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Prakash P, Swami Vetha BS, Chakraborty R, Wenegieme TY, Masenga SK, Muthian G, Balasubramaniam M, Wanjalla CN, Hinton AO, Kirabo A, Williams CR, Aileru A, Dash C. HIV-Associated Hypertension: Risks, Mechanisms, and Knowledge Gaps. Circ Res 2024; 134:e150-e175. [PMID: 38781298 PMCID: PMC11126208 DOI: 10.1161/circresaha.124.323979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
HIV type 1 (HIV-1) is the causative agent of AIDS. Since the start of the epidemic, HIV/AIDS has been responsible for ≈40 million deaths. Additionally, an estimated 39 million people are currently infected with the virus. HIV-1 primarily infects immune cells, such as CD4+ (cluster of differentiation 4+) T lymphocytes (T cells), and as a consequence, the number of CD4+ T cells progressively declines in people living with HIV. Within a span of ≈10 years, HIV-1 infection leads to the systemic failure of the immune system and progression to AIDS. Fortunately, potent antiviral therapy effectively controls HIV-1 infection and prevents AIDS-related deaths. The efficacy of the current antiviral therapy regimens has transformed the outcome of HIV/AIDS from a death sentence to a chronic disease with a prolonged lifespan of people living with HIV. However, antiviral therapy is not curative, is challenged by virus resistance, can be toxic, and, most importantly, requires lifelong adherence. Furthermore, the improved lifespan has resulted in an increased incidence of non-AIDS-related morbidities in people living with HIV including cardiovascular diseases, renal disease, liver disease, bone disease, cancer, and neurological conditions. In this review, we summarize the current state of knowledge of the cardiovascular comorbidities associated with HIV-1 infection, with a particular focus on hypertension. We also discuss the potential mechanisms known to drive HIV-1-associated hypertension and the knowledge gaps in our understanding of this comorbid condition. Finally, we suggest several directions of future research to better understand the factors, pathways, and mechanisms underlying HIV-1-associated hypertension in the post-antiviral therapy era.
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Affiliation(s)
- Prem Prakash
- The Center for AIDS Health Disparities Research
- Department of Microbiology, Immunology, and Physiology
- Department of Biochemistry, Cancer Biology, Pharmacology and Neuroscience Meharry Medical College, Nashville, Tennessee, 37208, USA
| | - Berwin Singh Swami Vetha
- Department of Foundational Sciences and Research, School of Dental Medicine, East Carolina University, 1851 MacGregor Downs Road, MS 701, Greenville, NC 27834
| | - Rajasree Chakraborty
- The Center for AIDS Health Disparities Research
- Department of Microbiology, Immunology, and Physiology
- Department of Biochemistry, Cancer Biology, Pharmacology and Neuroscience Meharry Medical College, Nashville, Tennessee, 37208, USA
| | - Tara-Yesomi Wenegieme
- Department of Neuroscience, Cell Biology and Physiology; Boonshoft School of Medicine and the College of Science and Mathematics; Wright State University, Dayton, OH 45435, USA
| | - Sepiso K. Masenga
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Kabwe, Central Province, 10101, Zambia
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Kabwe, Central Province, 10101, Zambia
| | - Gladson Muthian
- The Center for AIDS Health Disparities Research
- Department of Microbiology, Immunology, and Physiology
- Department of Biochemistry, Cancer Biology, Pharmacology and Neuroscience Meharry Medical College, Nashville, Tennessee, 37208, USA
| | - Muthukumar Balasubramaniam
- The Center for AIDS Health Disparities Research
- Department of Microbiology, Immunology, and Physiology
- Department of Biochemistry, Cancer Biology, Pharmacology and Neuroscience Meharry Medical College, Nashville, Tennessee, 37208, USA
| | | | - Antentor O Hinton
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37232, USA
| | - Annet Kirabo
- Division of Clinical Pharmacology, Department of Medicine
- Vanderbilt Center for Immunobiology
- Vanderbilt Institute for Infection, Immunology and Inflammation
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Clintoria R. Williams
- Department of Neuroscience, Cell Biology and Physiology; Boonshoft School of Medicine and the College of Science and Mathematics; Wright State University, Dayton, OH 45435, USA
| | - Azeez Aileru
- Department of Foundational Sciences and Research, School of Dental Medicine, East Carolina University, 1851 MacGregor Downs Road, MS 701, Greenville, NC 27834
| | - Chandravanu Dash
- The Center for AIDS Health Disparities Research
- Department of Microbiology, Immunology, and Physiology
- Department of Biochemistry, Cancer Biology, Pharmacology and Neuroscience Meharry Medical College, Nashville, Tennessee, 37208, USA
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Wang Q, Meeusen JW. Clinical Impacts of Implementing the 2021 Race-Free Chronic Kidney Disease Epidemiology Collaboration Estimated Glomerular Filtration Rate. J Appl Lab Med 2024; 9:586-598. [PMID: 38366867 DOI: 10.1093/jalm/jfad137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/01/2023] [Indexed: 02/18/2024]
Abstract
BACKGROUND Estimated glomerular filtration rate (eGFR) has become incorporated into multiple clinical management situations. Historically, equations included a Black race coefficient, which lacked biological plausibility and created potential to exacerbate health disparities. A new equation created in 2021 changed the weighting of age, sex, and creatinine by modeling against a diverse cohort and removing the Black race coefficient. CONTENT A variety of clinical outcomes including kidney disease risk stratification, medication dosing, patient eligibility for clinical trials, and kidney donation are impacted by implementation of the new equation. Nearly 2 years after its initial publication, many studies have reported on observed analytical performance of the 2021 eGFR determined as diagnostic concordance and percentage of estimates within 30% of measured GFR. Additionally, the potential clinical impacts following adoption of the new eGFR among different patient populations has also been reported. Here we review these studies with a focus on assessing the data associated with the transition from 2009 to 2021 Chronic Kidney Disease Epidemiology Collaboration equations. SUMMARY The reported interindividual variation in eGFR performance is significantly larger than any potential benefit derived from race coefficients. Both the 2021 eGFR and the 2009 eGFR analytical performance fall short of the validation cohort performance in most cohorts. However, the 2021 analytical is similar or better than the 2009 eGFR in most cohorts. Implementing the 2021 eGFR will remove a systematic overestimation of kidney function among Black patients.
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Affiliation(s)
- Qian Wang
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester MN, United States
| | - Jeffrey W Meeusen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester MN, United States
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Eaton LA, Huedo-Medina T, Earnshaw VA, Kalichman M, Watson RJ, Driver R, Chandler CJ, Kalinowski J, Kalichman SC. Randomized Clinical Trial of Stigma Counseling and HIV Testing Access Interventions to Increase HIV Testing Among Black Sexual Minority Men and Transwomen. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:650-660. [PMID: 37898978 DOI: 10.1007/s11121-023-01603-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 10/31/2023]
Abstract
Advances in HIV prevention tools have outpaced our ability to ensure equitable access to these tools. Novel approaches to reducing known barriers to accessing HIV prevention, such as stigma and logistical-related factors, are urgently needed. To evaluate the efficacy of a randomized controlled trial with four intervention arms to address barriers to HIV/STI testing uptake (primary outcome) and PrEP use, depression, and HIV test results (secondary outcomes). We tested a 2 × 2 research design: main effect 1-stigma-focused vs. health information evaluation-focused counseling, main effect 2-offering HIV/STI testing appointments in person vs. at home with a counselor via video chat, and the interaction of the main effects. Participants (N = 474) residing in the southeastern USA were screened and enrolled in a longitudinal trial. Intervention efficacy was established using generalized linear modeling with binomial or Poisson distributions. Intervention efficacy demonstrated an increase in HIV/STI testing uptake when testing was made available at home with a counselor via video chat vs. in person (83% vs. 75% uptake, p < .05), and participants were also more likely to test positive for HIV over the course of the study in the at-home condition (14.5% vs. 9.4%, p < .05). Stigma-focused counseling resulted in lower depression scores and greater uptake of PrEP among participants < 30 years of age when compared with health information counseling (15.4% vs. 9.6%, p < .05). In order to prevent further disparities between HIV prevention advances and access to HIV prevention tools, we must prioritize improvements in linking people to care. Novel interventions, such as those proposed here, offer a practical, evidence-based path to addressing long-standing barriers to HIV prevention strategies. Trial registration: NCT03107910.
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Affiliation(s)
- Lisa A Eaton
- Human Development and Family Sciences, University of Connecticut, 2006 Hillside Rd, Storrs, CT, 06279-1248, USA.
| | | | - Valerie A Earnshaw
- Human Development and Family Sciences, University of Delaware, Newark, DE, USA
| | | | - Ryan J Watson
- Human Development and Family Sciences, University of Connecticut, 2006 Hillside Rd, Storrs, CT, 06279-1248, USA
| | - Redd Driver
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Cristian J Chandler
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jolaade Kalinowski
- Human Development and Family Sciences, University of Connecticut, 2006 Hillside Rd, Storrs, CT, 06279-1248, USA
| | - Seth C Kalichman
- Psychological Sciences, University of Connecticut, Storrs, CT, USA
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White DAE, Solnick RE. Communicable Disease Screening and Human Immunodeficiency Virus Prevention in the Emergency Department. Emerg Med Clin North Am 2024; 42:369-389. [PMID: 38641395 DOI: 10.1016/j.emc.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
Emergency departments (ED) provide care to populations with high rates of communicable diseases, like HIV, hepatitis C virus, and syphilis. For many patients, the ED is their sole entry point into the healthcare system and they do not routinely access screening and prevention services elsewhere. As such, the ED can serve an important public health role through communicable disease identification, treatment, and prevention. In this article, we examine national recommendations, peer-reviewed literature, and expert consensus to provide cutting edge strategies for implementing communicable infectious disease screening and prevention programs into routine ED care.
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Affiliation(s)
- Douglas A E White
- Department of Emergency Medicine, Alameda Health System, Wilma Chan Highland Hospital, 1411 East 31st Street, Oakland, CA 94602, USA.
| | - Rachel E Solnick
- Icahn School of Medicine at Mount Sinai Hospital, 555 West 57th Street 5-25, New York, NY 10019, USA
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Vincent W, Siconolfi DE, Pollack L, Campbell CK, Kegeles SM, Storholm ED. What's in Your Dataset? Measuring Engagement in HIV Care Using Routinely Administered Items with a Population Disproportionately Burdened by HIV. AIDS Behav 2024; 28:1423-1434. [PMID: 38150065 DOI: 10.1007/s10461-023-04229-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 12/28/2023]
Abstract
We evaluated the psychometric properties of a measure consisting of items that assess current HIV care continuum engagement based on established definitions in the United States. At baseline, participants in this longitudinal study, which included three time points from 2015 to 2020, were 331 young Black sexual minority men ages 18-29 living with HIV in the southern United States residing in two large southern cities. Self-report items reflected four aspects of HIV care continuum engagement as binary variables: seeing a healthcare provider for HIV care, being on antiretroviral treatment, being retained in HIV care, and being virally suppressed. Of these, the following three variables loaded onto a single factor in exploratory factor analysis: being on antiretroviral treatment, being retained in HIV care, and being virally suppressed. A one-dimensional factor structure was confirmed using confirmatory factor analyses at separate time points. Additionally, the three items collectively showed measurement invariance by age, education level, employment status, and income level. The three-item measure also showed reliability based on coefficient omega and convergent validity in its associations with indicators of socioeconomic distress, depression, resilience, and healthcare empowerment. In sum, the items performed well as a single scale. The study demonstrated the potential psychometric strength of simple, feasible, commonly administered items assessing engagement in the HIV care continuum.
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Affiliation(s)
- Wilson Vincent
- Department of Psychology and Neuroscience, Temple University, Weiss Hall, Philadelphia, PA, 19122, USA.
| | | | - Lance Pollack
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Chadwick K Campbell
- Herbert Wertheim School of Public Health and Human Longevity, University of California, San Diego, CA, USA
| | - Susan M Kegeles
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Erik D Storholm
- School of Public Health, San Diego State University, San Diego, CA, USA
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Boyd DT, Quinn CR, Jones KV, Waller B, Coker EJ, Duprey EB, Cerulli C, McCoy H. Building stronger bonds: The impact of family support and communication on suicidal behaviors among Black men who have sex with men. Suicide Life Threat Behav 2024. [PMID: 38488644 DOI: 10.1111/sltb.13072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/10/2024] [Accepted: 03/01/2024] [Indexed: 03/28/2024]
Abstract
INTRODUCTION It has been well documented that men who identify with a sexual orientation other than heterosexual are at a greater risk for suicide-related outcomes. What is less known are the protective factors that can reduce such negative outcomes and contribute to their resilience. METHODS This study used data collected between December 1, 2021, and January 2022 to understand how family factors contribute to or prevent depression symptoms and suicide outcomes among young Black men who have sex with men (BMSM) ages 18 to 29 (N = 400). A path analysis was conducted to explore the direct and indirect effects of suicide attempts. RESULTS Surprisingly, there were nuanced findings that showed having a family member or friend die by suicide was indirectly associated with suicide planning and suicide attempts. It was also unexpectedly noted that there was a positive relationship between higher rates of depressive symptoms and higher levels of support from family members. CONCLUSIONS The population focused on in this study is understudied and has unique needs. Identifying familial support may not automatically reduce the thoughts and plans of young BMSM, which is an example of why their intersecting marginalized identities must be considered when conducting further research, creating interventions, and providing therapeutic services.
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Affiliation(s)
- Donte T Boyd
- College of Social Work, The Ohio State University, Columbus, Ohio, USA
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Camille R Quinn
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
- Center for Equitable Family and Community Well-being, School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Kristian V Jones
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Bernadine Waller
- Department of Psychiatry, Columbia University Irving Medical Center/New York State Psychiatric Institute, New York City, New York, USA
| | - Evelyn Joy Coker
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Erinn B Duprey
- Mt. Hope Family Center, Rochester, New York, USA
- Children's Institute, Rochester, New York, USA
| | - Catherine Cerulli
- Department of Psychiatry, University of Rochester, Rochester, New York, USA
- Community Engagement Core TRANSFORM Center, Mt. Hope Family Center, Rochester, New York, USA
| | - Henrika McCoy
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas, USA
- Texas Center for Equity Promotion, College of Education, The University of Texas at Austin, Austin, Texas, USA
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Vincent W. Willingness to Use Digital Health Screening and Tracking Tools for Public Health in Sexual Minority Populations in a National Probability Sample: Quantitative Intersectional Analysis. J Med Internet Res 2024; 26:e47448. [PMID: 38457790 PMCID: PMC10960216 DOI: 10.2196/47448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 11/29/2023] [Accepted: 12/20/2023] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Little is known about sexual minority adults' willingness to use digital health tools, such as pandemic-related tools for screening and tracking, outside of HIV prevention and intervention efforts for sexual minority men, specifically. Additionally, given the current cultural climate in the United States, heterosexual and sexual minority adults may differ in their willingness to use digital health tools, and there may be within-group differences among sexual minority adults. OBJECTIVE This study compared sexual minority and heterosexual adults' willingness to use COVID-19-related digital health tools for public health screening and tracking and tested whether sexual minority adults differed from each other by age group, gender, and race or ethnicity. METHODS We analyzed data from a cross-sectional, national probability survey (n=2047) implemented from May 30 to June 8, 2020, in the United States during the height of the public health response to the COVID-19 pandemic. Using latent-variable modeling, heterosexual and sexual minority adults were tested for differences in their willingness to use digital health tools for public health screening and tracking. Among sexual minority adults, specifically, associations with age, gender, and race or ethnicity were assessed. RESULTS On average, sexual minority adults showed greater willingness to use digital health tools for screening and tracking than heterosexual adults (latent factor mean difference 0.46, 95% CI 0.15-0.77). Among sexual minority adults, there were no differences by age group, gender, or race or ethnicity. However, African American (b=0.41, 95% CI 0.19-0.62), Hispanic or Latino (b=0.36, 95% CI 0.18-0.55), and other racial or ethnic minority (b=0.54, 95% CI 0.31-0.77) heterosexual adults showed greater willingness to use digital health tools for screening and tracking than White heterosexual adults. CONCLUSIONS In the United States, sexual minority adults were more willing to use digital health tools for screening and tracking than heterosexual adults. Sexual minority adults did not differ from each other by age, gender, or race or ethnicity in terms of their willingness to use these digital health tools, so no sexual orientation-based or intersectional disparities were identified. Furthermore, White heterosexual adults were less willing to use these tools than racial or ethnic minority heterosexual adults. Findings support the use of digital health tools with sexual minority adults, which could be important for other public health-related concerns (eg, the recent example of mpox). Additional studies are needed regarding the decision-making process of White heterosexual adults regarding the use of digital health tools to address public health crises, including pandemics or outbreaks that disproportionately affect minoritized populations.
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Affiliation(s)
- Wilson Vincent
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, United States
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Meisner A, Xia F, Chan KCG, Mayer K, Wheeler D, Zangeneh S, Donnell D. Estimating the Effect of PrEP in Black Men Who Have Sex with Men: A Framework to Utilize Data from Multiple Non-Randomized Studies to Estimate Causal Effects. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.10.24301113. [PMID: 38260494 PMCID: PMC10802753 DOI: 10.1101/2024.01.10.24301113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Black men who have sex with men (MSM) are disproportionately burdened by the HIV epidemic in the US. The effectiveness of pre-exposure prophylaxis (PrEP) in preventing HIV infection has been demonstrated through randomized placebo-controlled clinical trials in several populations. Importantly, no such trial has been conducted exclusively among Black MSM in the US, and it would be unethical and infeasible to do so now. To estimate the causal effects of PrEP access, initiation, and adherence on HIV risk, we utilized causal inference methods to combine data from two non-randomized studies that exclusively enrolled Black MSM. The estimated relative risks of HIV were: (i) 0.52 (95% confidence interval: 0.21, 1.22) for individuals with versus without PrEP access, (ii) 0.48 (0.12, 0.89) for individuals who initiated PrEP but were not adherent versus those who did not initiate, and (iii) 0.23 (0.02, 0.80) for individuals who were adherent to PrEP versus those who did not initiate. Beyond addressing the knowledge gap around the effect of PrEP in Black MSM in the US, which may have ramifications for public health, we have provided a framework to combine data from multiple non-randomized studies to estimate causal effects, which has broad utility.
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Affiliation(s)
- Allison Meisner
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, US
| | - Fan Xia
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, US
| | - Kwun C G Chan
- Department of Biostatistics, University of Washington, Seattle, WA, US
| | - Kenneth Mayer
- Harvard Medical School, Boston, MA, US
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, US
- The Fenway Institute, Boston, MA, US
- Infectious Diseases Division, Beth Israel Deaconess Medical Center, Boston, MA, US
| | - Darrell Wheeler
- State University of New York at New Paltz, New Paltz, NY, US
| | - Sahar Zangeneh
- RTI International, Research Triangle Park, NC, US
- School of Public Health, University of Washington, Seattle, WA, US
| | - Deborah Donnell
- Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Center, Seattle, WA, US
- Department of Global Health, University of Washington, Seattle, WA, US
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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] [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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Santos GM, Hernandez C, Lam E, Hern J, Rowe C. Racial/Ethnic Disparities in Club Drug Use, Situational Club Drug Use during Sex, and Sexual Risk Behaviors among Alcohol-Using Men Who Have Sex with Men (MSM) in San Francisco. Subst Use Misuse 2024; 59:895-901. [PMID: 38307836 PMCID: PMC11131949 DOI: 10.1080/10826084.2024.2310480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Abstract
BACKGROUND Club drug use-including 3,4-Methylenedioxymethamphetamine, ketamine, crack/cocaine, hallucinogens, gamma hydroxybutyrate, volatile nitrites, and methamphetamine-has been linked to sexual risk behaviors among MSM. Few studies examine how the use of club drugs and the association between club drug use during sex and sexual risk may differ by race/ethnicity. METHODS Using data from a cross-sectional study among alcohol-using MSM in San Francisco (n = 252), we examined the associations between the interaction of race/ethnicity and club drug use during sex, and the following behavioral outcomes: any condomless anal intercourse (CAI), insertive CAI, receptive CAI, and any serodiscordant sex in the past six months. All models controlled for income, HIV status, relationship status, age, and current use of a biomedical HIV prevention tool (i.e., Pre-Exposure Prophylaxis [PrEP] or antiretroviral therapy). RESULTS There were significant racial differences in club drug use (p < 0.001) and club drug use during sex (p = 0.01). Asian/Pacific Islander (API) and Latino participants reported using club drugs the most at 78.8% and 79%, respectively. Among users of club drugs, club drug use during sex was most common among Black (100%), and Latino MSM (93%). Significant interactions between race/ethnicity and club drug use during sex were observed for CAI (p = 0.02), insertive CAI (p = 0.01), and receptive CAI (p = 0.01). API participants who used club drug during sex had higher odds of reporting CAI (aOR = 15.27, CI = 1.50-155.34), insertive CAI (aOR = 21.11, CI = 2.04-218.10), and receptive CAI (aOR = 21.11, CI = 2.04-218.10). CONCLUSIONS Given the differing rates of club drug use during sex by race/ethnicity and the role race/ethnicity plays in modifying the relationships between club drug use during sex and sexual risk behaviors, culturally-tailored interventions may be needed to address the needs of ethnically-diverse, club drug-using MSM.
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Affiliation(s)
| | | | - Eric Lam
- Boston University School of Public Health, Boston, MA, USA
| | - Jaclyn Hern
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Christopher Rowe
- San Francisco Department of Public Health, San Francisco, CA, USA
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11
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Zaleta AK, Fortune EE, Miller MF, Olson JS, Hollis-Hansen K, Dohn SK, Kwait JL. HIV Support Source: Development of a Distress Screening Measure for Adults with HIV. AIDS Behav 2024; 28:713-727. [PMID: 38261220 DOI: 10.1007/s10461-023-04261-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2023] [Indexed: 01/24/2024]
Abstract
To provide an effective, multidimensional, and psychometrically valid measure to screen for distress among people with HIV, we developed and assessed the psychometric properties of HIV Support Source, a distress screening, referral, and support program designed to identify the unmet needs of adults with HIV and link them to desired resources and support. Development and testing were completed in three phases: (1) item generation and initial item pool testing (N = 375), (2) scale refinement via exploratory factor analysis (N = 220); external/internal item quality, and judging theoretical and practical implications of items, and (3) confirmatory validation (N = 150) including confirmatory factor analysis along with reliability and validity analyses to corroborate dimensionality and psychometric properties of the final measure. Nonparametric receiver operating characteristic (ROC) curve analyses determined scoring thresholds for depression and anxiety risk subscales. The final measure comprises 17-items representing four domains of concern: emotional well-being, financial and practical needs, physical well-being, and HIV treatment and sexual health, plus one screening item assessing tobacco and substance use. Our analyses showed strong internal consistency reliability, a replicable factor structure, and adequate convergent, discriminant, and known groups validity. Sensitivity of 2-item depression and 2-item anxiety risk subscales was 0.90 and 0.79, respectively. HIV Support Source is a reliable and valid multidimensional measure of distress that also screens for risk for clinically significant depression and anxiety. It can be implemented within a distress screening, referral, and follow-up program to rapidly assess and support the unmet needs of adults with HIV.
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Affiliation(s)
- Alexandra K Zaleta
- Cancer Support Community, Research and Training Institute, 520 Walnut Street, Suite 1170, Philadelphia, PA, 19106, USA
- Cancer Care, New York, NY, USA
| | - Erica E Fortune
- Cancer Support Community, Research and Training Institute, 520 Walnut Street, Suite 1170, Philadelphia, PA, 19106, USA
| | - Melissa F Miller
- Cancer Support Community, Research and Training Institute, 520 Walnut Street, Suite 1170, Philadelphia, PA, 19106, USA.
| | - Julie S Olson
- Cancer Support Community, Research and Training Institute, 520 Walnut Street, Suite 1170, Philadelphia, PA, 19106, USA
| | - Kelseanna Hollis-Hansen
- Cancer Support Community, Research and Training Institute, 520 Walnut Street, Suite 1170, Philadelphia, PA, 19106, USA
- UT Southwestern Medical Center, O'Donnell School of Public Health, Dallas, TX, USA
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Cummins B, Johnson K, Schneider JA, Del Vecchio N, Moshiri N, Wertheim JO, Goyal R, Skaathun B. Leveraging social networks for identification of people with HIV who are virally unsuppressed. AIDS 2024; 38:245-254. [PMID: 37890471 PMCID: PMC10843229 DOI: 10.1097/qad.0000000000003767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/06/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVES This study investigates primary peer-referral engagement (PRE) strategies to assess which strategy results in engaging higher numbers of people with HIV (PWH) who are virally unsuppressed. DESIGN We develop a modeling study that simulates an HIV epidemic (transmission, disease progression, and viral evolution) over 6 years using an agent-based model followed by simulating PRE strategies. We investigate two PRE strategies where referrals are based on social network strategies (SNS) or sexual partner contact tracing (SPCT). METHODS We parameterize, calibrate, and validate our study using data from Chicago on Black sexual minority men to assess these strategies for a population with high incidence and prevalence of HIV. For each strategy, we calculate the number of PWH recruited who are undiagnosed or out-of-care (OoC) and the number of direct or indirect transmissions. RESULTS SNS and SPCT identified 256.5 [95% confidence interval (CI) 234-279] and 15 (95% CI 7-27) PWH, respectively. Of these, SNS identified 159 (95% CI 142-177) PWH OoC and 32 (95% CI 21-43) PWH undiagnosed compared with 9 (95% CI 3-18) and 2 (95% CI 0-5) for SPCT. SNS identified 15.5 (95% CI 6-25) and 7.5 (95% CI 2-11) indirect and direct transmission pairs, whereas SPCT identified 6 (95% CI 0-8) and 5 (95% CI 0-8), respectively. CONCLUSION With no testing constraints, SNS is the more effective strategy to identify undiagnosed and OoC PWH. Neither strategy is successful at identifying sufficient indirect or direct transmission pairs to investigate transmission networks.
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Affiliation(s)
- Breschine Cummins
- Department of Mathematical Sciences, Montana State University, Bozeman, MT
| | - Kara Johnson
- Department of Mathematical Sciences, Montana State University, Bozeman, MT
| | - John A. Schneider
- Department of Medicine, University of Chicago
- Department of Public Health Sciences, University of Chicago, Chicago, IL
| | | | | | - Joel O. Wertheim
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Ravi Goyal
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Britt Skaathun
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
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13
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Demeke J, Djiadeu P, Yusuf A, Whitfield DL, Lightfoot D, Worku F, Abu-Ba'are GR, Mbuagbaw L, Giwa S, Nelson LE. HIV Prevention and Treatment Interventions for Black Men Who Have Sex With Men in Canada: Scoping Systematic Review. JMIR Public Health Surveill 2024; 10:e40493. [PMID: 38236626 PMCID: PMC10835596 DOI: 10.2196/40493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 12/28/2022] [Accepted: 08/29/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Black men who have sex with men (MSM) experience disproportionately high HIV incidence globally. A comprehensive, intersectional approach (race, gender, and sexuality or sexual behavior) in understanding the experiences of Black MSM in Canada along the HIV prevention and care continuums has yet to be explored. OBJECTIVE This scoping review aims to examine the available evidence on the access, quality, gaps, facilitators, and barriers of engagement and identify interventions relevant to the HIV prevention and care continuum for Black MSM in Canada. METHODS We conducted a systematic database search, in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist, of the available studies on HIV health experience and epidemiology concerning Black MSM living with or without HIV in Canada and were published after 1983 in either English or French. Searched databases include MEDLINE, Excerpta, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, the NHUS Economic Development Database, Global Health, PsycInfo, PubMed, Scopus, and Web of Science. From the 3095 articles identified, 19 met the inclusion criteria and were analyzed. RESULTS Black MSM in Canada consistently report multiple forms of stigma and lack of community support contributing to an increased HIV burden. They experience discrimination based on their intersectional identities while accessing HIV preventative and treatment interventions. Available data demonstrate that Black MSM have higher HIV incidences than Black men who have sex with women (MSW) and White MSM, and low preexposure prophylaxis knowledge and HIV literacy. Black MSM experience significant disparities in HIV prevention and care knowledge, access, and use. Structural barriers, including anti-Black racism, homophobia, and xenophobia, are responsible for gaps in HIV prevention and care continuums, poor quality of care and linkage to HIV services, as well as a higher incidence of HIV. CONCLUSIONS Considering the lack of targeted interventions, there is a clear need for interventions that reduce HIV diagnoses among Black MSM, increase access and reduce structural barriers that significantly affect the ability of Black MSM to engage with HIV prevention and care, and address provider's capacity for care and the structural barriers. These findings can inform future interventions, programming, and tools that may alleviate this HIV inequity. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2020-043055.
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Affiliation(s)
- Jemal Demeke
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Pascal Djiadeu
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Abban Yusuf
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | | | - David Lightfoot
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Fiqir Worku
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Gamji Rabiu Abu-Ba'are
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, United States
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Sulaimon Giwa
- School of Social Work, St John's College, Memorial University of Newfoundland, St John's, NL, Canada
| | - LaRon E Nelson
- School of Nursing, Yale University, New Haven, CT, United States
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14
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Figueroa CA, Manalo-Pedro E, Pola S, Darwish S, Sachdeva P, Guerrero C, von Vacano C, Jha M, De Maio F, Kennedy CJ. The stories about racism and health: the development of a framework for racism narratives in medical literature using a computational grounded theory approach. Int J Equity Health 2023; 22:265. [PMID: 38129909 PMCID: PMC10734166 DOI: 10.1186/s12939-023-02077-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION The scientific study of racism as a root cause of health inequities has been hampered by the policies and practices of medical journals. Monitoring the discourse around racism and health inequities (i.e., racism narratives) in scientific publications is a critical aspect of understanding, confronting, and ultimately dismantling racism in medicine. A conceptual framework and multi-level construct is needed to evaluate the changes in the prevalence and composition of racism over time and across journals. OBJECTIVE To develop a framework for classifying racism narratives in scientific medical journals. METHODS We constructed an initial set of racism narratives based on an exploratory literature search. Using a computational grounded theory approach, we analyzed a targeted sample of 31 articles in four top medical journals which mentioned the word 'racism'. We compiled and evaluated 80 excerpts of text that illustrate racism narratives. Two coders grouped and ordered the excerpts, iteratively revising and refining racism narratives. RESULTS We developed a qualitative framework of racism narratives, ordered on an anti-racism spectrum from impeding anti-racism to strong anti-racism, consisting of 4 broad categories and 12 granular modalities for classifying racism narratives. The broad narratives were "dismissal," "person-level," "societal," and "actionable." Granular modalities further specified how race-related health differences were related to racism (e.g., natural, aberrant, or structurally modifiable). We curated a "reference set" of example sentences to empirically ground each label. CONCLUSION We demonstrated racism narratives of dismissal, person-level, societal, and actionable explanations within influential medical articles. Our framework can help clinicians, researchers, and educators gain insight into which narratives have been used to describe the causes of racial and ethnic health inequities, and to evaluate medical literature more critically. This work is a first step towards monitoring racism narratives over time, which can more clearly expose the limits of how the medical community has come to understand the root causes of health inequities. This is a fundamental aspect of medicine's long-term trajectory towards racial justice and health equity.
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Affiliation(s)
- Caroline A Figueroa
- University of California Berkeley, Berkeley, USA.
- Department of Technology, Policy, and Management, Delft University of Technology, Policy & Management Room B3.230, Building 31, Jaffalaan 5, Delft, 2628 BX, the Netherlands.
| | - Erin Manalo-Pedro
- University of California Berkeley, Berkeley, USA
- Fielding School of Public Health, University of California Los Angeles, Los Angeles, USA
| | - Swetha Pola
- University of California Berkeley, Berkeley, USA
| | - Sajia Darwish
- University of California Berkeley, Berkeley, USA
- School of Public Health, University of California Berkeley, Berkeley, USA
| | | | | | | | | | - Fernando De Maio
- American Medical Association, Chicago, USA
- Department of Sociology, DePaul University, Chicago, USA
| | - Chris J Kennedy
- University of California Berkeley, Berkeley, USA
- Department of Psychiatry, Harvard Medical School, Boston, USA
- Center for Precision Psychiatry, Massachusetts General Hospital, Boston, USA
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15
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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 REGIONAL HEALTH. AMERICAS 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] [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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16
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Keralis JM. HIV Criminalization Laws and Enforcement: Assessing the Relationship Between HIV Criminalization at the State Level, Policing at the County Level, and County-level HIV Incidence Rates. AIDS Behav 2023; 27:3713-3724. [PMID: 37351686 DOI: 10.1007/s10461-023-04087-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 06/24/2023]
Abstract
The U.S. HIV epidemic disproportionately affects Black and Hispanic communities via ecosocial determinants of excess HIV risk, including HIV criminalization laws and overpolicing. This study used multilevel modeling to test the hypothesis that HIV criminalization laws are associated with higher county HIV incidence, and that this effect is modified by heavier county-level policing. County-level HIV incidence data from 2010 to 2019 were merged with county-level demographic, socioeconomic, and jailed population rate data for counties with stable HIV incidence rates (rates generated from a numerator of at least 12) for > 5 years. Multivariable multilevel (hierarchical) models for count-rate data were fitted, with years nested inside counties, and counties nested within states. An HIV criminalization law was associated with higher countywide HIV incidence rate for the general, Black, and Hispanic populations (aRR = 1.14, 1.30, and 1.32, respectively). This association was modified by an increased county jailed population rate for the general and Black populations.
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Affiliation(s)
- Jessica M Keralis
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, 4200 Valley Dr, College Park, MD, 20742, USA.
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17
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Ransome Y, Taggart T, Huang AS, Vermund SH, Mayer KH, Nunn AS. Increasing Spiritual Beliefs are Associated With Lower HIV Incidence Among Black Men Who Have Sex With Men: Results From HPTN 061 Longitudinal Study. J Acquir Immune Defic Syndr 2023; 94:196-202. [PMID: 37850978 DOI: 10.1097/qai.0000000000003278] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 07/17/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND There is a limited understanding about the impact of spiritual beliefs and activities on HIV seroconversion among black men who have sex with men (BMSM), which we investigate in this study. SETTING United States. METHODS The HIV Prevention Trials Network Study 061 collected demographic and biomedical assessments among BMSM across 6 United States cities for longitudinal analysis. Spiritual beliefs and spiritual activities are constructed composite scales. Bivariate analyses among 894 who provided data at 12-month follow-up compared men who seroconverted to HIV between baseline and 6 months with those who remained uninfected with HIV at 12 months. Cox proportional hazard regression among 944 men tested spiritual beliefs and activities on the longitudinal risk of HIV seroconversion adjusting for age and any sexually transmitted infection (STI). RESULTS Among this sample, HIV incidence between baseline and 6 months was 1.69%, (95% confidence intervals [CI]: 1.04 to 2.77). Men who seroconverted to HIV were significantly younger than those who remained uninfected at the 12-month follow-up: (mean age 27, SD = 11 vs 37, SD = 12) and a higher proportion reported any STI (46.67% vs 11.39%, P < 0.01). A one-unit increase in spiritual beliefs was associated with lower hazard rate of seroconverting to HIV at follow-up [adjusted hazard ratio (aHR) = 0.37, 95% CI: = (0.16 to 0.87)]. Religious service attendance and spiritual activities were unrelated to seroconverting. CONCLUSIONS Spirituality is important in the lives of BMSM. Biomedical and behavioral HIV prevention interventions should consider assessing spiritual beliefs in HIV care among BMSM.
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Affiliation(s)
- Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Heaven, CT
| | - Tamara Taggart
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Heaven, CT
- Department of Prevention and Community Health, The George Washington University Milken Institute, School of Public Health, Washington, DC
| | - Amber Shu Huang
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy University of Florida, Gainsville, FL
| | - Sten H Vermund
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, MA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
- Harvard Medical School, Boston, MA
| | - Amy S Nunn
- Department of Social and Behavioral Sciences, Brown University School of Public Health, Providence, RI; and
- Rhode Island Public Health Institute, Providence, RI
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18
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Feelemyer J, Abrams J, Mazumdar M, Irvine NM, Scheidell JD, Turpin RE, Dyer TV, Brewer RA, Hucks-Ortiz C, Caniglia EC, Remch M, Scanlon F, Gaydos CA, Sandh S, Cleland CM, Mayer KH, Khan MR. Age Differences in the Associations Between Incarceration and Subsequent Substance Use, Sexual Risk-Taking, and Incident STI Among Black Sexual Minority Men and Black Transgender Women in the HIV Prevention Trials 061 Cohort. Am J Mens Health 2023; 17:15579883231204120. [PMID: 37942721 PMCID: PMC10637158 DOI: 10.1177/15579883231204120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/30/2023] [Accepted: 09/12/2023] [Indexed: 11/10/2023] Open
Abstract
Incarceration can lead to different risk behaviors often due to increased distress and disruption of social networks. It is not well known, however, how these associations may differ by age. In this study, we measure age differences in longitudinal associations between incarceration and substance use, sex risk, and sexually transmitted infection (STI) among Black sexual minority men and Black transgender women (BSMM/BTW). We recruited BSMM/BTW from 2009 to 2011 that were part of the HIV Prevention Trials Network 061 study. We compared those less than 30 years old (n = 375) to those 30 years old or greater (n = 794) examining substance use, sex risk, and STI infection stratified by age. Logistic regression with inverse probability weighting was used for the statistical analysis. Approximately 59% of the sample reported incarceration history. In adjusted analysis, incarceration was more strongly associated with alcohol use and stimulant use among older individuals as was sexual risk behaviors including buying and selling sex. Concurrent partnerships were associated with the younger age groups. STI incidence was associated with younger individuals while associations with HIV infection were similar for the two age groups. Understanding differences in substance use and STI risk among age cohorts is imperative to the design and implementation of re-entry programs. Younger BSMM/BTW participating in re-entry support programs may benefit in particular from HIV/STI prevention and care efforts, while post-release substance abuse treatment and harm reduction programs should target older individuals with continued substance abuse.
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Affiliation(s)
- Jonathan Feelemyer
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Jasmyn Abrams
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Medha Mazumdar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Natalia M. Irvine
- 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
| | - Rodman E. Turpin
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | - Typhanye V. Dyer
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | | | | | - Ellen C. Caniglia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Molly Remch
- UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Faith Scanlon
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | | | - Simon Sandh
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Charles M. Cleland
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Kenneth H. Mayer
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center and 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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Graham T, Nyambi A, Barkhad A, Stevens-Uninsky M, Rehman N, Bhatnagar N, Mbuagbaw L. HIV and Black People in Canada: Protocol for a Scoping Review. JMIR Res Protoc 2023; 12:e49066. [PMID: 37862080 PMCID: PMC10625082 DOI: 10.2196/49066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/15/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Race-based health information is necessary to address disproportionate barriers racial communities face and to achieve optimal health outcomes. In Canada, Black people are disproportionately affected by HIV. There is an emerging body of literature on this topic, but a concise summary is lacking. There is a need to collectively and critically analyze research on HIV in the Black population in Canada to identify knowledge gaps and address this disproportionate burden. OBJECTIVE The aim of this scoping review is to summarize the evidence on HIV and Black people in Canada. The main outcomes of interest are HIV prevalence, access to care, HIV prevention and treatment, the HIV care cascade, and related HIV outcomes. Through this scoping review, we aim to provide a comprehensive overview of the existing literature and highlight topics that need more investigation in future research. METHODS We will conduct a scoping review of electronic databases using a systematic search strategy for qualitative, quantitative, or mixed methods studies reporting on HIV and Black people in Canada. We will conduct our searches in MEDLINE, Embase, CINAHL, Web of Science, EBSCO, and Google Scholar for literature published between 1985 and 2023. Gray literature, including government reports, dissertations, and other reports, will be included. Search results will be screened, and the full text of relevant literature will be retrieved. The extraction of data will be conducted independently by 2 reviewers. Consensus meetings will be held to resolve conflicts. Our results will be reported according to the PRISMA-ScR (Preferred Reporting Items for the Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). RESULTS The initial title and abstract review identified 447 articles. These articles will be critically appraised, and relevant information will be extracted. Information from these articles will be compared using charts and tables. Screening will start in November 2023, and we anticipate publishing the scoping review in June 2024. CONCLUSIONS The findings from this scoping review will help inform policy, practice, and research on HIV and Black people in Canada. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/49066.
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Affiliation(s)
- Tatyana Graham
- Health Sciences Library, McMaster University, Hamilton, ON, Canada
| | - Agatha Nyambi
- Health Sciences Library, McMaster University, Hamilton, ON, Canada
| | - Aisha Barkhad
- Department of Global Health, McMaster University, Hamilton, ON, Canada
| | | | - Nadia Rehman
- Health Sciences Library, McMaster University, Hamilton, ON, Canada
| | - Neera Bhatnagar
- Health Sciences Library, McMaster University, Hamilton, ON, Canada
| | - Lawrence Mbuagbaw
- Health Sciences Library, McMaster University, Hamilton, ON, Canada
- Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, ON, Canada
- Centre for the Development of Best Practices in Health, Yaoundé Central Hospital, Yaoundé, Cameroon
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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20
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Reyniers T, Fiorentino M, Babo SAY, Ouedraogo M, Kanta I, Agbegnigan LE, Rojas D, Anoma C, Dah TTE, Mensah E, Keita BD, Spire B, Vuylsteke B, Laurent C. The Perceived Added Value of Bimonthly Injectable Pre-Exposure Prophylaxis According to West African Men Who Have Sex with Men: A Focus Group Study. AIDS Patient Care STDS 2023; 37:480-488. [PMID: 37862074 DOI: 10.1089/apc.2023.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
Bimonthly long-acting injectable pre-exposure prophylaxis (LAI-PrEP) can become an important additional tool for HIV prevention among West African men who have sex with men (MSM). The objective was to explore the perceived added value of LAI-PrEP as an HIV prevention tool among MSM in Burkina Faso, Côte d'Ivoire, Mali, and Togo. We conducted eight focus group discussions among 62 HIV-negative MSM between April and May 2021. Participants were recruited via local community-based clinics. Data collection and analysis were guided by grounded theory and community-based participatory approaches. Participants were generally knowledgeable about HIV, and explained particular barriers for HIV prevention in their communities (e.g., denial of HIV). The added value of LAI-PrEP relative to condoms was similar to oral pre-exposure prophylaxis (PrEP) in terms of perceived advantages (e.g., improved sexual satisfaction) or disadvantages (e.g., no protection against other sexually transmitted infections). Compared with oral PrEP, LAI-PrEP was perceived to provide better protection against HIV and to be more convenient (e.g., no need to be mindful of intake and less risk for stigma). Concerns included fear of needles, doubts about efficacy, potential side effects, and difficulties for ensuring timely injections (e.g., when traveling abroad). The results demonstrate that injectable PrEP can be of particular interest to subgroups of West African MSM, although existing HIV prevention tools such as condoms and oral PrEP will remain valuable alongside of, or instead of, LAI-PrEP. Increasing awareness about HIV and tackling discrimination based on sexual orientation continue to be crucial factors to be addressed for HIV prevention.
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Affiliation(s)
- Thijs Reyniers
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Marion Fiorentino
- INSERM, IRD, Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale (SESSTIM), ISSPAM, Aix Marseille Université, Marseille, France
| | | | | | | | | | - Daniela Rojas
- INSERM, IRD, Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale (SESSTIM), ISSPAM, Aix Marseille Université, Marseille, France
- Coalition Plus, Community-Based Research Laboratory, Pantin, France
| | | | - Ter Tiero Elias Dah
- Association African Solidarité, Ouagadougou, Burkina Faso
- UFR Sciences de la Santé, Université de Ouahigouya, Ouahigouya, Burkina Faso
| | | | | | - Bruno Spire
- INSERM, IRD, Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale (SESSTIM), ISSPAM, Aix Marseille Université, Marseille, France
| | - Bea Vuylsteke
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Christian Laurent
- TransVIHMI, Université Montpellier, IRD, Inserm, Montpellier, France
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21
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Tao J, Sosnowy C, Arnold T, Kapadia J, Parent H, Rogers BG, Almonte A, Chan PA. Perspectives of a peer-driven approach to improve pre-exposure prophylaxis and HIV prevention among Black/African American and Hispanic/Latino men who have sex with men. Sex Health 2023; 20:453-460. [PMID: 37532286 PMCID: PMC10902904 DOI: 10.1071/sh23072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/11/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Black/African American (B/AA) and Hispanic/Latino (H/L) men who have sex with men (MSM) are significantly less likely than white MSM to initiate pre-exposure prophylaxis (PrEP). A peer-driven intervention (PDI) may be an effective approach to addressing this disparity. In this study, we explored community member perspectives of a PDI to promote PrEP uptake among B/AA and H/L MSM. METHODS We conducted semi-structured interviews with B/AA and H/L HIV-negative MSM between August 2018 and October 2019 in Rhode Island, USA. Participants reported their perspectives and recommendations for a PDI. Data from participant responses were thematically analysed. RESULTS Of 15 MSM, the median age was 25years (interquartile range: 22, 33). The majority identified as B/AA (53.3%), H/L (66.7%), and having a college education or above (53.3%). Most participants viewed a PDI positively and were willing to learn and promote PrEP among their peers. Participants identified and supported several potential intervention components, such as education about the benefit of PrEP, emphasising prevention-effective dosing, and clarifying no prevention effect towards other sexually transmitted infections. They preferred in-person meetings to electronic communication. Preferred characteristics of peer educators included compassion, good communication skills, and enthusiasm about PrEP. CONCLUSIONS This in-depth qualitative interview suggested that a PDI approach is promising in promoting PrEP uptake, as it could deliver culturally appropriate education and encourage PrEP uptake via peer influence among B/AA and H/L MSM.
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Affiliation(s)
- Jun Tao
- Infectious Diseases, Brown University Warren Alpert Medical School, 593 Eddy Street, Providence, RI 02903
- Division of Infectious Diseases, The Miriam Hospital, 11 4th Street, Providence, RI 02906, USA
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02912
| | - Collette Sosnowy
- Infectious Diseases, Brown University Warren Alpert Medical School, 593 Eddy Street, Providence, RI 02903
- Division of Infectious Diseases, The Miriam Hospital, 11 4th Street, Providence, RI 02906, USA
| | - Trisha Arnold
- Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, 345 Blackstone Blvd. Providence, RI 02906
| | - Jhanavi Kapadia
- Infectious Diseases, Brown University Warren Alpert Medical School, 593 Eddy Street, Providence, RI 02903
| | - Hannah Parent
- Division of Infectious Diseases, The Miriam Hospital, 11 4th Street, Providence, RI 02906, USA
| | - Brooke G. Rogers
- Infectious Diseases, Brown University Warren Alpert Medical School, 593 Eddy Street, Providence, RI 02903
- Division of Infectious Diseases, The Miriam Hospital, 11 4th Street, Providence, RI 02906, USA
| | - Alexi Almonte
- Division of Infectious Diseases, The Miriam Hospital, 11 4th Street, Providence, RI 02906, USA
| | - Philip A. Chan
- Infectious Diseases, Brown University Warren Alpert Medical School, 593 Eddy Street, Providence, RI 02903
- Division of Infectious Diseases, The Miriam Hospital, 11 4th Street, Providence, RI 02906, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 8 floor, 121 South Main Street, Providence, RI, 02912
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22
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Young LE. Effects of Online Friendships on Safer Sex Communication and Behavior among Black Sexual Minority Men: A Study of Network Exposure. HEALTH COMMUNICATION 2023:1-12. [PMID: 37712151 PMCID: PMC10940198 DOI: 10.1080/10410236.2023.2258309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
This study draws on social normative and social learning theories to examine the masspersonal safer sex communication (i.e., Facebook posts about safer sex) and safer sex behavior (i.e., condom use) in a cohort of Black sexual minority men (BSMM) (N = 340), with an eye toward understanding their relationship with the safer sex communication and behaviors of their BSMM Facebook friends. Using linear network autocorrelation regression models, results showed that BSMM's safer sex communication and condom use behavior were each associated with the communication and behavior of their online peers. Specifically, BSMM's condom use was positively associated with their friends' condom use and friends' safer sex communication, and BSMMs' safer sex communication was positively associated with friends' safer sex communication. Moreover, contrary to prior research, BSSM's safer sex communication and condom use were not related to one another, suggesting that talking about safer sex on social media should not be interpreted to be an indication of engageDment in safer sex behavior. These findings underscore an opportunity to leverage peer influence in social media networks, particularly in the form of masspersonal communication, to encourage cascades of safer sex messaging among peers and adoption of safer sex behavior.
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Affiliation(s)
- Lindsay E Young
- University of Southern California, Annenberg School for Communication and Journalism
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23
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Birnbaum J, Roberson M, Bailey MM, Smith MDR, Turner D, Qian HZ, Jeon S, Hirshfield S, Nelson LE. Leveraging family-based assets for Black men who have sex with men in House Ball Communities: Protocol for a cluster randomized controlled trial. PLoS One 2023; 18:e0289681. [PMID: 37683036 PMCID: PMC10490903 DOI: 10.1371/journal.pone.0289681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/17/2023] [Indexed: 09/10/2023] Open
Abstract
Black men who have sex with men (MSM) continue to have the highest incidence of new human immunodeficiency virus (HIV) diagnoses in the United States but are least likely to be engaged in care or to be virally suppressed. Many Black MSM face multiple stigmas, but some have found refuge in the House Ball Community (HBC)-a national network of Black lesbian, gay, bisexual, and transgender kinship commitments that provide care-giving, affirmation, and survival skills-building for its members. We propose to modify a skills-building and HIV prevention best-evidence, group-level intervention for HIV- negative Black MSM (Many Men Many Voices) into a family-based intervention to focus on asset-building for both HIV-negative and HIV-positive Black MSM within HBC families. The adapted intervention will be re-branded as Our Family Our Voices (OFOV). We proposed a mixed-methods study to test the feasibility and preliminary efficacy of OFOV adapted for HIV status-neutral use with HBC families. First, we will develop the intervention protocol using the ADAPT-ITT model for modifying behavioral interventions. Then, we will conduct a cluster randomized controlled trial with six HBC families in New York City. Families will be randomized to the OFOV intervention or waitlist control arm. Primary outcomes will be HIV testing, HIV pre-exposure prophylaxis use, currently in HIV care and on HIV treatment. Secondary outcomes will be the number of family-based assets, resilience, number of sexual partners, and relative frequency of condomless anal intercourse. The results of the formative research, including the pilot trial, will contribute to the evidence-base regarding the development of HIV status-neutral interventions that respond to the diversity and complexities of HBC families and that recognize the importance of asset-building for facilitating HBC resilience to stigma as a part of the United States' domestic policy objective of ending the HIV epidemic by 2030.
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Affiliation(s)
- Jeffrey Birnbaum
- Division of Infectious Diseases, Department of Pediatrics, The Children’s Hospital, State University of New York Downstate Health Sciences University, Brooklyn, New York, United States of America
| | - Michael Roberson
- Center for Race, Religion and Economic Democracy, Union Theological Seminary, New York, New York, United States of America
| | - Marlon M. Bailey
- Department of Women and Gender Studies, School of Social Transformation, Arizona State University, Tempe, Arizona, United States of America
| | - Martez D. R. Smith
- Division of Infectious Diseases, Department of Pediatrics, The Children’s Hospital, State University of New York Downstate Health Sciences University, Brooklyn, New York, United States of America
- School of Nursing, University of Rochester, Rochester, New York, United States of America
| | - DeAnne Turner
- College of Nursing, University of South Florida, Tampa, Florida, United States of America
| | - Han-Zhu Qian
- School of Public Health, Yale University, New Haven, Connecticut, United States of America
| | - Sangchoon Jeon
- School of Nursing, Yale University, New Haven, Connecticut, United States of America
| | - Sabina Hirshfield
- Department of Medicine, STAR Program, State University of New York Downstate Health Sciences University, Brooklyn, New York, United States of America
| | - LaRon E. Nelson
- School of Public Health, Yale University, New Haven, Connecticut, United States of America
- School of Nursing, Yale University, New Haven, Connecticut, United States of America
- Yale Institute for Global Health, School of Public Health, New Haven, Connecticut, United States of America
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24
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Stojanovski K, King EJ, O'Connell S, Gallagher KS, Theall KP, Geronimus AT. Spiraling Risk: Visualizing the multilevel factors that socially pattern HIV risk among gay, bisexual & other men who have sex with men using Complex Systems Theory. Curr HIV/AIDS Rep 2023; 20:206-217. [PMID: 37486568 PMCID: PMC10403445 DOI: 10.1007/s11904-023-00664-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 07/25/2023]
Abstract
PURPOSE OF REVIEW Global disparities in HIV infection, particularly among gay, bisexual, and other men who have sex with men (GBMSM), indicate the importance of exploring the multi-level processes that shape HIV's spread. We used Complex Systems Theory and the PRISMA guidelines to conduct a systematic review of 63 global reviews to understand how HIV is socially patterned among GBMSM. The purpose was to conduct a thematic analysis of the reviews to (1) synthesize the multi-level risk factors of HIV risk, (2) categorize risk across the socioecological model, and (3) develop a conceptual model that visualizes the interrelated factors that shape GBMSMS's HIV "risk." RECENT FINDINGS We included 49 studies of high and moderate quality studies. Results indicated that GBMSM's HIV risk stems from the individual, interpersonal, and structural levels of the socioecological model. We identified a few themes that shape GBMSM's risk of HIV infection related to biomedical prevention methods; sexual and sex-seeking behaviors; behavioral prevention methods; individual-level characteristics and syndemic infections; lived experiences and interpersonal relationships; country-level income; country-level HIV prevalence; and structural stigma. The multi-level factors, in tandem, serve to perpetuate GBMSM's risk of HIV infection globally. The amalgamation of our thematic analyses from our systematic reviews of reviews suggests that the risk of HIV infection operates in an emergent, dynamic, and complex nature across multiple levels of the socioecological model. Applying complex systems theory indicates how multilevel factors create a dynamic and reinforcing system of HIV risk among GBMSM.
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Affiliation(s)
- K Stojanovski
- Department of Social, Behavioral and Population Sciences, Tulane School of Public Health & Tropical Medicine, New Orleans, USA.
| | - E J King
- Department of Health Behavior & Health Education, School of Public Health, University of Michigan, Ann Arbor, USA
| | - S O'Connell
- Department of Epidemiology, Tulane School of Public Health & Tropical Medicine, New Orleans, USA
| | - K S Gallagher
- Department of Health Policy and Management, Tulane School of Public Health & Tropical Medicine, New Orleans, USA
| | - K P Theall
- Department of Social, Behavioral and Population Sciences, Tulane School of Public Health & Tropical Medicine, New Orleans, USA
- Department of Epidemiology, Tulane School of Public Health & Tropical Medicine, New Orleans, USA
| | - A T Geronimus
- Department of Health Behavior & Health Education, School of Public Health, University of Michigan, Ann Arbor, USA
- Institute for Social Research, University of Michigan, Ann Arbor, USA
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25
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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] [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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26
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Wien S, Guest JL, Luisi N, Taussig J, Kramer MR, Stephenson R, Millett G, del Rio C, Sullivan PS. Racial differences in the association of undetectable HIV viral load and transportation to an HIV provider among men who have sex with men in Atlanta, Georgia: a health equity perspective. AIDS Care 2023; 35:1154-1163. [PMID: 36878481 PMCID: PMC10426396 DOI: 10.1080/09540121.2023.2182871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 02/14/2023] [Indexed: 03/08/2023]
Abstract
There are inequities in HIV outcomes among Black gay, bisexual, and other sexual minority men who have sex with men (GBMSM) compared to GBMSM overall, including access to transportation to HIV care. It is unclear if the relationship between transportation and clinical outcomes extends to viral load. We assessed the relationship between transportation dependence to an HIV provider and undetectable viral load among Black and White GBMSM in Atlanta. We collected transportation and viral load information from GBMSM with HIV from 2016-2017 (n = 345). More Black than White GBMSM had a detectable viral load (25% vs. 15%) and took dependent (e.g. public) transportation (37% vs. 18%). Independent (e.g. car) transportation was associated with undetectable viral load for White GBMSM (cOR 3.61, 95% CI 1.45, 8.97) but was attenuated by income (aOR. 2.29, 95% CI 0.78, 6.71), and not associated for Black GBMSM (cOR 1.18, 95% CI 0.58, 2.24). One possible explanation for no association for Black GBMSM is that there are more competing barriers to HIV care for Black GBMSM than White GBMSM. Further investigation is needed to confirm whether 1) transportation is unimportant for Black GBMSM or 2) transportation interacts with additional factors not considered in this analysis.
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Affiliation(s)
- Simone Wien
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jodie L. Guest
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Nicole Luisi
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jennifer Taussig
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Michael R. Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rob Stephenson
- Department of Systems, Populations, and Leadership, School of Nursing, and the Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
| | - Greg Millett
- American Foundation for AIDS Research, Washington DC, USA
| | - Carlos del Rio
- Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Patrick S. Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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27
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Shrader CH, Duncan DT, Chen YT, Driver R, Russell J, Moody RL, Knox J, Skaathun B, Durrell M, Hanson H, Eavou R, Goedel WC, Schneider JA. Latent Profile Patterns of Network-Level Norms and Associations with Individual-Level Sexual Behaviors: The N2 Cohort Study in Chicago. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2355-2372. [PMID: 36877319 PMCID: PMC10480356 DOI: 10.1007/s10508-023-02555-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
Individual-level behavior can be influenced by injunctive and descriptive social network norms surrounding that behavior. There is a need to understand how the influence of social norms within an individual's social networks may influence individual-level sexual behavior. We aimed to typologize the network-level norms of sexual behaviors within the social networks of Black sexual and gender minoritized groups (SGM) assigned male at birth. Survey data were collected in Chicago, Illinois, USA, between 2018 and 2019 from Black SGM. A total of 371 participants provided individual-level information about sociodemographic characteristics and HIV vulnerability from sex (i.e., condomless sex, group sex, use of alcohol/drugs to enhance sex) and completed an egocentric network inventory assessing perceptions of their social network members' (alters') injunctive and descriptive norms surrounding sexual behaviors with increased HIV vulnerability. We used Latent Profile Analysis (LPA) to identify network-level norms based on the proportion of alters' approval of the participant engaging in condomless sex, group sex, and use of drugs to enhance sex (i.e., injunctive norms) and alters' engagement in these behaviors (i.e., descriptive norms). We then used binomial regression analyses to examine associations between network-level norm profiles and individual-level HIV vulnerability from sex. The results of our LPA indicated that our sample experienced five distinct latent profiles of network-level norms: (1) low HIV vulnerability network norm, (2) moderately high HIV vulnerability network norm, (3) high HIV vulnerability network norm, (4) condomless sex dominant network norm, and (5) approval of drug use during sex dominant network norm. Condomless anal sex, group sex, and using drugs to enhance sex were positively and significantly associated with higher HIV vulnerability social network norm profiles, relative to low HIV vulnerability norm profiles. To mitigate Black SGM's HIV vulnerability, future HIV risk reduction strategies can consider using network-level intervention approaches such as opinion leaders, segmentation, induction, or alteration, through an intersectionality framework.
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Affiliation(s)
- Cho-Hee Shrader
- Department of Epidemiology, ICAP at Columbia University, Columbia University, 211 W 117th St APT 3A, New York, NY, 10026, USA.
| | - Dustin T Duncan
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Yen-Tyng Chen
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA
| | - Redd Driver
- Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, NY, USA
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, New York, NY, USA
| | - Jonathan Russell
- Department of Epidemiology, ICAP at Columbia University, Columbia University, 211 W 117th St APT 3A, New York, NY, 10026, USA
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Raymond L Moody
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Justin Knox
- Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, NY, USA
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, New York, NY, USA
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Britt Skaathun
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Mainza Durrell
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Hillary Hanson
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Rebecca Eavou
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - William C Goedel
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - John A Schneider
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
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28
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Riley T, Bender M, Wang X, Mena L, Gipson J, Barnes A, Johnson KL, Backus KV, Gomillia CE, Ward LM, Khosropour CM. HIV Incidence Among Individuals Accessing Pre-Exposure Prophylaxis in Jackson, Mississippi. AIDS Patient Care STDS 2023; 37:332-336. [PMID: 37222734 PMCID: PMC10354303 DOI: 10.1089/apc.2023.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
Although pre-exposure prophylaxis (PrEP) is an efficacious biomedical intervention, the effectiveness of same-day PrEP programs has not been widely studied. We utilized data from three of the four largest PrEP providers in Mississippi from September 2018 to September 2021 linked to the Mississippi State Department of Health's Enhanced HIV/AIDS reporting system. HIV diagnosis was defined as testing newly positive for HIV at least 2 weeks after the initial PrEP visit. We calculated the cumulative incidence and incidence rate of HIV per 100 person-years (PY). Person-time was calculated as time from the initial PrEP visit to (1) HIV diagnosis or (2) December 31, 2021 (HIV surveillance data end date). We did not censor individuals if they discontinued PrEP to obtain an estimate of PrEP effectiveness rather than efficacy. Among the 427 clients initiating PrEP during the study period, 2.3% [95% confidence interval (CI): 0.9-3.8] subsequently tested positive for HIV. The HIV incidence rate was 1.18 per 100 PY (95% CI: 0.64-2.19) and median time to HIV diagnosis after the initial PrEP visit was 321 days (95% CI: 62-686). HIV incidence rates were highest among transgender and nonbinary individuals [10.35 per 100 PY (95% CI: 2.59-41.40)] compared with cisgender men and women, and among people racialized as Black [1.45 per 100 PY (95% CI: 0.76-2.80)] compared with White and other racialized groups. These findings indicate a need for more clinical and community interventions that support PrEP persistence and restarts among those at high risk of HIV acquisition.
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Affiliation(s)
- Taylor Riley
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Melverta Bender
- Mississippi State Department of Health, Jackson, Mississippi, USA
| | - Xueyuan Wang
- Mississippi State Department of Health, Jackson, Mississippi, USA
| | - Leandro Mena
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, Mississippi, USA
- Open Arms Healthcare Center, Jackson, Mississippi, USA
| | - June Gipson
- Open Arms Healthcare Center, Jackson, Mississippi, USA
| | - Alicia Barnes
- Open Arms Healthcare Center, Jackson, Mississippi, USA
| | - Kendra L. Johnson
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Kandis V. Backus
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Courtney E. Gomillia
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Lori M. Ward
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Christine M. Khosropour
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
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Reid SC, Wang V, Assaf RD, Kaloper S, Murray AT, Shoptaw S, Gorbach P, Cassels S. Novel Location-Based Survey Using Cognitive Interviews to Assess Geographic Networks and Hotspots of Sex and Drug Use: Implementation and Validation Study. JMIR Form Res 2023; 7:e45188. [PMID: 37347520 DOI: 10.2196/45188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND The Ending the HIV Epidemic initiative in the United States relies on HIV hotspots to identify where to geographically target new resources, expertise, and technology. However, interventions targeted at places with high HIV transmission and infection risk, not just places with high HIV incidence, may be more effective at reducing HIV incidence and achieving health equity. OBJECTIVE We described the implementation and validation of a web-based activity space survey on HIV risk behaviors. The survey was intended to collect geographic information that will be used to map risk behavior hotspots as well as the geography of sexual networks in Los Angeles County. METHODS The survey design team developed a series of geospatial questions that follow a 3-level structure that becomes more geographically precise as participants move through the levels. The survey was validated through 9 cognitive interviews and iteratively updated based on participant feedback until the saturation of topics and technical issues was reached. RESULTS In total, 4 themes were identified through the cognitive interviews: functionality of geospatial questions, representation and accessibility, privacy, and length and understanding of the survey. The ease of use for the geospatial questions was critical as many participants were not familiar with mapping software. The inclusion of well-known places, landmarks, and road networks was critical for ease of use. The addition of a Google Maps interface, which was familiar to many participants, aided in collecting accurate and precise location information. The geospatial questions increased the length of the survey and warranted the inclusion of features to simplify it and speed it up. Using nicknames to refer to previously entered geographic locations limited the number of geospatial questions that appeared in the survey and reduced the time taken to complete it. The long-standing relationship between participants and the research team improved comfort to disclose sensitive geographic information related to drug use and sex. Participants in the cognitive interviews highlighted how trust and inclusive and validating language in the survey alleviated concerns related to privacy and representation. CONCLUSIONS This study provides promising results regarding the feasibility of using a web-based mapping survey to collect sensitive location information relevant to ending the HIV epidemic. Data collection at several geographic levels will allow for insights into spatial recall of behaviors as well as future sensitivity analysis of the spatial scale of hotspots and network characteristics. This design also promotes the privacy and comfort of participants who provide location information for sensitive topics. Key considerations for implementing this type of survey include trust from participants, community partners, or research teams to overcome concerns related to privacy and comfort. The implementation of similar surveys should consider local characteristics and knowledge when crafting the geospatial components.
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Affiliation(s)
- Sean C Reid
- Department of Geography, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Vania Wang
- Department of Geography, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Ryan D Assaf
- Benioff Homelessness and Housing Initiative, Center for Vulnerable Populations, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Sofia Kaloper
- Department of Geography, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Alan T Murray
- Department of Geography, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Steven Shoptaw
- Family Medicine and Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Pamina Gorbach
- Department of Epidemiology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Susan Cassels
- Department of Geography, University of California, Santa Barbara, Santa Barbara, CA, United States
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Ayorinde A, Ghosh I, Ali I, Zahair I, Olarewaju O, Singh M, Meehan E, Anjorin SS, Rotheram S, Barr B, McCarthy N, Oyebode O. Health inequalities in infectious diseases: a systematic overview of reviews. BMJ Open 2023; 13:e067429. [PMID: 37015800 PMCID: PMC10083762 DOI: 10.1136/bmjopen-2022-067429] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVES The aim of this systematic overview of reviews was to synthesise available evidence on inequalities in infectious disease based on three dimensions of inequalities; inclusion health groups, protected characteristics and socioeconomic inequalities. METHODS We searched MEDLINE, Embase, Web of Science and OpenGrey databases in November 2021. We included reviews published from the year 2000 which examined inequalities in the incidence, prevalence or consequences of infectious diseases based on the dimensions of interest. Our search focused on tuberculosis, HIV, sexually transmitted infections, hepatitis C, vaccination and antimicrobial resistance. However, we also included eligible reviews of any other infectious diseases. We appraised the quality of reviews using the Assessment of Multiple Systematic Reviews V.2 (AMSTAR2) checklist. We conducted a narrative data synthesis. RESULTS We included 108 reviews in our synthesis covering all the dimensions of inequalities for most of the infectious disease topics of interest, however the quality and volume of review evidence and consistency of their findings varied. The existing literature reviews provide strong evidence that people in inclusion health groups and lower socioeconomic status are consistently at higher risk of infectious diseases, antimicrobial resistance and incomplete/delayed vaccination. In the protected characteristics dimension, ethnicity, and sexual orientation are important factors contributing to inequalities across the various infectious disease topics included in this overview of reviews. CONCLUSION We identified many reviews that provide evidence of various types of health inequalities in different infectious diseases, vaccination, and antimicrobial resistance. We also highlight areas where reviews may be lacking. The commonalities in the associations and their directions suggest it might be worth targeting interventions for some high risk-groups that may have benefits across multiple infectious disease outcomes rather than operating purely in infectious disease siloes.
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Affiliation(s)
| | - Iman Ghosh
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Ifra Ali
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Iram Zahair
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Olajumoke Olarewaju
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Megha Singh
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Edward Meehan
- School of Public Health and Prevention Medicine, Monash University, Clayton, Victoria, Australia
| | | | - Suzanne Rotheram
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Ben Barr
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Noel McCarthy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Oyinlola Oyebode
- Wolfson Institute of Population Health, Queen Mary University of London, London, London, UK
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Religiosity and Engagement in HIV Care Among African American People Living with HIV. J Racial Ethn Health Disparities 2023; 10:560-572. [PMID: 35079959 DOI: 10.1007/s40615-022-01246-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/12/2022] [Accepted: 01/19/2022] [Indexed: 10/19/2022]
Abstract
HIV continues to disproportionately impact Black/African Americans. New and innovative strategies are needed to increase and enhance engagement in HIV care. The Black/African American church is a powerful institution with the potential to enhance HIV care among congregants. This study examines perceptions on incorporating religiosity into engagement in HIV care for African Americans living with HIV among Black/African Americans persons living with HIV, church leaders and members, and HIV health and service providers. Findings indicated Black/African Americans living with HIV would be willing to engage in religiously tailored, joint church-health initiatives to increase engagement in care. Church leaders and members and HIV health and service providers also reported a willingness to provide religiously tailored services, and that providing these services would be both acceptable and feasible for implementation. These findings should be considered in future research designed to enhance engagement in HIV care for Black/African Americans living with HIV.
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Cassels S, Cerezo A, Reid SC, Rivera DB, Loustalot C, Meltzer D. Geographic mobility and its impact on sexual health and ongoing HIV transmission among migrant latinx men who have sex with men. Soc Sci Med 2023; 320:115635. [PMID: 36640703 PMCID: PMC10866558 DOI: 10.1016/j.socscimed.2022.115635] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 12/05/2022] [Accepted: 12/23/2022] [Indexed: 01/09/2023]
Abstract
An understudied social process that may determine variable HIV risk, testing, and linkage to care is geographic mobility, including immigration as well as short-term mobility, especially among sexual minority populations. We aimed to assess how geographic mobility over the lifecourse between Latin America and the U.S., and within the U.S., was linked to sexual risk and health behaviors among Latinx migrant men who have sex with men (MSM) in San Bernardino County, California. Qualitative analysis of 16 semi-structured interviews revealed four major domains of influence on participants' sexual risk behaviors. At the micro level, these included social environment/interpersonal factors (e.g., family and peer support) and geographic factors and pathways (e.g., migration journey to the U.S.). At the macro level data centered on cultural factors (e.g., gender norms in home country) and structural factors (e.g., HIV healthcare). Our results can illuminate and promote effective health policies and HIV reduction efforts for Latinx migrant MSM in metro areas.
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Affiliation(s)
- Susan Cassels
- Department of Geography, University of California, Santa Barbara, USA.
| | - Alison Cerezo
- Department of Counseling, Clinical, And School Psychology, University of California, Santa Barbara, USA
| | - Sean C Reid
- Department of Geography, University of California, Santa Barbara, USA
| | - David B Rivera
- Department of Counseling, Clinical, And School Psychology, University of California, Santa Barbara, USA
| | - Colin Loustalot
- Department of Geography, University of California, Santa Barbara, USA
| | - Dan Meltzer
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
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Houang ST, Kafka JM, Choi SK, Meanley SP, Muessig KE, Bauermeister JA, Hightow-Weidman LB. Co-occurring Epidemic Conditions Among Southern U.S. Black Men Who Have Sex with Men in an Online eHealth Intervention. AIDS Behav 2023; 27:641-650. [PMID: 35986818 PMCID: PMC9391640 DOI: 10.1007/s10461-022-03799-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 11/09/2022]
Abstract
Black men who have sex with men (BMSM) face disproportionately higher risks for adverse sexual health outcomes compared to their non-Hispanic White counterparts. This disparity can be attributable to overlapping and intersecting risk factors at the individual and structural levels and can be understood through syndemic theory. Using longitudinal data from the HealthMPowerment trial (n = 363), six conditions related to stigma syndemics were indexed as a cumulative risk score: high alcohol use, polydrug use, depression and anxiety symptomology, and experiences of racism and sexual minority stigma. Using Poisson regression, we found a positive association between baseline risk scores and sexual risk behavior (b: 0.32, SE: 0.03, p < 0.001). Using a Generalized Estimating Equation, we also found a 0.23 decrease in the within-participant risk scores at 3-month follow-up (SE: 0.10, p < 0.020). Future work examining how care and prevention trials improve health outcomes in this population is needed.
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Affiliation(s)
- Steven T Houang
- Department of Health Behavior, University of North Carolina Chapel Hill, 170 Rosenau Hall, CB #7400, Chapel Hill, NC, 27599, USA.
| | - Julie M Kafka
- Department of Health Behavior, University of North Carolina Chapel Hill, 170 Rosenau Hall, CB #7400, Chapel Hill, NC, 27599, USA
| | - Seul Ki Choi
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, USA
| | - Steven P Meanley
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, USA
| | - Kathryn E Muessig
- Department of Health Behavior, University of North Carolina Chapel Hill, 170 Rosenau Hall, CB #7400, Chapel Hill, NC, 27599, USA
| | - Jose A Bauermeister
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, USA
| | - Lisa B Hightow-Weidman
- Department of Health Behavior, University of North Carolina Chapel Hill, 170 Rosenau Hall, CB #7400, Chapel Hill, NC, 27599, USA
- Institute for Global Health and Infectious Diseases, University North Carolina Chapel Hill, Chapel Hill, USA
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REMIEN RH, DĀCUS JD, FARLEY JE, HUGHES JP, GAMBLE T, WANG Z(Z, BATEY DS, MAYER KH, DEL RIO C, BALÁN IC, IRVIN R, MITCHELL KM, CUMMINGS V, ESHLEMAN SH, CONSERVE DF, KNOX J, YU K, BEYRER C. HTPN 078: an enhanced case management study to achieve viral suppression among viremic HIV-positive men who have sex with men in the United States. AIDS 2023; 37:217-231. [PMID: 36541636 PMCID: PMC9983736 DOI: 10.1097/qad.0000000000003411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES After identifying and recruiting men who have sex with men living with HIV and virally unsuppressed, this study attempted to enhance treatment and care via case management to increase the proportion who achieved viral suppression. DESIGN Participants were randomized into one of two study arms: standard of care (SOC) or enhanced case management (CM) intervention. Participants were followed for 12 months with quarterly study assessments, with blood collected for CD4+ cell count testing, HIV viral load testing (primary prespecified outcome), and plasma storage. METHODS Participants identified via respondent-driven sampling and direct recruitment and were invited to participate in the randomized controlled trial. The CM intervention provided a wide range of support services including, health education, clinical care coordination, medication adherence support, and social service assistance. The month-12 assessment included questions about healthcare utilization, stigma, substance use, and mental health. RESULTS Among the 144 participants virally unsuppressed at baseline, most had had a previous positive HIV test result; were Black, non-Hispanic, gay and bisexual men, aged 22-50. Among the 128 participants at the last study visit, 68 were virally suppressed, with no statistically significant difference between the CM and SOC arms (viral suppression 42% and 53%, respectively; adjusted odds ratio = 0.62 [P = 0.15; 95% confidence interval: 0.32, 1.2]). CONCLUSIONS Reaching targets of at least 90% sustained viral suppression among all people with HIV will likely require more than an individual-level CM approach that addresses barriers to optimal care and treatment at multiple levels.
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Affiliation(s)
- Robert H. REMIEN
- Reprints: Robert H. Remien, PhD, HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality and Health, NY State Psychiatric Institute and Columbia University, Department of Psychiatry, Columbia University, Vagelos College of Physicians and Surgeons,
| | - Jagadīśa-devaśrī DĀCUS
- Correspondence: Jagadīśa-devaśrī Dācus, PhD, The Institute for Sexual and Gender Minority Health and Wellbeing at Northwestern Feinberg School of Medicine, 625 N. Michigan Avenue, Room 14-055, Chicago, IL 60611,
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Cortopassi AC, Kalichman SC. Objectification and racial homophily among black men who have sex with men logged onto Grindr. COMPUTERS IN HUMAN BEHAVIOR 2023. [DOI: 10.1016/j.chb.2023.107679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Wang G, Song W, Rao S, Heitgerd J, Mulatu MS, Karch D, Belcher L. HIV Positivity, Linkage to Medical Care, Interview for Partner Services, and Pre-Exposure Prophylaxis Awareness and Referral Among Men Who Have Sex With Men Tested in Non-healthcare Settings in the United States, 2019. J Acquir Immune Defic Syndr 2023; 92:34-41. [PMID: 36166309 PMCID: PMC10959101 DOI: 10.1097/qai.0000000000003106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/23/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV. This study reports data on HIV testing program outcomes among MSM tested for HIV in non-healthcare settings in the United States. METHODS We analyzed Centers for Disease Control and Prevention's National HIV Prevention Program Monitoring and Evaluation data collected in 2019. Descriptive and multivariate robust Poisson regression analyses were conducted to summarize the patterns of HIV testing program outcomes [ie, positivity, linkage to HIV medical care within 30 days of diagnosis, interview for partner services (PS), and pre-exposure prophylaxis (PrEP) awareness and referral] by demographic characteristics, HIV prevalence, and testing site type. RESULTS A total of 123,251 HIV tests were conducted among MSM; of these, 1773 (1.4%) were newly diagnosed with HIV. Among MSM newly diagnosed with HIV, 75% were linked to HIV medical care and 80% were interviewed for PS. Among MSM who tested HIV-negative, 63% were aware of PrEP and 47% of those who were eligible for PrEP were referred to PrEP providers. Referral or linkage to services varied by demographic characteristics or other factors. CONCLUSIONS Linkage to HIV medical care and interview for PS among MSM newly diagnosed with HIV in non-healthcare settings were below national or funding program targets. Most MSM with risk factors for HIV infection were not referred to PrEP providers. Expanded efforts to address barriers to equitable access to services may help improve HIV-related outcomes among MSM and contribute to ending the HIV epidemic in the United States.
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Affiliation(s)
- Guoshen Wang
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Wei Song
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Shubha Rao
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Janet Heitgerd
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mesfin S. Mulatu
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Debra Karch
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lisa Belcher
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Shangani S, van den Berg JJ, Dyer TV, Mayer KH, Operario D. Childhood sexual abuse, alcohol and drug use problems among Black sexual minority men in six US Cities: Findings from the HPTN 061 study. PLoS One 2022; 17:e0279238. [PMID: 36548261 PMCID: PMC9778556 DOI: 10.1371/journal.pone.0279238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 12/03/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Prior research has found a high prevalence of childhood sexual abuse (CSA) among sexual minority men (SMM) in the US, and has indicated that CSA is associated with higher rates of alcohol and drug use disorders. However, most of these studies have focused almost exclusively on White SMM. We assessed associations of CSA, alcohol use, and drug use problems among adult Black SMM. METHODS Participants were 1,016 Black SMM recruited from six US cities (Atlanta, Boston, Los Angeles, New York City, San Francisco, and Washington, DC) between July 2009 and December 2011. We used hierarchical logistic regression to evaluate the associations between CSA, alcohol use problems (≥ 8 AUDIT), and drug use problems (excluding marijuana). RESULTS Mean (SD) age was 37.8 (11.7) years, and 28.6% and 49.2% reported alcohol and drug use disorders in the past six months, respectively. Most of the study participants reported history of CSA (70.3%). Adjusting for sociodemographic and confounding variables, CSA was associated with higher odds of alcohol use problems (odds ratio (OR) = 1.52, 95% CI 1.09, 2.12) and drug use problems (OR = 1.58, 95% CI 1.19, 2.10) than non-CSA group. CONCLUSION Prevalence of CSA is high among BSMM in the US and is positively associated with alcohol and drug use problems. Substance use interventions should address the psychological health needs of BSMM with a history of CSA.
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Affiliation(s)
- Sylvia Shangani
- Department of Community Health Sciences, School of Public Health, Boston University, Boston, MA, United States of America
| | - Jacob J. van den Berg
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, Massachusetts, United States of America
- Department of Behavioral, Social and Health Education, and Social Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Typhanye V. Dyer
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland, United States of America
| | - Kenneth H. Mayer
- The Fenway Institute of Fenway Health, Boston, Massachusetts, United States of America
- Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts, United States of America
| | - Don Operario
- Department of Behavioral, Social and Health Education, and Social Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
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Hirshfield S, Birnbaum JM, Turner D, Roberson M, Bailey MM, Smith MDR, Nelson LE. An Innovative Adaptation of an HIV Status-Neutral, Community-Informed, Socioemotional Asset-Building Intervention With the House Ball Community. Health Promot Pract 2022; 24:398-400. [PMID: 36524579 DOI: 10.1177/15248399221140794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Black men who have sex with men (MSM) have the highest incidence of new HIV diagnoses compared to other populations and face multiple stigmas. Some have found refuge in the House Ball Community (HBC)—a national network of Black lesbian, gay, bisexual, and transgender (LGBT) kinship commitments (families) that affirm gender expression(s) and sexualities and provide skills-building for its members. Internal and external socioemotional assets influence the health of young Black sexual and gender minorities; building these assets in the HBC is critical to facilitating engagement in health-promoting behaviors. To address this critical gap in HIV prevention, we describe an adaptation of 3MV, a best-evidence, group-level retreat-based risk reduction intervention developed for HIV-negative Black MSM. Clinicians, researchers, HBC members/leaders, and community experts collaborated to adapt 3MV for the HBC. Our Family, Our Voices (OFOV) is an HIV status-neutral, risk-reduction intervention that focuses on asset-building for young, gender-diverse Black HBC members, with the HBC family unit as the focus of the intervention. We describe the collaborative adaptation process and the development of HBC-relevant intervention topics. This novel adaptation and collaborative community model provides a framework for researchers and clinicians to follow when adapting evidence-based interventions for priority populations.
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Affiliation(s)
| | | | | | - Michael Roberson
- The New School University–Eugene Lang College, New York, NY, USA
- Union Theological Seminary, New York, NY, USA
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Selvarajah S, Corona Maioli S, Deivanayagam TA, de Morais Sato P, Devakumar D, Kim SS, Wells JC, Yoseph M, Abubakar I, Paradies Y. Racism, xenophobia, and discrimination: mapping pathways to health outcomes. Lancet 2022; 400:2109-2124. [PMID: 36502849 DOI: 10.1016/s0140-6736(22)02484-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 10/06/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022]
Abstract
Despite being globally pervasive, racism, xenophobia, and discrimination are not universally recognised determinants of health. We challenge widespread beliefs related to the inevitability of increased mortality and morbidity associated with particular ethnicities and minoritised groups. In refuting that racial categories have a genetic basis and acknowledging that socioeconomic factors offer incomplete explanations in understanding these health disparities, we examine the pathways by which discrimination based on caste, ethnicity, Indigeneity, migratory status, race, religion, and skin colour affect health. Discrimination based on these categories, although having many unique historical and cultural contexts, operates in the same way, with overlapping pathways and health effects. We synthesise how such discrimination affects health systems, spatial determination, and communities, and how these processes manifest at the individual level, across the life course, and intergenerationally. We explore how individuals respond to and internalise these complex mechanisms psychologically, behaviourally, and physiologically. The evidence shows that racism, xenophobia, and discrimination affect a range of health outcomes across all ages around the world, and remain embedded within the universal challenges we face, from COVID-19 to the climate emergency.
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Affiliation(s)
- Sujitha Selvarajah
- Institute for Global Health, University College London, London, UK; St George's Hospital NHS Foundation Trust, London, UK.
| | | | - Thilagawathi Abi Deivanayagam
- Institute for Global Health, University College London, London, UK; Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | | | - Delan Devakumar
- Institute for Global Health, University College London, London, UK
| | - Seung-Sup Kim
- Department of Environmental Health Sciences, Seoul National University, Seoul, South Korea
| | - Jonathan C Wells
- University College London Great Ormond Street Institute of Child Health, London, UK
| | - Marcella Yoseph
- Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK; Sir Ketumile Masire Teaching Hospital, University of Botswana, Gaborone, Botswana
| | - Ibrahim Abubakar
- Institute for Global Health, University College London, London, UK
| | - Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Melbourne VIC, Australia
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Fujimoto K, Nyitray AG, Kuo J, Zhao J, Hwang LY, Chiao E, Giuliano AR, Schneider JA, Khanna A. Social networks, high-risk anal HPV and coinfection with HIV in young sexual minority men. Sex Transm Infect 2022; 98:557-563. [PMID: 35184046 PMCID: PMC9388701 DOI: 10.1136/sextrans-2021-055283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 01/03/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Young sexual minority men (SMM) exhibit a high prevalence and incidence of high-risk genotypes of human papillomavirus (hrHPV) anal infections and a confluence of a high prevalence of HIV and rectal STIs. Social determinants of health (SDOHs) are linked to social network contexts that generate and maintain racial disparities in HIV and STIs. A network perspective was provided to advance our knowledge of drivers of genotype-specific hrHPV infection and coinfection with HIV. The study also examined whether socially connected men are infected with the same high-risk HPV genotypes and, if so, whether this tendency is conditioned on coinfection with HIV. METHODS Our sample included 136 young SMM of predominantly black race and their network members of other races and ethnicities, aged 18-29 years, who resided in Houston, Texas, USA. These participants were recruited during 2014-2016 at the baseline recruitment period by network-based peer referral, where anal exfoliated cells and named social and sexual partners were collected. Exponential random graph models were estimated to assess similarity in genotype-specific hrHPV anal infection in social connections and coinfection with HIV in consideration of the effects of similarity in sociodemographic, sexual behavioural characteristics, SDOHs and syphilis infection. RESULTS Pairs of men socially connected to each other tend to be infected with the same hrHPV genotypes of HPV-16, HPV-45 and HPV-51 or HPV-16 and/or HPV-18. The tendency of social connections between pairs of men who were infected with either HPV-16 or HPV-18 were conditioned on HIV infection. CONCLUSIONS Networked patterns of hrHPV infection could be amenable to network-based HPV prevention interventions that engage young SMM of predominantly racial minority groups who are out of HIV care and vulnerable to high-risk HPV acquisition.
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Affiliation(s)
- Kayo Fujimoto
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Alan G Nyitray
- Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jacky Kuo
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Jing Zhao
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Lu-Yu Hwang
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Elizabeth Chiao
- Department of Epidemiology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer (CIIRC), Moffitt Cancer Center, Tampa, Florida, USA
| | - John A Schneider
- Department of Medicine and Health Studies, University of Chicago, Chicago, Illinois, USA
| | - Aditya Khanna
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, Rhode Island, USA
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41
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Nelson LE, Boyd DT, Beauchamp G, Emel L, Wilton L, Whitfield D, Ramos SR, Ajiboye W, Hill MJ, Conserve DF, Thomas P, Hightow-Weidman L, Shoptaw S, Magnus M, Mayer KH, Piwowar-Manning E, Fields SD, Wheeler DP. Freedom as Prevention: Mechanisms of Autonomy Support for Promoting HIV Pre-Exposure Prophylaxis Use and Condom Use among Black MSM in 3 US Cities-HPTN 073. J Urban Health 2022; 99:1157-1169. [PMID: 35939181 PMCID: PMC9727017 DOI: 10.1007/s11524-022-00666-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 02/04/2023]
Abstract
Healthcare providers who use controlling or coercive strategies may compel short-term enactment of HIV and sexually transmitted infection prevention behaviors but may inadvertently undermine their client's motivation to maintain those behaviors in the absence of external pressure. Autonomous motivation refers to the self-emanating and self-determined drive for engaging in health behaviors. It is associated with long-term maintenance of health behaviors. We used structural equation modeling to investigate whether autonomy support was associated with increased odds of therapeutic serum levels of pre-exposure prophylaxis, through a pathway that satisfies basic psychological needs for autonomous self-regulation and competence regarding pre-exposure prophylaxis use. We also investigated whether autonomy support was associated with decreased odds of condomless anal intercourse via the same psychological needs-satisfaction pathway of autonomous self-regulation and competence regarding condom use. We tested these two theorized pathways using secondary data from a longitudinal sample of Black men who have sex with men from across three cities in the US (N = 226). Data from the sample fit the theorized models regarding the pathways by which autonomy support leads to the presence of therapeutic PrEP levels in serum (χ2 = 0.56; RMSEA = 0.04; CFI = .99, TLI = 0.98) and how it also leads to decreased odds of condomless anal intercourse (χ2 = 0.58; RMSEA = 0.03; CFI = 0.99; TLI = 0.98). These findings provide scientific evidence for the utility of self-determination theory as a model to guide intervention approaches to optimize the implementation and impact of PrEP for Black men who have sex with men.
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Affiliation(s)
- LaRon E Nelson
- School of Nursing, Yale University, 400 West Campus Drive, New Haven, CT, USA.
- Center for Interdisciplinary Research On AIDS, School of Public Health, Yale University, New Haven, CT, USA.
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
| | - Donte T Boyd
- Center for Interdisciplinary Research On AIDS, School of Public Health, Yale University, New Haven, CT, USA
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Geetha Beauchamp
- Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Lynda Emel
- Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Leo Wilton
- Department of Human Development, College of Community and Public Affairs, State University of New York at Binghamton, Binghamton, NY, USA
- Department of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - Darren Whitfield
- School of Social Work, University of Maryland Baltimore, Baltimore, MD, USA
| | - S Raquel Ramos
- School of Nursing, Yale University, 400 West Campus Drive, New Haven, CT, USA
- Center for Interdisciplinary Research On AIDS, School of Public Health, Yale University, New Haven, CT, USA
| | - Wale Ajiboye
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Mandy J Hill
- Department of Emergency Medicine, McGovern Medical School, University of Texas Health, Houston, TX, USA
| | - Donaldson F Conserve
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington Universty, Washington, DC, USA
| | - Portia Thomas
- Center for Interdisciplinary Research On AIDS, School of Public Health, Yale University, New Haven, CT, USA
- Department of Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Lisa Hightow-Weidman
- Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Steve Shoptaw
- Division of Family Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Manya Magnus
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | | | - Sheldon D Fields
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
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42
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Wirtz AL, Burns PA, Poteat T, Malik M, White JJ, Brooks D, Kasaie P, Beyrer C. Abuse in the Continua: HIV Prevention and Care Outcomes and Syndemic Conditions Associated with Intimate Partner Violence Among Black Gay and Bisexual Men in the Southern United States. AIDS Behav 2022; 26:3761-3774. [PMID: 35661018 PMCID: PMC9561062 DOI: 10.1007/s10461-022-03705-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 02/04/2023]
Abstract
Intimate partner violence (IPV) has been implicated in HIV acquisition and worse HIV outcomes. Limited research focuses on the experiences of Black gay and bisexual men. Using data from cross-sectional surveys in Baltimore, Maryland, and Jackson, Mississippi, we analyzed the association between IPV victimization and HIV-related outcomes among 629 adult Black gay and bisexual men, among whom 53% self-reported a negative result at last HIV test. 40% of participants reported lifetime physical, sexual, and/or psychological IPV victimization, and 24% past-year victimization. Recent and lifetime IPV were associated with recent clinical diagnosis of STI (adjPrR: 1.44; 95%CI: 1.08-1.92) and ART medication interruptions (adjPrR: 1.59; 95%CI: 1.25-2.01), respectively. Physical IPV was inversely associated with current PrEP use (adjPrR: 0.35; 95%CI: 0.13-0.90). Recent IPV was independently correlated with depression symptomatology (adjPrR: 2.36; 95%CI: 1.61-3.47) and hazardous alcohol use (adjPrR: 1.93; 95%CI: 1.42-2.61), with evidence of interactions. IPV-HIV relationships were intersected by internalized stigma, housing instability, poverty, and lack of insurance. Tailored IPV services are urgently needed for comprehensive HIV services for Black gay and bisexual men in the U.S.
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Affiliation(s)
- Andrea L. Wirtz
- Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins School of Public Health, Baltimore, MD,Corresponding Author
| | - Paul A. Burns
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS
| | - Tonia Poteat
- Center for Health Equity Research, University of North Carolina Chapel Hill, Chapel Hill, NC
| | - Mannat Malik
- Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina, Chapel Hill, NC
| | - Jordan J. White
- School of Social Work, Morgan State University, Baltimore, MD
| | | | - Parastu Kasaie
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
| | - Chris Beyrer
- Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins School of Public Health, Baltimore, MD
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43
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Yu Y, Ling RHY, Ip TKM, Luo S, Lau JTF. Factors of COVID-19 Vaccination among Hong Kong Chinese Men Who Have Sex with Men during Months 5–8 since the Vaccine Rollout—General Factors and Factors Specific to This Population. Vaccines (Basel) 2022; 10:vaccines10101763. [PMID: 36298627 PMCID: PMC9609851 DOI: 10.3390/vaccines10101763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
This study investigated an under-researched topic regarding the prevalence of COVID-19 vaccination behavior among Chinese men who have sex with men (MSM) and the associations of this with general and MSM-specific perceptions grounded in the health belief model (HBM) and the theory of planned behaviors (TPB). A total of 400 Chinese MSM were recruited from multiple sources (site recruitment, online recruitment, and peer referral) in Hong Kong from July to October 2021, who then participated in a structured telephone interview. Of all the participants, the prevalence of COVID-19 vaccination (i.e., taking at least one dose of COVID-19 vaccination) was 78.3%. Multivariable logistic regression analyses showed that, after adjusting for background factors, (1) the general and MSM-specific HBM variables of perceived benefits and self-efficacy were positively associated with COVID-19 vaccination behavior; (2) the items or scale of general/MSM-specific perceived barriers and social norms were negatively associated with COVID-19 vaccination behavior; (3) the general perceived severity and MSM-specific perceived susceptibility, perceived severity, and cue to action were not significantly associated with COVID-19 vaccination behavior. The findings suggest that the HBM and social norm construct of the TPB only partially explained the participant’s COVID-19 vaccination behavior. Health promotion may need to focus more on modifying perceptions related to COVID-19 vaccination rather than COVID-19.
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Affiliation(s)
- Yanqiu Yu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China
- Key Laboratory of Public Health Safety, Fudan University, Shanghai 200032, China
| | - Rachel Hau Yin Ling
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Tsun Kwan Mary Ip
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sitong Luo
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Joseph T. F. Lau
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, China
- School of Mental Health, Wenzhou Medical University, Wenzhou 325000, China
- School of Public Health, Zhejiang University, Hangzhou 310058, China
- Correspondence:
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44
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LeGrand SH, Davis DA, Parnell HE, Trefney EJ, Goings B, Morgan T. Integrating HIV and Mental Health Services for Black Gay, Bisexual, and Other Men Who Have Sex with Men Living with HIV: Findings from the STYLE 2.0 Intervention. AIDS Patient Care STDS 2022; 36:S74-S85. [PMID: 36178383 PMCID: PMC9529312 DOI: 10.1089/apc.2022.0141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Black gay, bisexual, and other men who have sex with men (BMSM) in the US South are disproportionately impacted by HIV. We adapted Project Strength Through Youth Livin' Empowered (STYLE) to create STYLE 2.0 to assist young BMSM link and remain engaged in HIV care. The multi-component intervention included (1) health care navigators to facilitate linkage and engagement activities, (2) motivational interviewing by a behavioral health provider, and (3) a mobile app to reduce stigma and social isolation. We enrolled 66 BMSM from North and South Carolina in the 12-month intervention and analyzed longitudinal data to assess service utilization, dose, and delivery characteristics while also examining changes in HIV care continuum outcomes. We examined associations between intervention characteristics and HIV care continuum outcomes using logistic regression. We found that all HIV outcomes improved from baseline to 12-month follow-up, including receipt of HIV care (78.8-84.9%), retention in HIV care (75.9-87.7%), being prescribed antiretroviral therapy (ART) (96.8-98.5%), and achieving viral suppression (82.3-90.8%), although none were statistically significant. In multi-variable analyses, participants with more encounters categorized as food bank were more likely to report being prescribed ART [odds ratio (OR): 41.65; 95% confidence interval (CI): 2.72-637.74]. Clients with more referral to care encounters were less likely to have been prescribed ART (OR: 0.02; 95% CI: <0.001-0.42) and be virally suppressed (OR: 0.39; 95% CI: 0.18-0.84). Findings suggest that an integrated approach to HIV and behavioral health services may help BMSM living with HIV overcome structural and social barriers to HIV care.
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Affiliation(s)
- Sara H. LeGrand
- Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Dirk A. Davis
- Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Heather E. Parnell
- Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Elizabeth J. Trefney
- Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Brian Goings
- Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Ta'Jalik Morgan
- Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, North Carolina, USA
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45
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Barak N, Boyle C. Lessons from +LOVE, Improving HIV Care for Black Men Who Have Sex with Men in New Orleans Using an Integrated Behavioral Health Crisis Support Model of Care. AIDS Patient Care STDS 2022; 36:S65-S73. [PMID: 36178382 DOI: 10.1089/apc.2022.0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Black men who have sex with men (BMSM) experience higher rates of HIV infection than other groups. They also face disparities in linkage and retention to HIV care, as well as in viral suppression. To address the needs of the BMSM population living with HIV, we developed a novel intervention program (+LOVE), which integrated case management with behavioral health/crisis support. The intervention consisted of (1) a dedicated therapist; (2) an SMS (text message)-based engagement program, CareSignal that provided medication reminders and administered routine ecological momentary assessments (EMAs); (3) a triage crisis coordinator to respond to alerts generated by the EMA responses; and (4) a case manager. This study assessed the additional impact of the first three components of the intervention (a dedicated therapist, text messaging application, along with a triage crisis coordinator), compared with the fourth component alone, the current standard of care (a case manager) on access to HIV care, antiretroviral therapy (ART) adherence, and viral suppression. Analyzing electronic medical record data, survey data, and EMA response data extracted from CareSignal, we found that those who engaged in the behavioral health therapy had higher odds of remaining in HIV care than those who only engaged with the case manager. We also found that increased engagement with CareSignal led to an increased probability of achieving positive HIV-related health outcomes. Our results suggest that an integrated behavioral health/crisis support model of intervention integrated with case managementincreased positive outcomes over case management alone.
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Affiliation(s)
- Narquis Barak
- Department of Prevention, CrescentCare, New Orleans, Louisiana, USA
| | - Caitlin Boyle
- Department of Prevention, CrescentCare, New Orleans, Louisiana, USA
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46
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Kisler KA, Fletcher JB, Reback CJ. Peer Case Management Promoting Advancement Along the HIV Care Continuum Among Black Men Who Have Sex with Men Living with HIV: Building Brothers Up. AIDS Patient Care STDS 2022; 36:S46-S53. [PMID: 36178380 PMCID: PMC9529306 DOI: 10.1089/apc.2022.0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Black men who have sex with men (BMSM) in the United States are at elevated risk for HIV relative to their heterosexual and/or non-BMSM counterparts, yet on average demonstrate suboptimal HIV care linkage and rates of HIV primary care retention. From October 2019 to December 2020, 69 adult (i.e., aged 18-65) BMSM enrolled in Building Brothers Up (2BU), a 6-session peer case management intervention delivered across 3 months and designed to improve retention in HIV primary care through to full viral suppression. Peer case management sessions included detailed assessment of participants' needs and barriers to treatment, which led to the development of a participant-centered treatment plan. All participants self-identified as Black, about three-quarters self-identified as gay (72.5%), and 46.4% reported an annual income of $5000 or less. A total of 69 participants enrolled in 2BU; however, multiply imputed chained equation logistic regressions were carried out on the final analytical data set (n = 40; 99 imputations) due to a large amount of COVID-19-related missing data. Although analyses of retention and achievement of viral suppression did not reach full significance, the probability of a Type-II hypothesis testing error was high, and viral load results (adjusted odds ratio = 1.56; 95% confidence interval = 0.94-2.60; p = 0.08) suggested that increased attendance to peer case management sessions may be associated with improved odds of achieving full viral suppression among BMSM. The significant impact of national race-related civil unrest and the COVID-19 pandemic on the target population during implementation of 2BU is underscored.
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Affiliation(s)
- Kimberly A. Kisler
- Friends Research Institute, Inc., Los Angeles, California, USA.,Department of Public Health, Rongxiang Xu College of Health & Human Services, California State University, Los Angeles, Los Angeles, California, USA.,Address correspondence to: Kimberly A. Kisler, PhD, MPH, Department of Public Health, Rongxiang Xu College of Health & Human Services, California State University, Los Angeles, 5151 State University Drive, Los Angeles, CA 90032, USA
| | | | - Cathy J. Reback
- Friends Research Institute, Inc., Los Angeles, California, USA.,Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA.,Center for HIV Identification, Prevention and Treatment Services, Department of Family Medicine, University of California, Los Angeles, Los Angeles, California, USA
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47
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Daniels I, Anthony T, Peavie J, Miesfeld N, Pyatt T, Robinson D, Jones C. Black Men Who Have Sex with Men with HIV and Providers in HIV Care Settings Reflect on Stigma Reducing Strategies to Promote Engagement in Health Care. AIDS Patient Care STDS 2022; 36:S28-S35. [PMID: 36178381 DOI: 10.1089/apc.2022.0102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Black men who have sex with men (BMSM) with HIV face significant challenges in accessing health care, including routine HIV care and behavioral health care due in part to perceived stigma in health care settings. This study examined the perspectives of BMSM with HIV and health care providers of how stigma experiences can affect health care access to both clinical and behavioral health support services. We explored how providers can mitigate stigma practices and improve health care experiences for BMSM with HIV, which may ultimately improve engagement in care. Working with eight sites as part of the BMSM Initiative, we recruited 20 BMSM with HIV and 13 health care providers to participate in individual virtual interviews. Participants were asked about perceived discrimination and stigma experienced by BMSM with HIV and strategies to reduce stigma experiences. Participants discussed how current practices could be improved to reduce stigma and how the use of telehealth promoted engagement in care. Recommended strategies to reduce stigma in HIV care delivery included offering personable communication, providing nonclinical resources along with standard HIV care, requiring staff diversity training, diversifying health care teams, and offering telehealth options. Employing stigma reduction strategies can create a safe and comfortable environment for BMSM with HIV to engage in behavioral care in HIV care settings. Providers should seek to incorporate these strategies into current and future models of care with the goal to improve overall health outcomes in BMSM with HIV.
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Affiliation(s)
- Imari Daniels
- Department of Public Health, NORC at the University of Chicago, Bethesda, Maryland, USA
| | - Tamia Anthony
- Department of Public Health, NORC at the University of Chicago, Bethesda, Maryland, USA
| | - Jonovan Peavie
- Department of Public Health, NORC at the University of Chicago, Bethesda, Maryland, USA
| | - Noelle Miesfeld
- Department of Public Health, NORC at the University of Chicago, Bethesda, Maryland, USA
| | - Tabitha Pyatt
- Department of Public Health, NORC at the University of Chicago, Bethesda, Maryland, USA
| | - Deja Robinson
- Department of Public Health, NORC at the University of Chicago, Bethesda, Maryland, USA
| | - Chandria Jones
- Department of Public Health, NORC at the University of Chicago, Bethesda, Maryland, USA
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48
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Azucar D, Hidalgo MA, Wright D, Slay L, Kipke MD. Development of an HIV Prevention Intervention for African American Young Men Who Have Sex With Men (Y2Prevent): Study Protocol. JMIR Res Protoc 2022; 11:e36718. [PMID: 36173675 PMCID: PMC9562086 DOI: 10.2196/36718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 07/01/2022] [Accepted: 08/09/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND African American young men who have sex with men (YMSM) possess many intersecting identities that may increase their vulnerability to social stigmatization and discrimination, which yields a negative influence on their well-being and behaviors. These experiences often manifest as increased general and sexual risk-taking behaviors that place this particular group at an increased risk for HIV. This scenario is exacerbated by the lack of HIV prevention interventions specifically designed for African American YMSM. OBJECTIVE In this paper, we discuss the development of research designed to refine, pilot, and evaluate the feasibility, acceptability, and preliminary efficacy of a behavioral intervention designed to build resilience and reduce substance use and HIV risk behaviors among African American YMSM. The overarching aim of this research, funded by the National Institutes of Health, is to further refine and pilot test an intervention called Young Men's Adult Identity Monitoring (YM-AIM). YM-AIM is a theory-driven, group-level intervention designed to help African American YMSM develop a healthy vision for their future (or possible future self) by defining a set of short-term and long-term goals in the areas of education, health, family, and intimate relationships. METHODS Through partnerships with community members and community-based organizations, we will further strengthen and refine YM-AIM to include 3 new components: biomedical HIV prevention strategies (pre-exposure prophylaxis and postexposure prophylaxis); HIV and sexually transmitted infection (STI) testing and HIV care referral, drug screening, and drug treatment referral; and a youth mentoring component. We will recruit African American YMSM, aged 18 to 24 years, into 2 working groups; each group will consist of 6 to 8 members and will convene on a weekly basis, and each meeting will focus on one specific YM-AIM topic. This feedback will be used to further refine the intervention, which will then be evaluated for its feasibility and acceptability. Intervention outcomes include drug use in the past 30 days and 3 months, alcohol use, condomless sex, number of sex partners, and increasing condom use intention, condom use self-efficacy, HIV and STI testing recency and frequency, and linkage to care. RESULTS As of June 2022, we completed phase 1 of Y2Prevent and launched phase 2 of Y2Prevent to begin recruitment for working group participants. Phase 3 of Y2Prevent is anticipated to be launched in September and is expected to be completed by the end of this project period in December 2022. CONCLUSIONS Few youth-focused interventions have sought to help youth identify and develop the skills needed to navigate the social and structural factors that contribute to individual-level engagement in prevention among sexual minority youth. This research seeks to promote young men's adoption and maintenance of HIV-protective behaviors (eg, safer sex, pre-exposure prophylaxis use, HIV and STI testing, and health care use). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/36718.
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Affiliation(s)
- Danny Azucar
- Division of Research on Children, Youth, and Families, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Marco A Hidalgo
- Division of General Internal Medicine and Health Services Research, Department of Medicine, Medicine-Pediatrics Section, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Deja Wright
- Division of Research on Children, Youth, and Families, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Lindsay Slay
- Division of Research on Children, Youth, and Families, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Michele D Kipke
- Division of Research on Children, Youth, and Families, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, United States
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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49
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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. JOURNAL OF INTERPERSONAL 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] [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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50
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Arnold T, Stopka TJ, Gomillia CE, Murphy M, Johnson K, Chan PA, Klasko-Foster L, Rogers B, Soler JH, Monger ML, Jacque E, Coats CS, Willie TC, Ogunbajo A, Mena L, Nunn A. Locating the Risk: Using Participatory Mapping to Contextualize Perceived HIV Risk across Geography and Social Networks among Men Who Have Sex with Men in the Deep South. JOURNAL OF SEX RESEARCH 2022; 59:931-938. [PMID: 33826434 PMCID: PMC8522442 DOI: 10.1080/00224499.2021.1906397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
HIV incidence among African American (AA) young men who have sex with men (YMSM) has remained stable even though they made up the largest number of new HIV diagnoses among men who have sex with men (MSM) in 2017. HIV spreads at increased rates in dense sexual networks. Identifying the location of risk behaviors "activity spaces" could inform geographically circumscribed HIV prevention interventions. Utilizing the modified social ecological model we completed five semi-structured focus groups incorporating a modified social mapping technique, based on Singer et al.'s approach. Participants included 27 AA YMSM. Focus groups explored how and where HIV transmission happens in Jackson, Mississippi. Result themes included: 1) location of sexual behaviors, 2) knowledge of geographic hotspots of HIV infection in Jackson, and 3) traveling to meet partners: at home and away. HIV transmission or "activity spaces" may be occurring outside identified HIV hot spots. Mixed geospatial and qualitative methods offered a comprehensive assessment of where HIV transmission occurs, and suggests that geographically circumscribed interventions may need to focus on where individuals living with HIV reside and in specific geographic locations where they engage in behaviors that raise their HIV acquisition risks.
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Affiliation(s)
- Trisha Arnold
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Thomas J. Stopka
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, United States (U.S.)
| | - Courtney E.S. Gomillia
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
- School of Science and Mathematics, Mississippi College, Clinton, MS
| | - Matthew Murphy
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | | | - Philip A. Chan
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
- The Miriam Hospital, Providence, Rhode Island
| | - Lynne Klasko-Foster
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
- School of Public Health, Brown University, Providence, Rhode Island
| | - Brooke Rogers
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
- The Miriam Hospital, Providence, Rhode Island
| | | | - Mauda L. Monger
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Erin Jacque
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, United States (U.S.)
| | - Cassandra Sutten Coats
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
- The Miriam Hospital, Providence, Rhode Island
- School of Public Health, Brown University, Providence, Rhode Island
| | | | - Adedotun Ogunbajo
- Harvard University T H Chan School of Public Health, Department of Epidemiology
| | - Leandro Mena
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Amy Nunn
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
- The Miriam Hospital, Providence, Rhode Island
- School of Public Health, Brown University, Providence, Rhode Island
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