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Pagkas-Bather J, Motley DN, Schneider JA. Health equity for Black sexually minoritised men through status-neutral HIV care. Lancet HIV 2024:S2352-3018(24)00032-8. [PMID: 38430923 DOI: 10.1016/s2352-3018(24)00032-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/25/2024] [Accepted: 02/01/2024] [Indexed: 03/05/2024]
Abstract
Current strategies (both biomedical and barrier methods) for HIV elimination in the USA do not best serve those who are most affected by HIV. Improving healthc are for individuals most affected by HIV requires restructuring of care delivery to improve their HIV outcomes. The transformation of clinical care delivery is crucial to address the needs of one of the most affected populations along the HIV care continuum: Black sexually minoritised men (BSMM). Status-neutral HIV care delivery systems might address social determinants of health of BSMM who are stigmatised and disenfranchised within the context of American society. Addressing the needs of BSMM will bring us closer to health-care equity, which benefits us all.
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Affiliation(s)
- Jade Pagkas-Bather
- Section of Infectious Diseases & Global Health, Department of Medicine, University of Chicago, Chicago, IL, USA; Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA.
| | - Darnell N Motley
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
| | - John A Schneider
- Section of Infectious Diseases & Global Health, Department of Medicine, University of Chicago, Chicago, IL, USA; Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA; Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
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Ferreira RT, Gonçalves JS, de Oliveira JL, Dos Santos MVDR, Baldassarini CR, de Souza J. Role of sociodemographic factors and self-efficacy in the perception of social support of nursing students. Rev Esc Enferm USP 2021; 55:e20210209. [PMID: 34605537 DOI: 10.1590/1980-220x-reeusp-2021-0209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/26/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the role of sociodemographic factors and self-efficacy in the perception of social support by nursing students of the first years of nursing school. METHOD This is a quantitative cross-sectional research, developed with 121 undergraduate students from the early years of the course. A sociodemographic questionnaire, the Higher Education Self-Efficacy Scale and the abbreviated version of the Social Support Questionnaire were used. Spearman and Mann-Whitney correlation tests were performed using software for statistical analysis. RESULTS It was identified that students with better self-efficacy and who are self-declared black or brown reported, respectively, greater satisfaction with the support and a smaller number of supporters. CONCLUSION Considering that the race/color factor had a negative influence and self-efficacy a positive influence in the perception of social support, it is recommended that mental health promotion strategies be conducted that permeate both affirmative action policies and improvements in the teaching-learning process, especially in the first years of the nursing course.
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Affiliation(s)
- Rafaela Teodoro Ferreira
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Enfermagem Psiquiátrica, Ribeirão Preto, SP, Brazil
| | | | - Jaqueline Lemos de Oliveira
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Enfermagem Psiquiátrica, Ribeirão Preto, SP, Brazil
| | | | - Caíque Rossi Baldassarini
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Enfermagem Psiquiátrica, Ribeirão Preto, SP, Brazil
| | - Jacqueline de Souza
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Enfermagem Psiquiátrica, Ribeirão Preto, SP, Brazil
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Quinn KG, Spector A, Takahashi L, Voisin DR. Conceptualizing the Effects of Continuous Traumatic Violence on HIV Continuum of Care Outcomes for Young Black Men Who Have Sex with Men in the United States. AIDS Behav 2021; 25:758-772. [PMID: 32944841 PMCID: PMC7886964 DOI: 10.1007/s10461-020-03040-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 01/06/2023]
Abstract
The United States (US) is on track to achieve the 90-90-90 targets set forth by UNAIDS and the National HIV/AIDS strategy, yet significant racial disparities in HIV care outcomes remain, particularly for young Black men who have sex with men (YBMSM). Research has demonstrated that various types of violence are key aspects of syndemics that contribute to disparities in HIV risk. However, little research has looked collectively at cumulative violent experiences and how those might affect HIV treatment and care outcomes. Drawing on extant literature and theoretical underpinnings of syndemics, we provide a conceptual model that highlights how continuous traumatic violence experienced by YBMSM may affect HIV outcomes and contribute to racial disparities in HIV outcomes. The findings of this focused review suggest a need for research on how continuous exposure to various types of violence influence HIV prevention and treatment outcomes for young Black MSM.
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Affiliation(s)
- Katherine G Quinn
- Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, 2071 N. Summit Ave., Milwaukee, WI, 53202, USA.
| | - Antoinette Spector
- Medical College of Wisconsin, Institute for Health Equity, Milwaukee, USA
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Subramanian A, Mohan A, Nandi PK, Rajeshwari K. Perceived social support, depression and their impact on quality of life of people living with HIV in India. AIDS Care 2020; 33:1329-1334. [PMID: 32851860 DOI: 10.1080/09540121.2020.1810620] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Universal access to Antiretroviral Treatment (ART) has transformed HIV/AIDS into a chronic disease and issues like social support and Quality of life (QOL) have emerged as important components of care. Perceived social support influences QOL in People Living with HIV (PLHIV), though this has not been studied well in India. PLHIV were assessed for Social Support using the Multidimensional Scale of Perceived Social Support (MSPSS) and QOL was assessed with the Medical Outcomes Study HIV Health Survey (MOS-HIV) questionnaire. The factors impacting social support and its effect of on QOL were analysed. Amongst the 109 study subjects, 62 (56.9%) were men, 47 (43.1%) were women, mean age was 35 ± 7.5 years, 85.3% had WHO stage 1 disease and 80 (73.4%) were receiving ART. Only 43.1% subjects perceived high overall social support. Social support (from family/friends/others) was associated positively with physical functioning (p = 0.001), social and cognitive functioning (p = 0.000) and significantly inversely associated with depression (p = 0.002). Higher perceived social support was seen to correlate with higher CD4 count (Peak, Nadir and Current; p < 0.05) and better adherence (p = 0.003). It is concluded that social support, including support from beyond family, have a significant impact on clinical endpoints and QOL in PLHIV.
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Affiliation(s)
- Anuradha Subramanian
- ART Center, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | - Ayush Mohan
- ART Center, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | - Pijush Kanti Nandi
- ART Center, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | - Krishnan Rajeshwari
- ART Center, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
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Brown MJ, Serovich JM, Laschober TC, Kimberly JA, Lescano CM. Mediating Effects of Depressive Symptoms on Perceived Social Support and HIV Disclosure: Assessing Moderation by Sex. AIDS Behav 2019; 23:636-648. [PMID: 30539497 DOI: 10.1007/s10461-018-2369-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
People living with HIV may decide to disclose their HIV-positive status after considering the benefits and costs. Studies have shown associations between perceived social support, depressive symptoms and HIV disclosure among men and women; however, research assessing the mediating pathway among these variables and the associated disparities by sex are lacking. Therefore, the aims of this study were to determine the association between perceived social support from family and friends and HIV disclosure to sexual partners; assess the mediating effects of depressive symptoms; and examine the disparities by sex. Participants included 147 men and 115 women living with HIV who took part in a disclosure intervention study. Mediation analyses were conducted to determine the direct and indirect associations between perceived social support from family and friends, depressive symptoms, and disclosure behavior. Depressive symptoms mediated the association between perceived social support (from family: β = 0.103, p = 0.019; and from friends: β = 0.111, p = 0.009) and HIV disclosure to sexual partners, specifically among women. However, these pathways were not statistically significant among men. Women living with HIV may benefit from two types of interventions: (1) Disclosure to sexual partners interventions, which aim to accentuate perceived social support from family and friends through attenuating depressive symptoms; and (2) Social support interventions, which may increase disclosure to sexual partners via reducing depressive symptoms.
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Ford JD, Charak R, Modrowski CA, Kerig PK. PTSD and dissociation symptoms as mediators of the relationship between polyvictimization and psychosocial and behavioral problems among justice-involved adolescents. J Trauma Dissociation 2018; 19:325-346. [PMID: 29547076 DOI: 10.1080/15299732.2018.1441354] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Polyvictimization (PV) has been shown to be associated with psychosocial and behavioral impairment in community and high risk populations, including youth involved in juvenile justice. However, the mechanisms accounting for these adverse outcomes have not been empirically delineated. Symptoms of posttraumatic stress disorder (PTSD) and dissociation are documented sequelae of PV and are associated with a wide range of behavioral/emotional problems. This study used a cross-sectional research design and bootstrapped multiple mediation analyses with self-report measures completed by a large sample of justice-involved youth (N = 809, ages 12-19 years old, 27% female, 46.5% youth of color) to test the hypothesis that PTSD and dissociation symptoms mediate the relationship between PV and problems with anger, depression/anxiety, alcohol/drug use, and somatic complaints after controlling for the effects of exposure to violence and adversities related to juvenile justice involvement. As hypothesized, PTSD symptoms mediated the relationship of PV with all outcomes except alcohol/drug use problems (which had an unmediated direct association with PV). Partially supporting study hypotheses, dissociation symptoms mediated the relationship between PV and internalizing problems (i.e., depression anxiety; suicide ideation). Implications are discussed for prospective research demarcating the mechanisms linking PV and adverse outcomes in juvenile justice and other high risk populations.
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Affiliation(s)
- Julian D Ford
- a Department of Psychiatry , University of Connecticut Health Center , Farmington , CT , USA
| | - Ruby Charak
- b Department of Psychological Science , University of Texas Rio Grande Valley , Edinburg , TX , USA
| | - Crosby A Modrowski
- c Department of Psychology , University of Utah , Salt Lake City , UT , USA
| | - Patricia K Kerig
- c Department of Psychology , University of Utah , Salt Lake City , UT , USA
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