DOI: 10.1016/j.revmed.2008.03.269] [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: 10/22/2022]
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