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Sucaldito AD, Tanner AE, Mann-Jackson L, Alonzo J, Garcia M, Chaffin JW, Faller R, McGuire T, Jibriel M, Mertus S, Kline DM, Russell L, Stafford J, Aviles LR, Weil PH, Wilkin AM, Rhodes SD. Exploring Individual and Contextual Factors Associated With Sexual Risk and Substance Use Among Underserved GBQMSM and Transgender and Nonbinary Persons in South Central Appalachia. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2023; 35:495-506. [PMID: 38096454 PMCID: PMC11075819 DOI: 10.1521/aeap.2023.35.6.495] [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: 12/18/2023]
Abstract
Gay, bisexual, queer, and other men who have sex with men (GBQMSM) and transgender and nonbinary persons are at elevated risk for HIV, sexually transmitted infections (STIs), and hepatitis C (HCV); in Appalachia, these communities experience more disease burden. However, little is known about the factors influencing risk. Sixteen semistructured in-depth interviews were conducted examining factors influencing prevention and care. Data were analyzed using constant comparison methodology. Fifteen themes emerged within four domains: social environment (e.g., microaggressions across gender, sexual orientation, and racial identities), substance use (e.g., high prevalence, use as coping mechanism), sexual health (e.g., misinformation and denial of risk for HIV and STIs), and access to health care (e.g., cost and transportation barriers, lack of local respectful care). Findings highlighted salient barriers and assets influencing prevention and care and suggest that multilevel interventions are needed to improve access to and use of HIV, STI, and HCV prevention and care services.
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Affiliation(s)
- Ana D Sucaldito
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Amanda E Tanner
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Manuel Garcia
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - John W Chaffin
- Western North Carolina AIDS Project, Asheville, North Carolina
| | - Rachel Faller
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina
| | - Tucker McGuire
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina
| | - Mohammed Jibriel
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina
| | - Sulianie Mertus
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina
| | - David M Kline
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Laurie Russell
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Jeanette Stafford
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Lucero Refugio Aviles
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Peggy H Weil
- Western North Carolina AIDS Project, Asheville, North Carolina
| | - Aimee M Wilkin
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Scott D Rhodes
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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Lee JJ, Robles G, Leyva Vera CA, Orellana ER, Graham SM, Nguyen AM, Wei Y, Sanchez AH, Dombrowski JC, Simoni JM. A Peer-Based Intervention to Increase HIV and Sexually Transmitted Infection Testing Among Latinx Immigrant Sexual Minority Men in the US Pacific Northwest: Pilot Randomized Controlled Trial Conducted During the COVID-19 Pandemic. JMIR Form Res 2023; 7:e45871. [PMID: 37436792 PMCID: PMC10372765 DOI: 10.2196/45871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/25/2023] [Accepted: 06/06/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Hispanic and Latinx gay, bisexual, and other sexual minority men (SMM) are disproportionately affected by HIV in the United States. With the availability of self-testing services, HIV and sexually transmitted infection (STI) testing may be more accessible for Latinx immigrant SMM who face obstacles to obtaining HIV-related services. Combining the potential of self-testing kits and the influence of peer educators may present an opportunity to increase HIV and STI testing and preexposure prophylaxis (PrEP) uptake or linkage to HIV care among Latinx immigrant SMM. OBJECTIVE This study aimed to develop and pilot a peer intervention to distribute HIV and STI self-testing kits and provide peer counseling based on the information-motivation-behavioral skills model to increase PrEP uptake and HIV and STI testing among Latinx immigrant SMM. Our evaluation focused on determining the differences in HIV testing, STI testing, and PrEP uptake outcomes between the intervention and control groups. METHODS We conducted semistructured interviews with community stakeholders to elicit factors to consider for training and intervention. The interview findings informed the development of the intervention and peer training protocols. We piloted the intervention with Latinx immigrant SMM and randomly assigned participants to the intervention group, who received peer counseling and HIV and STI self-testing kits, or the control group, who only received peer counseling. We administered baseline, 1-week, 6-week, and 12-week follow-up surveys to assess behaviors related to HIV testing, STI testing, and PrEP uptake. Owing to the COVID-19 pandemic, the intervention components were delivered via web-based modalities. Chi-square tests were performed to examine the associations between HIV testing, STI testing, and PrEP motivation and behaviors across the study arms (intervention vs control). We conducted Cramer V test to determine the strength of the association between study arm and each of the outcome variables. We also assessed the impact of the COVID-19 pandemic on participants. RESULTS Overall, 50 (intervention, n=30 and control, n=20) Latinx immigrant SMM participated in the program. Participants reported life disruptions owing to COVID-19, with 68% (34/50) reporting job loss after the declaration of the pandemic. After intervention participation, a higher proportion of participants in the intervention group reported having been tested for STIs (76% vs 36.8%; P=.01; Cramer V=0.394). Among the participants in the intervention group, 91% (21/23) reported being motivated to use PrEP compared with 59% (10/17) in the control group (P=.02; Cramer V=0.385). CONCLUSIONS By facilitating access to HIV and STI testing through peer-delivered information, motivational support, and behavioral skills training as well as the provision of self-testing kits, our intervention demonstrated the potential to increase HIV prevention behaviors in Latinx immigrant SMM. Peer-based programs that offer self-testing and internet-based modes of accessing information may be a feasible strategy for reaching Latinx immigrant SMM. TRIAL REGISTRATION ClinicalTrials.gov NCT03922126; https://clinicaltrials.gov/ct2/show/NCT03922126.
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Affiliation(s)
- Jane J Lee
- School of Social Work, University of Washington, Seattle, WA, United States
| | - Gabriel Robles
- School of Social Work, Rutgers University, New Brunswick, NJ, United States
| | - Christopher A Leyva Vera
- School of Social Work, University of Washington, Seattle, WA, United States
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - E Roberto Orellana
- School of Social Work, University of Washington, Seattle, WA, United States
| | - Susan M Graham
- Department of Global Health, University of Washington, Seattle, WA, United States
- Department of Medicine, University of Washington, Seattle, WA, United States
| | - Anh-Minh Nguyen
- Department of Biostatistics, University of Washington, Seattle, WA, United States
| | - Yingying Wei
- Department of Biostatistics, University of Washington, Seattle, WA, United States
| | | | - Julia C Dombrowski
- Department of Medicine, University of Washington, Seattle, WA, United States
- HIV/STD Program, Public Health - Seattle & King County, Seattle, WA, United States
| | - Jane M Simoni
- Department of Global Health, University of Washington, Seattle, WA, United States
- Department of Psychology, University of Washington, Seattle, WA, United States
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Robles Arvizu JA, Mann‐Jackson L, Alonzo J, Garcia M, Refugio Aviles L, Smart BD, Rhodes SD. Experiences of peer navigators implementing a bilingual multilevel intervention to address sexually transmitted infection and HIV disparities and social determinants of health. Health Expect 2023; 26:728-739. [PMID: 36598033 PMCID: PMC10010095 DOI: 10.1111/hex.13698] [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: 08/14/2022] [Revised: 11/20/2022] [Accepted: 12/20/2022] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) disproportionately affect young gay, bisexual and other men who have sex with men (GBMSM) and transgender women of colour. We explored the experiences of community-based peer navigators ('Community Navigators') who participated in Impact Triad, a bilingual multilevel intervention developed by our community-based participatory research partnership to reduce STIs and HIV and address social determinants of health (e.g., employment, education, social support and discrimination) among young GBMSM and transgender women of colour. METHODS Individual in-depth interviews were conducted with 15 Community Navigators who participated in Impact Triad. Themes were identified through constant comparison. RESULTS Community Navigators' mean age was 31.4 years. Seven were self-identified as African American/Black, 5 as Latine, 2 as multiracial/multiethnic, 1 as Asian American, 10 as cisgender men, 4 as transgender women and 1 as gender nonbinary. Thirteen themes emerged in three domains: (1) key aspects of the Community Navigator role (e.g., desire to serve as a community resource, the importance of being part of the communities in which one was working, the value of having an official role, being connected to other Community Navigators to problem-solving and sustaining intervention aspects long-term); (2) experiences implementing Impact Triad (e.g., engaging community members, meeting prioritized needs, building trust, using social media, increasing awareness and knowledge and challenges related to COVID-19) and (3) lessons learned for future interventions (e.g., facilitating access to broader resources, building additional skills and increasing interactions among Community Navigators). CONCLUSION Interviews identified important learnings about serving as Community Navigators and implementing Impact Triad that can guide future efforts to address STI/HIV disparities and social determinants of health through community-based peer navigation. PATIENT OR PUBLIC CONTRIBUTION Throughout this intervention trial, our partnership worked collaboratively with a study-specific community advisory board (CAB) comprised primarily of young GBMSM and transgender women of colour. Members of this CAB participated in all aspects of the trial including trial design, intervention development, recruitment and retention strategies, data collection and analysis, interpretation of findings and dissemination.
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Affiliation(s)
- José A. Robles Arvizu
- Department of Social Sciences and Health PolicyWake Forest University School of MedicineNorth CarolinaWinston‐SalemUSA
| | - Lilli Mann‐Jackson
- Department of Social Sciences and Health PolicyWake Forest University School of MedicineNorth CarolinaWinston‐SalemUSA
| | - Jorge Alonzo
- Department of Social Sciences and Health PolicyWake Forest University School of MedicineNorth CarolinaWinston‐SalemUSA
| | - Manuel Garcia
- Department of Social Sciences and Health PolicyWake Forest University School of MedicineNorth CarolinaWinston‐SalemUSA
| | - Lucero Refugio Aviles
- Department of Social Sciences and Health PolicyWake Forest University School of MedicineNorth CarolinaWinston‐SalemUSA
| | - Benjamin D. Smart
- Department of Social Sciences and Health PolicyWake Forest University School of MedicineNorth CarolinaWinston‐SalemUSA
| | - Scott D. Rhodes
- Department of Social Sciences and Health PolicyWake Forest University School of MedicineNorth CarolinaWinston‐SalemUSA
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Tanner AE, Palakshappa D, Morse CG, Mann-Jackson L, Alonzo J, Garcia M, Wright E, Dharod A, Isom S, Sucaldito AD, Aviles LR, Rhodes SD. Exploring the consequences of food insecurity and harnessing the power of peer navigation and mHealth to reduce food insecurity and cardiometabolic comorbidities among persons with HIV: protocol for development and implementation trial of weCare/Secure. Trials 2022; 23:998. [PMID: 36510319 PMCID: PMC9743787 DOI: 10.1186/s13063-022-06924-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/12/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Food insecurity, or the lack of consistent access to nutritionally adequate and safe foods, effects up to 50% of people living with HIV (PWH) in the United States (US). PWH who are food insecure have lower antiretroviral adherence, are less likely to achieve viral suppression, and are at increased risk developing of serious illnesses, including cardiometabolic comorbidities. The objectives of this study are to better understand how food insecurity contributes to the development of cardiometabolic comorbidities among PWH and to test a novel bilingual peer navigation-mHealth intervention (weCare/Secure) designed to reduce these comorbidities in food-insecure PWH with prediabetes or Type 2 diabetes (T2DM). METHODS In Aim 1, we will recruit a longitudinal cohort of 1800 adult (≥18 years) PWH from our clinic-based population to determine the difference in the prevalence and incidence of cardiometabolic comorbidities between food-secure and food-insecure PWH. Food insecurity screening, indicators of cardiometabolic comorbidities, and other characteristics documented in the electronic health record (EHR) will be collected annually for up to 3 years from this cohort. In Aim 2, we will conduct a randomized controlled trial among a sample of food-insecure PWH who have prediabetes or T2DM to compare changes in insulin sensitivity over 6 months between participants in weCare/Secure and participants receiving usual care. In Aim 3, we will conduct semi-structured individual in-depth interviews to explore the effect of the intervention among intervention participants with varying insulin sensitivity outcomes. TRIAL STATUS Aim 1 (longitudinal cohort) recruitment began in May 2022 and is ongoing. Aim 2 (intervention) recruitment is planned for spring 2023 and is expected to be completed in spring 2024. Aim 3 (process evaluation) data collection will occur after sufficient completion of the 6-month assessment in Aim 2. Final results are anticipated in fall 2025. CONCLUSIONS This research seeks to advance our understanding of how food insecurity impacts the development of cardiometabolic comorbidities among PWH and how food insecurity interventions may alleviate relevant comorbidities. Given the growing interest among health systems in addressing food insecurity, if the intervention is found to be efficacious, it could be broadly disseminated across HIV clinical care settings. TRIAL REGISTRATION ClinicalTrials.gov NCT04943861 . Registered on June 29, 2021.
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Affiliation(s)
- Amanda E. Tanner
- grid.266860.c0000 0001 0671 255XDepartment of Public Health Education, University of North Carolina Greensboro, Coleman 437E, Greensboro, NC 27402 USA
| | - Deepak Palakshappa
- grid.241167.70000 0001 2185 3318Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, USA ,grid.241167.70000 0001 2185 3318Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, USA ,grid.241167.70000 0001 2185 3318Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Caryn G. Morse
- grid.241167.70000 0001 2185 3318Section on Infectious Diseases, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Lilli Mann-Jackson
- grid.241167.70000 0001 2185 3318Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Jorge Alonzo
- grid.241167.70000 0001 2185 3318Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Manuel Garcia
- grid.241167.70000 0001 2185 3318Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Elena Wright
- grid.241167.70000 0001 2185 3318Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Ajay Dharod
- grid.241167.70000 0001 2185 3318Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, USA ,grid.241167.70000 0001 2185 3318Department of Internal Medicine, Informatics and Analytics, Wake Forest University School of Medicine, Winston-Salem, USA ,grid.241167.70000 0001 2185 3318Wake Forest Center for Healthcare Innovation, Wake Forest University School of Medicine, Winston-Salem, USA ,grid.241167.70000 0001 2185 3318Wake Forest Center for Biomedical Informatics, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Scott Isom
- grid.241167.70000 0001 2185 3318Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Ana D. Sucaldito
- grid.241167.70000 0001 2185 3318Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Lucero Refugio Aviles
- grid.241167.70000 0001 2185 3318Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Scott D. Rhodes
- grid.241167.70000 0001 2185 3318Section on Infectious Diseases, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, USA ,grid.241167.70000 0001 2185 3318Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, USA
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Rhodes SD, Tanner AE, Mann-Jackson L, Alonzo J, Hall MA, Bertoni AG, McCoy TP, Aguilar-Palma SK, Garcia M, Miranda D, Turner MJ. Increasing COVID-19 testing and vaccination among Spanish speakers in the USA: protocol for the development and evaluation of the Nuestra Comunidad Saludable intervention using a group-randomised trial design. BMJ Open 2022; 12:e066585. [PMID: 36385019 PMCID: PMC9670094 DOI: 10.1136/bmjopen-2022-066585] [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] [Received: 07/13/2022] [Accepted: 10/28/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Our community-based participatory research partnership aims to expand understanding of the social, ethical and behavioural implications of COVID-19 testing and vaccination to inform the development of an integrated intervention that harnesses community-based peer navigation and mHealth strategies to improve COVID-19 testing and vaccination; test the intervention; and develop and disseminate practice, research and policy recommendations to further increase COVID-19 testing and vaccination among Spanish-speaking Latine communities in the USA. METHODS AND ANALYSIS We will conduct 50 individual in-depth interviews with health providers, who have conducted COVID-19 testing and/or vaccination activities within Spanish-speaking communities, and with representatives from Latine-serving community-based organisations. We will also conduct six focus groups with 8-12 Spanish-speaking Latine community member participants each for a total number of about 60 focus group participants. Next, we will develop the Nuestra Comunidad Saludable intervention based on findings from interviews and focus groups and use a longitudinal group-randomised trial design with two arms (intervention and delayed intervention) to evaluate the impact of the intervention. We will recruit, enrol and collect baseline data from 20 community-based peer navigators (Navegantes) and their social network members (n=8 unique social network members per Navegante). Navegantes (coupled with their social networks) will be randomised to intervention or delayed intervention groups (10 Navegantes and 80 social network members per group). ETHICS AND DISSEMINATION Ethical approval for data collection was granted by the Wake Forest University School of Medicine Institutional Review Board. Following the description of study procedures, we will obtain consent from all study participants. Study findings will be disseminated through an empowerment theory-based community forum, peer-reviewed publications and presentations at scientific meetings, and reports and briefs for lay, community and practitioner audiences. TRIAL REGISTRATION NUMBER NCT05302908.
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Affiliation(s)
- Scott D Rhodes
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Amanda E Tanner
- Department of Public Health Education, The University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Mark A Hall
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Wake Forest University School of Law, Winston-Salem, North Carolina, USA
| | - Alain G Bertoni
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Thomas P McCoy
- School of Nursing, The University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | | | - Manuel Garcia
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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Hawkins J, Kieffer EC, Sinco B, Piatt G, Jones L, Mitchell J, Espitia N, LeBron A, Kloss KA, Kurnick K, Palmsiano G, Spencer MS. Using Path Analysis and Linear Regression to Test for Gender and Participation: Effects in a Culturally Tailored Diabetes Intervention for Latino Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11982. [PMID: 36231282 PMCID: PMC9565909 DOI: 10.3390/ijerph191911982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/17/2022] [Accepted: 09/17/2022] [Indexed: 06/16/2023]
Abstract
While the incidence and prevalence of type 2 diabetes is higher among Latino/as, Latino men are disproportionately affected and have poorer outcomes. We aimed to determine whether gender impacted any outcomes in a culturally tailored type 2 diabetes (T2D) intervention and to evaluate the effects of gender and intervention participation intensity on outcomes at 6-month follow-up. Nested path and regression models were compared with the likelihood ratio test and information criteria in a sample of Latino/a adults with T2D (n = 222) participating in a T2D community health worker (CHW)-led intervention. Path analysis showed that the effect of the intervention did not vary by gender. The intervention was associated with significant improvements in knowledge of T2D management 0.24 (0.10); p = 0.014, diabetes distress, -0.26 (0.12); p = 0.023, and self-efficacy, 0.61 (0.21); p = 0.005. At 6-month follow-up, improved self-management was associated with greater self-efficacy and Hemoglobin A1c (HbA1c) was lower by -0.18 (0.08); p = 0.021 for each unit of self-management behavior. Linear regressions showed that class attendance and home visits contributed to positive intervention results, while gender was non-significant. Pathways of change in a CHW-led culturally tailored T2D intervention can have a significant effect on participant behaviors and health status outcomes, regardless of gender.
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Affiliation(s)
- Jaclynn Hawkins
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Edith C. Kieffer
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Brandy Sinco
- Center for Healthcare Outcomes & Policy, University of Michigan, 2800 Plymouth Road, North Campus Research Complex, Bldg. 16, Ann Arbor, MI 48109, USA
| | - Gretchen Piatt
- Department of Learning Health Sciences, School of Medicine, University of Michigan, 1111 E. Catherine Street, Ann Arbor, MI 48109, USA
| | - Lenette Jones
- School of Nursing, University of Michigan, 400 North Ingalls Building, Ann Arbor, MI 48109, USA
| | - Jamie Mitchell
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Nicolaus Espitia
- Department of Sociology, Anthropology, Social Work and Criminal Justice Oakland University, 614 Pioneer Dr, Rochester, MI 48309, USA
| | - Alana LeBron
- School of Public Health, University of California, Irvine, 3151 Social Science Plaza, SST 369 (Chicano/Latino Studies) OR 653 E Peltason Drive, AIRB 2026 (Public Health), Irvine, CA 92697, USA
| | - Katherine A. Kloss
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Katie Kurnick
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Gloria Palmsiano
- Community Health and Social Services Center, 5635 West Fort Street, Detroit, MI 48209, USA
| | - Michael S. Spencer
- School of Social Work, University of Washington, 4101 15th Avenue NE, Seattle, WA 98105, USA
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Ruiz-Sánchez HC, Macia L, Boyzo R, Documet PI. Community health workers promote perceived social support among Latino men: Respaldo. J Migr Health 2021; 4:100075. [PMID: 34927112 PMCID: PMC8646959 DOI: 10.1016/j.jmh.2021.100075] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/03/2021] [Accepted: 11/05/2021] [Indexed: 11/30/2022] Open
Abstract
Promotores or community health workers are trusted community members who offer information and support to marginalized groups in society. Latinx immigrants in new growth communities or emerging communities (areas with a small yet growing Latinx population) confront many challenges in their settling processes. De la Mano con la Salud was a community-based participatory project that trained Latino immigrant men as promotores. Promotores recruited 182 Latino immigrant men helped them to attain their own goals, connected them with health and social services and connected them to the larger community. We present data from 23 in-depth interviews with project participants conducted after six months of enrollment. Qualitative analysis confirmed participants’ vulnerabilities and showed that promotores addressed many of the health, legal, and occupational needs of participants. Emerging themes showed that 1) participants had a thirst for a united Latinx community; and 2) felt that promotores had their back (respaldo). The need for community may reflect the current invisibility of this Latinx population, as well as the desires for recognition and ethnic identity affirmation. Respaldo strongly resembles perceived social support, which is the kind of support most associated with health outcomes. Future research can determine what intervention components best foster respaldo.
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Valdes B, Martinez J, Quidley-Rodriguez N, Salani D, Provencio-Vasquez E, De Santis JP. Interventions for Hispanic/Latino gay, bisexual, and men who have sex with men: Critical appraisal. Public Health Nurs 2021; 39:572-585. [PMID: 34881458 DOI: 10.1111/phn.13022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/25/2021] [Accepted: 11/03/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Some interventions have been developed and tested to reduce high risk sexual behaviors among Hispanic/Latino gay, bisexual, and men who have sex with men (MSM). The purpose of this paper is to critically appraise published interventions designed to reduce high risk sexual behaviors among Hispanic/Latino gay, bisexual, and MSM. DESIGN/SAMPLE/MEASUREMENT A critical appraisal of published interventions designed to reduce high risk sexual behaviors among Hispanic/Latino gay, bisexual, and MSM was conducted. Using guidelines established by the Johns Hopkins Nursing Evidence-Based Practice Rating Scale published research articles were categorized and evaluated using these guidelines. RESULTS The critical appraisal identified nine intervention studies that met all inclusion criteria. The critical appraisal of these interventions highlighted strengths and weaknesses of these interventions which should be considered when developing future interventions to decrease high risk sexual practices among Hispanic/Latino gay, bisexual, and MSM. CONCLUSION While several interventions have been created to specifically address HIV infection among Hispanic/Latino gay, bisexual, and MSM, these interventions were varied. Suggestions for future intervention development to decrease high risk sexual behaviors among Hispanic/Latino gay, bisexual, and MSM based on the findings of the critical appraisal of the literature are included.
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Affiliation(s)
- Beatriz Valdes
- University of Miami School of Nursing and Health Studies, Coral Gables, Florida, USA
| | - Jacob Martinez
- School of Nursing, The University of Texas at El Paso, El Paso, Texas, USA
| | | | - Deborah Salani
- University of Miami School of Nursing and Health Studies, Coral Gables, Florida, USA
| | | | - Joseph P De Santis
- University of Miami School of Nursing and Health Studies, Coral Gables, Florida, USA
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Threats M, Brawner BM, Montgomery TM, Abrams J, Jemmott LS, Crouch PC, Freeborn K, Kamitani E, Enah C. A Review of Recent HIV Prevention Interventions and Future Considerations for Nursing Science. J Assoc Nurses AIDS Care 2021; 32:373-391. [PMID: 33929980 PMCID: PMC8715511 DOI: 10.1097/jnc.0000000000000246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT As our knowledge of HIV evolved over the decades, so have the approaches taken to prevent its transmission. Public health scholars and practitioners have engaged in four key strategies for HIV prevention: behavioral-, technological-, biomedical-, and structural/community-level interventions. We reviewed recent literature in these areas to provide an overview of current advances in HIV prevention science in the United States. Building on classical approaches, current HIV prevention models leverage intimate partners, families, social media, emerging technologies, medication therapy, and policy modifications to effect change. Although much progress has been made, additional work is needed to achieve the national goal of ending the HIV epidemic by 2030. Nurses are in a prime position to advance HIV prevention science in partnership with transdisciplinary experts from other fields (e.g., psychology, informatics, and social work). Future considerations for nursing science include leveraging transdisciplinary collaborations and consider social and structural challenges for individual-level interventions.
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Affiliation(s)
- Megan Threats
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Bridgette M. Brawner
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Tiffany M. Montgomery
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Jasmine Abrams
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Loretta Sweet Jemmott
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Pierre-Cedric Crouch
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Kellie Freeborn
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Emiko Kamitani
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Comfort Enah
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
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Miller J, Dawud B, Linder H, Willis S, Babington-Johnson A. Choosing Life in the Black Community, Achieving the Dream: A Traumatic Stress Curriculum Pilot Study. Community Ment Health J 2021; 57:711-719. [PMID: 33128097 PMCID: PMC7981244 DOI: 10.1007/s10597-020-00738-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 10/26/2020] [Indexed: 10/23/2022]
Abstract
This study measured changes in post-traumatic stress symptoms and collective-efficacy in African Americans participating in cohorts of "Choosing Life in the Black Community: Achieving the Dream", an Afrocentricity-based Cognitive Behavioral Therapy curriculum for trauma. Participants were recruited by key leaders in the black community of the Twin Cities, Minnesota Metropolitan Area and completed a 6-week group counselling curriculum led by lay health workers and supervised by professional psychologists. Twenty-six participants provided pre- and post-curriculum responses to validated measures of post-traumatic stress symptoms, collective-efficacy and adverse childhood experiences. Thirteen participants provided semi-structured interviews. Pre- to post-curriculum change score were calculated for post-traumatic stress symptoms and collective-efficacy. Interviews were analyzed using thematic analysis. Post-traumatic stress symptoms decreased and collective-efficacy increased, though neither change achieved statistical significance. Participants with more adverse childhood experiences showed significantly greater decreases in post-traumatic stress symptoms. There is evidence that this program may be particularly effective in participants that have greater past experiences of trauma.
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Affiliation(s)
- Jonathan Miller
- Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware St SE, Suite166, Minneapolis, MN, 55414, USA.
| | - Barite Dawud
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
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11
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Diaz JE, Schrimshaw EW, Tieu HV, Nandi V, Koblin BA, Frye V. Acculturation as a Moderator of HIV Risk Behavior Correlates Among Latino Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:2029-2043. [PMID: 31858309 PMCID: PMC7302998 DOI: 10.1007/s10508-019-01604-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 10/16/2019] [Accepted: 12/03/2019] [Indexed: 05/18/2023]
Abstract
Acculturation is associated with increased sexual risk behaviors among heterosexual Latinos, but its influence among Latino gay, bisexual, and other men who have sex with men (MSM) remains less clear. Elements of acculturation may create distinct lived experiences among sexual minority Latinos, moderating how beneficial and adverse influences contribute to their sexual risk behaviors. Latino MSM living in New York City (n = 412) were recruited using a modified time-space venue- and web-based sampling method. Negative binomial regression models estimated associations between indicators of acculturation (i.e., language use, nativity status, ethnic identification), sexual minority stressors (i.e., internalized homophobia, sexual orientation-based discrimination), peer condom use norms, and the number of serodiscordant condomless anal intercourse (SDCAI) encounters. Acculturation indicators were then tested as simultaneous moderators of the influence of each predictor variable on the outcome. The association between internalized homophobia and SDCAI was significant only among English language speakers (aIRR = 3.05 [2.13, 4.37]) and those born outside of the U.S. (foreign-born = 0, aIRR = 0.17 [0.08, 0.36]). Sexual orientation-based discrimination and SDCAI were also positively associated among both English-speaking (aIRR = 1.82 [1.22, 2.72]) and foreign-born men (aIRR = 0.34 [0.14, 0.84]). Stronger ethnic identification also moderated the protective effects of peer condom use norms on SDCAI (aIRR = 0.28 [0.15, 0.52]). Results suggest that different dimensions of acculturation help shape how both stressors and protective factors influence HIV risk among Latino MSM. Future research is needed to examine the mechanisms through which these differences in acculturation may act on sexual risk behaviors among Latino MSM.
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Affiliation(s)
- José E Diaz
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA.
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Eric W Schrimshaw
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York, NY, USA
| | - Vijay Nandi
- Laboratory of Data Analytic Services, Lindsley F. Kimball Research Institute, New York, NY, USA
| | - Beryl A Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York, NY, USA
| | - Victoria Frye
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, USA
- Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York, NY, USA
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12
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Rhodes SD, Alonzo J, Mann-Jackson L, Song EY, Tanner AE, Garcia M, Smart BD, Baker LS, Eng E, Reboussin BA. A peer navigation intervention to prevent HIV among mixed immigrant status Latinx GBMSM and transgender women in the United States: outcomes, perspectives and implications for PrEP uptake. HEALTH EDUCATION RESEARCH 2020; 35:165-178. [PMID: 32441760 PMCID: PMC7243724 DOI: 10.1093/her/cyaa010] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 04/11/2020] [Indexed: 05/23/2023]
Abstract
The Latinx population in the United States is disproportionately affected by HIV. Our community-based participatory research partnership developed, implemented and evaluated a Spanish-language peer navigation intervention designed to increase HIV testing and condom use among social networks of immigrant Spanish-speaking Latinx gay, bisexual and other men who have sex with men (GBMSM) and transgender women (TW). We randomized 21 social networks of Latinx GBMSM and TW, ages 18-55 years, to the intervention, known as HOLA, or a waitlist control group. Social network participants (n = 166) completed structured assessments at baseline and 12-month follow-up (24 months after baseline). Follow-up retention was 95%. Individual in-depth interviews with a sample of participants documented their intervention-related experiences, needs, and priorities to inform future research. At follow-up, HOLA participants reported increased HIV testing (adjusted odds ratio = 8.3; 95% CI = 3.0-23.0; P < 0.0001). All study participants reported increased condom use; there was no significant difference between HOLA and waitlist control participants. In-depth interviews identified critical intervention elements and impacts and community needs and priorities. The HOLA intervention is effective for increasing HIV testing among Latinx GBMSM and TW, an initial step within the HIV prevention and care continua, and may be adaptable to promote pre-exposure prophylaxis uptake.
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Affiliation(s)
- Scott D Rhodes
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
- Wake Forest Clinical and Translational Science Institute, Program in Community Engagement, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
- Wake Forest Clinical and Translational Science Institute, Program in Community Engagement, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Eunyoung Y Song
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Amanda E Tanner
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC 27402, USA
| | - Manuel Garcia
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Benjamin D Smart
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
- Wake Forest Clinical and Translational Science Institute, Program in Community Engagement, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Logan S Baker
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Eugenia Eng
- Department of Health Behavior, University of North Carolina at Chapel Hill, Rosenau Hall, Chapel Hill, NC 27599, USA
| | - Beth A Reboussin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
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Taylor TN, DeHovitz J, Hirshfield S. Intersectional Stigma and Multi-Level Barriers to HIV Testing Among Foreign-Born Black Men From the Caribbean. Front Public Health 2020; 7:373. [PMID: 31998675 PMCID: PMC6965168 DOI: 10.3389/fpubh.2019.00373] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 11/21/2019] [Indexed: 01/08/2023] Open
Abstract
Testing is the entry point into the HIV care continuum that includes linkage to and retention in prevention services, and adherence to prevention strategies, including repeat HIV testing. Despite US policy approaches to expand HIV testing to diverse clinical care and community settings, disparities in HIV testing among Black populations persist. Foreign-born (FB) Black persons from the Caribbean have higher annual rates of HIV diagnosis and a higher percentage of late-stage HIV diagnosis, compared with US-born Black persons; and most HIV infections among FB Blacks are among men. In this article, we provide an overview of HIV testing barriers among FB Black men who engage in HIV risk-taking behaviors (e.g., condomless sex with male and/or female partners of unknown HIV serostatus). Barriers to HIV testing for both FB and US-born Black men, include HIV stigma (anticipated, perceived, internalized), low perceived HIV risk, medical or government mistrust, and perceived low access to testing resources. We examine beliefs about masculinity and gender roles that may perpetuate heteronormative stereotypes associated with perceptions of low HIV risk and barriers to HIV testing. We also discuss the impact of recent immigration policies on accessing HIV testing and treatment services and how intersectional stigmas and structural forms of oppression, such as racism, prejudice against select immigrant groups, and homophobia that may further amplify barriers to HIV testing among FB Black men. Finally, we review comprehensive prevention approaches, and suggest innovative approaches, that may improve the uptake of HIV testing among FB Black men.
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Affiliation(s)
- Tonya N. Taylor
- SUNY Downstate Health Sciences University, Brooklyn, NY, United States
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Outcomes from a Male-to-Male Promotores Intervention in an Emerging Latino Community. J Immigr Minor Health 2019; 22:717-726. [PMID: 31617052 DOI: 10.1007/s10903-019-00939-w] [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: 10/25/2022]
Abstract
Emerging Latino communities experience social isolation and lack services tailored to their culture. Few male-to-male promotores (community health workers in Spanish) interventions exist. This 6-month participatory study aimed to improve social support, healthcare access, depressive symptoms, and decrease alcohol consumption among Latino immigrant men. Promotores delivered non-directive social support to participants recruited from community venues. We analyzed baseline and 6-month questionnaires data (n = 89) using paired chi square tests. All participants were immigrants; 47% had not finished high school, 29% had depression symptoms, 35% reported past month binge drinking and 93% were uninsured. The intervention significantly improved having a usual source of care (24 to 43%), doctor's visits (41 to 62%) and dentist's visits (27 to 42%) in the past year. Other outcomes did not improve. Male promotores increased healthcare access among vulnerable Latino men. Addressing drinking behavior and depression may require longer interventions or specialized providers.
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HIV outcomes among migrants from low-income and middle-income countries living in high-income countries: a review of recent evidence. Curr Opin Infect Dis 2019; 31:25-32. [PMID: 29095720 DOI: 10.1097/qco.0000000000000415] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Migrants living in high-income countries are disproportionately affected by HIV infection and frequently have characteristics associated with poor HIV clinical outcomes. HIV epidemiology among migrants is influenced by changes in migration patterns and variations in transmission risk behaviors. Here we review the recently published literature on known HIV outcomes among migrants from low-income and middle-income countries living in high-income countries. RECENT FINDINGS High proportions of migrants acquire HIV after migration, and this group frequently presents to care late. Once established in care, migrants are often more likely to experience worse HIV treatment outcomes compared with native populations. Multiple individual and structural factors influence HIV diagnosis and treatment outcomes among migrants, including disruption of social networks, increased sexual risk behaviors, communication barriers, limited access to care, and stigma. Few studies have examined interventions targeted at improving HIV outcomes among migrants. SUMMARY Stigma and limited access to care appear to be primary drivers of poor HIV outcomes among migrants in high-income countries. Addressing these disparities is limited by difficulties in identifying and monitoring this population as well as a lack of evidence regarding appropriate interventions for migrants living with HIV. Improving outcomes for this group requires interventions that are specifically targeted at this marginalized and growing population.
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Beyond efficacy: a qualitative organizational perspective on key implementation science constructs important to physical activity intervention translation to rural community cancer care sites. J Cancer Surviv 2019; 13:537-546. [PMID: 31250353 DOI: 10.1007/s11764-019-00773-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 05/31/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To identify constructs relevant to implementation of evidence-based physical activity (PA) behavior change interventions for rural women cancer survivors from an organizational perspective. METHODS During the development of a PA intervention implementation toolkit, 11 potential interventionists and 19 community and organizational stakeholders completed focus groups stratified by role. Narratives were audio recorded, transcribed, and coded for Consolidated Framework for Implementation Research (CFIR) constructs. RESULTS Multiple CFIR constructs were identified: Implementation Process (i.e., Engaging, Reflecting and Evaluating), Intervention Characteristics (i.e., Design Quality and Packaging, Cost, Evidence Strength and Quality, Adaptability, Complexity), Inner Setting (i.e., Implementation Readiness, Implementation Climate, Structural Characteristics), Outer Setting (i.e., Patient Needs and Resources, Cosmopolitanism), and Characteristics of Individuals (i.e., Knowledge and Beliefs, Stage of Change). Narratives identified rural implementation barriers (e.g., transportation) and facilitators (e.g., community-oriented). Unique needs of the cancer survivor (e.g., coping during cancer treatment and long-term effects on physical abilities) were emphasized as important barriers potentially addressed through Adaptability and Readiness implementation strategies. Narratives identified multi-level (i.e., individual-, organizational-, and community-level) strategies for targeting the identified constructs. CONCLUSIONS Fourteen CFIR constructs emerged as potentially important for organizations to consider when implementing PA interventions. Constructs were integrated into our implementation toolkit and research testing their potential mechanisms of action when implementing PA interventions in rural settings is warranted. IMPLICATIONS Strategies that target the identified constructs may enhance the implementation of PA programs for rural cancer survivors. Cancer survivors can facilitate these efforts by partnering with their health care providers and community organizations. IMPLICATIONS FOR CANCER SURVIVORS Organizations promoting physical activity programs for cancer survivors must overcome implementation barriers including but not limited to cost, necessary expertise, and lack of awareness. Cancer survivors can facilitate these efforts by partnering with their health care providers, cancer center, and local community organizations to raise awareness and champion these efforts. It will "take a village", with cancer survivors being their own best advocate, to bring physical activity promotion to a broad range of cancer survivors.
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Horridge DN, Oh TS, Alonzo J, Mann-Jackson L, Tanner AE, Song EY, Smart BD, Van Dam CN, Baker LS, Rhodes SD. Barriers to HIV Testing Within a Sample of Spanish-speaking Latinx Gay, Bisexual, and Other Men Who Have Sex with Men: Implications for HIV Prevention and Care. HEALTH BEHAVIOR RESEARCH 2019; 2:https://doi.org/10.4148/2572-1836.1069. [PMID: 31799502 PMCID: PMC6889883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
Gay, bisexual, and other men who have sex with men (GBMSM) have higher rates of HIV infection compared to the general population in the United States, and the infection rate is growing among Latinx GBMSM, compared to a decline in most other demographic subgroups. Uptake of pre-exposure prophylaxis (PrEP), a biomedical strategy designed to reduce HIV transmission, is very low among Latinx GBMSM. HIV testing is a critical first step in the HIV prevention and care continua. We analyzed data from a community-based sample of Latinx GBMSM in the southeastern United States to identify the most common HIV testing barriers and the factors associated with barriers. The five most commonly reported HIV testing barriers included not knowing where to get tested, not having health insurance, fear of being HIV positive, practicing safer sex and perceiving not needing to be tested, and not being recommended to get tested. Using multivariable logistic regression modeling, speaking only Spanish, being unemployed, and adhering to traditional notions of masculinity were associated with increased barriers to HIV testing. We recommend that interventions to increase HIV testing among Latinx GBMSM be in Spanish and use culturally congruent messaging, be accessible to those who are unemployed, and incorporate positive risk-reducing aspects of masculinity.
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Affiliation(s)
| | | | | | - Lilli Mann-Jackson
- Wake Forest School of Medicine and Wake Forest Clinical and Translational Science Institute, Program in Community Engagement
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Mann-Jackson L, Song EY, Tanner AE, Alonzo J, Linton JM, Rhodes SD. The Health Impact of Experiences of Discrimination, Violence, and Immigration Enforcement Among Latino Men in a New Settlement State. Am J Mens Health 2018; 12:1937-1947. [PMID: 29962271 PMCID: PMC6199437 DOI: 10.1177/1557988318785091] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 05/21/2018] [Accepted: 05/31/2018] [Indexed: 11/16/2022] Open
Abstract
Among Latinos in the United States, particularly in new settlement states, racial/ethnic discrimination, violence, and immigration enforcement contribute to health disparities. These types of experiences were explored among Latino men in North Carolina through quantitative assessment data ( n = 247). Qualitative in-depth interviews were also conducted with a subsample of Latino men who completed the assessment ( n = 20) to contextualize quantitative findings. Participants reported high rates of unfair treatment, discrimination or violence, and questioning about their immigration status. Having been questioned about one's immigration status was significantly associated with increased drug use (adjusted odds ratio [AOR] = 2.16; 95% confidence interval [CI] [1.07, 4.38]) and increased depressive symptoms (AOR = 2.87; 95% CI [1.07, 7.67]). Qualitative themes included: reports of frequent discrimination based on immigration status, race/ethnicity, and language; workplaces and police interactions as settings where reported discrimination is most common and challenging; frequent violent victimization; psychological consequences of experiences of discrimination and violence and concerns related to immigration enforcement for Latino men and their families; inter- and intra-community tensions; health-care services as safe spaces; use of coping strategies; and system-level approaches for reducing discrimination and violent victimization of Latinos. Findings point to the need to address underlying causes of discrimination and violence toward Latinos, particularly those related to immigration enforcement, to support health and well-being.
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Affiliation(s)
- Lilli Mann-Jackson
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Eunyoung Y. Song
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Amanda E. Tanner
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Julie M. Linton
- Department of Pediatrics and Maya Angelou Center for Health Equity, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Scott D. Rhodes
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Selling the product: Strategies to increase recruitment and retention of Spanish-speaking Latinos in biomedical research. J Clin Transl Sci 2018; 2:147-155. [PMID: 30510779 PMCID: PMC6269095 DOI: 10.1017/cts.2018.314] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction The Latino population in the United States is rapidly growing and faces profound health disparities; however, engagement of Latinos in biomedical research remains low. Our community-based participatory research partnership has recruited 2083 Spanish-speaking Latinos into 21 studies over 15 years. We sought to identify and describe the strategies we have used to successfully recruit and retain Spanish-speaking Latinos in research. Methods We abstracted and analyzed data from archived study notes, progress reports, team meeting minutes, and in-depth interviews conducted annually from community-based participatory research partnership members. We used a nominal group process to refine and prioritize strategies. Results Overall, 13 recruitment strategies and 12 retention strategies emerged. These strategies relied on the creativity and perseverance of the study team and partners. Conclusions It is essential that we develop and disseminate effective recruitment and retention strategies that engage Latinos in biomedical research to reduce health disparities and promote health equity.
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Rhodes SD, Tanner AE, Mann-Jackson L, Alonzo J, Horridge DN, Van Dam CN, Trent S, Bell J, Simán FM, Vissman AT, Nall J, Andrade M. Community-Engaged Research as an Approach to Expedite Advances in HIV Prevention, Care, and Treatment: A Call to Action. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2018; 30:243-253. [PMID: 29969308 PMCID: PMC6055521 DOI: 10.1521/aeap.2018.30.3.243] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Throughout the world, we continue to face profound challenges to reducing the impact of the HIV epidemic. Community-engaged research has emerged as an approach to increase our understanding of HIV and reduce health disparities, increase health equity, and promote community and population health. Our partnership has conducted more than 25 community-engaged research studies in the U.S. and Guatemala, and members have identified nine themes to facilitate community-engaged research and expedite advances in HIV prevention, care, and treatment. These themes include the inclusion of multisectoral partners, trust building and maintenance, the alignment of partner priorities, a can-do attitude, capacity and desire to move beyond service and conduct research, flexibility, power sharing, empowerment, an assets orientation, the shared and timely use of findings, and a stepwise approach. To reduce HIV disparities, community-engaged research is as critical now as ever, and we desperately need to reinvigorate our commitment to and support of it.
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Affiliation(s)
- Scott D Rhodes
- Wake Forest School of Medicine, Winston-Salem, North Carolina
- Wake Forest Clinical and Translational Science Institute Program in Community Engagement
| | | | - Lilli Mann-Jackson
- Wake Forest School of Medicine, Winston-Salem, North Carolina
- Wake Forest Clinical and Translational Science Institute Program in Community Engagement
| | - Jorge Alonzo
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | - Cornelius N Van Dam
- Regional Center for Infectious Diseases, Cone Health, Greensboro, North Carolina
| | | | - Jonathan Bell
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | - Aaron T Vissman
- Center for Health and Human Services Research, Talbert House, Cincinnati, Ohio
| | - Jennifer Nall
- Wake Forest School of Medicine, Winston-Salem, North Carolina
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Reich NG, Lessler J, Varma JK, Vora NM. Quantifying the Risk and Cost of Active Monitoring for Infectious Diseases. Sci Rep 2018; 8:1093. [PMID: 29348656 PMCID: PMC5773605 DOI: 10.1038/s41598-018-19406-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 12/29/2017] [Indexed: 11/26/2022] Open
Abstract
During outbreaks of deadly emerging pathogens (e.g., Ebola, MERS-CoV) and bioterror threats (e.g., smallpox), actively monitoring potentially infected individuals aims to limit disease transmission and morbidity. Guidance issued by CDC on active monitoring was a cornerstone of its response to the West Africa Ebola outbreak. There are limited data on how to balance the costs and performance of this important public health activity. We present a framework that estimates the risks and costs of specific durations of active monitoring for pathogens of significant public health concern. We analyze data from New York City's Ebola active monitoring program over a 16-month period in 2014-2016. For monitored individuals, we identified unique durations of active monitoring that minimize expected costs for those at "low (but not zero) risk" and "some or high risk": 21 and 31 days, respectively. Extending our analysis to smallpox and MERS-CoV, we found that the optimal length of active monitoring relative to the median incubation period was reduced compared to Ebola due to less variable incubation periods. Active monitoring can save lives but is expensive. Resources can be most effectively allocated by using exposure-risk categories to modify the duration or intensity of active monitoring.
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Affiliation(s)
- Nicholas G Reich
- University of Massachusetts-Amherst, Department of Biostatistics and Epidemiology, Amherst, MA, 01003, USA.
| | - Justin Lessler
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD, 21205, USA
| | - Jay K Varma
- New York City Department of Health and Mental Hygiene, New York, NY, 11101, USA
- Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Neil M Vora
- New York City Department of Health and Mental Hygiene, New York, NY, 11101, USA
- Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
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Rhodes SD, Tanner AE, Mann-Jackson L, Alonzo J, Simán FM, Song EY, Bell J, Irby MB, Vissman AT, Aronson RE. Promoting Community and Population Health in Public Health and Medicine: A Stepwise Guide to Initiating and Conducting Community-engaged Research. JOURNAL OF HEALTH DISPARITIES RESEARCH AND PRACTICE 2018; 11:16-31. [PMID: 31428533 PMCID: PMC6699784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Various methods, approaches, and strategies designed to understand and reduce health disparities, increase health equity, and promote community and population health have emerged within public health and medicine. One such approach is community-engaged research. While the literature describing the theory, principles, and rationale underlying community engagement is broad, few models or frameworks exist to guide its implementation. We abstracted, analyzed, and interpreted data from existing project documentation including proposal documents, project-specific logic models, research team and partnership meeting notes, and other materials from 24 funded community-engaged research projects conducted over the past 17 years. We developed a 15-step process designed to guide the community-engaged research process. The process includes steps such as: networking and partnership establishment and expansion; building and maintaining trust; identifying health priorities; conducting background research, prioritizing "what to take on"; building consensus, identifying research goals, and developing research questions; developing a conceptual model; formulating a study design; developing an analysis plan; implementing the study; collecting and analyzing data; reviewing and interpreting results; and disseminating and translating findings broadly through multiple channels. Here, we outline and describe each of these steps.
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Barrington C, Gandhi A, Gill A, Villa Torres L, Brietzke MP, Hightow-Weidman L. Social networks, migration, and HIV testing among Latinos in a new immigrant destination: Insights from a qualitative study. Glob Public Health 2017; 13:1507-1519. [PMID: 29199546 DOI: 10.1080/17441692.2017.1409783] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Latinos in the U.S. are disproportionately affected by HIV and are more likely than non-Latinos to present with a late diagnosis, which delays engagement in HIV care and treatment. Social networks may provide normative influence and social support for HIV testing, but a contextualised understanding of networks is needed in order to maximise these social resources. We conducted qualitative interviews with foreign-born Latino men and transgender women (n = 17) in a new immigrant destination to explore their social networks. Most participants described having smaller social networks after migrating. Networks included both local and transnational ties, but most participants had few close ties. Contextual factors including stigma and geographic dispersion limited the re-construction of networks with close ties after migration. HIV testing was not a common topic of discussion with social network ties. Efforts to improve early uptake of HIV testing among Latino immigrants may benefit from engaging with social networks, but such efforts need to address how the context in which networks operate enables access to testing.
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Affiliation(s)
- Clare Barrington
- a Department of Health Behavior, Gillings School of Global Public Health , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA.,b Carolina Population Center , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Anisha Gandhi
- c New York City Department of Health and Mental Hygiene , Queens , NY , USA.,d Department of Sociomedical Sciences, Mailman School of Public Health , Columbia University , New York , NY , USA
| | - Adrienne Gill
- a Department of Health Behavior, Gillings School of Global Public Health , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Laura Villa Torres
- a Department of Health Behavior, Gillings School of Global Public Health , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Maria Priscila Brietzke
- a Department of Health Behavior, Gillings School of Global Public Health , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Lisa Hightow-Weidman
- a Department of Health Behavior, Gillings School of Global Public Health , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA.,e School of Medicine, Institute for Global Health and Infectious Diseases , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
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Rhodes SD, Mann-Jackson L, Alonzo J, Simán FM, Vissman AT, Nall J, Abraham C, Aronson RE, Tanner AE. Engaged for Change: A Community-Engaged Process for Developing Interventions to Reduce Health Disparities. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2017; 29:491-502. [PMID: 29283276 PMCID: PMC5798238 DOI: 10.1521/aeap.2017.29.6.491] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The science underlying the development of individual, community, system, and policy interventions designed to reduce health disparities has lagged behind other innovations. Few models, theoretical frameworks, or processes exist to guide intervention development. Our community-engaged research partnership has been developing, implementing, and evaluating efficacious interventions to reduce HIV disparities for over 15 years. Based on our intervention research experiences, we propose a novel 13-step process designed to demystify and guide intervention development. Our intervention development process includes steps such as establishing an intervention team to manage the details of intervention development; assessing community needs, priorities, and assets; generating intervention priorities; evaluating and incorporating theory; developing a conceptual or logic model; crafting activities; honing materials; administering a pilot, noting its process, and gathering feedback from all those involved; and editing the intervention based on what was learned. Here, we outline and describe each of these 13 steps.
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Affiliation(s)
- Scott D. Rhodes
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, and the CTSI Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, NC
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, and the CTSI Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, NC
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, and the CTSI Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, NC
| | | | - Aaron T. Vissman
- Center for Health and Human Services Research, Talbert House, Cincinnati, OH
| | - Jennifer Nall
- Forsyth County Department of Public Health, Winston-Salem, NC
| | | | | | - Amanda E. Tanner
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC
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Page KR, Martinez O, Nieves-Lugo K, Zea MC, Grieb SD, Yamanis TJ, Spear K, Davis WW. Promoting Pre-exposure Prophylaxis to Prevent HIV Infections Among Sexual and Gender Minority Hispanics/Latinxs. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2017; 29:389-400. [PMID: 29068715 PMCID: PMC5765546 DOI: 10.1521/aeap.2017.29.5.389] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Sexual and gender minority Hispanics/Latinxs (henceforth: Latinxs) continue to be disproportionately impacted by HIV/AIDS in the U.S. Pre-exposure prophylaxis (PrEP) is a biomedical prevention approach which holds significant promise for at risk and vulnerable populations. We discuss barriers and facilitators to uptake of PrEP among sexual and gender minority Latinxs living in the U.S. through an ecosocial lens that takes into account structural, community, and individual contexts. The impact of immigration status on PrEP uptake emerges as a major and recurrent theme that must be understood and addressed by HIV prevention programs aiming to promote an inclusive strategy for sexual and gender minority Latinxs living in the U.S.
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Affiliation(s)
- Kathleen R Page
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Omar Martinez
- College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Karen Nieves-Lugo
- Department of Psychology, George Washington University, Washington, D.C
| | - Maria Cecilia Zea
- Department of Psychology, George Washington University, Washington, D.C
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Schafer KR, Albrecht H, Dillingham R, Hogg RS, Jaworsky D, Kasper K, Loutfy M, MacKenzie LJ, McManus KA, Oursler KAK, Rhodes SD, Samji H, Skinner S, Sun CJ, Weissman S, Ohl ME. The Continuum of HIV Care in Rural Communities in the United States and Canada: What Is Known and Future Research Directions. J Acquir Immune Defic Syndr 2017; 75:35-44. [PMID: 28225437 PMCID: PMC6169533 DOI: 10.1097/qai.0000000000001329] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The nature of the HIV epidemic in the United States and Canada has changed with a shift toward rural areas. Socioeconomic factors, geography, cultural context, and evolving epidemics of injection drug use are coalescing to move the epidemic into locations where populations are dispersed and health care resources are limited. Rural-urban differences along the care continuum demonstrate the implications of this sociogeographic shift. Greater attention is needed to build a more comprehensive understanding of the rural HIV epidemic in the United States and Canada, including research efforts, innovative approaches to care delivery, and greater community engagement in prevention and care.
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Affiliation(s)
- Katherine R Schafer
- *Section on Infectious Diseases, Wake Forest University Health Sciences, Winston-Salem, NC; †Department of Medicine, Division of Infectious Diseases, University of South Carolina School of Medicine; ‡Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA; §Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada; ‖BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; ¶Clinician Investigator Program, University of British Columbia, Vancouver, BC, Canada; #Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada; **Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON, Canada; ††CIHR Canadian HIV Trials Network, Vancouver, BC, Canada; ‡‡Clinician Investigator Program, University of Manitoba, Winnipeg, MB, Canada; §§Carver College of Medicine, University of Iowa, Iowa City, IA; ‖‖Salem Veterans Affairs Medical Center, Virginia Tech Carilion School of Medicine, Salem, VA; ¶¶Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC; ##British Columbia Centre for Disease Control, Vancouver, BC, Canada; ***University of Saskatchewan, Saskatoon, SK, Canada; and †††Oregon Health & Science University-Portland State University School of Public Health, Portland, OR
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Rhodes SD, Alonzo J, Mann L, Song EY, Tanner AE, Arellano JE, Rodriguez-Celedon R, Garcia M, Freeman A, Reboussin BA, Painter TM. Small-Group Randomized Controlled Trial to Increase Condom Use and HIV Testing Among Hispanic/Latino Gay, Bisexual, and Other Men Who Have Sex With Men. Am J Public Health 2017; 107:969-976. [PMID: 28426301 DOI: 10.2105/ajph.2017.303814] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To evaluate the HOLA en Grupos intervention, a Spanish-language small-group behavioral HIV prevention intervention designed to increase condom use and HIV testing among Hispanic/Latino gay, bisexual, and other men who have sex with men. METHODS In 2012 to 2015, we recruited and randomized 304 Hispanic/Latino men who have sex with men, aged 18 to 55 years in North Carolina, to the 4-session HOLA en Grupos intervention or an attention-equivalent general health education comparison intervention. Participants completed structured assessments at baseline and 6-month follow-up. Follow-up retention was 100%. RESULTS At follow-up, relative to comparison participants, HOLA en Grupos participants reported increased consistent condom use during the past 3 months (adjusted odds ratio [AOR] = 4.1; 95% confidence interval [CI] = 2.2, 7.9; P < .001) and HIV testing during the past 6 months (AOR = 13.8; 95% CI = 7.6, 25.3; P < .001). HOLA en Grupos participants also reported increased knowledge of HIV (P < .001) and sexually transmitted infections (P < .001); condom use skills (P < .001), self-efficacy (P < .001), expectancies (P < .001), and intentions (P < .001); sexual communication skills (P < .01); and decreased fatalism (P < .001). CONCLUSIONS The HOLA en Grupos intervention is efficacious for reducing HIV risk behaviors among Hispanic/Latino men who have sex with men.
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Affiliation(s)
- Scott D Rhodes
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Jorge Alonzo
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Lilli Mann
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Eunyoung Y Song
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Amanda E Tanner
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Jorge Elias Arellano
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Rodrigo Rodriguez-Celedon
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Manuel Garcia
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Arin Freeman
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Beth A Reboussin
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
| | - Thomas M Painter
- Scott D. Rhodes, Jorge Alonzo, Lilli Mann, Eunyoung Y. Song, and Beth A. Reboussin are with Wake Forest University School of Medicine, Winston-Salem, NC. Amanda E. Tanner is with the University of North Carolina, Greensboro. At the initiation of this study, Jorge Elias Arellano, Manuel Garcia, and Rodrigo Rodriguez-Celedon were with the Chatham Social Health Council, Siler City, NC. Arin Freeman and Thomas M. Painter are with the Centers for Disease Control and Prevention, Atlanta, GA
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Mann L, Tanner AE, Sun CJ, Erausquin JT, Simán FM, Downs M, Rhodes SD. Listening to the voices of Latina women: Sexual and reproductive health intervention needs and priorities in a new settlement state in the United States. Health Care Women Int 2016; 37:979-994. [PMID: 27050775 PMCID: PMC5053913 DOI: 10.1080/07399332.2016.1174244] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Latina women in the United States are disproportionately affected by negative sexual and reproductive health outcomes. Our community-based participatory research partnership conducted in-depth interviews exploring sexual and reproductive health needs and priorities with 25 Latinas in North Carolina and identified themes through constant comparison, a grounded theory development approach. Participants described individual-, interpersonal-, and clinic-level factors affecting their sexual and reproductive health as well as potentially successful intervention characteristics. Our findings can be used to inform culturally congruent interventions to reduce sexual and reproductive health disparities among Latinas, particularly in new settlement states in the southeastern United States.
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Affiliation(s)
- Lilli Mann
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Amanda E. Tanner
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Christina J. Sun
- School of Community Health, Portland State University, Portland, Oregon, USA
| | - Jennifer Toller Erausquin
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | | | - Mario Downs
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Scott D. Rhodes
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Rhodes SD, Wong FY. HIV Prevention Among Diverse Young MSM: Research Needs, Priorities, and Opportunities. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2016; 28:191-201. [PMID: 27244188 PMCID: PMC4939896 DOI: 10.1521/aeap.2016.28.3.191] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
There remains a profound need for innovative and effective interventions designed for young men who have sex with men (YMSM) generally, and racial and ethnic minority YMSM, YMSM living in rural communities, and low-income YMSM, particularly, to prevent HIV and improve health outcomes in the United States. This introduction to this theme issue, "Behavioral HIV Prevention Interventions for Diverse YMSM," of AIDS Education and Prevention identifies some of the research needs, priorities, and opportunities that emerged during a seminal NIMHD-sponsored workshop on HIV prevention behavioral interventions for diverse YMSM. It provides researchers, practitioners, and federal partners guidance in next steps to reduce the impact of the HIV epidemic among YMSM. The needs, priorities, and opportunities identified serve as a foundation to push both the science and the practice of HIV prevention forward. We recognize that considerably more research is needed, and this issue highlights intervention research-where we have been and where we should go. With the disparities faced by YMSM, we must act rapidly to do the work it will take to meet their prevention needs, reduce infections, and save lives.
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Affiliation(s)
- Scott D Rhodes
- Department of Social Sciences and Health Policy; Section of Infectious Diseases; The Maya Angelou Center for Health Equity; and The Clinical and Translational Institute, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Frank Y Wong
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia
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Tanner AE, Mann L, Song E, Alonzo J, Schafer K, Arellano E, Garcia JM, Rhodes SD. weCARE: A Social Media-Based Intervention Designed to Increase HIV Care Linkage, Retention, and Health Outcomes for Racially and Ethnically Diverse Young MSM. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2016; 28:216-30. [PMID: 27244190 PMCID: PMC5010783 DOI: 10.1521/aeap.2016.28.3.216] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Estimates suggest that only about 30% of all individuals living with HIV in the U.S. have achieved viral suppression. Men who have sex with men (MSM), particularly racial/ethnic minority young MSM, are at increased risk for HIV infection and may have even lower viral suppression rates. HIV testing rates among MSM are low, and when tested, racial/ethnic minority young MSM have disproportionately lower rates of retention in care and viral suppression compared to other subgroups. This article describes the design and development of weCare, our social media-based intervention to improve care linkage and retention and health outcomes among racially and ethnically diverse MSM, ages 13-34, living with HIV that will be implemented and evaluated beginning in late 2016. The intervention harnesses established social media that MSM between these ages commonly use, including Facebook, text messaging, and established GPS-based mobile applications (apps). We are using community-based participatory research (CBPR) to enhance the quality and validity of weCare, equitably involving community members, organization representatives, healthcare providers, clinic staff, and academic researchers.
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Affiliation(s)
- Amanda E. Tanner
- Department of Public Health Education, University of North Carolina Greensboro
| | - Lilli Mann
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Eunyoung Song
- Department of Social Sciences & Health Policy and Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Jorge Alonzo
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Katherine Schafer
- Section on Infectious Diseases, Wake Forest University Health Sciences
| | - Elías Arellano
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Jesus M. Garcia
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Scott D. Rhodes
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
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Alonzo J, Mann L, Tanner AE, Sun CJ, Painter TM, Freeman A, Reboussin BA, Song E, Rhodes SD. Reducing HIV risk among Hispanic/Latino men who have sex with men: Qualitative analysis of behavior change intentions by participants in a small-group intervention. ACTA ACUST UNITED AC 2016; 7. [PMID: 27468361 DOI: 10.4172/2155-6113.1000572] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The southeastern United States has the fastest-growing Hispanic/Latino population in the country and carries a disproportionate HIV burden. Among Hispanics/Latinos, men, and men who have sex with men (MSM) in particular, are at elevated risk of HIV infection; however, very few efficacious behavioral HIV prevention interventions are available for use with this vulnerable population. To address this shortage of prevention resources, our community-based participatory research (CBPR) partnership developed and is currently evaluating the efficacy of the HOLA en Grupos intervention to increase condom use and HIV testing among Hispanic/Latino MSM. METHODS We recruited 304 Hispanic/Latino MSM who were randomized to receive the small group HOLA en Grupos intervention that was implemented during four 4-hour long sessions over four consecutive Sundays, or a 4-session small group general health education comparison intervention. At the end of the fourth session of the HOLA en Grupos intervention, the intervention facilitators asked participants to write down the sexual health-related behaviors they intended to change as a result of their participation. RESULTS Qualitative analysis of the participants' responses identified six types of intended behavior changes: increasing and maintaining condom use; identifying strategies to support correct and consistent condom use; increasing communication and negotiation with sexual partners about condom use; getting tested for HIV and other sexually transmitted infections; applying other sexual health promotion strategies; and sharing newly learned sexual health information with their peers. CONCLUSION Most risk-reduction intentions aligned with the intervention's key messages of using condoms consistently and getting tested for HIV. However, participants' stated intentions may have also depended on which behavior changes they perceived as most salient after participating in the intervention. Participants' intentions to share information with their peers may result in elements of the intervention content reaching others within their social networks, and potentially contributing to a broader community-level impact.
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Affiliation(s)
- Jorge Alonzo
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Winston-Salem, NC, USA; ; Tel: 336-713-5048
| | - Lilli Mann
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Winston-Salem, NC, USA; ; Tel: 336-716-7441
| | - Amanda E Tanner
- University of North Carolina at Greensboro, Department of Public Health Education, Greensboro, NC, USA; ; Tel: 336-334-5389
| | - Christina J Sun
- Portland State University, School of Community Health, OR, USA; ; Tel: 503-725-3616
| | - Thomas M Painter
- Prevention Research Branch Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta GA, USA; ; Tel: 404-639-6113
| | - Arin Freeman
- Prevention Research Branch Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta GA, USA; ; Tel: 404-639-8432
| | - Beth A Reboussin
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Winston-Salem, NC, USA; ; Tel: 336-713-5213
| | - Eunyoung Song
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Winston-Salem, NC, USA; ; Tel: 336-716-9280
| | - Scott D Rhodes
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Winston-Salem, NC, USA 27157; ; Tel: 336-713-5080
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Abstract
In 2011, CDC published the first CDC Health Disparities and Inequalities Report (CHDIR). This report examined health disparities in the United States associated with various characteristics, including race/ethnicity, sex, income, education, disability status, and geography. Health disparities were defined as "differences in health outcomes and their determinants between segments of the population, as defined by social, demographic, environmental, and geographic attributes". Among other recommendations, the 2011 CHDIR emphasized the need to address health disparities with a dual intervention strategy focused on populations at greatest need and on improving the health of the U.S. population by making interventions available to everyone. The 2013 CHDIR updated the 2011 CHDIR and included additional reports on social and environmental determinants of health; the supplement emphasized the importance of multisectoral collaboration, highlighting the need for a comprehensive, community-driven approach to reducing health disparities in the United States. A follow-up report described five interventions that were shown to be effective or demonstrated promise for reducing health disparities. These publications have focused attention on the need to address health disparities in the United States, as well as on programs and interventions that address them. This supplement describes additional interventions that address particular disparities observed by race and ethnicity, socioeconomic status, geographic location, disability, and/or sexual orientation across a range of conditions, including asthma, infection with HIV and hepatitis A, use of colorectal cancer screening, youth violence, food security, and health-related quality of life.
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Liburd LC, Bouye KE, Penman-Aguilar A. Epilogue. MMWR Suppl 2016; 65:68-9. [PMID: 26916989 DOI: 10.15585/mmwr.su6501a11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
In 1985, the Report of the Secretary's Task Force on Black and Minority Health was published after the federal government convened the first group of health experts to analyze racial/ethnic health disparities among minorities. This analysis, also known as the Heckler report, revealed higher illness and death rates among minorities. The year 2015 marks the 30th anniversary of the Heckler Report and presents an opportunity to evaluate and continue to improve minority health at the national, state, tribal, territorial, and local levels.
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