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Feelemyer J, Bershteyn A, Scheidell JD, Brewer R, Dyer TV, Cleland CM, Hucks-Ortiz C, Justice A, Mayer K, Grawert A, Kaufman JS, Braithwaite S, Khan MR. Impact of Decarceration Plus Alcohol, Substance Use, and Mental Health Screening on Life Expectancies of Black Sexual Minority Men and Black Transgender Women Living With HIV in the United States: A Simulation Study Based on HPTN 061. J Acquir Immune Defic Syndr 2024; 95:283-290. [PMID: 38032748 PMCID: PMC10922416 DOI: 10.1097/qai.0000000000003354] [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: 04/19/2023] [Accepted: 08/30/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Given the disproportionate rates of incarceration and lower life expectancy (LE) among Black sexual minority men (BSMM) and Black transgender women (BTW) with HIV, we modeled the impact of decarceration and screening for psychiatric conditions and substance use on LE of US BSMM/BTW with HIV. METHODS We augmented a microsimulation model previously validated to predict LE and leading causes of death in the US with estimates from the HPTN 061 cohort and the Veteran's Aging Cohort Studies. We estimated independent associations among psychiatric and substance use disorders, to simulate the influence of treatment of one condition on improvement on others. We used this augmented simulation to estimate LE for BSMM/BTW with HIV with a history of incarceration under alternative policies of decarceration (ie, reducing the fraction exposed to incarceration), screening for psychiatric conditions and substance use, or both. RESULTS Baseline LE was 61.3 years. Reducing incarceration by 25%, 33%, 50%, and 100% increased LE by 0.29, 0.31, 0.53, and 1.08 years, respectively, versus no reductions in incarceration. When reducing incarceration by 33% and implementing screening for alcohol, tobacco, substance use, and depression, in which a positive screen triggers diagnostic assessment for all psychiatric and substance use conditions and linkage to treatment, LE increased by 1.52 years compared with no screening or decarceration. DISCUSSION LE among BSMM/BTW with HIV is short compared with other people with HIV. Reducing incarceration and improving screening and treatment of psychiatric conditions and substance use could substantially increase LE in this population.
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Affiliation(s)
- Jonathan Feelemyer
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Anna Bershteyn
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Joy D. Scheidell
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
- Department of Health Sciences, University of Central Florida, Orlando, FL, USA
| | - Russell Brewer
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Typhanye V Dyer
- University of Maryland School of Public Health, College Park MD, USA
| | - Charles M Cleland
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | | | | | - Ken Mayer
- Fenway Institute, Fenway Health, Boston, MA, USA
| | - Ames Grawert
- Brennan Center Justice Program, New York University School of Law, New York, NY, USA
| | - Jay S. Kaufman
- Department of Epidemiology, Biostatistics, & Occupational Health, McGill University, Montreal, QC, Canada
| | - Scott Braithwaite
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Maria R Khan
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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Whitten T, Cale J, Brewer R, Logos K, Holt TJ, Goldsmith A. Exploring the Role of Self-Control Across Distinct Patterns of Cyber-Deviance in Emerging Adolescence. Int J Offender Ther Comp Criminol 2024:306624X231220011. [PMID: 38178553 DOI: 10.1177/0306624x231220011] [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] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
A disproportionally large number of adolescents engage in cyber-deviance. However, it is unclear if distinct patterns of adolescent cyber-deviance are evident, and if so, whether and to what extent low self-control is associated with different patterns of cyber-deviance. The current study addressed this research gap by examining the relationship between self-control and distinct latent classes of adolescent cyber-deviance net of potential confounders among a cross-sectional sample of 1793 South Australian adolescents. Four latent classes were identified, each characterized by varying probabilities of involvement in six types of cyber-deviance that were measured. The versatile class (n = 413) had the lowest average level of self-control, followed by the harmful content users (n = 439) and digital piracy (n = 356) classes, with the abstainer class (n = 585) characterized by the highest self-control. Analysis of covariance indicated that the abstainer group had significantly higher self-control than other classes of cyber-deviance. Although the versatile class had noticeably lower average self-control scores than the harmful content users and digital piracy groups, this difference was not significant after correcting for multiple comparisons. Collectively, these findings suggest that self-control appears to distinguish between those who do and do not engage in cyber-deviance but may not distinguish between distinct patterns of cyber-deviance net of other factors.
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Affiliation(s)
- Tyson Whitten
- Center for Law and Justice, Charles Sturt University, Port Macquarie, NSW, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
| | - Jesse Cale
- School of Criminology and Criminal Justice, Griffith University, Brisbane, QLD, Australia
| | - Russell Brewer
- School of Social Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Katie Logos
- School of Social Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Thomas J Holt
- School of Criminal Justice, Michigan State University, Michigan, USA
| | - Andrew Goldsmith
- Centre for Crime Policy and Research, Flinders University, Adelaide, SA, Adelaide
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Hotton AL, Lee F, Sheeler D, Ozik J, Collier N, Edali M, Ardestani BM, Brewer R, Schrode KM, Fujimoto K, Harawa NT, Schneider JA, Khanna AS. Impact of post-incarceration care engagement interventions on HIV transmission among young Black men who have sex with men and their sexual partners: an agent-based network modeling study. Lancet Reg Health Am 2023; 28:100628. [PMID: 38026447 PMCID: PMC10679934 DOI: 10.1016/j.lana.2023.100628] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 10/21/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023]
Abstract
Background Understanding the impact of incarceration on HIV transmission among Black men who have sex with men is important given their disproportionate representation among people experiencing incarceration and the potential impact of incarceration on social and sexual networks, employment, housing, and medical care. We developed an agent-based network model (ABNM) of 10,000 agents representing young Black men who have sex with men in the city of Chicago to examine the impact of varying degrees of post-incarceration care disruption and care engagement interventions following release from jail on HIV incidence. Methods Exponential random graph models were used to model network formation and dissolution dynamics, and network dynamics and HIV care continuum engagement were varied according to incarceration status. Hypothetical interventions to improve post-release engagement in HIV care for individuals with incarceration (e.g., enhanced case management, linkage to housing and employment services) were compared to a control scenario with no change in HIV care engagement after release. Finding HIV incidence at 10 years was 4.98 [95% simulation interval (SI): 4.87, 5.09 per 100 person-years (py)] in the model population overall; 5.58 (95% SI 5.38, 5.76 per 100 py) among those with history of incarceration, and 12.86 (95% SI 11.89, 13.73 per 100 py) among partners of agents recently released from incarceration. Sustained post-release HIV care for agents with HIV and experiencing recent incarceration resulted in a 46% reduction in HIV incidence among post-incarceration partners [incidence rate (IR) per 100 py = 5.72 (95% SI 5.19, 6.27) vs. 10.61 (95% SI 10.09, 11.24); incidence rate ratio (IRR) = 0.54; (95% SI 0.48, 0.60)] and a 19% reduction in HIV incidence in the population overall [(IR per 100 py = 3.89 (95% SI 3.81-3.99) vs. 4.83 (95% SI 4.73, 4.92); IRR = 0.81 (95% SI 0.78, 0.83)] compared to a scenario with no change in HIV care engagement from pre-to post-release. Interpretation Developing effective and scalable interventions to increase HIV care engagement among individuals experiencing recent incarceration and their sexual partners is needed to reduce HIV transmission among Black men who have sex with men. Funding This work was supported by the following grants from the National Institutes of Health: R01DA039934; P20 GM 130414; P30 AI 042853; P30MH058107; T32 DA 043469; U2C DA050098 and the California HIV/AIDS Research Program: OS17-LA-003; H21PC3466.
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Affiliation(s)
- Anna L. Hotton
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Francis Lee
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Daniel Sheeler
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Jonathan Ozik
- Argonne National Laboratory, Lemont, IL, USA
- Consortium for Advanced Science and Engineering, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Nicholson Collier
- Argonne National Laboratory, Lemont, IL, USA
- Consortium for Advanced Science and Engineering, University of Chicago, Chicago, IL, USA
| | - Mert Edali
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Department of Industrial Engineering, Yildiz Technical University, Besiktas, Istanbul, 34349, Turkey
| | | | - Russell Brewer
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Katrina M. Schrode
- Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Kayo Fujimoto
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Nina T. Harawa
- Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - John A. Schneider
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Aditya S. Khanna
- Center for Alcohol and Addiction Studies and Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
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Kerman J, Brewer R, Hotton A, Flores R, Devlin SA, Friedman EE, Schneider JA, McNulty MC. Multi-Level and Intersectional Stigma Experienced by Black Transgender Women in Chicago: a Qualitative Study to Inform Sociostructural Interventions for Reducing Stigma and Improving Health Outcomes. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01853-6. [PMID: 37957538 DOI: 10.1007/s40615-023-01853-6] [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: 09/11/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Stigma contributes to health disparities including increased HIV vulnerability among minority communities. Black transgender women experience multiple forms of stigma (e.g., anticipated, experienced), which can result in poor HIV-related outcomes. We utilized an adapted social ecological model (ASEM) to better understand the levels at which stigma is encountered and its impact on lived experience, particularly related to making healthcare decisions. METHODS Semi-structured interviews and two focus groups (n = 38) were conducted with Black transgender women and Black transfeminine individuals in Chicago from 2016 to 2017. Participants were asked about discrimination in the community, healthcare experiences, and their thoughts and decision-making process with their healthcare provider regarding HIV pre-exposure prophylaxis. We conducted thematic analysis and organized our findings based on the levels of the ASEM: individual, interpersonal, organizational, community, and structural. RESULTS Participants experienced and anticipated stigma at each ASEM level. Stigma was not experienced in isolation: stigma experienced at one level caused anticipated stigma at other levels and internalized stigma leading to negative self-image. In each case, stigma adversely impacted health outcomes (e.g., medication nonadherence, disengagement from care). Stigma within healthcare settings, medication-related stigma, and stigma directed at appearance and identity are particularly detrimental to shared decision-making with a healthcare provider. CONCLUSIONS Recognizing and valuing Black transgender women's experience with stigma are essential for developing social and structural interventions that may work collaboratively across multiple levels of lived experience to reduce stigma and healthcare disparities faced by Black transgender women.
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Affiliation(s)
- Jared Kerman
- Chicago Center for HIV Elimination, Chicago, IL, USA
- Section of Infectious Diseases and Global Health, Department of Medicine, University of Chicago, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA
| | - Russell Brewer
- Chicago Center for HIV Elimination, Chicago, IL, USA
- Section of Infectious Diseases and Global Health, Department of Medicine, University of Chicago, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA
| | - Anna Hotton
- Chicago Center for HIV Elimination, Chicago, IL, USA
- Section of Infectious Diseases and Global Health, Department of Medicine, University of Chicago, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA
| | - Rey Flores
- Chicago Center for HIV Elimination, Chicago, IL, USA
- Section of Infectious Diseases and Global Health, Department of Medicine, University of Chicago, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA
| | - Samantha A Devlin
- Chicago Center for HIV Elimination, Chicago, IL, USA
- Section of Infectious Diseases and Global Health, Department of Medicine, University of Chicago, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA
| | - Eleanor E Friedman
- Chicago Center for HIV Elimination, Chicago, IL, USA
- Section of Infectious Diseases and Global Health, Department of Medicine, University of Chicago, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA
| | - John A Schneider
- Chicago Center for HIV Elimination, Chicago, IL, USA
- Section of Infectious Diseases and Global Health, Department of Medicine, University of Chicago, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA
| | - Moira C McNulty
- Chicago Center for HIV Elimination, Chicago, IL, USA.
- Section of Infectious Diseases and Global Health, Department of Medicine, University of Chicago, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA.
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Coleman JL, Jones M, Washington D, Almirol E, Forberg P, Dyer TV, Spieldenner A, Martinez O, Rodriguez-Diaz CE, Parker SD, Schneider JA, Brewer R. Using the Meaningful Involvement of People Living with HIV/AIDS (MIPA) Framework to Assess the Engagement of Sexual Minority Men of Color in the US HIV Response: a Literature Review. J Racial Ethn Health Disparities 2023; 10:2374-2396. [PMID: 36171496 PMCID: PMC10098811 DOI: 10.1007/s40615-022-01417-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [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: 07/28/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 11/29/2022]
Abstract
Black and Latino sexual minority men (SMM) continue to be disproportionately impacted by HIV. We utilized eight components of the Meaningful Involvement of People Living with HIV/AIDS (MIPA) framework to assess the engagement of Black and Latino SMM. Thirty-six (36) studies were included in the literature review. Forty-two percent of studies were Black SMM-specific, followed by Latino SMM-specific (31%) studies. Twenty-eight percent of studies were conducted among both groups. Most studies (72%) were intervention-related and focused on HIV prevention. The top five most common methods of community engagement were focus groups (39%), followed by interviews (36%), community-based participatory research (14%), the utilization of community advisory boards or peer mentorship (11%), and the establishment of multi-stakeholder coalitions, observations, or surveys (8%). We documented at least 7 MIPA components in 47% of the included studies. Community-based participatory research was more commonly utilized to engage Latino SMM. Researchers were more likely to initiate the engagement across all included studies. Few studies documented how Black and Latino SMM perceived the engagement. Engagement responsiveness was a well-documented MIPA component. In terms of engagement power dynamics, there were several examples of power imbalances, especially among Black SMM-specific studies. The inclusion of Black and Latino SMM had robust impacts on HIV research and interventions. There were limited examples of engagement capacity and maintenance. This is one of the first studies focused on utilizing MIPA to document the engagement of SMM of color. MIPA served as a useful framework for understanding the engagement of SMM of color in the US HIV response. The engagement of SMM of color is critical to reducing health inequities.
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Affiliation(s)
| | - Mickaya Jones
- Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA
| | | | - Ellen Almirol
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, MC 5065, Chicago, IL, 60637, USA
| | | | - Typhanye V Dyer
- Department of Epidemiology and Biostatistics, University of Maryland, College Park, MD, USA
| | - Andrew Spieldenner
- MPact Global, Oakland, CA, USA
- California State University-San Marcos, San Marcos, CA, USA
| | - Omar Martinez
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Carlos E Rodriguez-Diaz
- Department of Prevention and Community Health, George Washington University - Milken Institute School of Public Health, Washington, DC, USA
| | - Sharon D Parker
- North Carolina Agricultural and Technical State University, Greensboro, NC, USA
| | - John A Schneider
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, MC 5065, Chicago, IL, 60637, USA
| | - Russell Brewer
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, MC 5065, Chicago, IL, 60637, USA.
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Remch M, Scheidell JD, Cleland CM, Turpin R, Duncan DT, Dyer TT, Kaufman JS, Mazumdar M, Brewer R, Feelemyer J, Mayer KH, Khan MR. Mediation of the Effect of Incarceration on Selling Sex Among Black Sexual Minority Men and Black Transgender Women in the HPTN 061 Study. AIDS Behav 2023; 27:2791-2802. [PMID: 36746876 DOI: 10.1007/s10461-023-04003-5] [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: 01/23/2023] [Indexed: 02/08/2023]
Abstract
Incarceration among Black sexual minority men and Black transgender women (BSMM/BTW) is disproportionately high in the United States. Limited research has documented the disruptive effect of incarceration on sexual networks and sexual partnership exchange among BSMM/BTW. We estimate the influence of incarceration on selling sex and mediating pathways among 1169 BSMM/BTW enrolled in the HIV Prevention Trials Network (HPTN) 061 cohort to assess this relationship. Mediators investigated were social support, violence, illicit drug use, and distress due to experienced racism and homophobia. During the 6 months following baseline, 14% of the cohort was incarcerated, including 24% of BTW. After adjustment, recent incarceration was associated with 1.57 (95% CI 1.02, 2.42) times the risk of subsequently selling sex. The hypothesized mediators together explained 25% of the relationship, with an indirect effect risk ratio of 1.09 (95% CI 0.97, 1.24). Our results document an association and call for more research investigating mechanisms.
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Affiliation(s)
- Molly Remch
- Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, CB 7435, McGavran-Greenberg Hall, Chapel Hill, NC, 27599, USA.
| | - Joy D Scheidell
- Department of Health Sciences, University of Central Florida, Orlando, FL, USA
| | - Charles M Cleland
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Rodman Turpin
- Department of Global and Community Health, George Mason University College of Public Health, Fairfax, VA, USA
| | - Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Typhanye T Dyer
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics, & Occupational Health, McGill University, Montreal, QC, Canada
| | - Medha Mazumdar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Russell Brewer
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Jonathan Feelemyer
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Kenneth H Mayer
- Fenway Institute, Fenway Health, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Maria R Khan
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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Powell N, Taylor B, Hotton A, Lamuda P, Flanagan E, Pyra M, Brewer R, Johnson O, Pollack HA, Schneider JA. The Relationship between Substance Use Stigma and COVID-19 Vaccine Hesitancy. Vaccines (Basel) 2023; 11:1194. [PMID: 37515010 PMCID: PMC10383134 DOI: 10.3390/vaccines11071194] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023] Open
Abstract
Two parallel public health epidemics affecting the United States include the COVID-19 pandemic and a rise in substance use disorders (SUDs). Limited research has examined the potential relationship between these two epidemics. Our objective was therefore to perform an exploratory study in order to examine the association between public stigma toward people with a past history of opioid, methamphetamine, cocaine, and alcohol use disorder and COVID-19 vaccine hesitancy. A national sample of U.S. adults (N = 6515) completed a survey which assessed the degree of negative perceptions toward individuals with a past history of substance use disorders (referred to as substance use stigma) and COVID-19 vaccine hesitancy, along with variables such as racial prejudice, source of health news, and other demographics. We evaluated four multivariable logistic regression models to predict COVID-19 vaccine hesitancy, utilizing substance use stigma toward opioids, methamphetamine, cocaine, and alcohol use as independent variables. We found that COVID-19 vaccine hesitancy was positively associated with substance use stigma toward opioid (AOR = 1.34, p < 0.05), methamphetamine (AOR = 1.40, p < 0.01), and cocaine (AOR = 1.28, p < 0.05) use, but not alcohol use (AOR = 1.06, n.s.). Predictive models that incorporate substance use stigma may therefore improve our ability to identify individuals that may benefit from vaccine hesitancy interventions. Future research to understand the underlying reasons behind the association between substance use stigma and COVID-19 vaccine hesitancy may help us to construct combined interventions which address belief systems that promote both substance use stigma and vaccine hesitancy.
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Affiliation(s)
- Natasha Powell
- Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Bruce Taylor
- NORC at the University of Chicago, Chicago, IL 60637, USA
| | - Anna Hotton
- Departments of Medicine and Public Health, University of Chicago, Chicago, IL 60637, USA
| | - Phoebe Lamuda
- NORC at the University of Chicago, Chicago, IL 60637, USA
| | | | - Maria Pyra
- Department of Medical Social Sciences, Northwestern University, Evanston, IL 60201, USA
| | - Russell Brewer
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - O'Dell Johnson
- Southern Public Health and Criminal Justice Research Center, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Harold A Pollack
- Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, IL 60637, USA
| | - John A Schneider
- Departments of Medicine and Public Health, University of Chicago, Chicago, IL 60637, USA
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Jones MD, Jones K, Almirol E, Payne G, Graves B, Schneider JA, Rijos D, Zawitz C, Zimmerman R, Seal DW, Brewer R, DrPH RB. Examining the Awareness, Acceptability, and Adoption of Conventional and non-conventional Forms of Pre-Exposure Prophylaxis (PrEP) for HIV Prevention Among jail-involved Black Sexual Minority men (BSMM) and Black Transgender Women (BTW) in Two Diverse US Cities. AIDS Behav 2023; 27:1304-1313. [PMID: 36264406 PMCID: PMC10038813 DOI: 10.1007/s10461-022-03866-4] [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: 09/14/2022] [Indexed: 11/01/2022]
Abstract
Black sexual minority men (BSMM) and Black transgender women (BTW) are disproportionately impacted by HIV and incarceration in the United States. In-depth interviews (N=34) and ongoing thematic analysis guided by the Exploration Phase of the Exploration, Preparation, Implementation, Sustainment framework were conducted to uncover key themes focused on the awareness, acceptability, and early adoption of conventional (i.e., daily oral pill) and non-conventional forms of PrEP (i.e., long-acting injectable, e-prescription for pick up post release) among jail-involved BSMM and BTW in Chicago, Illinois and Baton Rouge, Louisiana. The majority of participants were cisgender BSMM (88%) and were enrolled in Chicago (65%). There was greater awareness, availability, and adoption of conventional PrEP and non-conventional PrEP e-prescription for pick up post release among Chicago participants compared with Baton Rouge participants. Participants were largely receptive to all three forms of PrEP and stated a high need for HIV prevention in jails and immediately following release. PrEP stigma emerged as a major barrier to conventional daily PrEP adoption while incarcerated; potential misuse (e.g., pill selling) as a potential barrier to PrEP eprescription; and needle aversion and added clinic time as potential barriers to longacting injectable (LAI)-PrEP. Participants indicated that PrEP e-prescription could help support continuity of care post release and highlighted reduced stigma, convenience, and longer-term HIV protection as benefits for LAI-PrEP. Study findings provided context-specific information to inform the implementation of future PrEP interventions for jail-involved BSMM and BTW in two highly HIV-impacted jurisdictions.
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Affiliation(s)
| | - Keyira Jones
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Ellen Almirol
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Gjvar Payne
- Capitol Area Reentry Program, Baton Rouge, LA, USA
| | - Bobby Graves
- Capitol Area Reentry Program, Baton Rouge, LA, USA
| | | | | | | | - Rick Zimmerman
- College of Nursing, Wayne State University, Detroit, MI, USA
| | - David W Seal
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Russell Brewer
- Department of Medicine, University of Chicago, Chicago, IL, USA.
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9
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Walters SM, Liu W, Lamuda P, Huh J, Brewer R, Johnson O, Bluthenthal RN, Taylor B, Schneider JA. A National Portrait of Public Attitudes toward Opioid Use in the US: A Latent Class Analysis. Int J Environ Res Public Health 2023; 20:4455. [PMID: 36901465 PMCID: PMC10001548 DOI: 10.3390/ijerph20054455] [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] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 02/17/2023] [Accepted: 02/25/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Opioid overdose rates have steadily been increasing in the United States (US) creating what is considered an overdose death crisis. The US has a mixture of public health and punitive policies aimed to address opioid use and the overdose crisis, yet little is known about public opinion relating to opioid use and policy support. Understanding the intersection of public opinion about opioid use disorder (OUD) and policy can be useful for developing interventions to address policy responses to overdose deaths. METHODS A national sample of cross-sectional data from the AmeriSpeak survey conducted from 27 February 2020 through 2 March 2020 was analyzed. Measures included attitudes toward OUD and policy beliefs. Latent class analysis, a person-centered approach, was used to identify groups of individuals endorsing similar stigma and policy beliefs. We then examined the relationship between the identified groups (i.e., classes) and key behavioral and demographic factors. RESULTS We identified three distinct groups: (1) "High Stigma/High Punitive Policy", (2) "High Stigma/Mixed Public Health and Punitive Policy", and (3) "Low Stigma/High Public Health Policy". People with higher levels of education had reduced odds of being in the "High Stigma/High Punitive Policy" group. CONCLUSION Public health policies are most effective in addressing OUD. We suggest targeting interventions toward the "High Stigma/Mixed Public Health and Punitive Policy" group since this group already displays some support for public health policies. Broader interventions, such as eliminating stigmatizing messaging in the media and redacting punitive policies, could reduce OUD stigma among all groups.
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Affiliation(s)
- Suzan M. Walters
- Department of Epidemiology, School of Global Public Health, New York University, New York, NY 10003, USA
- Center for Drug Use and HIV/HCV Research, New York, NY 10003, USA
| | - Weiwei Liu
- Public Health Department, NORC at the University of Chicago, Chicago, IL 60603, USA
| | - Phoebe Lamuda
- Public Health Department, NORC at the University of Chicago, Chicago, IL 60603, USA
| | - Jimi Huh
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Russell Brewer
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - O’Dell Johnson
- Southern Public Health and Criminal Justice Research Center, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Ricky N. Bluthenthal
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Bruce Taylor
- Public Health Department, NORC at the University of Chicago, Chicago, IL 60603, USA
| | - John A. Schneider
- Public Health Department, NORC at the University of Chicago, Chicago, IL 60603, USA
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA
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10
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Goings B, Iglesias-McElwee C, Le BV, Keller K, Sykes D, Brewer R. Frontline Perspectives from the Implementation of Evidenced-Informed Interventions to Improve Behavioral Health and HIV Outcomes Among Black Men Who Have Sex with Men in the United States. AIDS Patient Care STDS 2022; 36:S36-S45. [PMID: 36178387 DOI: 10.1089/apc.2022.0093] [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] [Indexed: 01/29/2023] Open
Abstract
The perspectives and contributions of frontline staff are critical to the success of integrated HIV and behavioral health services in the United States (US). In this analytic essay, we share five key priority areas from frontline staff at four diverse sites funded by the Health Resources and Services Administration to support the implementation of interventions to improve HIV and behavioral health outcomes among Black men who have sex with men (BMSM) living with HIV. The five main priorities focused on: (1) COVID-19 pandemic adaptations; (2) recruitment/enrollment; (3) retention; (4) frontline self-care; and (5) replication considerations. Projects had to be nimble and innovative in their delivery of services; leverage existing infrastructure; and they had to try multiple approaches to reach BMSM and modify/drop them as needed. Future implementers should expect to support frontline staff self-care given the added stress of working under COVID-19 pandemic conditions and in communities with limited and uncoordinated behavioral health services.
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Affiliation(s)
| | | | | | | | | | - Russell Brewer
- Biological Sciences Division, Department of Medicine, University of Chicago, Chicago, Illinois, USA
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11
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Scheidell JD, Kapadia F, Turpin RE, Mazumdar M, Dyer TV, Feelemyer J, Cleland CM, Brewer R, Parker SD, Irvine NM, Remch M, Mayer KH, Khan MR. Incarceration, Social Support Networks, and Health among Black Sexual Minority Men and Transgender Women: Evidence from the HPTN 061 Study. Int J Environ Res Public Health 2022; 19:12064. [PMID: 36231367 PMCID: PMC9564690 DOI: 10.3390/ijerph191912064] [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] [Received: 08/16/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Support from social networks buffers against negative effects of stress but is disrupted by incarceration. Few studies examine incarceration, social support networks, and health among Black sexual minority men (BSMM) and Black transgender women (BTW). We conducted a secondary analysis using HIV Prevention Trials Network 061 (HPTN 061), a sample of BSMM/BTW recruited from six US cities. We measured associations between recent incarceration reported at six months follow-up and social support networks at twelve months follow-up, and cross-sectional associations between support networks and twelve-month health outcomes (e.g., sexual partnerships, substance use, healthcare access and depressive symptoms). Among the analytic sample (N = 1169), recent incarceration was associated with small medical support networks (adjusted risk ratio [aRR] 1.16, 95% CI 1.01, 1.34) and small financial support networks (aRR 1.18, 95% CI 1.04, 1.35). Support networks were associated with multiple partnerships (adjusted prevalence ratio [aPR] 0.77, 95% CI 0.65, 0.90), unhealthy alcohol use (aPR 1.20, 95% CI 0.96, 1.51), and depressive symptoms (aPR 1.16, 95% CI 0.99, 1.36). Incarceration adversely impacts social support networks of BSMM/BTW, and support networks were associated with a range of important health outcomes.
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Affiliation(s)
- Joy D. Scheidell
- Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Farzana Kapadia
- School of Global Public Health, New York University, New York, NY 10012, USA
| | - Rodman E. Turpin
- School of Public Health, Epidemiology and Biostatistics, University of Maryland at College Park, College Park, MD 20742, USA or
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, VA 22030, USA
| | - Medha Mazumdar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Typhanye V. Dyer
- School of Public Health, Epidemiology and Biostatistics, University of Maryland at College Park, College Park, MD 20742, USA or
| | - Jonathan Feelemyer
- Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Charles M. Cleland
- Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Russell Brewer
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Sharon D. Parker
- Department of Social Work, North Carolina Agricultural and Technical State University, Greensboro, NC 27411, USA
| | - Natalia M. Irvine
- Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Molly Remch
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Kenneth H. Mayer
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
- The Fenway Institute, Fenway Health, Boston, MA 02215, USA
| | - Maria R. Khan
- Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
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12
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Hoff L, Scheidell JD, Mazumdar M, Feelemyer J, Dyer TV, Turpin RE, Cleland CM, Caniglia EC, Remch M, Brewer R, Hucks-Ortiz C, Irvine NM, Mayer KH, Khan MR. The associations of incarceration and depression with healthcare experiences and utilization among Black men who have sex with men in HPTN 061. AIDS Care 2022; 34:1169-1178. [PMID: 34384304 PMCID: PMC8837705 DOI: 10.1080/09540121.2021.1966695] [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] [Received: 03/30/2021] [Accepted: 08/03/2021] [Indexed: 01/26/2023]
Abstract
Associations of incarceration with healthcare access and utilization among Black sexual minority men (BSMM) and differences in association among those with and without pre-incarceration symptoms of depression were measured. Secondary analysis using survey data from the longitudinal cohort HIV Prevention Trials Network 061 study was conducted among 1553 BSMM from six major U.S. cities from 2009 to 2011. We used modified log-binomial regression with robust standard errors to estimate associations of incarceration (reported at 6 month follow-up) on next six-month healthcare utilization and access (reported at the 12 month follow-up). We tested the significance of baseline depressive symptoms by incarceration interaction and reported differences in associations when observed. Participants with a history of incarceration were more likely to have depressive symptoms at baseline compared to those without. Recent incarceration was associated with almost twice the risk of mistrust in healthcare providers and emergency room utilization. Among men reporting depressive symptoms, a history of incarceration was associated with almost tripled risk of reporting providers do not communicate understandably. Among those with depression, one in five reported a missed visit regardless of incarceration status.
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Affiliation(s)
- Lee Hoff
- SUNY Downstate Medical Center School of Public Health, New York, NY
- New York University Grossman School of Medicine, Department of Population Health, New York, NY
| | - Joy D Scheidell
- New York University Grossman School of Medicine, Department of Population Health, New York, NY
| | - Medha Mazumdar
- New York University Grossman School of Medicine, Department of Population Health, New York, NY
| | - Jonathan Feelemyer
- New York University Grossman School of Medicine, Department of Population Health, New York, NY
| | - Typhanye V Dyer
- University of Maryland School of Public Health, Department of Epidemiology and Biostatistics, College Park, MD
| | - Rodman E Turpin
- University of Maryland School of Public Health, Department of Epidemiology and Biostatistics, College Park, MD
| | - Charles M Cleland
- New York University Grossman School of Medicine, Department of Population Health, New York, NY
| | - Ellen C Caniglia
- New York University Grossman School of Medicine, Department of Population Health, New York, NY
| | - Molly Remch
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, NC
| | - Russell Brewer
- University of Chicago, Department of Medicine, Chicago, IL
| | | | - Natalia M Irvine
- New York University Grossman School of Medicine, Department of Population Health, New York, NY
| | | | - Maria R Khan
- New York University Grossman School of Medicine, Department of Population Health, New York, NY
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13
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Dyer TV, Feelemyer J, Scheidell JD, Turpin RE, Brewer R, Mazumdar M, Fortune N, Severe M, Cleland CM, Remch M, Mayer K, Khan MR. Estimating the Influence of Incarceration on Subsequent Experience With Violence Among Black Men Who Have Sex With Men in the HPTN061 Study. J Interpers Violence 2022; 37:NP16327-NP16350. [PMID: 34107789 PMCID: PMC10091627 DOI: 10.1177/08862605211021970] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 06/12/2023]
Abstract
Black men who have sex with men (BMSM) are disproportionately incarcerated in the United States. Incarceration is a barrier to health equity and may be a risk factor for experiences of interpersonal violence. However, the effect of incarceration on experienced violence among BMSM is understudied. We examined associations between recent incarceration on subsequent experiences of race- or sexuality-based violence, intimate partner violence, or community violence. We analyzed data from the HPTN 061 study. Analysis includes data on 1,169 BMSM recruited from 6 U.S. cities who were present at baseline as well as 6- and 12-month follow-up interview. We tested if self-reported incarceration between baseline and 6 months was associated with self-reported outcomes between 6 and 12 months using logistic regression with inverse probability of treatment weighting and multiple imputation methods. Experienced outcomes included violence due to race or sexuality, intimate partner violence and aggression, and community violence (i.e., gang violence, robbery, shooting). Approximately 14% reported incarceration between baseline and 6 months and 90% reported experiencing violence between 6 and 12 months. In adjusted analyses, incarceration was associated with subsequent race- or sexuality-based violence [aOR (adjusted odds ratio) range: 1.25-1.41, 95% CI (confidence interval) range: 1.00-1.74], experiences of physical abuse and aggression from intimate partners (aOR: 2.35; 95% CI: 1.50, 3.70) and community violence (OR 1.82; 95% CI: 1.23, 2.72). Recent incarceration experience increased risk of exposure to future violence in this population. Mixed methods research examining mediating paths between and downstream effects of incarceration and violence on the wellbeing and health of BMSM is needed. We implore researchers to study violence and incarceration among BMSM. Practitione should implement strategies such as trauma-informed interventions, and policies strengthening the social and economic support needs of Black populations.
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Affiliation(s)
- Typhanye V. Dyer
- University of Maryland School of Public Health, College Park, MD, USA
| | | | | | - Rodman E. Turpin
- University of Maryland School of Public Health, College Park, MD, USA
| | | | - Medha Mazumdar
- New York University School of Medicine, New York, NY, USA
| | - Nicole Fortune
- University of Maryland School of Public Health, College Park, MD, USA
| | | | | | - Molly Remch
- University of North Carolina, Chapel Hill, NC, USA
| | | | - Maria R. Khan
- New York University School of Medicine, New York, NY, USA
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14
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Brewer R, Ramani SL, Khanna A, Fujimoto K, Schneider JA, Hotton A, Wilton L, Escobedo T, Harawa NT. A Systematic Review up to 2018 of HIV and Associated Factors Among Criminal Justice-Involved (CJI) Black Sexual and Gender Minority Populations in the United States (US). J Racial Ethn Health Disparities 2022; 9:1357-1402. [PMID: 34296420 PMCID: PMC8297427 DOI: 10.1007/s40615-021-01076-7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 11/29/2022]
Abstract
Black men who have sex with men (BMSM) and Black transgender women (BTW) are impacted by dual epidemics of HIV and incarceration. We advanced understanding of the relationship between criminal justice involvement, HIV, and other key HIV-related characteristics among these key populations in the US. We conducted a systematic review up to 2018 and 47 articles met the inclusion criteria of scientific publications involving quantitative findings of US-based HIV-related studies focused on criminal justice-involved (CJI) BMSM and BTW. Overall, there was a dearth of studies focused specifically on BTW. Criminal justice involvement was relatively high among BMSM and BTW and more pronounced among BTW. The current evidence favors no association between incarceration and HIV acquisition among BMSM with limited information about BTW. Criminal justice involvement was associated with a greater likelihood of STIs among BMSM with mixed results for sexual risk behaviors. Criminal justice settings served as an important venue for HIV testing/diagnosis for both BMSM and BTW. However, these settings were not conducive for subsequent stages of the HIV care continuum. Studies pointed to an independent association between criminal justice involvement, substance use, housing instability, and greater odds of incarceration among BMSM who were unemployed and had limited education. Future incarceration was associated with high levels of perceived racism among BMSM. Among young BMSM, high network criminal justice prevalence was also associated with sexual risk behaviors, poorer mental health outcomes, drug use, and housing instability. CJI BMSM and BTW represent a critical subpopulation to end the HIV epidemic in the US.
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Affiliation(s)
- Russell Brewer
- Department of Medicine, University of Chicago, 5837 S. Maryland Ave, MC5065, Chicago, IL, 60637, USA.
| | - Santhoshini L Ramani
- Department of Medicine, University of Chicago, 5837 S. Maryland Ave, MC5065, Chicago, IL, 60637, USA
| | - Aditya Khanna
- Department of Behavioral and Social Science, Brown University, Providence, RI, USA
| | - Kayo Fujimoto
- Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - John A Schneider
- Department of Medicine, University of Chicago, 5837 S. Maryland Ave, MC5065, Chicago, IL, 60637, USA
| | - Anna Hotton
- Department of Medicine, University of Chicago, 5837 S. Maryland Ave, MC5065, Chicago, IL, 60637, USA
| | - Leo Wilton
- State University of New York at Binghamton, Binghamton, NY, USA
- Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - Tania Escobedo
- Department of Medicine, University of Chicago, 5837 S. Maryland Ave, MC5065, Chicago, IL, 60637, USA
| | - Nina T Harawa
- David Geffen School of Medicine, General Internal Medicine and Health Services Research, University of California Los Angeles, Los Angeles, CA, USA
- College of Medicine, Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
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15
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Khan MR, Brewer R, Abrams J, Mazumdar M, Scheidell JD, Feelemyer J, Dyer TV, Turpin RE, Hucks-Ortiz C, Gaydos CA, Severe M, Irvine NM, Kaufman JS, Cleland CM, Mayer KH. Incarceration and Sexual Risk Behavior and Incident Sexually Transmitted Infection/HIV in HIV Prevention Trials Network 061: Differences by Study City and Among Black Sexual Minority Men Who Have Sex With Men, Black Sexual Minority Men Who Have Sex With Men and Women, and Black Transgender Women. Sex Transm Dis 2022; 49:284-296. [PMID: 35312668 PMCID: PMC9387752 DOI: 10.1097/olq.0000000000001594] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND Black sexual minority men (BSMM) and Black transgender women face a disproportionate risk of incarceration and sexually transmitted infection (STI)/HIV, yet research on the longitudinal association between incarceration and STI/HIV risk in these groups is limited. METHODS We used data from the HIV Prevention Trials Network (HPTN) 061 study conducted among BSMM and Black transgender women in Atlanta, Boston, Los Angeles, New York City, San Francisco, and Washington, DC, restricting analyses to those who returned for the 6-month follow-up visit when recent incarceration was measured (n = 1169). Using inverse probability of treatment weighting, we measured associations between incarceration and next 6-month multiple partnerships; selling or buying sex; condomless anal intercourse; and incident chlamydia, gonorrhea, syphilis, and HIV. We explored differences by study city, and among BSMM who had sex with men only, BSMM who had sex with men and women, and Black transgender women. RESULTS Approximately 14% reported past 6-month incarceration. Incarceration was associated with next 6-month selling sex (adjusted risk ratio [ARR], 1.80; 95% confidence interval [CI], 1.12-2.87) in the overall sample and multiple partnerships among BSMM who had sex with men and women (ARR, 1.34; 95% CI, 1.10-1.63) and transgender women (ARR, 1.77; 95% CI, 1.22-2.57). There is evidence suggesting that incarceration may predict gonorrhea (ARR, 2.35; 95% CI, 0.95-5.77), with particularly strong associations observed in Los Angeles (ARR, 6.48; 95% CI, 1.48-28.38). CONCLUSIONS Incarceration may increase STI/HIV risk among BSMM and Black transgender women. Additional mixed-methods research is needed to validate associations and understand pathways.
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Affiliation(s)
- Maria Rabia Khan
- From the Department of Population Health, New York University School of Medicine, New York, University, New York, NY
| | - Russell Brewer
- Department of Medicine, University of Chicago, Chicago, IL
| | - Jasmyn Abrams
- From the Department of Population Health, New York University School of Medicine, New York, University, New York, NY
| | - Medha Mazumdar
- From the Department of Population Health, New York University School of Medicine, New York, University, New York, NY
| | - Joy D Scheidell
- From the Department of Population Health, New York University School of Medicine, New York, University, New York, NY
| | - Jonathan Feelemyer
- From the Department of Population Health, New York University School of Medicine, New York, University, New York, NY
| | - Typhanye V Dyer
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD
| | - Rodman E Turpin
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD
| | | | - Charlotte A Gaydos
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - MacRegga Severe
- From the Department of Population Health, New York University School of Medicine, New York, University, New York, NY
| | - Natalia M Irvine
- From the Department of Population Health, New York University School of Medicine, New York, University, New York, NY
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Charles M Cleland
- From the Department of Population Health, New York University School of Medicine, New York, University, New York, NY
| | - Kenneth H Mayer
- The Fenway Institute, and Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA
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16
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Pyra M, Brewer R, Rusie L, Kline J, Willis I, Schneider J. Long-term HIV Pre-exposure Prophylaxis Trajectories Among Racial & Ethnic Minority Patients: Short, Declining, & Sustained Adherence. J Acquir Immune Defic Syndr 2022; 89:166-171. [PMID: 34636809 PMCID: PMC8752481 DOI: 10.1097/qai.0000000000002833] [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: 05/27/2021] [Accepted: 07/13/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND HIV pre-exposure prophylaxis (PrEP) requires continued use at an effective dosage to reduce HIV incidence. Data suggest early PrEP drop-off among many populations. We sought to describe PrEP use over the first year among racial and ethnic minority patients in the US. SETTING Racial and ethnic minority patients initiating PrEP at a federally qualified health center in Chicago, IL. METHODS Using electronic health records, we determined the adherence (≥6 weekly doses) trajectories over the first year of PrEP use and compared baseline and time-varying patient characteristics. RESULTS From 2159 patients, we identified 3 PrEP use trajectories. Sustained use was the most common (40%) trajectory, followed by short use (30%) and declining use (29%). In adjusted models, younger age, Black race, as well as gender, sexual orientation, insurance status at baseline, and neighborhood were associated with trajectory assignment; within some trajectories, insurance status during follow-up was associated with odds of monthly adherence (≥6 weekly doses). CONCLUSION Among racial and ethnic minorities, a plurality achieved sustained PrEP persistence. Access to clinics, insurance, and intersectional stigmas may be modifiable barriers to effective PrEP persistence; in addition, focus on younger users and beyond gay, cismale populations are needed.
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Affiliation(s)
- Maria Pyra
- Howard Brown Health, Chicago IL
- Department of Medicine, University of Chicago, Chicago IL
| | - Russell Brewer
- Department of Medicine, University of Chicago, Chicago IL
| | | | | | | | - John Schneider
- Howard Brown Health, Chicago IL
- Department of Medicine, University of Chicago, Chicago IL
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17
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Brewer R, Hood KB, Hotton A, Moore M, Spieldenner A, Daunis C, Mukherjee S, Sprague L, Schneider JA, Smith-Davis M, Brown G, Bowen B. Associations Between Experienced HIV Stigma, Resulting Consequences, and the HIV Care Continuum: Moderating Effects of Two Resilience Characteristics Among Persons Living with HIV (PLWH) in Louisiana. J Racial Ethn Health Disparities 2022; 9:9-22. [PMID: 33211250 PMCID: PMC7676401 DOI: 10.1007/s40615-020-00925-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 01/10/2023]
Abstract
INTRODUCTION HIV-related stigma continues to serve as a major barrier to HIV care. HIV stigma reduction interventions are urgently needed to promote and protect the health of persons living with HIV (PLWH). Resilience has been identified as a potential leverage to mitigate the impact of HIV-related stigma among PLWH. METHODS We examined whether two resilience measures (i.e., social support and resilience assets and resources [RAR]) moderated the relationship between experienced HIV stigma and the HIV care continuum as well as how they moderated the relationship between the consequences of experienced HIV stigma (CES) and the HIV care continuum among 300 PLWH in Louisiana. Separate bootstrapping analyses were conducted to test for evidence of moderated moderation. RESULTS Most participants were Black (79%) and had been living with HIV for 10 years or more. A relatively high sample of men who have sex with men (MSM) were enrolled (37%). The most common CES were depression (67%). The most common manifestation of experienced HIV stigma was being gossiped about (53%). Participants reported moderate levels of social support. In terms of RAR, most participants (71%) reported that they knew of groups that could support them in responding to experienced HIV stigma. After adjusting for potential covariates, social support and RAR both significantly moderated the relationship between experienced HIV stigma and length of time since their last HIV care visit, B(SE) = .003(.001), p = .03. At high levels of RAR and high levels of social support, those with higher levels of experienced HIV stigma reported a longer length of time since their last HIV care visit than those who reported lower levels of experienced HIV stigma (B(SE) = .17(.04), p < .001). RAR moderated the relationship between social support and HIV care, B(SE) = .01(.004), p < .001. Those who experienced greater CES reported a longer length of time since their last doctor's visit B(SE) = .04(.02), p < .05. Experienced HIV stigma was not significantly associated with viral load results. However, social support significantly moderated the relationship between experienced stigma and viral load results. At higher levels of social support, those who experienced lower levels of stigma were more likely to report an undetectable viral load than those who had higher levels of stigma, B(SE) = - .13(.03), p < .001. Finally, both RAR and social support moderated the relationship between CES and viral load results. Those who reported higher levels of RAR B(SE) = - .07(.02), p < .001, and social support, B(SE) = - .02(.01), p < .05, also reported having an undetectable viral load at most recent HIV care visit. CES was not significantly related to reporting an undetectable viral load (p = .61). CONCLUSIONS Enrolled PLWH already have some level of resilience which plays an important protective role within the context of the HIV care continuum up to a certain extent. Interventions to enhance the RAR and social support components may be useful especially among MSM and persons who have been living with HIV for a shorter period of time.
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Affiliation(s)
- Russell Brewer
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, MC 5065, Chicago, IL 60637 USA
| | | | - Anna Hotton
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, MC 5065, Chicago, IL 60637 USA
| | | | | | | | - Snigdha Mukherjee
- Foundation for Advancement of International Medical Education and Research, Philadelphia, PA USA
| | - Laurel Sprague
- Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland
| | - John A. Schneider
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, MC 5065, Chicago, IL 60637 USA
| | | | - Gina Brown
- Southern AIDS Coalition, Birmingham, AL USA
| | - Brandi Bowen
- New Orleans Regional AIDS Planning Council, New Orleans, LA USA
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18
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Sterrett-Hong EM, DeBow J, Caton E, Harris M, Brewer R, Roberts E, Marchal M, Tauzer M, Arnold EA. Non-parental Adults and Sexual Health Behaviors Among Young Minority Men: A Qualitative Examination. Front Psychol 2021; 12:598120. [PMID: 35027894 PMCID: PMC8751617 DOI: 10.3389/fpsyg.2021.598120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 10/21/2021] [Indexed: 11/17/2022] Open
Abstract
Young Black and Latino sexual minority men (YBLSM) exhibit disproportionately high rates of negative sexual health outcomes, including HIV and other sexually transmitted infections, compared to other groups, partly due to relatively higher rates of exposure to a host of socio-structural risk factors (e.g., unstable housing and under-employment). However, an under-studied interpersonal resource exists for many YBLSM, non-parental adults (NPAs, i.e., adults who act as role models and provide social support), who may be able to influence contextual (e.g., unemployment) and individual (e.g., reduced health expectations) factors underlying sexual health disparities. Aims: This study sought to examine the role of NPAs in factors that affect sexual health behaviors and in supporting those health behaviors directly, among YBLSM living in a mid-sized city in the southern United States. A total of n=20 participants, n=10 YBLSM (ages 16 to 22), and n=10 NPAs (ages 26 to 52) were interviewed using semi-structured guides to examine NPA involvement in the lives of YBLSM from both sides of the relationship. The research team used a framework analysis approach to iteratively identify and define meaningful codes and sub-codes. Both YBLSM and NPAs described NPAs helping YBLSM through role modeling and social support in a variety of areas found to affect sexual health behaviors, such as housing instability and psychological distress, as well as in specific behaviors, such as condom use and HIV medication adherence. Given the multiple socio-structural obstacles facing YBLSM and their multifaceted relationships with NPAs, NPAs may be a promising resource to help address these impediments to health. Partnering more intentionally with NPAs is a potentially promising strategy to help reduce HIV-related disparities affecting YBLSM that is worthy of additional empirical attention.
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Affiliation(s)
- Emma M. Sterrett-Hong
- Kent School of Social Work, University of Louisville, Louisville, KY, United States
- *Correspondence: Emma M. Sterrett-Hong,
| | - Joseph DeBow
- Kent School of Social Work, University of Louisville, Louisville, KY, United States
| | - Erica Caton
- Center for the Advancement of Teaching, Florida International University, Miami, FL, United States
| | - Matthew Harris
- Kent School of Social Work, University of Louisville, Louisville, KY, United States
| | - Russell Brewer
- Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Erin Roberts
- Marriage and Family Therapy Program, East Carolina University, Greenville, NC, United States
| | - Madeline Marchal
- Kent School of Social Work, University of Louisville, Louisville, KY, United States
| | - Marjorie Tauzer
- Center for AIDS Prevention Studies, University of California, San-Francisco, San Francisco, CA, United States
| | - Emily A. Arnold
- Center for AIDS Prevention Studies, University of California, San-Francisco, San Francisco, CA, United States
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19
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Holt KM, Holt TJ, Cale J, Brewer R, Goldsmith A. Assessing the role of self-control and technology access on adolescent sexting and sext dissemination. Computers in Human Behavior 2021. [DOI: 10.1016/j.chb.2021.106952] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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20
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Schneider JA, Taylor BG, Hotton AL, Lamuda PA, Ozik J, Lin Q, Flanagan E, Tuyet Pho M, Kolak M, Brewer R, Pagkas-Bather J, Pollack HA. National variability in Americans' COVID-19 protective behaviors: Implications for vaccine roll-out. PLoS One 2021; 16:e0259257. [PMID: 34739498 PMCID: PMC8570526 DOI: 10.1371/journal.pone.0259257] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 04/05/2021] [Accepted: 10/16/2021] [Indexed: 11/19/2022] Open
Abstract
Protective behaviors such as mask wearing and physical distancing are critical to slow the spread of COVID-19, even in the context of vaccine scale-up. Understanding the variation in self-reported COVID-19 protective behaviors is critical to developing public health messaging. The purpose of the study is to provide nationally representative estimates of five self-reported COVID-19 protective behaviors and correlates of such behaviors. In this cross-sectional survey study of US adults, surveys were administered via internet and telephone. Adults were surveyed from April 30-May 4, 2020, a time of peaking COVID-19 incidence within the US. Participants were recruited from the probability-based AmeriSpeak® national panel. Brief surveys were completed by 994 adults, with 73.0% of respondents reported mask wearing, 82.7% reported physical distancing, 75.1% reported crowd avoidance, 89.8% reported increased hand-washing, and 7.7% reported having prior COVID-19 testing. Multivariate analysis (p critical value .05) indicates that women were more likely to report protective behaviors than men, as were those over age 60. Respondents who self-identified as having low incomes, histories of criminal justice involvement, and Republican Party affiliation, were less likely to report four protective behaviors, though Republicans and individuals with criminal justice histories were more likely to report having received COVID-19 testing. The majority of Americans engaged in COVID-19 protective behaviors, with low-income Americans, those with histories of criminal justice involvement, and self-identified Republicans less likely to engage in these preventive behaviors. Culturally competent public health messaging and interventions might focus on these latter groups to prevent future infections. These findings will remain highly relevant even with vaccines widely available, given the complementarities between vaccines and protective behaviors, as well as the many challenges in delivering vaccines.
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Affiliation(s)
- John A Schneider
- Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | | | - Anna L Hotton
- Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | | | - Jonathan Ozik
- Argonne National Laboratory, Chicago, Illinois, United States of America
| | - Qinyun Lin
- Center for Spatial Data Science, University of Chicago, Chicago, Illinois, United States of America
| | - Elizabeth Flanagan
- Argonne National Laboratory, Chicago, Illinois, United States of America
| | - Mai Tuyet Pho
- Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | - Marynia Kolak
- Center for Spatial Data Science, University of Chicago, Chicago, Illinois, United States of America
| | - Russell Brewer
- Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | - Jade Pagkas-Bather
- Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | - Harold A Pollack
- Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, Illinois, United States of America
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21
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Timmins L, Schneider JA, Chen YT, Goedel WC, Brewer R, Callander D, Knox J, Eavou R, Hanson H, Duncan DT. Sexual Identity, Sexual Behavior and Pre-exposure Prophylaxis in Black Cisgender Sexual Minority Men: The N2 Cohort Study in Chicago. AIDS Behav 2021; 25:3327-3336. [PMID: 33852095 PMCID: PMC8419005 DOI: 10.1007/s10461-021-03246-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 03/23/2021] [Indexed: 01/04/2023]
Abstract
This study investigated sexual identity and behavior and their potential associations with PrEP use and attitudes in cisgender Black gay and bisexual men. A total of N = 173 (mean age 25.2) participants from the Neighborhoods and Networks (N2) Study in Chicago were included. Of these, 104 were gay-identified and reported sex with men only (GSMO), 26 were gay-identified and reported sex with men and women (GSMW), 8 were bisexual-identified and reported sex with men only (BSMO), and 35 were bisexual-identified and reported sex with men and women (BSMW). Reporting sex with men and women in the past 6 months, RR = 0.39, 95% CI [0.17, 0.89], identifying as bisexual, RR = 0.52, 95% CI [0.29, 0.92], and the combination of the two, RR = 0.24, 95% CI [0.07, 0.76] were significantly associated with lower rates of current oral PrEP use. Black bisexual-identifying men who reported sex with men and women were significantly more likely to have discontinued oral PrEP, RR = 2.50, 95% CI [1.14, 5.50], than Black gay-identified men who reported sex with men only. Participants who had not used oral PrEP before reported lower levels of interest in long-acting injectable PrEP than those who were currently using oral PrEP, RR = 0.56, 95% CI [0.40, 0.79]. No other significant differences were found. Overlooking the combination of sexual identity and behavior may mischaracterize PrEP rates and miss uniquely vulnerable subgroups. Black gay and bisexual men who had not used oral PrEP may be particularly disinterested in long-acting injectable PrEP.
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Affiliation(s)
- Liadh Timmins
- Columbia Spatial Epidemiology Lab, Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 729, New York, NY, 10032, USA.
| | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago School of Medicine, Chicago, IL, USA
| | - Yen-Tyng Chen
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
- Department of Public Health, William Paterson University of New Jersey, Wayne, NJ, USA
| | - William C Goedel
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Russell Brewer
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago School of Medicine, Chicago, IL, USA
| | - Denton Callander
- Columbia Spatial Epidemiology Lab, Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 729, New York, NY, 10032, USA
| | - Justin Knox
- Columbia Spatial Epidemiology Lab, Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 729, New York, NY, 10032, USA
| | - Rebecca Eavou
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
| | - Hillary Hanson
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
| | - Dustin T Duncan
- Columbia Spatial Epidemiology Lab, Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 729, New York, NY, 10032, USA
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22
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Khanna AS, Edali M, Ozik J, Collier N, Hotton A, Skwara A, Ardestani BM, Brewer R, Fujimoto K, Harawa N, Schneider JA. Projecting the number of new HIV infections to formulate the "Getting to Zero" strategy in Illinois, USA. Math Biosci Eng 2021; 18:3922-3938. [PMID: 34198418 PMCID: PMC8281377 DOI: 10.3934/mbe.2021196] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 06/13/2023]
Abstract
OBJECTIVES Getting to Zero (GTZ) initiatives focus on expanding use of antiretroviral treatment (ART) and pre-exposure prophylaxis (PrEP) to eliminate new HIV infections. Computational models help inform policies for implementation of ART and PrEP continuums. Such models, however, vary in their design, and may yield inconsistent predictions. Using multiple approaches can help assess the consistency in results obtained from varied modeling frameworks, and can inform optimal implementation strategies. METHODS A study using three different modeling approaches is conducted. Two approaches use statistical time series analysis techniques that incorporate temporal HIV incidence data. A third approach uses stochastic stimulation, conducted using an agent-based network model (ABNM). All three approaches are used to project HIV incidence among a key population, young Black MSM (YBMSM), over the course of the GTZ implementation period (2016-2030). RESULTS All three approaches suggest that simultaneously increasing PrEP and ART uptake is likely to be more effective than increasing only one, but increasing ART and PrEP by 20% points may not eliminate new HIV infections among YBMSM. The results further suggest that a 20% increase in ART is likely to be more effective than a 20% increase in PrEP. All three methods consistently project that increasing ART and PrEP by 30% simultaneously can help reach GTZ goals. CONCLUSIONS Increasing PrEP and ART uptake by about 30% might be necessary to accomplish GTZ goals. Such scale-up may require addressing psychosocial and structural barriers to engagement in HIV and PrEP care continuums. ABNMs and other flexible modeling approaches can be extended to examine specific interventions that address these barriers and may provide important data to guide the successful intervention implementation.
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Affiliation(s)
- Aditya Subhash Khanna
- Center for Alcohol and Addiction Studies, Brown University, Providence RI USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence RI USA
| | - Mert Edali
- Chicago Center for HIV Elimination, The University of Chicago, Chicago, IL, USA
- Department of Medicine, The University of Chicago, Chicago, IL, USA
- Department of Industrial Engineering, Yildiz Technical University, Besiktas, Istanbul 34349, Turkey
| | - Jonathan Ozik
- Decision and Infrastructure Sciences Division, Argonne National Laboratory, Lemont, IL, USA
| | - Nicholson Collier
- Decision and Infrastructure Sciences Division, Argonne National Laboratory, Lemont, IL, USA
| | - Anna Hotton
- Chicago Center for HIV Elimination, The University of Chicago, Chicago, IL, USA
- Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Abigail Skwara
- Chicago Center for HIV Elimination, The University of Chicago, Chicago, IL, USA
- Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Babak Mahdavi Ardestani
- Chicago Center for HIV Elimination, The University of Chicago, Chicago, IL, USA
- Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Russell Brewer
- Chicago Center for HIV Elimination, The University of Chicago, Chicago, IL, USA
- Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Kayo Fujimoto
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Nina Harawa
- Department of Psychiatry and Human Behavior, Charles R. Drew University, Los Angeles, CA, USA
- Department of Epidemiology, University of California, Los Angeles, CA, USA
| | - John A. Schneider
- Chicago Center for HIV Elimination, The University of Chicago, Chicago, IL, USA
- Department of Medicine, The University of Chicago, Chicago, IL, USA
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23
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Remch M, Duncan DT, Geller A, Turpin R, Dyer T, Scheidell JD, Cleland CM, Kaufman JS, Brewer R, Hucks-Ortiz C, van der Mei W, Mayer KH, Khan MR. Police harassment and psychosocial vulnerability, distress, and depressive symptoms among black men who have sex with men in the U.S.: Longitudinal analysis of HPTN 061. SSM Popul Health 2021; 13:100753. [PMID: 33665335 PMCID: PMC7902537 DOI: 10.1016/j.ssmph.2021.100753] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/27/2021] [Accepted: 02/02/2021] [Indexed: 11/24/2022] Open
Abstract
The mental health impact of exposure to police harassment is understudied, particularly among Black men who have sex with men (BMSM), a group at elevated risk of exposure to such discrimination. This study aimed to identify the associations among BMSM between recent police harassment and psychosocial vulnerability, psychological distress, and depression measured six months later. Data come from the HIV Prevention Trials Network (HPTN) 061 Study, a cohort study of BMSM recruited in 6 U.S. cities (Atlanta, GA, Boston, MA, Los Angeles, CA, New York, NY, San Francisco, CA, and Washington DC). Participants completed baseline, 6-month follow-up, and 12-month follow-up interviews. A convenience sample of 1553 BMSM was recruited between July 2009 and October 2010 of whom 1155 returned for a follow-up interview 12 months later. Accounting for previous police interaction, poverty, psychopathology, drug use, and alcohol use, we estimated associations between recent police harassment reported at the 6 month follow-up interview and 12 month outcomes including psychosocial vulnerability (elevated racial/sexual identity incongruence), psychological distress (being distressed by experiences of racism and/or homophobia), and depression. About 60% of men reported experiencing police harassment between the baseline and 6-month interview due to their race and/or sexuality. Adjusted analyses suggested police harassment was independently associated with a 10.81 (95% CI: 7.97, 13.66) point increase and 8.68 (95% CI: 6.06, 11.30) point increase in distress due to experienced racism and distress due to experienced homophobia scores, respectively. Police harassment perceived to be dually motivated predicted disproportionate levels of distress. Police harassment is prevalent and associated with negative influences on psychosocial vulnerability and psychological distress among BMSM. Reducing exposure to police harassment may improve the psychosocial health of BMSM. We examine the impact of police harassment on Black men who have sex with men. Data from the HPTN 061 Study show that police harassment is highly prevalent. Police harassment is associated with psychosocial vulnerability. Police harassment is associated with psychological distress. Harassment motivated by racism and homophobia is associated with added distress.
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Affiliation(s)
- Molly Remch
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Amanda Geller
- Department of Criminology, Law and Society, University of California Irvine, Irvine, CA, USA
| | - Rodman Turpin
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | - Typhanye Dyer
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | - Joy D Scheidell
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Charles M Cleland
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics, & Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Russell Brewer
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | | | - Willem van der Mei
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Kenneth H Mayer
- Harvard Medical School, Boston, MA, USA.,Fenway Institute, Fenway Health, Boston, MA, USA
| | - Maria R Khan
- Department of Population Health, New York University School of Medicine, New York, NY, USA
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24
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Teixeira da Silva D, Bouris A, Ramachandran A, Blocker O, Davis B, Harris J, Pyra M, Rusie LK, Brewer R, Pagkas-Bather J, Hotton A, Ridgway JP, McNulty M, Bhatia R, Schneider JA. Embedding a Linkage to Preexposure Prophylaxis Care Intervention in Social Network Strategy and Partner Notification Services: Results From a Pilot Randomized Controlled Trial. J Acquir Immune Defic Syndr 2021; 86:191-199. [PMID: 33109935 PMCID: PMC8103968 DOI: 10.1097/qai.0000000000002548] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 05/19/2020] [Accepted: 09/23/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Increased preexposure prophylaxis (PrEP) uptake among black men who have sex with men and black transgender women (BMSM/TW) is needed to end the HIV epidemic. Embedding a brief intervention in network services that engage individuals in HIV transmission networks for HIV/ sexually transmitted infections testing may be an important strategy to accelerate PrEP uptake. SETTING Partner Services PrEP study is a pilot, randomized, control trial to improve linkage to PrEP care among BMSM/TW presenting for network services in Chicago, IL, from 2015 to 2017. METHODS BMSM/TW (N = 146) aged 18-40 years were recruited from network services (partners services and social network strategy services). Intervention participants developed an individualized linkage plan based on the information-motivation-behavioral skills model and received minibooster sessions. Control participants received treatment as usual. Sociodemographic, behavioral, and clinical factors were examined at baseline and 3- and 12-month postintervention. Intent-to-treat analyses examined linkage to PrEP care within 3-month postintervention (primary outcome). Secondary outcomes were PrEP initiation, time to linkage to PrEP care, and time to PrEP initiation. RESULTS Compared with control participants, a significantly greater proportion of the intervention participants were linked to PrEP care within 3 months (24% vs. 11%; P = 0.04) and initiated PrEP (24% vs. 11%; P = 0.05). Among those linked to PrEP care within the study period, intervention participants were linked significantly sooner than control participants [median (interquartile range) days, 26.5 (6.0-141.8) vs. 191.5 (21.5-297.0); P = 0.05]. CONCLUSION Study results support the preliminary efficacy of Partner Services PrEP to improve linkage to PrEP care and PrEP initiation among BMSM/TW.
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Affiliation(s)
- Daniel Teixeira da Silva
- Department of Combined Internal Medicine and Pediatrics, University of Chicago, Chicago, IL
- Department of Medicine, University of Chicago, Chicago, IL
| | - Alida Bouris
- School of Social Service Administration, University of Chicago, Chicago, IL
- Chicago Center for HIV Elimination, Chicago, IL
| | | | | | - Billy Davis
- Chicago Center for HIV Elimination, Chicago, IL
| | | | - Maria Pyra
- Chicago Center for HIV Elimination, Chicago, IL
- Howard Brown Health, Chicago, IL
| | | | - Russell Brewer
- Department of Medicine, University of Chicago, Chicago, IL
- Chicago Center for HIV Elimination, Chicago, IL
| | - Jade Pagkas-Bather
- Department of Medicine, University of Chicago, Chicago, IL
- Chicago Center for HIV Elimination, Chicago, IL
- Howard Brown Health, Chicago, IL
| | - Anna Hotton
- Chicago Center for HIV Elimination, Chicago, IL
| | - Jessica P Ridgway
- Department of Medicine, University of Chicago, Chicago, IL
- Chicago Center for HIV Elimination, Chicago, IL
| | - Moira McNulty
- Department of Medicine, University of Chicago, Chicago, IL
- Chicago Center for HIV Elimination, Chicago, IL
| | | | - John A Schneider
- Department of Medicine, University of Chicago, Chicago, IL
- Chicago Center for HIV Elimination, Chicago, IL
- Howard Brown Health, Chicago, IL
- Department of Public Health Sciences, University of Chicago, Chicago, IL
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25
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Hotton AL, Chen YT, Schumm P, Khanna AS, Brewer R, Skaathun B, Issema RS, Ramani S, Ramachandran A, Ozik J, Fujimoto K, Harawa NT, Schneider JA. Socio-Structural and Neighborhood Predictors of Incident Criminal Justice Involvement in a Population-Based Cohort of Young Black MSM and Transgender Women. J Urban Health 2020; 97:623-634. [PMID: 32180129 PMCID: PMC7560631 DOI: 10.1007/s11524-020-00428-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Black men who have sex with men (MSM) and transgender women are disproportionately affected by criminal justice involvement (CJI) and HIV. This study recruited 618 young Black MSM and transgender women in Chicago, IL, using respondent-driven sampling between 2013 and 2014. Random effects logistic regression evaluated predictors of incident CJI over 18 months of follow-up. Controlling for respondent age, gender and sexual identity, spirituality (aOR 0.56, 95% CI 0.33-0.96), and presence of a mother figure (aOR 0.41, 95% CI 0.19-0.89) were protective against CJI. Economic hardship (financial or residential instability vs. neither aOR 2.23, 95% CI 1.10-4.51), two or more past episodes of CJI vs. none (aOR 2.66, 95% CI 1.40-5.66), and substance use (marijuana use vs. none aOR 2.79, 95% CI 1.23-6.34; other drug use vs. none aOR 4.49, 95% CI 1.66-12.16) were associated with CJI during follow-up. Research to identify and leverage resilience factors that can buffer the effects of socioeconomic marginalization may increase the effectiveness of interventions to address the socio-structural factors that increase the risk for CJI among Black MSM and transgender women. Given the intersection of incarceration, HIV and other STIs, and socio-structural stressors, criminal justice settings are important venues for interventions to reduce health inequities in these populations.
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Affiliation(s)
- Anna L Hotton
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA.
| | - Yen-Tyng Chen
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA
| | - Phil Schumm
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Aditya S Khanna
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA
| | - Russell Brewer
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA
| | - Britt Skaathun
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA
| | - Rodal S Issema
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA
| | - Santhoshini Ramani
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA
| | - Arthi Ramachandran
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA
| | - Jonathan Ozik
- Consortium for Advanced Science and Engineering, University of Chicago, Chicago, IL, USA.,Decision and Infrastructure Sciences Division, Argonne National Laboratory, Lemont, IL, USA
| | | | | | - John A Schneider
- Departments of Medicine and Public Health Sciences, Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
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26
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Abstract
Spirituality is a culturally relevant phenomenon that has been found to significantly affect Black sexual minority (SM) men’s health in the United States. However, many studies that have investigated spirituality among Black SM men have often used conceptualizations of spirituality that were not defined by this group. This research investigation used qualitative methods to determine how Black SM men defined spirituality for themselves. Ten Black SM men from across the United States were individually interviewed via Zoom videoconferencing. Grounded theory analyses revealed four themes that described Black SM men’s culturally specific spirituality: (a) spiritual definition, (b) specificity of Black SM men’s spirituality, (c) physical manifestations of spirituality, and (d) images of the sacred. The implications of these findings for future research and clinical work with Black SM men, within a Black psychological framework, are discussed.
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Affiliation(s)
| | | | - Leo Wilton
- State University of New York at Binghamton, Binghamton, NY, USA
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27
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Brewer R, Hood KB, Moore M, Spieldenner A, Daunis C, Mukherjee S, Smith-Davis M, Brown G, Bowen B, Schneider JA. An Exploratory Study of Resilience, HIV-Related Stigma, and HIV Care Outcomes Among Men who have Sex with Men (MSM) Living with HIV in Louisiana. AIDS Behav 2020; 24:2119-2129. [PMID: 31916097 DOI: 10.1007/s10461-020-02778-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [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: 12/31/2022]
Abstract
The various forms of HIV-related stigma continue to serve as major barriers to HIV care and treatment among men who have sex with men (MSM). The study of resilience within the context of HIV-related stigma among MSM living with HIV represents a promising area of research to inform the development of future HIV interventions for this population. We examined resilience within the context of HIV related stigma among MSM living with HIV in Louisiana with a particular interest in how resilience may be more relevant for Black MSM. We utilized Pearson's correlations and layered chi-square non-parametric tests to examine associations and racial differences in resilience, four HIV-related stigma measures/consequences (i.e., anticipated, internalized, enacted, and consequences of enacted HIV stigma), and HIV care outcomes (i.e., length of time since last HIV care visit, time since last HIV lab result, most recent HIV viral load result) among 110 MSM living with HIV in Louisiana who participated in the Louisiana HIV Stigma Index Project. The majority of MSM participants were Black (75%), lived in New Orleans (52%), and reported limited education (52%) and income (76%). MSM who reported higher levels of enacted HIV stigma, consequences of enacted HIV stigma, and internalized HIV stigma reported poorer HIV care outcomes. Both internalized and anticipated HIV stigma significantly negatively impacted Black MSM perceptions of their overall health compared with White MSM. Compared with White MSM, Black MSM who reported greater consequences of enacted HIV stigma had poorer HIV care outcomes. Resilience was associated with positive HIV care outcomes for both Black and White MSM. However, having higher levels of resilience may have been more protective for Black MSM such that higher levels of resilience were associated with less time since last HIV care visit for Black MSM than for White MSM. The current study provides preliminary information on the potential positive relationship between resilience and HIV care outcomes among MSM, particularly Black MSM. However, these findings need to be confirmed among a more representative sample of Black and White MSM in Louisiana.
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Affiliation(s)
- Russell Brewer
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, MC 5065, Chicago, IL, 60637, USA.
- Chicago Center for HIV Elimination, Chicago, IL, USA.
| | | | - Mary Moore
- Dillard University, New Orleans, LA, USA
| | | | | | - Snigdha Mukherjee
- Educational Commission for Foreign Medical Graduates, Philadelphia, PA, USA
| | | | - Gina Brown
- Southern AIDS Coalition, New Orleans, LA, USA
| | - Brandi Bowen
- New Orleans Regional AIDS Planning Council, New Orleans, LA, USA
| | - John A Schneider
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, MC 5065, Chicago, IL, 60637, USA
- Chicago Center for HIV Elimination, Chicago, IL, USA
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Teixeira da Silva D, Bouris A, Voisin D, Hotton A, Brewer R, Schneider J. Social Networks Moderate the Syndemic Effect of Psychosocial and Structural Factors on HIV Risk Among Young Black Transgender Women and Men who have Sex with Men. AIDS Behav 2020; 24:192-205. [PMID: 31289985 DOI: 10.1007/s10461-019-02575-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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] [Indexed: 01/30/2023]
Abstract
The interaction between the cumulative effect of psychosocial and structural factors (i.e. syndemic effect) and social networks among young Black transgender women and men who have sex with men (YBTM) remains understudied. A representative cohort of 16-29 year-old YBTM (n = 618) was assessed for syndemic factors [i.e. substance use; community violence; depression; poverty; justice system involvement (JSI)], social network characteristics, condomless anal sex (CAS), group sex (GS), and HIV-infection. The syndemic index significantly increased the odds of CAS, GS, and HIV-infection, and these effects were moderated by network characteristics. Network JSI buffered the effect on CAS, romantic network members buffered the effect on GS, and network age and proportion of family network members buffered the effect on HIV-infection. The proportion of friend network members augmented the effect on GS and HIV-infection. Future research to prevent HIV among YBTM should consider social network approaches that target both structural and psychosocial syndemic factors.
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Affiliation(s)
- Daniel Teixeira da Silva
- Department of Internal Medicine, University of Chicago, Chicago, IL, USA.
- Department of Combined Internal Medicine and Pediatrics, University of Chicago, 5841 S Maryland Avenue MC 7082, Chicago, IL, 60637, USA.
| | - Alida Bouris
- School of Social Service Administration, University of Chicago, Chicago, IL, USA
- Chicago Center for HIV Elimination, Chicago, IL, USA
| | - Dexter Voisin
- School of Social Service Administration, University of Chicago, Chicago, IL, USA
- Chicago Center for HIV Elimination, Chicago, IL, USA
| | - Anna Hotton
- Chicago Center for HIV Elimination, Chicago, IL, USA
| | | | - John Schneider
- Department of Internal Medicine, University of Chicago, Chicago, IL, USA
- Chicago Center for HIV Elimination, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
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29
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Downs BW, Blum K, Bagchi D, Kushner S, Bagchi M, Galvin JM, Lewis M, Siwicki D, Brewer R, Boyett B, Baron D, Giordano J, Badgaiyan RD. Molecular neuro-biological and systemic health benefits of achieving dopamine homeostasis in the face of a catastrophic pandemic (COVID- 19): A mechanistic exploration. ACTA ACUST UNITED AC 2020; 7. [PMID: 32934824 DOI: 10.15761/jsin.1000228] [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: 12/22/2022]
Abstract
In the face of the global pandemic of COVID 19, approaching 1.75 Million infected worldwide (4/12/2020) and associated mortality (over 108, 000 as of 4/12/2020) as well-as other catastrophic events including the opioid crisis, a focus on brain health seems prudent [1] (https://www.coronavirus.gov). This manuscript reports on the systemic benefits of restoring and achieving dopamine homeostasis to reverse and normalize thoughts and behaviors of Reward Deficiency Syndrome (RDS) dysfunctional conditions and their effects on behavioral physiology; function of reward genes; and focuses on digestive, immune, eye health, and the constellation of symptomatic behaviors. The role of nutrigenomic interventions on restoring normal brain functions and its benefits on these systems will be discussed. We demonstrate that modulation of dopamine homeostasis using nutrigenomic dopamine agonists, instead of pharmaceutical interventions, is achievable. The allied interlinking with diverse chronic diseases and disorders, roles of free radicals and incidence of anaerobic events have been extensively highlighted. In conjunction, the role of dopamine in aspects of sleep, rapid eye movement and waking are extensively discussed. The integral aspects of food indulgence, the influence of taste sensations, and gut-brain signaling are also discussed along with a special emphasis on ocular health. The detailed mechanistic insight of dopamine, immune competence and the allied aspects of autoimmune disorders are also highlighted. Finally, the integration of dopamine homeostasis utilizing a patented gene test and a research-validated nutrigenomic intervention are presented. Overall, a cutting-edge nutrigenomic intervention could prove to be a technological paradigm shift in our understanding of the extent to which achieving dopamine homeostasis will benefit overall health.
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Affiliation(s)
- B W Downs
- Department of Nutrigenomics Research, Victory Nutrition International, Inc., Lederach, PA, USA
| | - K Blum
- Department of Nutrigenomics Research, Victory Nutrition International, Inc., Lederach, PA, USA.,Western University, Health Sciences, Graduate School of Biomedical Sciences, Pomona, CA, USA.,Division of Neuroscience and Addiction Research, Pathway Healthcare, Birmingham, AL, USA.,Eotvos Loránd University, Institute of Psychology, Budapest, Hungary.,Department of Psychiatry, Wright State University Boonshoft School of Medicine and Dayton VA Medical Center, Dayton, OH, USA.,Division of Precision Nutrition, GARS IP., LLC, Hollywood Fl., USA, & Geneus Health, LLC., San Antonio, TX, USA
| | - D Bagchi
- Department of Nutrigenomics Research, Victory Nutrition International, Inc., Lederach, PA, USA.,Department of Pharmacological & Pharmaceutical Sciences, University of Houston College of Pharmacy, Houston, TX, USA
| | - S Kushner
- ALM Research & Development, Oldsmar, FL, USA
| | | | - J M Galvin
- Vitality Medical Wellness Institute, PLLC, Charlotte, NC, USA
| | - McG Lewis
- Departments of Anatomy & Psychiatry, Howard University, School of Medicine, Washington, D., USA
| | - D Siwicki
- Division of Precision Nutrition, GARS IP., LLC, Hollywood Fl., USA, & Geneus Health, LLC., San Antonio, TX, USA
| | - R Brewer
- Division of Precision Nutrition, GARS IP., LLC, Hollywood Fl., USA, & Geneus Health, LLC., San Antonio, TX, USA
| | - B Boyett
- Division of Neuroscience and Addiction Research, Pathway Healthcare, Birmingham, AL, USA
| | - D Baron
- Western University, Health Sciences, Graduate School of Biomedical Sciences, Pomona, CA, USA
| | - J Giordano
- National Institute of Holistic and Addiction Studies, Davie, FL, USA
| | - R D Badgaiyan
- Department of Psychiatry, ICHAN School of Medicine, Mount Sinai, New York, NYC. & Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, San Antonio, TX, Long School of Medicine, University of Texas Medical Center, San Antonio, TX, USA
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Blum K, Bowirrat A, Baron D, Lott L, Ponce JV, Brewer R, Siwicki D, Boyett B, Gondre-Lewis MC, Smith DE, Panayotis K T, Badgaiyan S, Hauser M, Fried L, A R, Downs BW, Badgaiyan RD. Biotechnical development of genetic addiction risk score (GARS) and selective evidence for inclusion of polymorphic allelic risk in substance use disorder (SUD). ACTA ACUST UNITED AC 2019; 6. [PMID: 33614164 PMCID: PMC7891477 DOI: 10.15761/jsin.1000221] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Research into the neurogenetic basis of addiction identified and characterized by Reward Deficiency Syndrome (RDS) includes all drug and non-drug addictive, obsessive and compulsive behaviors. We are proposing herein that a new model for the prevention and treatment of Substance Use Disorder (SUD) a subset of RDS behaviors, based on objective biologic evidence, should be given serious consideration in the face of a drug epidemic. The development of the Genetic Addiction Risk Score (GARS) followed seminal research in 1990, whereby, Blum’s group identified the first genetic association with severe alcoholism published in JAMA. While it is true that no one to date has provided adequate RDS free controls there have been many studies using case –controls whereby SUD has been eliminated. We argue that this deficiency needs to be addressed in the field and if adopted appropriately many spurious results would be eliminated reducing confusion regarding the role of genetics in addiction. However, an estimation, based on these previous literature results provided herein, while not representative of all association studies known to date, this sampling of case- control studies displays significant associations between alcohol and drug risk. In fact, we present a total of 110,241 cases and 122,525 controls derived from the current literature. We strongly suggest that while we may take argument concerning many of these so-called controls (e.g. blood donors) it is quite remarkable that there are a plethora of case –control studies indicating selective association of these risk alleles ( measured in GARS) for the most part indicating a hypodopaminergia. The paper presents the detailed methodology of the GARS. Data collection procedures, instrumentation, and the analytical approach used to obtain GARS and subsequent research objectives are described. Can we combat SUD through early genetic risk screening in the addiction field enabling early intervention by the induction of dopamine homeostasis? It is envisaged that GARS type of screening will provide a novel opportunity to help identify causal pathways and associated mechanisms of genetic factors, psychological characteristics, and addictions awaiting additional scientific evidence including a future meta- analysis of all available data –a work in progress.
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Affiliation(s)
- K Blum
- Western University Health Sciences Graduate School of Biomedical Sciences, Pomona, CA, USA.,Department of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA.,Division Addiction Services, Dominion Diagnostics, LLC, North Kingston, RI, USA.,Division of Nutrigenomics, Victory Nutrition International. Inc. Lederach, PA, USA.,Divion of Neuroscience & Addiction Research, Pathway HealthCare, LLC, Birmingham, AL.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Department of Psychiatry, University of Vermont, Burlington, VM. USA.,Centre for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology, Nonakuri, Purba Medinipur, West Bengal, India.,Department of Psychiatry, Wright State University Boonshoft School of Medicine and Dayton VA Medical Centre, Dayton, OH, USA
| | - A Bowirrat
- Departments of Clinical Neuroscience and Population Genetics, Interdisciplinary Center (IDC) Herzliya, Department of Neuroscience, Israel
| | - D Baron
- Western University Health Sciences Graduate School of Biomedical Sciences, Pomona, CA, USA
| | - L Lott
- Department of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA
| | - J V Ponce
- Department of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA
| | - R Brewer
- Department of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA
| | - D Siwicki
- Department of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA
| | - B Boyett
- Divion of Neuroscience & Addiction Research, Pathway HealthCare, LLC, Birmingham, AL
| | - M C Gondre-Lewis
- National Human Genome Center, Howard University, Washington DC, USA.,Departments of Anatomy, and Psychiatry & Behavioral Sciences, Howard University College of Medicine, Washington DC, USA
| | - D E Smith
- Department of Pharmacology, University of California San Francisco School of Medicine, San Francisco, USA
| | - Thanos Panayotis K
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Research Institute on Addictions, University at Buffalo, Buffalo, NY, USA
| | - S Badgaiyan
- Department of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA
| | - M Hauser
- Division Addiction Services, Dominion Diagnostics, LLC, North Kingston, RI, USA
| | - L Fried
- Transformations Treatment Center, Del-Ray Beach, FL, USA
| | - Roy A
- Department of Psychiatry, Tulane University School of Medicine, New Orleans, LA, USA
| | - B W Downs
- Division of Nutrigenomics, Victory Nutrition International. Inc. Lederach, PA, USA
| | - R D Badgaiyan
- Department of Psychiatry, Ichan School of Medicine at Mount Sinai, New York, NY., USA.,Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, San Antonio, TX, USA.,Long School of Medicine, University of Texas Medical Center, San Antonio, USAInstituto Nacional de Neurología y Neurocirugía
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Dehlin JM, Issema R, Eavou R, Pickett J, Alon L, Brewer R, Schneider JA. The Motivational PrEP Cascade Guides Interpretation of Early PrEP Linkage to Care for Young Black Men Who Have Sex With Men: The Case of Chicago's PrEPLine. AIDS Educ Prev 2019; 31:491-504. [PMID: 31815532 PMCID: PMC7229569 DOI: 10.1521/aeap.2019.31.6.491] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 05/26/2023]
Abstract
Pre-exposure prophylaxis (PrEP) uptake remains low among Black men who have sex with men (BMSM). PrEPLine, launched in August 2015, based in Chicago, was designed to support PrEP linkage among BMSM. PrEPLine moves clients through the Motivational PrEP Cascade, addresses barriers, and tracks outcomes. Study findings suggest that three variables (i.e., being gay/same gender loving, living more than 15 miles from a clinic location, rescheduling an appointment) demonstrated a significant positive association with initiating PrEP. A subanalysis of BMSM found that two variables (i.e., living on the West Side of Chicago relative to those living on the South Side, and among those living in communities with a higher rate of poverty [more than 30%], relative to those living in communities with a lower rate of poverty [less than 20%]) demonstrated a significant negative association with initiating PrEP.
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Affiliation(s)
| | | | | | | | - Leigh Alon
- University of Chicago, Chicago, Illinois
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Brewer R, Issema R, Moore M, Chrestman S, Mukherjee S, Odlum M, Schneider JA. Correlates of Durable Viral Suppression (DVS) Among Criminal Justice-involved (CJI) Black Men Living with HIV in Louisiana. AIDS Behav 2019; 23:2980-2991. [PMID: 31250229 DOI: 10.1007/s10461-019-02578-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 01/25/2023]
Abstract
Durable viral suppression (DVS) is needed to reduce HIV transmission risk and prevent new HIV infections. We examined changes in viral suppression and correlates of DVS among 97 criminal justice-involved (CJI) Black men living with HIV in Louisiana enrolled in a linkage, re-engagement, and retention in care intervention. Most participants (75%) were Black men who have sex with men. Forty-four percent (44%) were virally suppressed at baseline and only 20% had achieved DVS over a 12-month period. Multinomial logistic regression analyses showed that compared with DVS participants, those with no viral suppression (NVS) and some viral suppression (SVS) were more likely to have lived with HIV for a longer period of time and were less likely to be adherent at baseline. Medication adherence was critical for DVS among this sample of CJI Black men living with HIV who represent a high priority population for HIV care and treatment interventions.
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Affiliation(s)
- Russell Brewer
- Department of Medicine, University of Chicago, Chicago, IL, USA.
- Chicago Center for HIV Elimination, Chicago, IL, USA.
| | - Rodal Issema
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Chicago Center for HIV Elimination, Chicago, IL, USA
| | - Mary Moore
- Dillard University, New Orleans, LA, USA
| | | | - Snigdha Mukherjee
- Educational Commission for Foreign Graduates (ECFG), Philadelphia, PA, USA
| | | | - John A Schneider
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Chicago Center for HIV Elimination, Chicago, IL, USA
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Khanna AS, Schneider JA, Collier N, Ozik J, Issema R, di Paola A, Skwara A, Ramachandran A, Webb J, Brewer R, Cunningham W, Hilliard C, Ramani S, Fujimoto K, Harawa N. A modeling framework to inform preexposure prophylaxis initiation and retention scale-up in the context of 'Getting to Zero' initiatives. AIDS 2019; 33:1911-1922. [PMID: 31490212 PMCID: PMC6760326 DOI: 10.1097/qad.0000000000002290] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE(S) 'Getting to Zero' (GTZ) initiatives aim to eliminate new HIV infections over a projected time frame. Increased preexposure prophylaxis (PrEP) uptake among populations with the highest HIV incidence, such as young Black MSM, is necessary to accomplish this aim. Agent-based network models (ABNMs) can help guide policymakers on strategies to increase PrEP uptake. DESIGN Effective PrEP implementation requires a model that incorporates the dynamics of interventions and dynamic feedbacks across multiple levels including virus, host, behavior, networks, and population. ABNMs are a powerful tool to incorporate these processes. METHODS An ABNM, designed for and parameterized using data for young Black MSM in Illinois, was used to compare the impact of PrEP initiation and retention interventions on HIV incidence after 10 years, consistent with GTZ timelines. Initiation interventions selected individuals in serodiscordant partnerships, or in critical sexual network positions, and compared with a controlled setting where PrEP initiators were randomly selected. Retention interventions increased the mean duration of PrEP use. A combination intervention modeled concurrent increases in PrEP initiation and retention. RESULTS Selecting HIV-negative individuals for PrEP initiation in serodiscordant partnerships resulted in the largest HIV incidence declines, relative to other interventions. For a given PrEP uptake level, distributing effort between increasing PrEP initiation and retention in combination was approximately as effective as increasing only one exclusively. CONCLUSION Simulation results indicate that expanded PrEP interventions alone may not accomplish GTZ goals within a decade, and integrated scale-up of PrEP, antiretroviral therapy, and other interventions might be necessary.
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Affiliation(s)
| | | | - Nicholson Collier
- Consortium for Advanced Science and Engineering, The University of Chicago, Chicago, Illinois
| | - Jonathan Ozik
- Consortium for Advanced Science and Engineering, The University of Chicago, Chicago, Illinois
| | - Rodal Issema
- Chicago Center for HIV Elimination
- Department of Medicine
| | - Angela di Paola
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
| | - Abigail Skwara
- Chicago Center for HIV Elimination
- Department of Medicine
| | | | - Jeannette Webb
- Chicago Center for HIV Elimination
- Department of Medicine
| | - Russell Brewer
- Chicago Center for HIV Elimination
- Department of Medicine
| | - William Cunningham
- Department of Health Policy and Management, University of California, Los Angeles
| | - Charles Hilliard
- Department of Psychiatry and Human Behavior, Charles R. Drew University
| | | | - Kayo Fujimoto
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
| | - Nina Harawa
- Department of Psychiatry and Human Behavior, Charles R. Drew University
- Department of Epidemiology, University of California, Los Angeles, Los Angeles, California, USA
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Harawa NT, Brewer R, Buckman V, Ramani S, Khanna A, Fujimoto K, Schneider JA. HIV, Sexually Transmitted Infection, and Substance Use Continuum of Care Interventions Among Criminal Justice-Involved Black Men Who Have Sex With Men: A Systematic Review. Am J Public Health 2019; 108:e1-e9. [PMID: 30383433 DOI: 10.2105/ajph.2018.304698] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Because Black men who have sex with men (BMSM) experience high rates of both HIV and incarceration relative to other groups, the various stages of criminal justice involvement may serve as important intervention points for addressing HIV and related conditions in this group. Although systematic reviews of HIV interventions targeting MSM in general and BMSM in particular exist, no review has explored the range and impact of HIV, sexually transmitted infection (STI), and substance use prevention and care continuum interventions focused on criminal justice-involved (CJI) populations. OBJECTIVES To describe the range and impact of published HIV, STI, and related substance use interventions for US-based CJI populations and to understand their relevance for BMSM. SEARCH METHODS We conducted systematic searches in the following databases: PubMed, MEDLINE, Cochrane, CINAHL, and PsycINFO, covering the period preceding December 1, 2016. SELECTION CRITERIA We selected articles in scientific publications involving quantitative findings for studies of US-based interventions that focused on CJI individuals, with outcomes related to sexual or substance use risk behaviors, HIV, or STIs. We excluded studies if they provided no demographic information, had minimal representation of the population of interest (< 30 African American or Black male or transgender participants), had study populations limited to those aged younger than 18 years, or were limited to evaluations of preexisting programs. DATA COLLECTION AND ANALYSIS We abstracted data from these articles on study design; years covered; study location; participant number, demographics, and sexual orientation (if available); criminal justice setting or type; health condition; targeted outcomes; and key findings. We scored studies by using the Downs and Black quality and bias assessment. We conducted linear regression to examine changes in study quality by publication year. MAIN RESULTS Fifty-eight articles met inclusion criteria, including 8 (13.8%) modeling or cost-effectiveness studies and 13 (22.4%) randomized controlled trials. Just 3 studies (5.2%) focused on sexual or gender minorities, with only 1 focused on BMSM. In most studies (n = 36; 62.1%), however, more than 50% of participants were Black. The most common intervention addressed screening, including 20 empirical studies and 7 modeling studies. Education-focused interventions were also common (n = 15) and usually employed didactic rather than skill-building approaches. They were more likely to demonstrate increases in HIV testing, knowledge, and condom-use intentions than reductions in sex- and drug-risk behaviors. Screening programs consistently indicated cost-effectiveness, including with BMSM. Care continuum interventions for people living with HIV showed mixed results; just 3 involved randomized controlled trials, and these interventions did not show significant differences compared with control conditions. A minority of programs targeted non-custody-based CJI populations, despite their constituting a majority of the CJI population at any given time. AUTHORS' CONCLUSIONS Screening CJI populations for HIV and other STIs is effective and cost-efficient and holds promise for reducing HIV in BMSM. Education-based and care provision interventions also hold promise for addressing HIV, STIs, mental health, and substance use in CJI populations. Additional empirical and modeling studies and results specific to sexual minorities are needed; their paucity represents a disparity in how HIV is addressed. Public Health Implications. HIV and STI screening programs focused on CJI populations should be a priority for reducing HIV risk and numbers of undiagnosed infections among BMSM. Funding agencies and public health leaders should prioritize research to improve the knowledge base regarding which care continuum intervention approaches are most effective for BMSM with criminal justice involvement. Developments in modeling approaches could allow researchers to simulate the impacts and costs of criminal justice involvement-related interventions that might otherwise be cost, time, or ethically prohibitive to study empirically.
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Affiliation(s)
- Nina T Harawa
- Nina T. Harawa is with the Department of Medicine, David Geffen School of Medicine, University of California Los Angeles. At the time of the study, Russell Brewer was with the HIV/STI Portfolio, Louisiana Public Health Institute, New Orleans. Victoria Buckman is with The Chicago Center for HIV Elimination, University of Chicago, Chicago, IL. Santhoshini Ramani, Aditya Khanna, and John A. Schneider are with the Department of Medicine, University of Chicago. Kayo Fujimoto is with the Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston
| | - Russell Brewer
- Nina T. Harawa is with the Department of Medicine, David Geffen School of Medicine, University of California Los Angeles. At the time of the study, Russell Brewer was with the HIV/STI Portfolio, Louisiana Public Health Institute, New Orleans. Victoria Buckman is with The Chicago Center for HIV Elimination, University of Chicago, Chicago, IL. Santhoshini Ramani, Aditya Khanna, and John A. Schneider are with the Department of Medicine, University of Chicago. Kayo Fujimoto is with the Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston
| | - Victoria Buckman
- Nina T. Harawa is with the Department of Medicine, David Geffen School of Medicine, University of California Los Angeles. At the time of the study, Russell Brewer was with the HIV/STI Portfolio, Louisiana Public Health Institute, New Orleans. Victoria Buckman is with The Chicago Center for HIV Elimination, University of Chicago, Chicago, IL. Santhoshini Ramani, Aditya Khanna, and John A. Schneider are with the Department of Medicine, University of Chicago. Kayo Fujimoto is with the Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston
| | - Santhoshini Ramani
- Nina T. Harawa is with the Department of Medicine, David Geffen School of Medicine, University of California Los Angeles. At the time of the study, Russell Brewer was with the HIV/STI Portfolio, Louisiana Public Health Institute, New Orleans. Victoria Buckman is with The Chicago Center for HIV Elimination, University of Chicago, Chicago, IL. Santhoshini Ramani, Aditya Khanna, and John A. Schneider are with the Department of Medicine, University of Chicago. Kayo Fujimoto is with the Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston
| | - Aditya Khanna
- Nina T. Harawa is with the Department of Medicine, David Geffen School of Medicine, University of California Los Angeles. At the time of the study, Russell Brewer was with the HIV/STI Portfolio, Louisiana Public Health Institute, New Orleans. Victoria Buckman is with The Chicago Center for HIV Elimination, University of Chicago, Chicago, IL. Santhoshini Ramani, Aditya Khanna, and John A. Schneider are with the Department of Medicine, University of Chicago. Kayo Fujimoto is with the Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston
| | - Kayo Fujimoto
- Nina T. Harawa is with the Department of Medicine, David Geffen School of Medicine, University of California Los Angeles. At the time of the study, Russell Brewer was with the HIV/STI Portfolio, Louisiana Public Health Institute, New Orleans. Victoria Buckman is with The Chicago Center for HIV Elimination, University of Chicago, Chicago, IL. Santhoshini Ramani, Aditya Khanna, and John A. Schneider are with the Department of Medicine, University of Chicago. Kayo Fujimoto is with the Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston
| | - John A Schneider
- Nina T. Harawa is with the Department of Medicine, David Geffen School of Medicine, University of California Los Angeles. At the time of the study, Russell Brewer was with the HIV/STI Portfolio, Louisiana Public Health Institute, New Orleans. Victoria Buckman is with The Chicago Center for HIV Elimination, University of Chicago, Chicago, IL. Santhoshini Ramani, Aditya Khanna, and John A. Schneider are with the Department of Medicine, University of Chicago. Kayo Fujimoto is with the Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston
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Duncan DT, Hickson DA, Goedel WC, Callander D, Brooks B, Chen YT, Hanson H, Eavou R, Khanna AS, Chaix B, Regan SD, Wheeler DP, Mayer KH, Safren SA, Carr Melvin S, Draper C, Magee-Jackson V, Brewer R, Schneider JA. The Social Context of HIV Prevention and Care among Black Men Who Have Sex with Men in Three U.S. Cities: The Neighborhoods and Networks (N2) Cohort Study. Int J Environ Res Public Health 2019; 16:ijerph16111922. [PMID: 31151275 PMCID: PMC6603520 DOI: 10.3390/ijerph16111922] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [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: 04/12/2019] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 01/01/2023]
Abstract
Background: In many parts of the world, stark racial disparities in human immunodeficiency virus (HIV) prevalence, incidence, prevention, and care outcomes persist among gay, bisexual, and other men who have sex with men (MSM), with Black MSM significantly impacted in the United States (U.S.). Individual-level characteristics, including sexual behaviors and socioeconomic status, do not fully account for racial/ethnic disparities in HIV among MSM. We hypothesize that neighborhood contexts and network characteristics influence risk for HIV infection as well as HIV-related prevention and care behaviors. As such, the study design includes the use of real-time geospatial methods and in-depth assessments of multiple network typologies to investigate the impact of neighborhood and network-level factors on HIV prevention and treatment among Black MSM residing in longstanding priority HIV elimination areas in the U.S., namely Chicago, Illinois and in the Deep South (Jackson, Mississippi and New Orleans, Louisiana) (n = 450, n = 50, and n = 100, respectively). We describe the design, sampling methods, data collection, data management methods, and preliminary findings of the ongoing ‘Neighborhoods and Networks (N2) Cohort Study’. Methods/Design: N2 employs a prospective longitudinal design. The sample includes Black MSM participants in Chicago recruited via respondent-driven sampling and assessed every six months over two years of follow-up. Participants enrolled in Jackson and New Orleans are being recruited through existing health and community services and assessed every six months over one year of follow-up. Mobility within and between neighborhoods is being assessed using global positioning system (GPS) technology. Social and sexual networks among Black MSM are being studied through egocentric network inventories as well as newer methods of creating meso-level networks that involve social media (Facebook) and mobile phone contacts. Key HIV prevention outcomes such as pre-exposure prophylaxis (PrEP) care engagement, and HIV/STI (sexually transmitted infections) biomarkers will be examined at baseline and follow-up. Results: As of 31 December 2018, a total of 361 men were enrolled across all study sites: 259 in Chicago and 102 in the Deep South (75 in New Orleans and 27 in Jackson). At baseline, participants ranged in age from 17 to 65 years old (mean = 34.3, standard deviation = 5.1) with 123 men (34.1%) self-reported as HIV positive. While HIV treatment levels were similar between sites, men in the Deep South reported higher rates of adherence than men in Chicago (63.3% versus 49.4%, p = 0.03). Sexual risk profiles were mainly the same between men from different study sites, with 22.9% of men in Chicago and 28.9% in the Deep South reporting consistent condom use during vaginal and anal sex (p = 0.26). Regarding their home neighborhoods, men in the Deep South were more likely than those in Chicago to characterize theirs as having a good reputation (43.1% versus 24.7%, p < 0.001) and as being safe (37.3% versus 21.2%, p = 0.002). Conclusions: The focus on Black MSM in the N2 Study will allow for a nuanced exploration of the attitudes, beliefs, behaviors, and practices of a diverse group of Black MSM. The study is also positioned to provide novel insight about neighborhood and network characteristics that influence HIV-related behaviors. A health equity framework ensures that Black MSM are not explicitly or implicitly deemed as deviant, disordered, or the non-reference group. Findings from N2 will provide guidance for the implementation of more impactful HIV prevention interventions that engage a diverse population of Black MSM as we work toward HIV elimination in the U.S.
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Affiliation(s)
- Dustin T Duncan
- NYU Spatial Epidemiology Lab, Department of Population Health, NYU School of Medicine, New York, NY 10016, USA.
| | - DeMarc A Hickson
- Center for Research, Evaluation, and Environmental & Policy Change, My Brother's Keeper, Inc., Jackson, MS 39202, USA.
- Us Helping Us, People Into Living, Inc., Washington, DC 20010, USA.
| | - William C Goedel
- NYU Spatial Epidemiology Lab, Department of Population Health, NYU School of Medicine, New York, NY 10016, USA.
| | - Denton Callander
- NYU Spatial Epidemiology Lab, Department of Population Health, NYU School of Medicine, New York, NY 10016, USA.
| | - Brandon Brooks
- NYU Spatial Epidemiology Lab, Department of Population Health, NYU School of Medicine, New York, NY 10016, USA.
| | - Yen-Tyng Chen
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL 60637, USA.
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA.
| | - Hillary Hanson
- Survey Lab, University of Chicago, Chicago, IL 60637, USA.
| | - Rebecca Eavou
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL 60637, USA.
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA.
| | - Aditya S Khanna
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL 60637, USA.
| | - Basile Chaix
- Pierre-Louis Institute of Epidemiology Public Health (UMR-S 1136), Faculté de Médecine Saint-Antoine, Sorbonne Universités, 75012 Paris, France.
| | - Seann D Regan
- NYU Spatial Epidemiology Lab, Department of Population Health, NYU School of Medicine, New York, NY 10016, USA.
| | | | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, MA 02215, USA.
- Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
| | - Steven A Safren
- The Fenway Institute, Fenway Health, Boston, MA 02215, USA.
- Department of Psychology, College of Arts and Sciences, University of Miami, Coral Gables, FL 33124, USA.
| | - Sandra Carr Melvin
- Center for Research, Evaluation, and Environmental & Policy Change, My Brother's Keeper, Inc., Jackson, MS 39202, USA.
| | - Cordarian Draper
- Center for Research, Evaluation, and Environmental & Policy Change, My Brother's Keeper, Inc., Jackson, MS 39202, USA.
| | | | - Russell Brewer
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL 60637, USA.
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA.
| | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL 60637, USA.
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA.
- Department of Public Health Sciences, University of Chicago, Chicago, IL 60637, USA.
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Odlum M, Yoon S, Broadwell P, Brewer R, Kuang D. How Twitter Can Support the HIV/AIDS Response to Achieve the 2030 Eradication Goal: In-Depth Thematic Analysis of World AIDS Day Tweets. JMIR Public Health Surveill 2018; 4:e10262. [PMID: 30467102 PMCID: PMC6284144 DOI: 10.2196/10262] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 09/17/2018] [Accepted: 10/04/2018] [Indexed: 12/31/2022] Open
Abstract
Background HIV/AIDS is a tremendous public health crisis, with a call for its eradication by 2030. A human rights response through civil society engagement is critical to support and sustain HIV eradication efforts. However, ongoing civil engagement is a challenge. Objective This study aimed to demonstrate the use of Twitter data to assess public sentiment in support of civil society engagement. Methods Tweets were collected during World AIDS Days 2014 and 2015. A total of 39,940 unique tweets (>10 billion users) in 2014 and 78,215 unique tweets (>33 billion users) in 2015 were analyzed. Response frequencies were aggregated using natural language processing. Hierarchical rank-2 nonnegative matrix factorization algorithm generated a hierarchy of tweets into binary trees. Tweet hierarchy clusters were thematically organized by the Joint United Nations Programme on HIV/AIDS core action principles and categorized under HIV/AIDS Prevention, Treatment or Care, or Support. Results Topics tweeted 35 times or more were visualized. Results show a decrease in 2015 in the frequency of tweets associated with the fight to end HIV/AIDS, the recognition of women, and to achieve an AIDS-free generation. Moreover, an increase in tweets was associated with an integrative approach to the HIV/AIDS response. Hierarchical thematic differences in 2015 included no prevention discussion and the recognition of the pandemic’s impact and discrimination. In addition, a decrease was observed in motivation to fast track the pandemic’s end and combat HIV/AIDS. Conclusions The human rights–based response to HIV/AIDS eradication is critical. Findings demonstrate the usefulness of Twitter as a low-cost method to assess public sentiment for enhanced knowledge, increased hope, and revitalized expectations for HIV/AIDS eradication.
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Affiliation(s)
- Michelle Odlum
- Columbia University Medical Center, New York, NY, United States
| | - Sunmoo Yoon
- Columbia University Medical Center, New York, NY, United States
| | - Peter Broadwell
- Charles E Young Research Library, University of California Los Angeles, Los Angeles, CA, United States
| | - Russell Brewer
- University of Chicago Medicine, Chicago, IL, United States
| | - Da Kuang
- Amazon, Seattle, WA, United States
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Odlum M, Davis N, Owens O, Preston M, Brewer R, Black D. Correlates and aetiological factors associated with hedonic well-being among an ageing population of US men and women: secondary data analysis of a national survey. BMJ Open 2018; 8:e020962. [PMID: 30429142 PMCID: PMC6252705 DOI: 10.1136/bmjopen-2017-020962] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To understand the gender-specific factors that uniquely contribute to successful ageing in a US population of men and women, 57-85 years of age. This was achieved through the examination of the correlates of subjective well-being defined by health-related quality of life (HRQoL), across several biological and psychosocial determinants of health. DESIGN Cross-sectional study. SETTING The National Social Life, Health and Ageing Project (NSHAP), 2010-2011 a representative sample of the US population. PARTICIPANTS 3377 adults aged 57-85 (1538 men, 1839 women) from the NSHAP. MAIN OUTCOME MEASURES The biopsychosocial factors of biological/physiological function, symptom status, functional status, general health perceptions and HRQoL happiness. METHOD HRQoL was measured using the NSHAP wave 2 multistage, stratified area probability sample of US households (n=3377). Variable selection was guided by the Wilson and Cleary model (WCM) that classifies health outcomes at five main levels and characteristics. RESULTS Our findings indicate differences in biopsychosocial factors comprised in the WCM and their relative importance and unique impact on HRQoL by gender. Women reported significantly lower HRQoL than men (t=3.5, df=3366). The most significant contributors to HRQoL in women were mental health (B=0.31; 0.22, 0.39), loneliness (B=-0.26; -0.35, -0.17), urinary incontinence (B=-0.22; -0.40, -0.05) and support from spouse/partner (B=0.27; 0.10, 0.43) and family B=0.12; 0.03, 0.20). Men indicated mental health (B=0.21; 0.14, 0.29), physical health (B=0.17; 0.10, 0.23), functional difficulties (B=0.38; 0.10, 0.65), loneliness (B=-0.20; -0.26, -0.12), depression (B=-0.36; -0.58, -0.15) and support from friends (B=0.06; 0.10, 0.11) as significant contributors. Those with greater social support had better HRQoL (F=4.22, df=4). Lack of companionship and reliance on spouse/partner were significant HRQoL contributors in both groups. CONCLUSION Our findings offer insight into ageing, gender and subjective well-being. The results provide an opportunity to identify biopsychosocial factors to inform interventions to support successful ageing.
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Affiliation(s)
- Michelle Odlum
- School of Nursing, Columbia University, New York City, New York, USA
| | - Nicole Davis
- School of Nursing, Clemson University, Clemson, South Carolina, USA
| | - Otis Owens
- College of Social Work, University of South Carolina, Columbia, South Carolina, USA
| | - Michael Preston
- COM/Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Russell Brewer
- Section of Infectious Diseases and Global Health, University of Chicago Medicine, Chicago, Illinois, USA
| | - Danielle Black
- School of Nursing, Columbia University, New York City, New York, USA
- School of Public Health, Columbia University Mailman, New York City, New York, USA
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Lassiter JM, Brewer R, Wilton L. Black Sexual Minority Men's Disclosure of Sexual Orientation Is Associated With Exposure to Homonegative Religious Messages. Am J Mens Health 2018; 13:1557988318806432. [PMID: 30311832 PMCID: PMC6771123 DOI: 10.1177/1557988318806432] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Previous research has highlighted the homonegative atmospheres of many religious communities in Western society and their harmful impact on Black sexual minority (SM) people's mental and physical health. However, few studies have examined the relationship between sexual orientation disclosure to church members and exposure to homonegative religious messages in religious settings. This online quantitative study investigated this relationship among a sample of 320 Black SM men. The participants for this study were recruited nationally from across the United States and had a mean age of 34 years. Descriptive statistics and linear regression analyses were conducted. Findings indicated that sexual orientation disclosure to church members was significantly associated with exposure to homonegative religious messages, even when controlling for geographic region of residence and denominational affiliation. Black SM men who had higher levels of disclosure were exposed to fewer homonegative religious messages. The implications of these findings for health research and clinical work with Black SM men are discussed in detail.
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Affiliation(s)
| | - Russell Brewer
- 2 Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Leo Wilton
- 3 Department of Human Development, State University of New York at Binghamton, NY, USA
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Duncan DT, Chaix B, Regan SD, Park SH, Draper C, Goedel WC, Gipson JA, Guilamo-Ramos V, Halkitis PN, Brewer R, Hickson DA. Collecting Mobility Data with GPS Methods to Understand the HIV Environmental Riskscape Among Young Black Men Who Have Sex with Men: A Multi-city Feasibility Study in the Deep South. AIDS Behav 2018; 22:3057-3070. [PMID: 29797163 DOI: 10.1007/s10461-018-2163-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 12/27/2022]
Abstract
While research increasingly studies how neighborhood contexts influence HIV among gay, bisexual and other men who have sex with men (MSM) populations, to date, no research has used global positioning system (GPS) devices, an innovative method to study spatial mobility through neighborhood contexts, i.e., the environmental riskscape, among a sample of Black MSM. The purpose of this study was to examine the feasibility of collecting two-week GPS data (as measured by a pre- and post-surveys as well as objectively measured adherence to GPS protocol) among a geographically-diverse sample of Black MSM in the Deep South: Gulfport, MS, Jackson, MS, and New Orleans LA (n = 75). GPS feasibility was demonstrated including from survey items, e.g. Black MSM reported high ratings of pre-protocol acceptability, ease of use, and low levels of wear-related concerns. Findings from this study demonstrate that using GPS methods is acceptable and feasible among Black MSM in the Deep South.
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Affiliation(s)
- Dustin T Duncan
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA.
| | - Basile Chaix
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
- Inserm, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Seann D Regan
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Su Hyun Park
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Cordarian Draper
- Center for Research, Evaluation and Environmental & Policy Change, My Brother's Keeper, Inc, Jackson, MS, USA
| | - William C Goedel
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - June A Gipson
- Center for Community-Based Programs, My Brother's Keeper, Inc, Jackson, MS, USA
| | - Vincent Guilamo-Ramos
- Center for Latino Adolescent and Family Health (CLAFH), Silver School of Social Work, New York University, New York, NY, USA
| | - Perry N Halkitis
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University School of Public Health, New Brunswick, NJ, USA
| | - Russell Brewer
- Louisiana Public Health Institute (LPHI), New Orleans, LA, USA
| | - DeMarc A Hickson
- Center for Research, Evaluation and Environmental & Policy Change, My Brother's Keeper, Inc, Jackson, MS, USA
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Duncan DT, Park SH, Hambrick HR, Dangerfield Ii DT, Goedel WC, Brewer R, Mgbako O, Lindsey J, Regan SD, Hickson DA. Characterizing Geosocial-Networking App Use Among Young Black Men Who Have Sex With Men: A Multi-City Cross-Sectional Survey in the Southern United States. JMIR Mhealth Uhealth 2018; 6:e10316. [PMID: 29903702 PMCID: PMC6024099 DOI: 10.2196/10316] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [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: 03/06/2018] [Revised: 04/30/2018] [Accepted: 05/10/2018] [Indexed: 01/26/2023] Open
Abstract
Background Understanding where and how young black men who have sex with men (YBMSM) in the southern United States meet their sexual partners is germane to understanding the underlying factors contributing to the ongoing HIV transmission in this community. Men who have sex with men (MSM) commonly use geosocial networking apps to meet sexual partners. However, there is a lack of literature exploring geosocial networking app use in this particular population. Objective Our aim was to examine the characteristics, preferences, and behaviors of a geographically diverse sample of geosocial networking app-using YBMSM in the southern United States. Methods Data were collected from a sample of 75 YBMSM across three cities (Gulfport, Mississippi; Jackson, Mississippi; and New Orleans, Louisiana). Multiple aspects of geosocial networking app use were assessed, including overall app use, age of participant at first app use, specific apps used, reasons for app use, photos presented on apps, logon times and duration, number of messages sent and received, and characteristics of and behaviors with partners met on apps. Survey measures of app-met partner and sexual behavior characteristics assessed at midpoint (Day 7) and completion visits (Day 14) were compared using McNemar’s test or Wilcoxon signed-rank test. In addition, we assessed activity spaces derived from GPS devices that participants wore for 2 weeks. Results Of the 70 participants who responded to the overall app-use item, almost three-quarters (53/70, 76%) had ever used geosocial networking apps. Jack’d was the most commonly used geosocial networking app (37/53, 70%), followed by Adam4Adam (22/53, 42%), and Grindr (19/53, 36%). The mean and median number of apps used were 4.3 (SD 2.7) and 4.0 (range 0-13), respectively. Most app-using participants displayed their face on the profile picture (35/52, 67%), whereas fewer displayed their bare legs (2/52, 4%) or bare buttocks (or ass; 2/52, 4%). The mean age at the initiation of app use was 20.1 years (SD 2.78) ranging from 13-26 years. Two-thirds (35/53, 66%) of the sample reported using the apps to “kill time” when bored. A minority (9/53, 17%) reported using the apps to meet people to have sex/hook up with. The vast majority of participants reported meeting black partners for sex. Over two-thirds (36/53, 68%) reported that the HIV status of their app-met partners was negative, and 26% (14/53) reported that they did not know their partner’s HIV status. There was a significant difference in GPS activity spaces between app using YBMSM compared to nonapp using YBMSM (2719.54 km2 vs 1855.68 km2, P=.011). Conclusions Use of geosocial networking apps to meet sexual partners among our sample of YBMSM in the southern United States was common, with a diverse range of app use behaviors being reported. Further research should characterize the association between geosocial networking app use and engagement in sexual behaviors that increase risk for HIV acquisition and transmission. In addition, geosocial networking apps present a promising platform for HIV prevention interventions targeting YBMSM who use these apps.
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Affiliation(s)
- Dustin T Duncan
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Su Hyun Park
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - H Rhodes Hambrick
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Derek T Dangerfield Ii
- The REACH Initiative, Johns Hopkins University School of Nursing, Baltimore, MD, United States
| | - William C Goedel
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Russell Brewer
- Chicago Center for HIV Elimination, Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Ofole Mgbako
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Joseph Lindsey
- MBK Gulf Coast, My Brother's Keeper, Inc, Gulfport, MS, United States
| | - Seann D Regan
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - DeMarc A Hickson
- Us Helping Us, People Into Living, Inc, Washington, DC, United States
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Bhat G, Aggarwal A, Tatooles A, Slaughter M, Jorde U, Brewer R, Chen L, Sundareswaran K, Farrar D. Racial Differences in over 1000 Patients with Continuous Flow Left Ventricular Assist Devices. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.428] [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: 10/27/2022] Open
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Srivastava A, Czerska B, Williams C, Alesh I, Krese L, Huang M, Drost C, Smith C, Nemeh H, Tita C, Brewer R, Lanfear D. 267: High Rates of False-Positive Hepatitis C Antibody Tests Can Occur after Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2009. [DOI: 10.1016/j.healun.2008.11.274] [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: 10/21/2022] Open
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Brewer R, Wang M, Rastogi S, Ilsar I, Jiang A, Viole T, Konstam M, Sabbah H. 281: Acute Left Ventricular Unloading in Dogs with Chronic Heart Failure: Comparison of Hemodynamics and Gene Expression between Intra-Aortic Balloon Counterpulsation and Continuous Aortic Flow Augmentation. J Heart Lung Transplant 2008. [DOI: 10.1016/j.healun.2007.11.290] [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: 11/16/2022] Open
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Srivastava A, Alesh I, Williams C, Lanfear D, Tita C, Brewer R, Nemeh H, Krese L, Drost C, Jacobsen G, Czerska B. 147: Comparison of Post Cardiac Transplant Outcomes between African American (AA) and Caucasian (CA) Patients: A Single Center Experience. J Heart Lung Transplant 2008. [DOI: 10.1016/j.healun.2007.11.153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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The sub‐committee for Soil‐Stratigr, Brewer R, Crook KAW, Speight JG. Proposal for Soil‐Stratigraphic units in the Australian Stratigraphic code. ACTA ACUST UNITED AC 2007. [DOI: 10.1080/00167617008728728] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
Strategies for establishing a national voluntary public health agency accreditation program have been gathering momentum. Recent efforts funded by the Robert Wood Johnson Foundation (RWJF) and the Centers for Disease Control and Prevention (CDC) have made a significant impact on the potential for national diffusion of accreditation models. The Exploring Accreditation Project was a collaboration of the American Public Health Association, the Association of State and Territorial Health Officials, the National Association of County and City Health Officials, and the National Association of Local Boards of Health with a national steering committee that studied the feasibility and desirability of a national voluntary accreditation program for state and local public health agencies. Concurrently, the Robert Wood Johnson Foundation funded the "Multi-State Learning Collaborative on Performance and Capacity Assessment or Accreditation of Public Health Departments" (MLC). Among the other purposes of the MLC was the intent for states already engaged in accreditation or assessment activities to inform the national accreditation debate. Five states were selected to be MLC grantees from 18 states completing a formal application process. This article reviews data extracted from the applications of 16 of the 18 applicant states and reviews common themes emerging across programs. Other states contemplating similar programs, as well as those charged with implementing the voluntary model at the national level, may find guidance from these examples.
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Affiliation(s)
- Glen Mays
- Center for Medicine and Public Health, Florida State University College of Medicine, Tallahassee, USA.
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Sabbah H, Brewer R, Rastogi S, Sabbah M, Viole T, Konstam M. 385: Molecular recovery of the failing canine left ventricular myocardium following extended therapy with the Orqis Medical Cardiac Recovery System. J Heart Lung Transplant 2007. [DOI: 10.1016/j.healun.2006.11.406] [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: 10/23/2022] Open
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Boguszewski A, Abu-mafouz M, Czerska B, Grant C, Lanfear D, Brewer R, Somers C, Franklin G, Kiesweter B, Bogdon L. 258. J Heart Lung Transplant 2006. [DOI: 10.1016/j.healun.2005.11.268] [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: 10/25/2022] Open
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Abstract
Persistent pain is common following thoracotomy. A 64-year-old retired electrician with Type 2 diabetes presented with chest wall and abdominal pain 3 months following video-assisted thoracoscopic surgery (VATS). Postoperatively the patient had suffered pain despite a functioning thoracic epidural catheter. Following investigation, his persistent pain was due to diabetic thoracic radiculopathy (DTR). The disorder is characterized by pain, sensory loss, abdominal and thoracic muscle weakness in patients with diabetes. As in this patient, the pain and sensory loss usually resolve within one year after onset. The disorder may be distinguished from intercostal neuralgia based upon clinical and electromyographic features.
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Affiliation(s)
- R Brewer
- Department of Anesthesiology, Neurology, Neuroscience, Duke University Medical Center, Durham, NC 27710, USA.
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