Predicting HIV testing in low threshold community contexts among young African American women living in the Southern United States

Innovation and implementation determinants of HIV testing and linkage-to-care in the U.S.: a systematic review

OBJECTIVE

To identify innovation and implementation determinants of HIV testing, diagnosis, and linkage-to-care in the U.S.

DATA SOURCES AND STUDY SETTING

Between November 2020 and January 2022, a broad search strategy was employed in three literature databases: Ovid MEDLINE, PsycINFO, and Web of Science.

STUDY DESIGN

A systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement.

DATA COLLECTION/EXTRACTION METHODS

A team of master's and Ph.D.-level researchers screened eligible studies against the inclusion criteria and extracted the data using COVIDENCE software in pairs with consensus performed by a senior member of the team. Barriers and facilitators were extracted and analyzed according to the Consolidated Framework for Implementation Research (CFIR). Frequency of determinants across studies was mapped according to CFIR, valence, study design, delivery setting, unit of analysis, population of interest, region of the U.S., and year.

RESULTS

We identified 1,739 implementation and innovation determinants from 186 articles. Most determinants were for HIV testing rather than linkage-to-care. Most determinants were identified in the inner setting and individuals domains of CFIR, with the fewest identified in the process and innovations domains. Determinants of providers were only slightly more frequently identified than determinants of recipients. However, determinants of organizations and systems were rarely identified.

CONCLUSION

This review provides a synthesis of innovation and implementation determinants of HIV testing and linkage-to-care using the most-cited implementation science (IS) framework, CFIR. This synthesis enables the larger field of HIV science to utilize IS in efforts to end the HIV epidemic and positions IS to consider the application of IS frameworks to fields like HIV.

Time Horizons, Drug Use, and Risky Sex in Young Women from Poor Urban Areas

Aims

Emerging adulthood is marked by elevated risk-taking, and young people living in disadvantaged urban areas experience disproportionately more negative outcomes. Using a sample of young African American women living in such communities, this cross-sectional observational study investigated the hypothesis that greater substance use and sexual risk-taking would be associated with present-dominated time perspectives and higher delay discounting.

Methodology

Young women (N = 223, M age = 20.4 years) from disadvantaged urban areas were recruited using Respondent Driven Sampling, a peer-driven recruitment method. Structured field interviews assessed substance use, sexual practices, and risk/protective factors, including time perspectives (Zimbardo Time Perspective Inventory [ZTPI]) and behavioral impulsivity (delay discounting task).

Results

Regression models showed that present hedonism time perspectives were related to sexual risk-taking and substance involvement, whereas discounting was associated only with sexual risk-taking (ps < .05). Future time perspectives were not associated with either risk behavior.

Conclusions

Risk behaviors among young African American women living in disadvantaged urban areas appear to be related to hedonistic rewards available in the present without considering future outcomes. Future research should investigate experimentally if lengthening time perspectives and enriching views of possible futures may aid risk reduction in this population.

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

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.

Utility of digital Respondent Driven Sampling to recruit community-dwelling emerging adults for assessment of drinking and related risks

INTRODUCTION

Emerging adulthood often entails heightened risk-taking, including risky drinking, and research is needed to guide intervention development and delivery. This study adapted Respondent Driven Sampling, a peer-driven recruitment method, to a digital platform (d-RDS) and evaluated its utility to recruit community-dwelling emerging adult (EA) risky drinkers, who are under-served and more difficult to reach for assessment and intervention than their college student peers.

MATERIALS AND METHODS

Community-dwelling EA risky drinkers (N = 357) were recruited using d-RDS (M age = 23.6 years, 64.0% women). Peers recruited peers in an iterative fashion. Participants completed a web-based cross-sectional survey of drinking practices and problems and associated risk and protective factors.

RESULTS

d-RDS successfully recruited EA risky drinkers. On average, the sample reported recent drinking exceeding low-risk drinking guidelines and 8.80 negative consequences in the past three months. Compared to age-matched respondents from the representative U.S. National Survey on Drug Use and Health, the sample reported more past month drinking days and more drinks consumed per drinking day (ps < 0.001). At higher consumption levels, predicted positive associations were found with lower education and receipt of public assistance.

CONCLUSIONS

Results supported the utility of d-RDS as a sampling method and grassroots platform for research and intervention with community-dwelling EA drinkers who are harder to reach than traditional college students. The study provides a method and lays an empirical foundation for extending efficacious alcohol brief interventions with college drinkers to this underserved population.