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Zapata JP, Queiroz A, Rodriguez-Diaz CE, Mustanski B. Factors Associated with HIV Testing Among Spanish and English-Speaking Latino Adolescents Aged 13-18. AIDS Behav 2024; 28:343-356. [PMID: 37848599 DOI: 10.1007/s10461-023-04206-w] [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] [Accepted: 09/28/2023] [Indexed: 10/19/2023]
Abstract
Adolescent Latino men who have sex with men (LMSM) in the U.S. are disproportionately impacted by HIV. However, there has been limited focus on their HIV prevention and risk behaviors. In this study, we examine the rates of HIV testing and explore the significant demographic and healthcare factors that influence HIV prevention among adolescent LMSM. The analysis for this study utilized data collected during the baseline assessment of SMART, a pragmatic trial aimed at evaluating the effectiveness of an online HIV prevention intervention for adolescent LMSM (N = 524). Only 35.5% of participants had ever had an HIV test in their lifetime. Rates of testing increased among adolescent LMSM who had a doctor with whom they spoke about their sexual health (odds ratio: 4.0; 95% confidence interval: 2.1-8.4; P < 0.001) or HIV testing (odds ratio: 5.8; 95% confidence interval: 3.1-10.7; P < 0.001). Out of the 61 participants who took part in the survey conducted in Spanish, only 26% reported ever having an HIV test. Additionally, 24.5% stated that they had discussed their sexual orientation with a doctor, and only 8.2% had undergone HIV testing. Spanish-speaking adolescents who completed the SMART survey were less likely to openly discuss their sexual orientation or sexual health with most people or have a doctor with whom they discussed these topics, compared to those who completed the survey in English. These findings suggest that Spanish-speaking adolescent LMSM may face obstacles in accessing HIV prevention services in the U.S.
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Affiliation(s)
- Juan Pablo Zapata
- Department of Medical Social Science and the Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Chicago, IL, USA
| | - Artur Queiroz
- Department of Medical Social Science and the Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Chicago, IL, USA
| | - Carlos E Rodriguez-Diaz
- School of Public Health, Boston University, 801 Massachusetts Ave. Suite 431, Boston, MA, USA
| | - Brian Mustanski
- Department of Medical Social Science and the Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Chicago, IL, USA.
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2
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Mayo D, Lozano A, Williams RS, Safren SA, Harkness A. The Relationship Between Intersectional Oppression and Affirmation and Latino Sexual Minority Men's Mental Health. LGBT Health 2023; 10:629-638. [PMID: 37466482 PMCID: PMC10712364 DOI: 10.1089/lgbt.2022.0212] [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: 07/20/2023] Open
Abstract
Purpose: Latino sexual minority men (LSMM) may experience oppression based on their ethnicity, sexual orientation, and migratory status, yet scientific literature is only beginning to explore the intersection of these experiences. This study examined mental health (MH) in relation to LSMM's experiences of intersectional oppression and affirmation. Methods: We conducted a secondary analysis of baseline data from a cohort study examining LSMM's (n = 290) health care engagement in Miami, FL, from February to September 2020. Latent class analysis (LCA) identified classes based on self-reported multiple identity discrimination (e.g., race, ethnicity, and skin color), sexual orientation stigma/affirmation, and migration-related stress. Logistic and linear regressions examined associations between class membership and anxious, depressive, post-traumatic stress, somatic symptoms, and overall MH burden. Results: The LCA revealed a three-class solution: (1) affirmed LSMM (73.8%), (2) LSMM with intersectional oppression (21.7%), and (3) LSMM with immigration stress (4.5%). The three classes varied in terms of multiple identity discrimination, sexual orientation stigma/affirmation, and migration-related stress. Compared with Class 1, Class 2 had greater conditional probabilities of reporting clinically significant depressive (p = 0.033) and post-traumatic stress symptoms (p = 0.031), and at least one MH concern (p = 0.018). Greater depressive symptoms (p = 0.007), post-traumatic stress symptoms (p = 0.049), somatic symptoms (p = 0.024), and clinically significant MH concerns (p = 0.018) were found among Class 2 than among Class 1. Conclusion: Findings identified three groups of LSMM based on their experiences of intersectional oppression and affirmation. Discrimination at the intersection of multiple identities, sexual orientation stigma/affirmation, and migration-related stress were associated with LSMM's MH outcomes, particularly among immigrants.
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Affiliation(s)
- Daniel Mayo
- College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Alyssa Lozano
- Department of Public Health Sciences and University of Miami, Miami, Florida, USA
| | | | - Steven A. Safren
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Audrey Harkness
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
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3
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Gonzalez-Guarda RM, McCabe BE, Nagy GA, Stafford AM, Matos L, Lu M, Felsman I, Rocha-Goldberg P, Cervantes RC. Acculturative Stress, Resilience, and a Syndemic Factor Among Latinx Immigrants. Nurs Res 2023; 72:249-258. [PMID: 37350696 PMCID: PMC10299814 DOI: 10.1097/nnr.0000000000000655] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
BACKGROUND The process of immigration and subsequent adaptation can expose Latinx immigrants to chronic and compounding challenges (i.e., acculturative stress), but little is known about how resilience factors and these stressors interact to influence syndemic conditions, intertwined epidemics that disproportionally affect historically marginalized communities. OBJECTIVES The purpose of this study was to describe the influence of acculturative stress and resilience on the syndemic factor underlying substance abuse, intimate partner violence, HIV risk, and mental conditions. METHODS Baseline cross-sectional data from a community-engaged, longitudinal study of 391 adult (ages 18-44 years) Latinx immigrants in North Carolina were obtained using standardized measures available in English and Spanish. Structural equation modeling tested the syndemic model, and random forest variable importance identified the most influential types of acculturative stressors and resilience factors, including their interactions, on the syndemic factor. RESULTS Results indicated that a single syndemic factor explained variations in heavy drinking, drug use, intimate partner violence, depression, and anxiety and fit the data well. Age, being a woman, acculturative stress, acculturation to the United States, and emotional support were significantly related to the syndemic factor. The relationship between acculturative stress and the syndemic factor was buffered by ethnic pride, coping, enculturation, social support, and individual resilience. The most influential acculturative stressors were marital, family, and occupation/economic stress. DISCUSSION Findings from this study underscore the importance of considering the co-occurrence of behavioral and mental health conditions among Latinx immigrants. Health promotion programs for Latinx immigrants should address acculturative stress and bolster ethnic pride, social support, and coping as sources of resilience.
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Affiliation(s)
| | - Brian E. McCabe
- Auburn University, Dept of Special Education, Rehabilitation, and Counseling, Auburn, AL
| | - Gabriela A. Nagy
- Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, Durham, NC
| | | | | | - Min Lu
- University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL
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4
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Robles G, Bosco SC, Cardenas I, Hostetter J, Starks TJ. Psychosocial and Culturally-Specific Factors Related to Intimate Partner Violence Victimization among a Sample of Latino Sexual Minority Cis Men in the U.S. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP22501-NP22527. [PMID: 35166599 PMCID: PMC9376202 DOI: 10.1177/08862605211072167] [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] [Indexed: 06/14/2023]
Abstract
A growing body of research illustrates that sexual minority men (SMM) experience elevated rates of intimate partner violence (IPV) compared to heterosexual individuals. Researchers have examined the relationship between minority stress and IPV victimization among sexual minority men. A majority of the IPV research identifying risk factors associated with IPV victimization among SMM have sampled predominately non-Hispanic White SMM, while Latino SMM are consistently under-represented in IPV research. This study examines the associations between (1) co-occurring psychosocial factors (e.g., depression, anxiety, childhood sexual abuse, drug use, and problematic drinking) and (2) Latino-specific minority stress factors (e.g., U.S.-born, language, race/ethnic identities, and discrimination) on IPV victimization in a nationwide sample of Latino SMM. Data were collected from Latino SMM aged 18 or older, identified as cis-male, and in a romantic relationship with a cis-male partner (N = 530). The participants were recruited through social media and geo-location-based dating mobile applications. A majority (72%) of the sample reported IPV victimization in their lifetime. Specific to forms of IPV, more than half (51.9%) of the sample reported monitoring behaviors, while 49.6% reported emotional IPV, 45.1% reported physical IPV, 31.5% reported controlling behaviors, and 22.3% reported HIV-related IPV. In multivariable models, psychosocial and Latino-specific factors were associated with the increased likelihood of IPV victimization. Regarding Latino-specific factors, being born in the U.S. and race-based discrimination predicted IPV victimization. These findings highlight the extent to which minority stress elevates the risk of IPV for Latino SMM and point to the need to address social factors in IPV prevention services. Further, work on SMM IPV victimization tends to focus on the potential role of sexual orientation-related discrimination, whereas the current study points to the importance of race-based discrimination.
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Affiliation(s)
- Gabriel Robles
- School of Social Work, Rutgers University, New Brunswick, NJ
| | - Stephen C. Bosco
- Doctoral Program in Health Psychology and Clinical Science, the Graduate Center of the City University of New York, New York, NY
- Department of Psychology, Hunter College of the City University of New York, New York, NY
| | - Iris Cardenas
- School of Social Work, Rutgers University, New Brunswick, NJ
| | | | - Tyrel J. Starks
- Department of Psychology, Hunter College of the City University of New York, New York, NY
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5
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Gonzalez-Guarda RM, Felsman IC, Solorzano RM. Promoting Health Equity in the Latinx Community, Locally and Globally. Nurs Clin North Am 2022; 57:393-411. [PMID: 35985727 PMCID: PMC10153429 DOI: 10.1016/j.cnur.2022.04.006] [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] [Indexed: 11/15/2022]
Abstract
It is imperative that nurses are equipped to promote the health and well-being of diverse populations in United States, including the growing Latinx community, which experiences significant health disparities. This article summarizes the values, programs, and impact of the Duke University School of Nursing Latinx Engagement Health Equity Model. Collaborative partnerships with diverse community partners addressing Latinx populations across the life span were developed, spanning the education, research, and service missions of the university. Programs were rooted in cultural values and were delivered through diverse interprofessional teams and with support from the university. Programs included local and global immersion programs, volunteer work, courses in Medical Spanish, community engaged research projects, and leadership in coalitions. These models have resulted in favorable outcomes for learners, faculty and staff, and the Latinx community more broadly and can serve as a model for strategies to promote health equity at schools of nursing.
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Affiliation(s)
- Rosa M Gonzalez-Guarda
- Duke University School of Nursing, 307 Trent Drive, Durham, NC 27710, USA; Duke Clinical Translational Science Institute, 200 Morris Street, 3rd Floor, Durham, NC 27701, USA.
| | - Irene C Felsman
- Duke University School of Nursing, 307 Trent Drive, Durham, NC 27710, USA; Duke Global Health Institute, 310 Trent Drive, Durham, NC 27710, USA
| | - Rosa M Solorzano
- Duke University School of Nursing, 307 Trent Drive, Durham, NC 27710, USA; Duke University Romance Studies SLP, 413 Chapel Drive, Durham, NC 27708, USA
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6
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Abstract
In this article, we address the nature of syndemics and whether, as some have asserted, these epidemiological phenomena are global configurations. Our argument that syndemics are not global rests on recognition that they are composed of social/environment contexts, disease clusters, demographics, and biologies that vary across locations. These points are illustrated with the cases of syndemics involving COVID-19, diabetes mellitus, and HIV/AIDS. We draw on theoretical discourse from epidemiology, biology, and anthropology to present what we believe is a more accurate framework for thinking about syndemics with shared elements.
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Affiliation(s)
- Merrill Singer
- Department of Anthropology, University of Connecticut, Storrs, Connecticut, USA
| | - Nicola Bulled
- InCHIP, University of Connecticut, Storrs, Connecticut, USA
| | - Thomas Leatherman
- Department of Anthropology, University of Massachusetts, Amherst, Massachusetts, USA
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7
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Gonzalez-Guarda RM, Stafford AM, Nagy GA, Befus DR, Conklin JL. A Systematic Review of Physical Health Consequences and Acculturation Stress Among Latinx Individuals in the United States. Biol Res Nurs 2021; 23:362-374. [PMID: 33138635 PMCID: PMC8755947 DOI: 10.1177/1099800420968889] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The health of Latinx immigrants decays over time and across generations. Acculturation stress influences decays in behavioral and mental health in this population, but the effect on physical health outcomes is less understood. This systematic review synthesizes findings from 22 studies that examined the influence of acculturation stress on physical health outcomes among Latinx populations in the United States. The Society-to-Cell Resilience Framework was used to synthesize findings according to individual, physiological, and cellular levels. There is mounting evidence identifying acculturation stress as an important social contributor to negative physical health outcomes, especially at the individual level. More research is needed to identify the physiological and cellular mechanisms involved. Interventions are also needed to address the damaging effects of acculturation stress on a variety of physical health conditions in this population.
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Affiliation(s)
| | | | - Gabriela A. Nagy
- Duke Department of Psychiatry and Behavioral Science, Duke University School of Medicine, Durham, NC, USA
| | - Deanna R. Befus
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | - Jamie L. Conklin
- Health Sciences Library, The University of North Carolina at Chapel Hill, NC, USA
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8
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McCabe BE, Gonzalez-Guarda R, de Tantillo L, Mitrani VB. A Mental Health-Physical Health-Violence (MPV) Syndemic Factor in Women with Mental Disorders. STIGMA AND HEALTH 2019; 4:383-390. [PMID: 33094162 PMCID: PMC7575040 DOI: 10.1037/sah0000152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study extended research on syndemics for women with mental disorders by including self-reported mental and physical health conditions. Syndemics explain complex relationships among co-occurring conditions, and the social circumstances that influence their overlap. Data were from the baseline assessment of a randomized trial of Healthy Home, a nursing home-visit intervention for women with children. 172 adult women who were in mental health or substance use treatment completed measures (in Spanish or English) of anxiety, depression, violence during adulthood, physical health, and cigarette use. Structural Equation Modeling was used to evaluate a single-factor syndemic, and to test the relationships of theoretical predictors of the syndemic: income, number of children, women's abuse during childhood, mental health stigma, social support, and stress. Results supported a single factor syndemic model that explained variation in mental health, physical health, and violence during adulthood. Stress, β = .45, p < .001, and stigma, β = .22, p = .007, were related to the syndemic factor. There was evidence that self-reported mental and physical health share covariation, which suggested that integrated services for women with mental disorders may have synergistic effects on health. Findings suggest the need to develop and test interventions that address stress and stigma as a means of reducing health disparities for women with mental disorders.
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Affiliation(s)
- Brian E McCabe
- School of Nursing and Health Studies, University of Miami
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9
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Petruzzella A, Feinstein BA, Davila J, Lavner JA. Moderators of the Association Between Community Connectedness and Internalizing Symptoms Among Gay Men. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1519-1528. [PMID: 31123947 DOI: 10.1007/s10508-018-1355-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 11/16/2018] [Accepted: 11/19/2018] [Indexed: 06/09/2023]
Abstract
Sexual minorities are exposed to various gay-related and general stressors that increase risk of mental and physical health problems. Yet, less attention has been paid to positive factors such as ameliorative coping strategies and social supports that reduce risk of mental health difficulties in this population. The current study sought to address this gap by examining the association between gay community connectedness and internalizing symptoms (i.e., general psychological distress, anxiety, and depression) in a sample of 147 self-identified gay men living in the greater New York City area, as well as the conditions under which gay community connectedness is associated with better mental health. Data were collected between 2013 and 2014. Findings indicated that gay community connectedness was associated with lower levels of internalizing symptoms among gay men, consistent with minority stress theory and other work examining the benefits of community coping resources. This association was strongest for non-White gay men, those whose gay identity was more central to their overall identity, and those with higher levels of femininity. These findings underscore the need to consider multiple aspects of gay men's identity (e.g., race/ethnicity, centrality, femininity) in order to fully understand the factors associated with mental health outcomes in this population.
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Affiliation(s)
- Antonio Petruzzella
- Department of Psychology, University of Georgia, 125 Baldwin Street, Psychology Building, Athens, GA, 30602, USA.
| | - Brian A Feinstein
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Joanne Davila
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Justin A Lavner
- Department of Psychology, University of Georgia, 125 Baldwin Street, Psychology Building, Athens, GA, 30602, USA
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10
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Maclin-Akinyemi C, Thurston IB, Howell KH, Jamison LE, Anderson MB. The protective roles of ethnic identity and community cohesion on substance use among Black women experiencing adversity. J Ethn Subst Abuse 2019; 20:225-240. [PMID: 31185850 DOI: 10.1080/15332640.2019.1622477] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study employs a strengths-based approach to explore associations of ethnic identity and community cohesion with substance use among Black women experiencing adversity. Black women (N = 107; Mage = 34.2, SD = 7.7) completed interviews about their sociodemographics, HIV status, intimate partner violence exposure, ethnic identity, community connectedness, and substance use. Hierarchical linear regression analysis was used to examine associations of ethnic identity and community cohesion with substance use, accounting for age and socioeconomic status. The overall model was significant, with greater ethnic identity (β = -.25, p < .01) and more community cohesion (β = -.29, p < .01) associated with lower substance use. Findings highlight the value of contextual factors in substance use prevention among Black women.
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Affiliation(s)
| | - Idia B Thurston
- Department of Psychology, The University of Memphis, Memphis, Tennessee.,Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Kathryn H Howell
- Department of Psychology, The University of Memphis, Memphis, Tennessee
| | - Lacy E Jamison
- Department of Psychology, The University of Memphis, Memphis, Tennessee
| | - Mollie B Anderson
- Department of Psychology, The University of Memphis, Memphis, Tennessee
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11
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Collazos F, Markle SL, Chavez L, Brugal MT, Aroca P, Wang Y, Hussain I, Alegría M. HIV Testing in Clinical and Community Settings for an International Sample of Latino Immigrants and Nonimmigrants. ACTA ACUST UNITED AC 2019; 7:59-75. [PMID: 30859017 DOI: 10.1037/lat0000101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Latino/as in the U.S. and Spain make up a disproportionate percentage of cases of HIV infection, and often are diagnosed later than their non-Latino/a counterparts. Understanding the factors that affect HIV testing in different contexts is critical to best promote HIV testing, which is considered essential to both prevention and early treatment. This study explored differences in HIV testing rates among Latino/a participants in an international study designed to examine behavioral health screening for Latino/a populations. We collected data on testing rates and results from 407 Latino/as - both first generation immigrants and those of Latino/a descent - in the U.S. (Boston) and Spain (Madrid and Barcelona), through interviews conducted in community clinics and agencies. Using multivariate logit models, we evaluated predictors of screening and positive testing, adjusting for sex, age, and clinic type. HIV testing rates were highest in Boston, followed by Barcelona and Madrid (82%, 69%, and 59%, respectively, p < .0001). In multivariate regression models, Barcelona and Madrid patients were significantly less likely to have received testing than Boston patients. Significant positive predictors of HIV testing were: education level higher than high school, HIV concerns, infrequent condom use, other risk behaviors, reports of discrimination, and higher benzodiazepine consumption. Significant differences in HIV testing found in this study help to illuminate best practices for engaging patients in testing across sites.
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Affiliation(s)
- Francisco Collazos
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM.,Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona
| | - Sheri Lapatin Markle
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School
| | | | | | | | - Ye Wang
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School
| | - Isra Hussain
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School
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12
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Milburn NG, Hamilton AB, Lopez S, Wyatt GE. Mentoring the next generation of behavioral health scientists to promote health equity. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2019; 89:369-377. [PMID: 31070422 PMCID: PMC7577403 DOI: 10.1037/ort0000415] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Health inequities and disparities among various racial/ethnic minority, sexual minority, and rural populations are the focus of increasing national efforts. Three health problems disproportionately affecting these populations-HIV/AIDS, substance abuse, and trauma-deserve particular attention because of their harmful effects on health across the life span. To address these problems, our training program, the UCLA HIV/AIDS, Substance Abuse, and Trauma Training Program (HA-STTP), mentors and trains early career behavioral health scientists to conduct research using scientifically sound, culturally collaborative, and population-centered approaches. HA-STTP has been highly successful in training a diverse, productive, nationwide group of scholars. The program provides 2 years of training and mentorship to 20 (5 per year over 4 years) scholars. It is unique in its attention to traumatic stress as a form of dysregulation, particularly as experienced by underserved populations. Furthermore, our training program embraces a uniquely comprehensive, culturally grounded understanding of traumatic stress and its implications for substance abuse and HIV. HA-STTP advances scholars' knowledge of the interconnections among substance abuse, HIV/AIDS, traumatic stress, and health disparities, particularly in underrepresented populations; provides intensive mentorship to support scholars' research interests and career trajectories; capitalizes on a multidisciplinary, multiracial/ethnic network of expert faculty; and evaluates the program's impact on scholars' knowledge and productivity. By fostering the growth of scholars committed to conducting research with underrepresented populations that are disproportionately affected by HIV/AIDS, substance abuse, and traumatic stress, this program enhances nationwide efforts to diminish the prevalence of these problems and improve health and quality of life. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Norweeta G Milburn
- Department of Psychiatry and Biobehavioral Sciences, Division of Population Behavioral Health, Semel Institute for Neuroscience & Human Behavior, University of California
| | - Alison B Hamilton
- Department of Psychiatry and Biobhavioral Sciences, University of California, Los Angeles
| | - Susana Lopez
- Department of Psychiatry and Biobehavioral Sciences, Division of Population Behavioral Health, University of California
| | - Gail E Wyatt
- Department of Psychiatry and Biobhavioral Sciences, University of California, Los Angeles
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13
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Social Support, Loneliness, Depressive Symptoms, and High-Risk Sexual Behaviors of Middle-Aged Hispanic Men Who Have Sex With Men. J Assoc Nurses AIDS Care 2019; 30:98-110. [DOI: 10.1097/jnc.0000000000000002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Hall J, Hutson SP, West F. Anticipating Needs at End of Life in Narratives Related by People Living With HIV/AIDS in Appalachia. Am J Hosp Palliat Care 2018; 35:985-992. [PMID: 29378424 DOI: 10.1177/1049909118754879] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
As part of a mixed methods study determining end-of-life and advanced care planning needs in southern Appalachia, a narrative analysis was done of stories told in interviews of 8 selected participants using transcript data. Narratives were fraught with contradiction and paradox. Tensions were evident about living in Appalachia, the Bible Belt, and an area wherein distances are long and community rejection can occur as news travels quickly. The primary finding was that stigma, from several sources, and shrinking circles of social support for people living with HIV/AIDS, all of whom were in treatment, combined to create a sense of solitariness. Narratives were fraught with tensions, contradictions, and paradoxes. Living in Appalachia, the Bible Belt, and an area wherein distances are long and community rejection can occur as news travels quickly. The rejection-based religiously based stigma was often predicated on stereotypes about sexual behavior and illicit drug use. Diagnosis was a key turning point after which many spiraled downward financially and socially. Implications for research and advanced care planning are included.
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Affiliation(s)
- Joanne Hall
- 1 College of Nursing, The University of Tennessee, Knoxville, TN, USA
| | - Sadie P Hutson
- 1 College of Nursing, The University of Tennessee, Knoxville, TN, USA
| | - Frankie West
- 2 Department of Anthropology, The University of Tennessee, Knoxville, TN, USA
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