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Wyatt GE, Norwood-Scott E, Cooley-Strickland M, Zhang M, Smith A, Jordan W, Liu H, Hamilton AB. Increasing Urban African American Women's Readiness for Pre-exposure Prophylaxis: A Pilot Study of the Women Prepping for PrEp Plus Program (WP3+). Womens Health Issues 2024:S1049-3867(23)00187-1. [PMID: 38267337 DOI: 10.1016/j.whi.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/20/2023] [Accepted: 11/03/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND African American women are disproportionately at risk for HIV infection. To increase women's readiness to consider taking pre-exposure prophylaxis (PrEP), we conducted a pilot study of Women Prepping for PrEP Plus (WP3+). Adapted from an evidence-based HIV risk reduction intervention for African American couples who are HIV-serodiscordant, WP3+ is a group-based culturally congruent program designed for African American women without HIV. METHODS Women were screened for eligibility; if eligible, they were invited to participate in the four-session WP3+ group. Participants completed surveys at baseline (n = 47) and post-implementation (n = 28); surveys assessed demographics, HIV and PrEP knowledge, depression and posttraumatic stress (PTS) symptoms, substance use, sexual risk behaviors, health care-related discrimination, and social support. In a process evaluation, a subset of women completed qualitative interviews at baseline (n = 35) and post-implementation (n = 18); the interviews were designed to converge with (e.g., on HIV and PrEP knowledge) and expand upon (e.g., unmeasured perceived impacts of WP3+) quantitative measures. To triangulate with the quantitative data, deductive qualitative analysis concentrated on women's knowledge and awareness of PrEP and HIV, their relationship dynamics and challenges, and their considerations (e.g., barriers, facilitators) related to taking PrEP; inductive analysis focused on women's experiences in the intervention. RESULTS Participants in the WP3+ intervention reported: improved proportion of condom use in the past 90 days (p < .01) and in a typical week (p < .05); reduced PTS symptoms (p < .05); increased HIV knowledge (p < .0001) and awareness of PrEP (p < .001); and greater consideration of using PrEP (p < .001). In interviews, participants expressed not only increased knowledge but also appreciation for learning how to protect themselves against HIV, communicate with their partners, and take charge of their health, and they expressed greater receptiveness to using PrEP as a result of the knowledge and skills they gained. CONCLUSIONS The WP3+ pilot study demonstrated preliminary efficacy and acceptability as an HIV-prevention program for African American women. A controlled trial is needed to confirm its efficacy for increasing PrEP use among African American women.
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Affiliation(s)
- Gail E Wyatt
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California.
| | - Enricka Norwood-Scott
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
| | - Michele Cooley-Strickland
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
| | - Muyu Zhang
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
| | - Amber Smith
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
| | - Wilbert Jordan
- Clarles R. Drew University/OASIS Clinic, Los Angeles, California
| | - Honghu Liu
- Section of Public and Population Health, School of Dentistry, University of California Los Angeles, Los Angeles, California; Departments of Biostatistics and Medicine, University of California Los Angeles, Los Angeles, California
| | - Alison B Hamilton
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California; Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California
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Cooley-Strickland M, Wyatt GE, Loeb TB, Nicholas LA, Smith-Clapham A, Hamman A, Abraham M, Scott EN, Albarran G. Need for Sexual, Reproductive, and Mental Health Promotion Among Diverse College Students in a COVID-19 Era. Clin Child Fam Psychol Rev 2023; 26:1077-1096. [PMID: 37934361 PMCID: PMC10640429 DOI: 10.1007/s10567-023-00460-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 11/08/2023]
Abstract
In 2020, the COVID-19 pandemic forced unprecedented disruptions in higher education operations. While the adverse mental health effects experienced by college students due to these changes are well documented, less is known about the impact on their sexual and reproductive health (SRH), and the reciprocal relationships between SRH and mental health among adolescents and emerging adults. This position paper reviews existing literature on the effects of the COVID-19 pandemic on SRH, sexual violence, unintended pregnancy, sexually transmitted illness and human immunodeficiency virus rates and highlights issues specific to college-aged males, females, racial/ethnic and sexual minorities, and individuals with disabilities. The need to conceptualize SRH as an integral component of normal development, overall health, and well-being in the context of COVID-19 is discussed. The need to prioritize the design and implementation of developmentally appropriate, evidence-based SRH interventions specifically targeting college students is identified. Furthermore, an intergenerational approach to SRH that includes parents/caregivers and/or college faculty and staff (e.g., coaches, trainers) could facilitate comprehensive SRH prevention programming that enhances sexual violence prevention training programs currently mandated by many colleges. Policies and programs designed to mitigate adverse pandemic-related exacerbations in negative SRH outcomes are urgently needed and should be included in mainstream clinical psychology, not only focused on preventing unwanted outcomes but also in promoting rewarding interpersonal relationships and overall well-being. Recommendations for clinical psychologists and mental health researchers are made.
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Affiliation(s)
- Michele Cooley-Strickland
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA.
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Gail E Wyatt
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA
| | - Tamra Burns Loeb
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA
| | - Lisa A Nicholas
- Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Amber Smith-Clapham
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA
| | - Amina Hamman
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA
| | - Misha Abraham
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Enricka Norwood Scott
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA
| | - Graciela Albarran
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA
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Loeb TB, Viducich I, Smith-Clapham AM, Adkins-Jackson P, Zhang M, Cooley-Strickland M, Davis T, Pemberton JV, Wyatt GE. Unmet need for mental health services utilization among under-resourced Black and Latinx adults. Fam Syst Health 2023; 41:149-159. [PMID: 36521110 PMCID: PMC10267286 DOI: 10.1037/fsh0000750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Substantial unmet need for mental health services (MHS) exists in the United States, with pronounced disparities among people of color. Research highlights the need to identify facilitators and barriers to MHS utilization among Black and Latinx individuals to better promote overall health. We tested an expanded model of MHS use based on Andersen's (1995) conceptual framework of health care utilization. Associations were examined between sociodemographic variables, trauma and adversity burden, living with HIV, and unmet need for MHS in a community sample of underresourced Black and Latinx individuals. Barriers to MHS utilization are described. METHODS Five-hundred participants completed the UCLA Life Adversities Screener (LADS), sociodemographic measures, and items assessing need for and barriers to MHS. RESULTS 228 (46%) participants reported a need for MHS; of these, 115 (51%) reported receiving MHS. A binomial logistic regression model estimated the relative contribution of the LADS on need for MHS. Severity of LADS, younger age, and living with HIV predicted unmet need for MHS. Barriers to MHS included financial and time constraints and health system-related issues. One-way analysis of variance (ANOVA) tests revealed differences in mental health symptoms by MHS need. DISCUSSION The unmet need for MHS in this sample of Black and Latinx individuals highlights the importance of addressing the systemic roots of trauma and adversity burden, and eliminating structural barriers to treatment to reduce existing health and mental health inequities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Tamra B Loeb
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute, University of California, Los Angeles
| | - Isabella Viducich
- Luskin School of Social Welfare, University of California, Los Angeles
| | - Amber M Smith-Clapham
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute, University of California, Los Angeles
| | | | - Muyu Zhang
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute, University of California, Los Angeles
| | - Michele Cooley-Strickland
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute, University of California, Los Angeles
| | - Teri Davis
- Department of Clinical Psychology, Chicago School of Professional Psychology
| | - Jennifer V Pemberton
- Department of Educational Psychology and Counseling, California State University
| | - Gail E Wyatt
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute, University of California, Los Angeles
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Loeb TB, Banks D, Ramm K, Viducich I, Beasley Q, Barron J, Chen EL, Norwood-Scott E, Fuentes K, Zhang M, Brown AF, Wyatt GE, Hamilton AB. Achieving Health Equity and Continuity of Care for Black and Latinx People Living With HIV. Am J Public Health 2023; 113:S107-S109. [PMID: 37339419 PMCID: PMC10282861 DOI: 10.2105/ajph.2023.307222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2023] [Indexed: 06/22/2023]
Affiliation(s)
- Tamra Burns Loeb
- Tamra Burns Loeb, Enricka Norwood-Scott, Muyu Zhang, Gail E. Wyatt, and Alison B. Hamilton are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Gail E. Wyatt and Alison B. Hamilton are also guest editors of this special issue. Devin Banks is with the Department of Psychological Sciences, University of Missouri‒St Louis. Kate Ramm is with the Department of Medicine‒Endocrinology Division, UCLA Health. Isabella Viducich is with Jennifer Keaney and Associates Inc, Los Angeles. Quonta Beasley is with the Graduate School of Education and Psychology, Pepperdine University, Los Angeles. Juan Barron and Arleen F. Brown are with the Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA. Elizabeth Lee Chen is with the Fielding School of Public Health, UCLA. Kimberly Fuentes is with the Luskin School of Public Affairs, UCLA
| | - Devin Banks
- Tamra Burns Loeb, Enricka Norwood-Scott, Muyu Zhang, Gail E. Wyatt, and Alison B. Hamilton are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Gail E. Wyatt and Alison B. Hamilton are also guest editors of this special issue. Devin Banks is with the Department of Psychological Sciences, University of Missouri‒St Louis. Kate Ramm is with the Department of Medicine‒Endocrinology Division, UCLA Health. Isabella Viducich is with Jennifer Keaney and Associates Inc, Los Angeles. Quonta Beasley is with the Graduate School of Education and Psychology, Pepperdine University, Los Angeles. Juan Barron and Arleen F. Brown are with the Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA. Elizabeth Lee Chen is with the Fielding School of Public Health, UCLA. Kimberly Fuentes is with the Luskin School of Public Affairs, UCLA
| | - Kate Ramm
- Tamra Burns Loeb, Enricka Norwood-Scott, Muyu Zhang, Gail E. Wyatt, and Alison B. Hamilton are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Gail E. Wyatt and Alison B. Hamilton are also guest editors of this special issue. Devin Banks is with the Department of Psychological Sciences, University of Missouri‒St Louis. Kate Ramm is with the Department of Medicine‒Endocrinology Division, UCLA Health. Isabella Viducich is with Jennifer Keaney and Associates Inc, Los Angeles. Quonta Beasley is with the Graduate School of Education and Psychology, Pepperdine University, Los Angeles. Juan Barron and Arleen F. Brown are with the Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA. Elizabeth Lee Chen is with the Fielding School of Public Health, UCLA. Kimberly Fuentes is with the Luskin School of Public Affairs, UCLA
| | - Isabella Viducich
- Tamra Burns Loeb, Enricka Norwood-Scott, Muyu Zhang, Gail E. Wyatt, and Alison B. Hamilton are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Gail E. Wyatt and Alison B. Hamilton are also guest editors of this special issue. Devin Banks is with the Department of Psychological Sciences, University of Missouri‒St Louis. Kate Ramm is with the Department of Medicine‒Endocrinology Division, UCLA Health. Isabella Viducich is with Jennifer Keaney and Associates Inc, Los Angeles. Quonta Beasley is with the Graduate School of Education and Psychology, Pepperdine University, Los Angeles. Juan Barron and Arleen F. Brown are with the Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA. Elizabeth Lee Chen is with the Fielding School of Public Health, UCLA. Kimberly Fuentes is with the Luskin School of Public Affairs, UCLA
| | - Quonta Beasley
- Tamra Burns Loeb, Enricka Norwood-Scott, Muyu Zhang, Gail E. Wyatt, and Alison B. Hamilton are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Gail E. Wyatt and Alison B. Hamilton are also guest editors of this special issue. Devin Banks is with the Department of Psychological Sciences, University of Missouri‒St Louis. Kate Ramm is with the Department of Medicine‒Endocrinology Division, UCLA Health. Isabella Viducich is with Jennifer Keaney and Associates Inc, Los Angeles. Quonta Beasley is with the Graduate School of Education and Psychology, Pepperdine University, Los Angeles. Juan Barron and Arleen F. Brown are with the Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA. Elizabeth Lee Chen is with the Fielding School of Public Health, UCLA. Kimberly Fuentes is with the Luskin School of Public Affairs, UCLA
| | - Juan Barron
- Tamra Burns Loeb, Enricka Norwood-Scott, Muyu Zhang, Gail E. Wyatt, and Alison B. Hamilton are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Gail E. Wyatt and Alison B. Hamilton are also guest editors of this special issue. Devin Banks is with the Department of Psychological Sciences, University of Missouri‒St Louis. Kate Ramm is with the Department of Medicine‒Endocrinology Division, UCLA Health. Isabella Viducich is with Jennifer Keaney and Associates Inc, Los Angeles. Quonta Beasley is with the Graduate School of Education and Psychology, Pepperdine University, Los Angeles. Juan Barron and Arleen F. Brown are with the Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA. Elizabeth Lee Chen is with the Fielding School of Public Health, UCLA. Kimberly Fuentes is with the Luskin School of Public Affairs, UCLA
| | - Elizabeth Lee Chen
- Tamra Burns Loeb, Enricka Norwood-Scott, Muyu Zhang, Gail E. Wyatt, and Alison B. Hamilton are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Gail E. Wyatt and Alison B. Hamilton are also guest editors of this special issue. Devin Banks is with the Department of Psychological Sciences, University of Missouri‒St Louis. Kate Ramm is with the Department of Medicine‒Endocrinology Division, UCLA Health. Isabella Viducich is with Jennifer Keaney and Associates Inc, Los Angeles. Quonta Beasley is with the Graduate School of Education and Psychology, Pepperdine University, Los Angeles. Juan Barron and Arleen F. Brown are with the Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA. Elizabeth Lee Chen is with the Fielding School of Public Health, UCLA. Kimberly Fuentes is with the Luskin School of Public Affairs, UCLA
| | - Enricka Norwood-Scott
- Tamra Burns Loeb, Enricka Norwood-Scott, Muyu Zhang, Gail E. Wyatt, and Alison B. Hamilton are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Gail E. Wyatt and Alison B. Hamilton are also guest editors of this special issue. Devin Banks is with the Department of Psychological Sciences, University of Missouri‒St Louis. Kate Ramm is with the Department of Medicine‒Endocrinology Division, UCLA Health. Isabella Viducich is with Jennifer Keaney and Associates Inc, Los Angeles. Quonta Beasley is with the Graduate School of Education and Psychology, Pepperdine University, Los Angeles. Juan Barron and Arleen F. Brown are with the Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA. Elizabeth Lee Chen is with the Fielding School of Public Health, UCLA. Kimberly Fuentes is with the Luskin School of Public Affairs, UCLA
| | - Kimberly Fuentes
- Tamra Burns Loeb, Enricka Norwood-Scott, Muyu Zhang, Gail E. Wyatt, and Alison B. Hamilton are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Gail E. Wyatt and Alison B. Hamilton are also guest editors of this special issue. Devin Banks is with the Department of Psychological Sciences, University of Missouri‒St Louis. Kate Ramm is with the Department of Medicine‒Endocrinology Division, UCLA Health. Isabella Viducich is with Jennifer Keaney and Associates Inc, Los Angeles. Quonta Beasley is with the Graduate School of Education and Psychology, Pepperdine University, Los Angeles. Juan Barron and Arleen F. Brown are with the Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA. Elizabeth Lee Chen is with the Fielding School of Public Health, UCLA. Kimberly Fuentes is with the Luskin School of Public Affairs, UCLA
| | - Muyu Zhang
- Tamra Burns Loeb, Enricka Norwood-Scott, Muyu Zhang, Gail E. Wyatt, and Alison B. Hamilton are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Gail E. Wyatt and Alison B. Hamilton are also guest editors of this special issue. Devin Banks is with the Department of Psychological Sciences, University of Missouri‒St Louis. Kate Ramm is with the Department of Medicine‒Endocrinology Division, UCLA Health. Isabella Viducich is with Jennifer Keaney and Associates Inc, Los Angeles. Quonta Beasley is with the Graduate School of Education and Psychology, Pepperdine University, Los Angeles. Juan Barron and Arleen F. Brown are with the Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA. Elizabeth Lee Chen is with the Fielding School of Public Health, UCLA. Kimberly Fuentes is with the Luskin School of Public Affairs, UCLA
| | - Arleen F Brown
- Tamra Burns Loeb, Enricka Norwood-Scott, Muyu Zhang, Gail E. Wyatt, and Alison B. Hamilton are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Gail E. Wyatt and Alison B. Hamilton are also guest editors of this special issue. Devin Banks is with the Department of Psychological Sciences, University of Missouri‒St Louis. Kate Ramm is with the Department of Medicine‒Endocrinology Division, UCLA Health. Isabella Viducich is with Jennifer Keaney and Associates Inc, Los Angeles. Quonta Beasley is with the Graduate School of Education and Psychology, Pepperdine University, Los Angeles. Juan Barron and Arleen F. Brown are with the Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA. Elizabeth Lee Chen is with the Fielding School of Public Health, UCLA. Kimberly Fuentes is with the Luskin School of Public Affairs, UCLA
| | - Gail E Wyatt
- Tamra Burns Loeb, Enricka Norwood-Scott, Muyu Zhang, Gail E. Wyatt, and Alison B. Hamilton are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Gail E. Wyatt and Alison B. Hamilton are also guest editors of this special issue. Devin Banks is with the Department of Psychological Sciences, University of Missouri‒St Louis. Kate Ramm is with the Department of Medicine‒Endocrinology Division, UCLA Health. Isabella Viducich is with Jennifer Keaney and Associates Inc, Los Angeles. Quonta Beasley is with the Graduate School of Education and Psychology, Pepperdine University, Los Angeles. Juan Barron and Arleen F. Brown are with the Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA. Elizabeth Lee Chen is with the Fielding School of Public Health, UCLA. Kimberly Fuentes is with the Luskin School of Public Affairs, UCLA
| | - Alison B Hamilton
- Tamra Burns Loeb, Enricka Norwood-Scott, Muyu Zhang, Gail E. Wyatt, and Alison B. Hamilton are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Gail E. Wyatt and Alison B. Hamilton are also guest editors of this special issue. Devin Banks is with the Department of Psychological Sciences, University of Missouri‒St Louis. Kate Ramm is with the Department of Medicine‒Endocrinology Division, UCLA Health. Isabella Viducich is with Jennifer Keaney and Associates Inc, Los Angeles. Quonta Beasley is with the Graduate School of Education and Psychology, Pepperdine University, Los Angeles. Juan Barron and Arleen F. Brown are with the Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA. Elizabeth Lee Chen is with the Fielding School of Public Health, UCLA. Kimberly Fuentes is with the Luskin School of Public Affairs, UCLA
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Wyatt GE, Chin D, Loeb TB, Norwood-Scott E, McEwan JA, Zhang M, Smith-Clapham AM, Cooley-Strickland M, Trinidad C, Flint JR, Wells Y, Divinity R, Liu H. Women-Centered Program for Women of Color (WC4WC): A Community-Based Participatory, Culturally Congruent Sexual Health Intervention in Los Angeles County, California. Am J Public Health 2023; 113:S110-S114. [PMID: 37339413 PMCID: PMC10282859 DOI: 10.2105/ajph.2023.307296] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 06/22/2023]
Abstract
The Women-Centered Program for Women of Color, a culturally congruent sexual health intervention, was implemented in 2018 in Los Angeles County, California, according to the principles of community-based participatory research: enhancing community capacity, establishing sustainable programs, and translating research findings to community settings. Participants exhibited significantly increased knowledge of and interest in preexposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) over time, but no significant change in condom use was evident. Booster sessions are needed to maintain interest in PrEP and PEP given concerns about reproductive and sexual health. (Am J Public Health. 2023;113(S2):S110-S114. https://doi.org/10.2105/AJPH.2023.307296).
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Affiliation(s)
- Gail E Wyatt
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Dorothy Chin
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Tamra B Loeb
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Enricka Norwood-Scott
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Jenna A McEwan
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Muyu Zhang
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Amber M Smith-Clapham
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Michele Cooley-Strickland
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Cheryl Trinidad
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Janette R Flint
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Yvette Wells
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Rosalynd Divinity
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
| | - Honghu Liu
- Gail E. Wyatt, Dorothy Chin, Tamra B. Loeb, Enricka Norwood-Scott, Jenna A. McEwan, Muyu Zhang, Amber M. Smith-Clapham, and Michele Cooley-Strickland are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Cheryl Trinidad is with To Help Everyone Health and Wellness Centers, Los Angeles. Janette R. Flint is with Black Women for Wellness, Los Angeles. Yvette Wells and Rosalynd Divinity are with Watts Healthcare Corporation, Los Angeles. Honghu Liu is with the Section of Public and Population Health, University of California, Los Angeles
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6
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Wyatt GE, Hamilton AB, Milburn N. Mentoring to Dismantle Structural Racism. Am J Public Health 2023; 113:S94-S97. [PMID: 37339420 PMCID: PMC10282851 DOI: 10.2105/ajph.2023.307343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 06/22/2023]
Affiliation(s)
- Gail E Wyatt
- All authors are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles. They are also guest editors of this special issue
| | - Alison B Hamilton
- All authors are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles. They are also guest editors of this special issue
| | - Norweeta Milburn
- All authors are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles. They are also guest editors of this special issue
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7
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Smith-Clapham AM, Childs JE, Cooley-Strickland M, Hampton-Anderson J, Novacek DM, Pemberton JV, Wyatt GE. Implications of the COVID-19 Pandemic on Interpersonal Violence Within Marginalized Communities: Toward a New Prevention Paradigm. Am J Public Health 2023; 113:S149-S156. [PMID: 37339424 PMCID: PMC10282862 DOI: 10.2105/ajph.2023.307289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 06/22/2023]
Abstract
During the COVID-19 pandemic, reports of domestic violence across the United States increased from 21% to 35%. Stay-at-home orders, designed to protect the public against the spread of COVID-19, along with heightened societal stressors as a result of the global pandemic, inadvertently increased rates of illicit drug and alcohol use, job loss, and isolation, resulting in increased stress and nonphysical (e.g., psychological, emotional, economic, technological) abuse that often escalated to physical violence. These processes were exacerbated in marginalized communities. These risks were heightened among Black women and Latinas, who experience high rates of domestic violence, long-standing distrust in law enforcement, and compromised self-reporting or anonymous reporting of abuse. We make recommendations for training key stakeholders (e.g., law enforcement, mental health clinicians, and public health care professionals) to facilitate the safety and well-being of domestic violence survivors and to better manage prevention or intervention efforts targeted at domestic violence. We make public health policy suggestions for individuals, communities, and governing structures. (Am J Public Health. 2023;113(S2):S149-S156. https://doi.org/10.2105/AJPH.2023.307289).
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Affiliation(s)
- Amber M Smith-Clapham
- Amber M. Smith-Clapham, Michele Cooley-Strickland, and Gail E. Wyatt are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Julia E. Childs is with the School of Social Work, California State University Dominguez Hills, Los Angeles. Joya Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA. Derek M. Novacek is with the VA Greater Los Angeles Healthcare System, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA. Jennifer V. Pemberton is with the School of Educational Psychology and Counseling, California State University, Northridge
| | - Julia E Childs
- Amber M. Smith-Clapham, Michele Cooley-Strickland, and Gail E. Wyatt are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Julia E. Childs is with the School of Social Work, California State University Dominguez Hills, Los Angeles. Joya Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA. Derek M. Novacek is with the VA Greater Los Angeles Healthcare System, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA. Jennifer V. Pemberton is with the School of Educational Psychology and Counseling, California State University, Northridge
| | - Michele Cooley-Strickland
- Amber M. Smith-Clapham, Michele Cooley-Strickland, and Gail E. Wyatt are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Julia E. Childs is with the School of Social Work, California State University Dominguez Hills, Los Angeles. Joya Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA. Derek M. Novacek is with the VA Greater Los Angeles Healthcare System, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA. Jennifer V. Pemberton is with the School of Educational Psychology and Counseling, California State University, Northridge
| | - Joya Hampton-Anderson
- Amber M. Smith-Clapham, Michele Cooley-Strickland, and Gail E. Wyatt are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Julia E. Childs is with the School of Social Work, California State University Dominguez Hills, Los Angeles. Joya Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA. Derek M. Novacek is with the VA Greater Los Angeles Healthcare System, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA. Jennifer V. Pemberton is with the School of Educational Psychology and Counseling, California State University, Northridge
| | - Derek M Novacek
- Amber M. Smith-Clapham, Michele Cooley-Strickland, and Gail E. Wyatt are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Julia E. Childs is with the School of Social Work, California State University Dominguez Hills, Los Angeles. Joya Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA. Derek M. Novacek is with the VA Greater Los Angeles Healthcare System, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA. Jennifer V. Pemberton is with the School of Educational Psychology and Counseling, California State University, Northridge
| | - Jennifer V Pemberton
- Amber M. Smith-Clapham, Michele Cooley-Strickland, and Gail E. Wyatt are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Julia E. Childs is with the School of Social Work, California State University Dominguez Hills, Los Angeles. Joya Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA. Derek M. Novacek is with the VA Greater Los Angeles Healthcare System, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA. Jennifer V. Pemberton is with the School of Educational Psychology and Counseling, California State University, Northridge
| | - Gail E Wyatt
- Amber M. Smith-Clapham, Michele Cooley-Strickland, and Gail E. Wyatt are with the Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Gail E. Wyatt is also a guest editor of this special issue. Julia E. Childs is with the School of Social Work, California State University Dominguez Hills, Los Angeles. Joya Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA. Derek M. Novacek is with the VA Greater Los Angeles Healthcare System, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA. Jennifer V. Pemberton is with the School of Educational Psychology and Counseling, California State University, Northridge
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Wyatt GE, Loeb TB, Cooley-Strickland M, Chin D, Wyatt LE, Smith-Clapham A. Novel methodologies using history to document the effects of African American sexual trauma: Perspectives of Gail E. Wyatt, PhD. Am Psychol 2023; 78:563-575. [PMID: 37384508 PMCID: PMC10414760 DOI: 10.1037/amp0001132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
This article describes the nearly half a century career of Dr. Gail E. Wyatt, PhD, and her development of novel methodologies and measures of sexual trauma, specifically the Wyatt Sex History Questionnaire and the University of California, Los Angeles, Life Adversities Screener. These approaches broke the silence around experiences of sexual violence, particularly among African Americans, identifying their effects on sexual functioning and mental health. These novel methods are designed without assuming sexual literacy of respondents, knowledge of anatomy, or that discussing sex is easy or common; they include topics that are considered private and may evoke emotions. Trained professionals administering face-to-face interviews can serve to establish rapport and educate the participant or client while minimizing possible discomfort and shame around the disclosure of sexual practices. In this article, four topics are discussed focusing on African Americans, but they may also be relevant to other racial/ethnic groups: (a) breaking the silence about sex, (b) sexual harassment: its disclosure and effects in the workplace, (c) racial discrimination: identifying its effects as a form of trauma, and (d) the cultural relevance of promoting sexual health. Historical patterns of abuse and trauma can no longer be ignored but need to be better understood by psychologists and used to improve policy and treatment standards. Recommendations for advancing the field using novel methods are provided. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Gail E. Wyatt
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Tamra Burns Loeb
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Michele Cooley-Strickland
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Dorothy Chin
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Lance E. Wyatt
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Amber Smith-Clapham
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
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Chin D, Smith-Clapham AM, Wyatt GE. Race-based trauma and post-traumatic growth through identity transformation. Front Psychol 2023; 14:1031602. [PMID: 36844351 PMCID: PMC9944138 DOI: 10.3389/fpsyg.2023.1031602] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 01/09/2023] [Indexed: 02/11/2023] Open
Abstract
Race-based trauma has been linked to multiple adverse health and mental health outcomes, including hypertension, post-traumatic stress, anxiety, and depression. While the possibility of post-traumatic growth (PTG) has been investigated following other types of trauma, relatively less work has been done on PTG following race-based trauma. In this article, we present a theoretical framework integrating three areas of research: race-based trauma, PTG, and racial identity narratives. Based on the work on Black and Asian American identity and integrating theory and research on historical trauma and PTG, this framework posits that the transformation of externally imposed narratives into more authentic, internally generated ones can serve as an important influence that sparks PTG after racial trauma. Based on this framework, strategies and tools that enact the cognitive processes of PTG, including writing and storytelling, are suggested as ways to promote post-trauma growth in response to racial trauma.
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Affiliation(s)
| | - Amber M. Smith-Clapham
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Gail E. Wyatt
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
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S. Idemudia E, D. Olawa B, E. Wyatt G, G. Milburn N. Reciprocal Association between Psychological Distress and PTSD and Their Relationship with Pre-Displacement Stressors among Displaced Women. International Journal of Mental Health Promotion 2023. [DOI: 10.32604/ijmhp.2023.026852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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11
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Mashaphu S, Wyatt GE, Zhang M, Liu H. Condom use consistency among South African HIV serodiscordant couples following an HIV risk-reduction intervention. Int J STD AIDS 2022; 33:479-484. [PMID: 35315305 DOI: 10.1177/09564624221076617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Although there are several ways to transmit HIV, condomless sex remains the primary mode in sub-Saharan Africa, including South Africa, with KwaZulu-Natal Province being one of the epicentres of HIV infection. This study explored the use of condoms in serodiscordant couples who were exposed to an HIV-risk reduction intervention that aimed to improve condom use and reduce the spread of HIV.Methods: A Total of 30 couples completed a paper-based questionnaire on their demographics and general health at baseline and 3 months, plus a semi-structured questionnaire with four domains. An analysis of HIV knowledge, condom use, condom use attitudes and protection perceptions about how other serodiscordant couples behave was conducted following a 12-week HIV risk reduction intervention. Participants were randomised 2:1 into intervention and control groups.Results: Condom use increased from 55% at baseline to 73.7% (p = .0047) at 3 months for the intervention group and condom use in the last 7 days increased from 53% to 86% (p = .0117). For the control group, condom use remained low at the 3 months follow up period (p = .625). HIV knowledge improved significantly from baseline to 3 months for the intervention group (p < .0001), as well as the control group (p = .0005). Negative HIV condom use attitude scores in both groups decreased significantly from baseline to 3 months; intervention group (p = .0059) and control group (p = .0007).Conclusion: HIV knowledge and condom use improved significantly, while negative condom use attitudes and HIV protection perceptions decreased significantly following exposure to a risk-reduction intervention, suggesting that HIV preventive interventions should focus on partnership interventions.
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Affiliation(s)
- Sibongile Mashaphu
- Department of Psychiatry, 56394University of KwaZulu-Natal, Durban, South Africa
| | - Gail E Wyatt
- 145230UCLA Jane and Terry Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | - Muyu Zhang
- 145230UCLA Jane and Terry Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | - Honghu Liu
- Division of Public Health and Community Dentistry, 8783University of California Los Angeles, Los Angeles, CA, USA
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12
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Smith AM, Hamilton AB, Loeb T, Pemberton J, Wyatt GE. Reactions of Novice Interviewers Conducting Trauma Research With Marginalized Communities: A Qualitative Analysis. J Interpers Violence 2021; 36:NP12176-NP12197. [PMID: 31789090 DOI: 10.1177/0886260519889925] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Trauma-focused research highlights the reactions of seasoned professionals when engaging with vulnerable clients; however, less is known about the common reactions of novices engaged in trauma research, who may lack the skills to cope and interact with traumatized participants. The purpose of this study is to (a) describe common reactions experienced by novice trauma interviewers; (b) examine whether the issues they face are similar to those of seasoned helping professionals; and (c) discuss ways in which training and supervision can increase the well-being of interviewers in trauma research. A semi-structured assessment was administered to novice interviewers who had previously conducted psychosocial and trauma assessments with diverse community participants. Participation was voluntary. The assessment elicited responses concerning secondary traumatic stress, vicarious trauma, posttraumatic growth, and self-help and resources. Audio files were transcribed; responses were compiled to explore themes and identify illustrative quotes. Eight interviewers (two males, six females) participated. Six reported no prior experience working with populations with histories of trauma. Novice interviewers described experiences of secondary traumatic stress, vicarious trauma, compassion fatigue, posttraumatic growth, and resilience. Novice interviewers described symptoms consistent with those reported by seasoned helping professionals; positive and negative symptoms often coexisted. Interviewers who completed more assessments described reactions of sadness, anger, insomnia, and changes in worldview. Interviewers who shared similar traumatic histories or environments reported more examples of countertransference. All reported similar feelings of posttraumatic growth, such as hope and optimism, for their participants and an increased appreciation of their resilience. Implications for training and supervision are discussed.
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Affiliation(s)
| | | | - Tamra Loeb
- University of California, Los Angeles, USA
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13
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Wyatt GE, Hamilton AB, Loeb TB, Moss NJ, Zhang M, Liu H. A hybrid effectiveness/implementation trial of an evidence-based intervention for HIV-serodiscordant African American couples. ACTA ACUST UNITED AC 2021; 75:1146-1157. [PMID: 33252951 DOI: 10.1037/amp0000712] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Couples-based behavioral HIV prevention interventions have demonstrated efficacy, but few are routinely available in community-based settings in the United States. The Eban intervention, designed for heterosexual African American serodiscordant couples and proven efficacious in a cluster randomized trial, was implemented in community-based HIV service organizations in two cities disproportionately affected by the HIV epidemic. This article reports primarily on the effectiveness results related to condom use and results related to retention challenges within a Hybrid Type 2 implementation/effectiveness trial. Ninety-one individuals enrolled at baseline; 39 completed the posttest, and 30 completed the 3-month follow-up. Although condom use did not monotonically increase from baseline to posttest and 3-month follow-up, it did increase from baseline (44%) to posttest (73%), and from baseline to 3-month follow-up with an overall positive slope of Time 0.13 to 0.14 (p < .001). There was a significant increase in the number of people who used condoms 100% of the time from baseline (36.3%) to posttest (56.4%; p = .04) but not from baseline to 3-month follow-up (46.7%; p = .2907). Challenges with resources as basic as housing, food, and transportation complicated participation (and therefore implementation) and may have impeded couples' maintenance of risk reduction strategies beyond the intervention. In light of couples' numerous observed vulnerabilities, we constructed a composite score of "critical vulnerability" and found that depression was persistently related to critical vulnerability and that retention was higher among those with less vulnerability. These findings highlight the important yet underaddressed role of patient-level factors in the process and outcomes of hybrid implementation/effectiveness research. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Gail E Wyatt
- David Geffen School of Medicine, University of California, Los Angeles
| | - Alison B Hamilton
- David Geffen School of Medicine, University of California, Los Angeles
| | - Tamra Burns Loeb
- David Geffen School of Medicine, University of California, Los Angeles
| | - Nicholas J Moss
- Division of Communicable Disease Control and Prevention, Alameda County Public Health Department
| | - Muyu Zhang
- David Geffen School of Medicine, University of California, Los Angeles
| | - Honghu Liu
- David Geffen School of Medicine, University of California, Los Angeles
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14
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Loeb TB, Ebor MT, Smith-Clapham AM, Chin D, Novacek DM, Hampton-Anderson JN, Norwood-Scott E, Hamilton AB, Brown AF, Wyatt GE. How Mental Health Professionals Can Address Disparities in the Context of the COVID-19 Pandemic. ACTA ACUST UNITED AC 2020; 27:60-69. [PMID: 34025223 DOI: 10.1037/trm0000292] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The Coronavirus 2019 (COVID-19) pandemic is an unparalleled crisis, yet also a unique opportunity for mental health professionals to address and prioritize mental and physical health disparities that disproportionately impact marginalized populations. Black, Indigenous, and People of Color (BIPOC) have long experienced structural racism and oppression, resulting in disproportionately high rates of trauma, poverty, and chronic diseases that span generations and are associated with increased COVID-19 morbidity and mortality rates. The current pandemic, with the potential of conferring new trauma exposure, interacts with and exacerbates existing disparities. To assist mental health professionals in offering more comprehensive services and programs for those who have minimal resources and the most profound barriers to care, four critical areas are highlighted as being historically problematic and essential to address: (a) recognizing psychology's role in institutionalizing disparities; (b) examining race/ethnicity as a critical variable; (c) proactively tackling growing mental health problems amidst the COVID-19 crisis; and (d) understanding the importance of incorporating historical trauma and discrimination in research and practice. Recommendations are provided to promote equity at the structural (e.g., nationwide, federal), professional (e.g., the mental health professions), and individual (e.g., practitioners, researchers) levels.
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Affiliation(s)
- Tamra Burns Loeb
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA, 90095
| | - Megan T Ebor
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA, 90095
| | - Amber M Smith-Clapham
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA, 90095
| | - Dorothy Chin
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA, 90095
| | - Derek M Novacek
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA, 90095.,Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA, 90073
| | - Joya N Hampton-Anderson
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA, 30322
| | - Enricka Norwood-Scott
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA, 90095
| | - Alison B Hamilton
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA, 90095.,Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA, 90073
| | - Arleen F Brown
- Division of General Internal Medicine and Health Services Research (GIM and HSR), University of California Los Angeles, CA, USA, 90095.,Division of GIM and HSR, Olive View-UCLA Medical Center, Sylmar, CA, USA, 91342
| | - Gail E Wyatt
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA, 90095
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15
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Idemudia ES, Olawa BD, Wyatt GE, Milburn N. Pre-displacement stressors, psychological morbidity, and PTSD symptoms among displaced women by Boko-Haram in North-East Nigeria: The buffering roles of psychological capital. Journal of Psychology in Africa 2020. [DOI: 10.1080/14330237.2020.1796032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - Babatola D. Olawa
- Faculty of Humanities, North-West University, Mafikeng Campus, South Africa
| | - Gail E. Wyatt
- Department of Psychiatry & Biobehavioral Sciences, UCLA Semel Institute Centre for Community Health, Los Angeles, USA
| | - Norweeta Milburn
- Department of Psychiatry & Biobehavioral Sciences, UCLA Semel Institute Centre for Community Health, Los Angeles, USA
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Chin D, Loeb TB, Zhang M, Liu H, Cooley-Strickland M, Wyatt GE. Racial/ethnic discrimination: Dimensions and relation to mental health symptoms in a marginalized urban American population. Am J Orthopsychiatry 2020; 90:614-622. [PMID: 32584076 DOI: 10.1037/ort0000481] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
That racial/ethnic discrimination has adverse physical and psychological consequences, including stress, anxiety, depression, and their attendant health effects, is well documented. However, the particular dimensions within the broad construct of discrimination and their role in mental health are less well understood. This study investigates the dimensions of discrimination and explores their relation to depression and posttraumatic stress (PTS) symptoms. Using the Brief Perceived Ethnic/Racial Discrimination Questionnaire-Community Version, discrimination experiences were assessed among a community sample of African American and Latinx participants (N = 500). Factor analyses revealed 4 dimensions: Social Rejection, Stereotyping, Direct Threats/Attacks, and Police Mistreatment. In multivariate analyses, full regression models were significantly related to PTS and depression symptoms. Among the individual predictors, Social Rejection and ethnicity (Latinx) uniquely contributed to PTS symptoms in men, whereas Stereotyping and Direct Threat/Attack were associated with PTS symptoms for women. In regards to depressive symptoms, income, ethnicity (Latinx), and Social Rejection were significant predictors for men, while Social Rejection had an independent contribution for women. Thus, social rejection emerged as a significant unique predictor in 3 of the four models, suggesting that social ostracism may be a particularly harmful aspect of discrimination. Implications of these findings include the use of proactive and intervention strategies that emphasize a sense of belonging and mitigate the effects of exclusion and rejection. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Dorothy Chin
- Semel Institute for Neuroscience and Human Behavior
| | - Tamra B Loeb
- Semel Institute for Neuroscience and Human Behavior
| | - Muyu Zhang
- Semel Institute for Neuroscience and Human Behavior
| | | | | | - Gail E Wyatt
- Semel Institute for Neuroscience and Human Behavior
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17
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Novacek DM, Hampton-Anderson JN, Ebor MT, Loeb TB, Wyatt GE. Mental health ramifications of the COVID-19 pandemic for Black Americans: Clinical and research recommendations. Psychol Trauma 2020; 12:449-451. [PMID: 32525370 DOI: 10.1037/tra0000796] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Mental health clinicians and researchers must be prepared to address the unique needs of Black Americans who have been disproportionately affected by the COVID-19 pandemic. Race-conscious and culturally competent interventions that consider factors such as discrimination, distrust of health care providers, and historical and racial trauma as well as protective factors including social support and culturally sanctioned coping strategies are needed. Research to accurately assess and design treatments for the mental health consequences of COVID-19 among Black Americans is warranted. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Derek M Novacek
- Desert Pacific Mental Illness Research, Education, and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System
| | | | - Megan T Ebor
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Tamra B Loeb
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Gail E Wyatt
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
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18
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Alarcon J, Loeb TB, Hamilton AB, Moss NJ, Curley CM, Zhang M, Jordan WC, Lockett G, Carey-Grant C, Wyatt GE. Barriers to Testing for Sexually Transmitted Infections among HIV-Serodiscordant Couples: The Influence of Discrimination. Ethn Dis 2020; 30:261-268. [PMID: 32346271 DOI: 10.18865/ed.30.2.261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives African Americans face challenges in accessing services for sexually transmitted infections (STIs). From 2012-2016, the EBAN II intervention was funded by the NIH to test the effectiveness of implementing a culturally congruent, evidence-based HIV/AIDS prevention program in Los Angeles and Oakland, California. This study examined the impact of personal characteristics and experiences of discrimination on the likelihood of being tested for STIs. Methods Participants (N=91) completed a baseline survey. Descriptive statistics were used to test for differences between those who did and did not obtain STI testing. Factors included HIV serostatus, sociodemographic variables, STI history, the presence of outside partners, and discrimination experiences. Multiple logistic regressions were conducted for men and women separately. Results Participants with no recent experiences of discrimination were more than 3 (3.4) times more likely to obtain a baseline STI test than those who reported discrimination experiences. HIV-positive women with no recent experiences of discrimination were 11 times more likely than those with reports of recent discrimination to obtain STI tests. Conclusions It is often women who are the gatekeepers for health seeking in families and the same may be for these couples. Experiences of discrimination may impede STI testing, and heighten several health risks, particularly among HIV-positive African American women in HIV-serodiscordant relationships. Addressing the impact of discrimination experiences may be important for STI prevention and treatment efforts in interventions promoting health care utilization.
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Affiliation(s)
- Jenna Alarcon
- UCLA Semel Institute for Neuroscience and Behavior, Los Angeles, CA
| | - Tamra B Loeb
- UCLA Semel Institute for Neuroscience and Behavior, Los Angeles, CA
| | | | | | - Condessa M Curley
- Clinic Services, SPA 4, 5, 6, & 8 Los Angeles County Department of Public Health, Los Angeles, CA
| | - Muyu Zhang
- UCLA Semel Institute for Neuroscience and Behavior, Los Angeles, CA
| | | | | | | | - Gail E Wyatt
- UCLA Semel Institute for Neuroscience and Behavior, Los Angeles, CA
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19
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Wyatt GE, Davis C. The Paradigm Shift-The Impact of HIV/AIDS on Black Women and Families: Speaking Truth to Power. Ethn Dis 2020; 30:241-246. [PMID: 32346268 PMCID: PMC7186049 DOI: 10.18865/ed.30.2.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Ethn Dis. 2020;30(2):241-246; doi:10.18865/ed.30.2.241
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Affiliation(s)
- Gail E. Wyatt
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA
| | - Cynthia Davis
- College of Medicine & College of Science and Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA
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20
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Mthembu J, Hamilton AB, Milburn NG, Sinclair D, Mkabile S, Mashego M, Manengela T, Wyatt GE. "It Had a Lot of Cultural Stuff in It": HIV-Serodiscordant African American Couples' Experiences of a Culturally Congruent Sexual Health Intervention. Ethn Dis 2020; 30:269-276. [PMID: 32346272 DOI: 10.18865/ed.30.2.269] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Objective The increased life expectancy of people living with HIV has brought about an increase in serodiscordant couples, in which there is risk of HIV transmission. Therefore, interventions that promote sexual health and reduce risk are critical to develop for these couples. Given the disproportionate burden of HIV among populations of color, it is also critical that these interventions are culturally congruent. The EBAN intervention for African American serodiscordant couples recognizes the centrality of culture in shaping sexual behaviors and helps couples develop intimacy and positive prevention behaviors. The analytic objective of our study was to examine the knowledge and awareness gained by participants in the intervention. Participants Participants (n=17) who completed at least half of the eight intervention sessions. Methods Brief post-implementation semi-structured interviews were conducted between January 1, 2016 and December 31, 2016. Team-based, targeted content analysis focused on knowledge and awareness gains. Results Participants described learning about sexual health, expanded sexual options, and sexual communication. The "EBAN café," a component that gives couples a menu of options for safer sex behaviors, was particularly popular. Participants also noted the value of learning how to communicate with one another about their sexual health-related concerns and preferences. They appreciated the "cultural stuff" that was infused throughout the sessions, including the emphasis on learning from one another as couples. Conclusions Couples at risk for HIV transmission benefit from strengthening skills and knowledge related to healthy sexuality. A behavioral intervention that aligns with cultural values and imparts culturally congruent sexual health information appeals to couples who seek ways to enhance their intimacy and sexual options while also reducing risk.
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Affiliation(s)
- Jacqueline Mthembu
- Social Aspects of Public Health Research Programme, Human Sciences Research Council, South Africa
| | - Alison B Hamilton
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA.,Center for the Study of Healthcare Innovation, Implementation, & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Norweeta G Milburn
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA
| | - Deborah Sinclair
- Child and Family Studies, University of the Western Cape, South Africa.,Department of Special Needs Education, Ghent University, Belgium
| | - Siyabulela Mkabile
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa.,Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Mmathabo Mashego
- University of Venda, Limpopo, South Africa.,Department of Community Strengthening Systems, HIV South Africa, South Africa
| | | | - Gail E Wyatt
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA
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21
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Gamble-George JC, Longenecker CT, Webel AR, Au DH, Brown AF, Bosworth H, Crothers K, Cunningham WE, Fiscella KA, Hamilton AB, Helfrich CD, Ladapo JA, Luque A, Tobin JN, Wyatt GE. ImPlementation REsearCh to DEvelop Interventions for People Living with HIV (the PRECluDE consortium): Combatting chronic disease comorbidities in HIV populations through implementation research. Prog Cardiovasc Dis 2020; 63:79-91. [PMID: 32199901 PMCID: PMC7237329 DOI: 10.1016/j.pcad.2020.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 03/11/2020] [Indexed: 02/08/2023]
Abstract
Antiretroviral therapy (ART) prevented premature mortality and improved the quality of life among people living with the human immunodeficiency virus (PLWH), such that now more than half of PLWH in the United States are 50 years of age and older. Increased longevity among PLWH has resulted in a significant rise in chronic, comorbid diseases. However, the implementation of guideline-based interventions for preventing, treating, and managing such age-related, chronic conditions among the HIV population is lacking. The PRECluDE consortium supported by the Center for Translation Research and Implementation Science at the National Heart, Lung, and Blood Institute catalyzes implementation research on proven-effective interventions for co-occurring heart, lung, blood, and sleep diseases and conditions among PLWH. These collaborative research studies use novel implementation frameworks with HIV, mental health, cardiovascular, and pulmonary care to advance comprehensive HIV and chronic disease healthcare in a variety of settings and among diverse populations.
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Affiliation(s)
- Joyonna Carrie Gamble-George
- Health Scientist Administrator and AAAS Science and Technology Policy Fellow, Implementation Science Branch (ISB), Center for Translation Research and Implementation Science (CTRIS), National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), U.S. Department of Health and Human Services, Bethesda, MD 20892, United States of America; Office of Science Policy (OSP), Office of the Director (OD), National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD 20892, United States of America.
| | - Christopher T Longenecker
- Department of Medicine, Case Western Reserve University School of Medicine, University Hospitals Harrington Heart and Vascular Institute, Cleveland, OH 44106, United States of America
| | - Allison R Webel
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, United States of America
| | - David H Au
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington School of Medicine, Seattle, WA 98195, United States of America; Seattle-Denver Center of Innovation (COIN) for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA 98108, United States of America
| | - Arleen F Brown
- Department of Medicine, Division of General Internal Medicine and Health Services Research (GIM and HSR), David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, United States of America; GIM and HSR, Olive View-UCLA Medical Center Sylmar, Los Angeles, CA 90095, United States of America; Community Engagement and Research Program, UCLA Clinical and Translational Science Institute, Los Angeles, CA 90095, United States of America
| | - Hayden Bosworth
- Department of Medicine, Duke University School of Medicine, Durham, NC 27701, United States of America; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27701, United States of America; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27701, United States of America
| | - Kristina Crothers
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington School of Medicine, Seattle, WA 98195, United States of America; Pulmonary and Critical Care Section, VA Puget Sound Health Care System, Seattle, WA 98108, United States of America
| | - William E Cunningham
- Department of Medicine, GIM and HSR, David Geffen School of Medicine, UCLA, Los Angeles, CA 90095, United States of America; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA 90095, United States of America
| | - Kevin A Fiscella
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY 14620, United States of America; Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14620, United States of America; Center for Community Health and Prevention, University of Rochester Medical Center, Rochester, NY 14620, United States of America; Center for Communication and Disparities Research, University of Rochester Medical Center, Rochester, NY 14620, United States of America; Greater Rochester Practice-Based Research Network, Clinical and Translational Science Institute (CTSI), University of Rochester Medical Center, Rochester, NY 14642, United States of America
| | - Alison B Hamilton
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA Jane and Terry Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90095, United States of America; VA Health Services Research and Development (HSR&D) Service, Center for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, North Hills, CA 91343, United States of America
| | - Christian D Helfrich
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA 98101, United States of America; Health Services Research and Development, Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Administration (VA) Puget Sound Health Care System, Seattle, WA 98108, United States of America
| | - Joseph A Ladapo
- Department of Medicine, GIM and HSR, David Geffen School of Medicine, UCLA, Los Angeles, CA 90095, United States of America; Department of Population Health, New York University (NYU) Grossman School of Medicine, New York, NY 10016, United States of America
| | - Amneris Luque
- HIV Clinical Services, Parkland Health and Hospital System, Dallas, TX 75235, United States of America; Department of Internal Medicine, University of Texas (UT) Southwestern Medical Center, Dallas, TX 75390, United States of America
| | - Jonathan N Tobin
- Clinical Directors Network, Inc. (CDN), New York, NY 10018; Community-Engaged Research, The Rockefeller University Center for Clinical and Translational Science, New York, NY 10065, United States of America
| | - Gail E Wyatt
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA Jane and Terry Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90095, United States of America; Sexual Health Programs, UCLA Jane and Terry Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90095, United States of America; The Center for Culture, Trauma, and Mental Health Disparities, UCLA Jane and Terry Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90024, United States of America; University of Cape Town, Rondebosch, Cape Town 7701, South Africa
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22
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Hamilton AB, Brown A, Loeb T, Chin D, Grills C, Cooley-Strickland M, Liu HH, Wyatt GE. Enhancing patient and organizational readiness for cardiovascular risk reduction among Black and Latinx patients living with HIV: Study protocol. Prog Cardiovasc Dis 2020; 63:101-108. [PMID: 32109483 DOI: 10.1016/j.pcad.2020.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 02/23/2020] [Indexed: 01/14/2023]
Abstract
Cardiovascular disease (CVD) is an increasingly important cause of morbidity and mortality among people living with HIV (PLWH) now that HIV is a manageable chronic disease. Identification and treatment of comorbid medical conditions for PLWH, including CVD and its risk factors, typically lack a critical component of care: integrated care for histories of trauma. Experiences of trauma are associated with increased HIV infection, CVD risk, inconsistent treatment adherence, and poor CVD outcomes. To address this deficit among those at greatest risk and disproportionately affected by HIV and trauma-i.e., Black and Latinx individuals-a novel culturally-congruent, evidence-informed care model, "Healing our Hearts, Minds and Bodies" (HHMB), has been designed to address patients' trauma histories and barriers to care, and to prepare patients to engage in CVD risk reduction. Further, in recognition of the need to ensure that PLWH receive guideline-concordant cardiovascular care, implementation strategies have been identified that prepare providers and clinics to address CVD risk among their Black and Latinx PLWH. The focus of this paper is to describe the hybrid Type 2 effectiveness/implementation study design, the goal of which is to increase both patient and organizational readiness to address trauma and CVD risk among 260 Black and Latinx PLWH recruited from two HIV service organizations in Southern California. This study is expected to produce important information regarding the value of the HHMB intervention and implementation processes and strategies designed for use in implementing HHMB and other evidence-informed programs in diverse, resource-constrained treatment settings, including those that serve patients living in deep poverty. Clinical trials registry: NCT04025463.
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Affiliation(s)
- Alison B Hamilton
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, United States of America; Center for the Study of Healthcare Innovation, Implementation, & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States of America.
| | - Arleen Brown
- Division of General Internal Medicine and Health Services Research (GIM and HSR), University of California Los Angeles, United States of America; Division of GIM and HSR, Olive View-UCLA Medical Center, Sylmar, CA United States of America
| | - Tamra Loeb
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, United States of America
| | - Dorothy Chin
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, United States of America
| | - Cheryl Grills
- Department of Psychology, Loyola Marymount University, United States of America
| | - Michele Cooley-Strickland
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, United States of America
| | - Honghu H Liu
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, United States of America
| | - Gail E Wyatt
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, United States of America
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23
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Wyatt GE, Chin D, Milburn N, Hamilton A, Lopez S, Kim A, Stone JD, Belcher HME. Mentoring the mentors of students from diverse backgrounds for research. Am J Orthopsychiatry 2019; 89:321-328. [PMID: 31070417 DOI: 10.1037/ort0000414] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This article defines and discusses 6 beliefs, attitudes, and practices that can erode or undermine self-esteem and self confidence in student-scholars from underrepresented and marginalized groups in academic settings. Specifically, the beliefs and practices are reactions to implicit bias, color blindness, imposter syndrome, internalized racism, stereotype threat, and code-switching. Mentors need to know how to discuss these reactions because they can also influence the mentoring process and academic performance. To minimize incidents or interactions that might result in scholars not being able to find their place in these settings, recommendations for basic mentoring strategies and individual- and systemic-level approaches to address institutional racism are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Gail E Wyatt
- Department of Psychiatry and Biobehavioral Sciences
| | - Dorothy Chin
- Department of Psychiatry and Biobehavioral Sciences
| | | | | | - Susana Lopez
- Department of Psychiatry and Biobehavioral Sciences
| | - Alex Kim
- Department of Psychiatry and Biobehavioral Sciences
| | - Jacqueline D Stone
- Center for Diversity in Public Health Leadership Training, Kennedy Krieger Institute, Johns Hopkins University School of Medicine
| | - Harolyn M E Belcher
- Center for Diversity in Public Health Leadership Training, Kennedy Krieger Institute, Johns Hopkins University School of Medicine
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24
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Wyatt GE, Belcher HME. Establishing the foundation: Culturally congruent mentoring for research scholars and faculty from underrepresented populations. Am J Orthopsychiatry 2019; 89:313-316. [PMID: 31070415 DOI: 10.1037/ort0000417] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This issue is a call for more culturally congruent mentorship training, support, and research on the effectiveness of mentoring strategies. The role of mentoring is fundamental to professional growth and success. Importantly, one size does not fit all. A repertoire of mentoring strategies and formats is necessary to include the talent, skills, and contributions of the next generation of diverse researchers in public health and biomedical sciences. It is incumbent on us now to grow a comprehensive knowledge base so we may best promote health and well-being for all citizens through innovative and effective strategies to support mentoring and research that eliminates health disparities. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Gail E Wyatt
- Department of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
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25
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Maulsby CH, Holtgrave DR, Hamilton AB, Campbell D, Liu H, Wyatt GE. A Cost and Cost-Threshold Analysis of Implementation of an Evidence-Based Intervention for HIV-Serodiscordant Couples. AIDS Behav 2019; 23:2486-2489. [PMID: 31254191 DOI: 10.1007/s10461-019-02558-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To address gaps in the cost literature by estimating the cost of delivering an evidence-based HIV risk reduction intervention for HIV-serodiscordant, heterosexual, African American couples (Eban II) and calculating the cost-effective thresholds at three participating sites. The cost, cost-saving, and cost-effectiveness thresholds for Eban II were calculated using standard methods. The analytic time period was from July 1 to September 31, 2014. Total costs for 3 months of program implementation were from $13,747 to $25,937, with societal costs ranging from $5632 to $17,008 and program costs ranging from $8115 to $14,122. The costs per participant were from $1621 to $2160; the cost per session (per participant) ranged from $147 to $196. Sites had achievable cost-saving thresholds, which were all less than one for the 3-month costing timeframe.
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Affiliation(s)
- Catherine H Maulsby
- Department of Health Behavior and Society, Johns Hopkins School of Public Health, Baltimore, USA
| | - David R Holtgrave
- School of Public Health, University at Albany, State University of New York, New York, USA
| | - Alison B Hamilton
- UCLA Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, Box 175919, Los Angeles, CA, 90024-1759, USA.
- VA Center for the Study of Healthcare Innovation, Implementation, and Policy, Los Angeles, CA, USA.
| | - Danielle Campbell
- UCLA Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, Box 175919, Los Angeles, CA, 90024-1759, USA
| | - Honghu Liu
- Division of Public Health and Community Dentistry, School of Dentistry, UCLA, Los Angeles, USA
- Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, USA
| | - Gail E Wyatt
- UCLA Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, Box 175919, Los Angeles, CA, 90024-1759, USA
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26
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Mashaphu S, Wyatt GE, Zhang M, Mthiyane T, Liu H, Gomo E. Effectiveness of an HIV-risk reduction intervention to reduce HIV transmission among serodiscordant couples in Durban, South Africa. A randomized controlled trial. AIDS Care 2019; 32:537-545. [PMID: 31269801 DOI: 10.1080/09540121.2019.1634785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Lack of condom use by married or cohabiting couples in populations with high rates of HIV infection has become a significant public health issue. This study investigated whether an HIV risk-reduction intervention (RRI) would increase condom use when delivered to serodiscordant couples as a unit. Of the 62 couples that were screened, 30 serodiscordant couples were enrolled in the study, and randomized 2:1 to an immediate intervention-waitlist control study. The 12-week intervention focused on communication, problem-solving, and negotiation skills. Participants were assessed at baseline, three and six months after the intervention. The main outcome measures were consistent condom use, HIV seroconversion and fidelity to the programme. The use of condoms increased for both the intervention and control groups after receiving a 12-week RRI. Group comparisons showed a significant difference at three months, with a significantly higher mean proportion of condom-protected sex acts (p = 0.0119) between the control and intervention groups, the later showing an increase in condom use. No seroconversion was detected, and the overall retention rate of participants was 83.33%. Counselling heterosexual couples as a unit prompted an increase in condom use, but sustained condom use remains a challenge.
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Affiliation(s)
- Sibongile Mashaphu
- School of Clinical Medicine, University of KwaZulu-Natal, College of Health Sciences, Durban, South Africa
| | - Gail E Wyatt
- Department of Psychiatry and Bio-Behavioural, Sciences University of California, Los Angeles, CA, USA
| | - Muyu Zhang
- Department of Psychiatry and Bio-Behavioural, Sciences University of California, Los Angeles, CA, USA
| | - Thuli Mthiyane
- South African Medical Research Council, Pretoria, South Africa
| | - Honghu Liu
- Department of Psychiatry and Bio-Behavioural, Sciences University of California, Los Angeles, CA, USA
| | - Exnevia Gomo
- School of Nursing and Public Health, University of KwaZulu-Natal, College of Health Sciences, Durban, South Africa
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27
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Milburn NG, Hamilton AB, Lopez S, Wyatt GE. Mentoring the next generation of behavioral health scientists to promote health equity. Am J Orthopsychiatry 2019; 89:369-377. [PMID: 31070422 PMCID: PMC7577403 DOI: 10.1037/ort0000415] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Health inequities and disparities among various racial/ethnic minority, sexual minority, and rural populations are the focus of increasing national efforts. Three health problems disproportionately affecting these populations-HIV/AIDS, substance abuse, and trauma-deserve particular attention because of their harmful effects on health across the life span. To address these problems, our training program, the UCLA HIV/AIDS, Substance Abuse, and Trauma Training Program (HA-STTP), mentors and trains early career behavioral health scientists to conduct research using scientifically sound, culturally collaborative, and population-centered approaches. HA-STTP has been highly successful in training a diverse, productive, nationwide group of scholars. The program provides 2 years of training and mentorship to 20 (5 per year over 4 years) scholars. It is unique in its attention to traumatic stress as a form of dysregulation, particularly as experienced by underserved populations. Furthermore, our training program embraces a uniquely comprehensive, culturally grounded understanding of traumatic stress and its implications for substance abuse and HIV. HA-STTP advances scholars' knowledge of the interconnections among substance abuse, HIV/AIDS, traumatic stress, and health disparities, particularly in underrepresented populations; provides intensive mentorship to support scholars' research interests and career trajectories; capitalizes on a multidisciplinary, multiracial/ethnic network of expert faculty; and evaluates the program's impact on scholars' knowledge and productivity. By fostering the growth of scholars committed to conducting research with underrepresented populations that are disproportionately affected by HIV/AIDS, substance abuse, and traumatic stress, this program enhances nationwide efforts to diminish the prevalence of these problems and improve health and quality of life. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Norweeta G Milburn
- Department of Psychiatry and Biobehavioral Sciences, Division of Population Behavioral Health, Semel Institute for Neuroscience & Human Behavior, University of California
| | - Alison B Hamilton
- Department of Psychiatry and Biobhavioral Sciences, University of California, Los Angeles
| | - Susana Lopez
- Department of Psychiatry and Biobehavioral Sciences, Division of Population Behavioral Health, University of California
| | - Gail E Wyatt
- Department of Psychiatry and Biobhavioral Sciences, University of California, Los Angeles
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Loeb TB, Joseph NT, Wyatt GE, Zhang M, Chin D, Thames A, Aswad Y. Predictors of somatic symptom severity: The role of cumulative history of trauma and adversity in a diverse community sample. Psychol Trauma 2018; 10:491-498. [PMID: 29154595 PMCID: PMC6021222 DOI: 10.1037/tra0000334] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Somatic symptoms are often reported among victims of trauma, and place a significant burden on primary care health providers. We examined the relationship between lifetime histories of trauma and adversity, including aspects not previously studied (i.e., perceived discrimination), and somatic symptoms, as well as the mediating role of posttraumatic stress symptoms (PTSS) and depressive symptoms. METHOD A multiethnic community sample of 500 male and female participants (230 African American and 270 Latino) completed measures of demographic characteristics, the University of California, Los Angeles Lifetime Adversities Screener (LADS), depressive symptoms, PTSS, and somatic symptoms. RESULTS An ordinary least-squares regression analysis controlling for age, gender, and race/ethnicity indicated that higher levels of lifetime adversity and trauma were significantly associated with more severe somatic symptoms (b = 6.95, p < .0001). Formal mediation tests indicated that there was a significant indirect effect of LADS on somatic symptoms via PTSS and depressive symptoms, indirect effect = 2.64 (95% confidence interval [CI] [1.2, 4.1]) and 2.19 (95% CI [1.3, 3.3]), respectively. Even after PTSS and depressive symptoms were taken into account, the LADS remained significantly associated with somatic symptoms (b = 2.13, p < .05), suggesting partial mediation. CONCLUSION Exposure to traumatic and adverse events (the LADS) was associated with somatic symptom severity. Furthermore, although PTSS and depressive symptoms partially accounted for the association between the LADS and somatic symptoms, the LADS remained significant, suggesting that both exposure to trauma and adversity and the resultant development of PTSS and depressive symptoms influence the development of somatic symptoms. (PsycINFO Database Record
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Affiliation(s)
- Tamra Burns Loeb
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | | | - Gail E Wyatt
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Muyu Zhang
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Dorothy Chin
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - April Thames
- Department of Psychiatry, University of California, Los Angeles
| | - Yvorn Aswad
- Charles R. Drew University of Medicine and Science, David Geffen School of Medicine at University of California, Los Angeles
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Mashaphu S, Burns JK, Wyatt GE, Vawda NB. Psychosocial and behavioural interventions towards HIV risk reduction for serodiscordant couples in Africa: A systematic review. S Afr J Psychiatr 2018; 24:1136. [PMID: 30263215 PMCID: PMC6138108 DOI: 10.4102/sajpsychiatry.v24i0.1136] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 04/19/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Sexual transmission of HIV frequently occurs in the context of a primary relationship between two partners; however, HIV prevention interventions generally focus on individuals at risk, rather than specifying couples as a unit of change and analysis, neglecting the crucial role that partners may play in sexual behaviour. This article reviews published scientific literature addressing couple-oriented HIV counselling and testing and other behavioural interventions using an online search for peer-reviewed papers. METHODS A systematic review was conducted to evaluate what has been published on psychosocial interventions in HIV serodiscordant couples in Africa. Electronic databases were searched from January 1990 to December 2015. Quality assessment of included studies was conducted using the Systematic Appraisal of Quality in Observational Research tool. RESULTS The electronic database searches initially retrieved 493 records; after cross-referencing, removing duplicates and applying strict inclusion and exclusion criteria, only eight papers were included in this review. All the studies under review showed that couples-focused counselling and educational programmes were associated with positive outcomes including reduced HIV transmission, reduced unprotected sex, increased rates of status disclosure and high levels of treatment adherence. CONCLUSIONS The literature on interventions for HIV serodiscordant couples is sparse. However, most interventions indicate that couples-focused interventions are effective in HIV risk reduction. In spite of the limited available data and repeated recommendations by different health authorities, couple-centred approaches to HIV prevention have not been implemented on a large scale.
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Affiliation(s)
| | | | - Gail E. Wyatt
- Department of Psychiatry and Bio-behavioural Sciences, University of California Los Angeles, United States
| | - Naseema B. Vawda
- Department of Behavioural Medicine, University of KwaZulu-Natal, South Africa
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Wyatt GE, Thames A, Simbayi L, Stein DJ, Burns J, Maselesele M. Trauma and mental health in South Africa: Overview. Psychol Trauma 2018; 9:249-251. [PMID: 28459266 DOI: 10.1037/tra0000144] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Provides an introduction to this special edition of Psychological Trauma. The papers included in this special section focus on aspects of trauma and the effects of trauma in a cultural context that pertains to the way of life in South Africa. These articles highlight the complexities of the effects of trauma and call for tailored interventions to address the lasting effects on health and mental health. (PsycINFO Database Record
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Affiliation(s)
- Gail E Wyatt
- Semel Institute for Neuroscience and Human Behavior
| | - April Thames
- Semel Institute for Neuroscience and Human Behavior
| | | | - Dan J Stein
- Psychiatry and Mental Health Department, University of Cape Town
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Hamilton AB, Mittman BS, Campbell D, Hutchinson C, Liu H, Moss NJ, Wyatt GE. Understanding the impact of external context on community-based implementation of an evidence-based HIV risk reduction intervention. BMC Health Serv Res 2018; 18:11. [PMID: 29316922 PMCID: PMC5759288 DOI: 10.1186/s12913-017-2791-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 12/12/2017] [Indexed: 12/19/2022] Open
Affiliation(s)
- Alison B Hamilton
- UCLA Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, 38-240 NPI, Box 175919, Los Angeles, CA, 90024-1759, USA. .,VA Center for the Study of Healthcare Innovation, Implementation, & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA, 90073, USA.
| | - Brian S Mittman
- VA Center for the Study of Healthcare Innovation, Implementation, & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA, 90073, USA.,Kaiser Permanente Southern California, Department of Research and Evaluation, 100 S. Los Robles Avenue, Pasadena, CA, 91101-2453, USA
| | - Danielle Campbell
- UCLA Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, 38-240 NPI, Box 175919, Los Angeles, CA, 90024-1759, USA
| | - Craig Hutchinson
- UCLA Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, 38-240 NPI, Box 175919, Los Angeles, CA, 90024-1759, USA
| | - Honghu Liu
- UCLA Department of Medicine, 760 Westwood Plaza, Los Angeles, CA, 90024-1759, USA
| | - Nicholas J Moss
- HIV STD Section, Alameda County Public Health Department, 1000 Broadway, Suite 310, Oakland, CA, 94607, USA
| | - Gail E Wyatt
- UCLA Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, 38-240 NPI, Box 175919, Los Angeles, CA, 90024-1759, USA
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Wyatt GE, Davhana-Maselesele M, Zhang M, Wong LH, Nicholson F, Sarkissian AD, Makhado L, Myers HF. A longitudinal study of the aftermath of rape among rural South African women. Psychol Trauma 2017; 9:309-316. [PMID: 28459272 DOI: 10.1037/tra0000246] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Sexual assaults against women are a global health crisis, with alarmingly high rates in South Africa. However, we know very little about the circumstances and the aftermath of these experiences. Further, there is limited information about how factors specific to the rape (e.g., fighting back) versus those that are specific to the individual-and potentially modifiable-influence mental health outcomes. This study examined how situational characteristics of rape as well as individual and situational factors confer risk for symptoms of depression, posttraumatic stress disorder (PTSD), and dysfunctional sexual behavior at 12-month follow-up. METHOD Two hundred nine (N = 209) South African women were recruited from rural rape clinics in the Limpopo Province (LP) and North West Province (NWP) of South Africa. Interviews were conducted at baseline (within 6 months of the rape incident) and at 6 and 12 months by trained staff at the clinics in English or the women's native languages. Women were interviewed after services were provided in a private room. RESULTS One hundred thirty-two (n = 132) women were lost to follow-up at 12 months, resulting in 77 women with interview data for all time points. Undermining by the survivor's social support system and an increased belief in myths about rape were associated with increased dysfunctional sexual practices and symptoms of depression. CONCLUSIONS These findings demonstrate the need for interventions that address the most pervasive effects of rape over time. These behaviors can increase risks for revictimization and reduce psychological well-being in the aftermath of rape. (PsycINFO Database Record
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Affiliation(s)
- Gail E Wyatt
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior
| | | | - Muyu Zhang
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior
| | - Lauren H Wong
- Department of Epidemiology, University of California San Francisco
| | | | - Alissa Der Sarkissian
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior
| | | | - Hector F Myers
- Department of Medicine, Health, and Society and Psychology, Vanderbilt University
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Abstract
HIV/AIDS research, prevention, and intervention efforts have widened in recent years to include minorities and women, partly in response to the rise of infection among these groups [1]. However, conventional research methods (i.e., random community samples) are likely to exclude more marginalized groups such as undocumented immigrants. We conducted ethnographic interviews of twenty-one recently immigrated and undocumented Latinas regarding their HIV-related risk behaviors, partners risk behaviors, HIV knowledge and attitudes, and sexual communication and decision making. Findings indicated low rates of risk behaviors. However, condom use was also low, and partners' behavior appeared to pose a risk. The immigration process, often necessitating periods of separation, may prohibit women from having accurate knowledge about partners' risk behaviors. Interviews were conducted at community agencies where respondents were recruited and at respondents' home in Los Angeles County. Findings suggest the importance of considering the effects of immigration, acculturation, and gender and relationship dynamics when examining risk in this population.
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Romero GJ, Wyatt GE, Loeb TB, Carmona JV, Solis BM. The Prevalence and Circumstances of Child Sexual Abuse among Latina Women. Hispanic Journal of Behavioral Sciences 2016. [DOI: 10.1177/0739986399213009] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the prevalence and circumstances of child sexual abuse in a community sample of Latina women, 18 to 50 years of age. Chi-square tests of independence and t -test procedures were used to assess the prevalence, characteristics of the victim, assault, perpetrator, disclosure, and long-term effects. One in three Latina women reported incidents of sexual abuse, regardless of acculturation or citizenship status. More than one third of the women also experienced revictimization, with more than 80% of initial incidents occurring from the age of 7 years. The majority of the experiences occurred in private locations, by young male perpetrators, known to the victim. Four women were forced to marry perpetrators of their abuse. Treatment implications and community-based interventions for Latina survivors of child sexual abuse are discussed.
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Abstract
Predictions generated by cognitive adaptation theory and conservation of resources theory were tested with regard to positive and negative changes associated with HIV infection in an ethnically diverse, low socioeconomic status sample of 189 HIV-positive women. Women reported a significantly greater number of benefits than losses in their experiences with HIV infection. Changes in the domains of the self and life priorities were significantly positive, whereas changes in romantic/sexual relations and view of body were significantly negative. Women who reported more benefits were less likely to report depressive and anxious symptoms. Although health status and optimism significantly predicted depression, anxiety, and negative HIV-related changes, socioeconomic resources (education and income) were the most significant predictors of HIV-related benefit finding. Implications of these results are discussed.
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Abstract
This paper addresses five existing societal myths and their underlying faulty assumptions about women's sexuality. The following myths are examined: (a) women possess adequate sexual knowledge to understand their sexual needs, (b) they know how to communicate about sex, (c) they engage in sex because they want to do so, (d) if they are sexually active, they enjoy sex, and (e) they use their knowledge of sex to protect themselves from sexually transmitted diseases and pregnancy. These myths need to be considered when conducting research and developing interventions designed to decrease women's sexual risk-taking. Research that assesses women's levels of factual sexual knowledge, comfort and skills discussing sexual information, and literacy is needed. The importance of examining ethnic, cultural, economic, religious, relationship factors, and psychological issues is discussed in order to encourage research relevant to women's sexual decision-making.
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El-Bassel N, Jemmott JB, Bellamy SL, Pequegnat W, Wingood GM, Wyatt GE, Richard Landis J, Remien RH. Mediation Analysis of the Efficacy of the Eban HIV/STD Risk-Reduction Intervention for African American HIV Serodiscordant Couples. AIDS Behav 2016; 20:1197-207. [PMID: 26577402 DOI: 10.1007/s10461-015-1249-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Targeting couples is a promising behavioral HIV risk-reduction strategy, but the mechanisms underlying the effects of such interventions are unknown. We report secondary analyses testing whether Social-Cognitive-Theory variables mediated the Eban HIV-risk-reduction intervention's effects on condom-use outcomes. In a multisite randomized controlled trial conducted in four US cities, 535 African American HIV-serodiscordant couples were randomized to the Eban HIV risk-reduction intervention or attention-matched control intervention. Outcomes were proportion condom-protected sex, consistent condom use, and frequency of unprotected sex measured pre-, immediately post-, and 6 and 12 months post-intervention. Potential mediators included Social-Cognitive-Theory variables: outcome expectancies and self-efficacy. Mediation analyses using the product-of-coefficients approach in a generalized-estimating-equations framework revealed that condom-use outcome expectancy, partner-reaction outcome expectancy, intention, self-efficacy, and safer-sex communication improved post-intervention and mediated intervention-induced improvements in condom-use outcomes. These findings underscore the importance of targeting outcome expectancies, self-efficacy, and safer-sex communication in couples-level HIV risk-reduction interventions.
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Gutzmer K, Ludwig-Barron NT, Wyatt GE, Hamilton AB, Stockman JK. "Come on Baby. You Know I Love You": African American Women's Experiences of Communication with Male Partners and Disclosure in the Context of Unwanted Sex. Arch Sex Behav 2016; 45:807-819. [PMID: 26892099 PMCID: PMC4821775 DOI: 10.1007/s10508-015-0688-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 12/18/2015] [Accepted: 12/28/2015] [Indexed: 06/05/2023]
Abstract
We examined African American women's experiences of communication with their male intimate partners a couple of hours before and after an incident of unwanted sex. We also examined women's experiences of disclosure following an incident of unwanted sex. Semi-structured qualitative interviews were conducted with a community-based sample of sexually active African American women (n = 19) reporting at least one incident of sexual coercion (i.e., being pressured into unwanted sex without consent) by an intimate male partner since the age of 18. Our analysis was guided by "the sexual division of power" from Connell's (1987) theory of gender and power. Data were analyzed inductively by examining the interviews for common themes in the following domains: communication before the unwanted sex, communication after the unwanted sex, and disclosure to others. Men pressured partners for unwanted sex through verbal and non-verbal tactics, ranging from pestering and blunt requests for sex to verbal bullying and violence. Many women responded by clearly saying no. However, many women also described eventually ceasing to resist their partners and engaging in unwanted sex. After the unwanted sex, men actively and passively avoided discussing the incident. Although many women discussed the unwanted sex with family and friends, less women disclosed to trained professionals. In some cases, women did not discuss the incident with anyone at all. These findings indicate that, when addressing sexual violence against women, there is a need to target men as well as the norms of masculinity that underpin physical and sexual violence against women.
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Affiliation(s)
- Kyle Gutzmer
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Natasha T Ludwig-Barron
- Division of Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA
| | - Gail E Wyatt
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alison B Hamilton
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, Los Angeles, CA, USA
| | - Jamila K Stockman
- Division of Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA.
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Hamilton AB, Mittman BS, Eccles AM, Hutchinson CS, Wyatt GE. Conceptualizing and measuring external context in implementation science: Studying the impacts of regulatory, fiscal, technological and social change. Implement Sci 2015. [PMCID: PMC4551725 DOI: 10.1186/1748-5908-10-s1-a72] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Collier KL, Colarossi LG, Hazel DS, Watson K, Wyatt GE. Healing Our Women for Transgender Women: Adaptation, Acceptability, and Pilot Testing. AIDS Educ Prev 2015; 27:418-431. [PMID: 26485232 DOI: 10.1521/aeap.2015.27.5.418] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Healing Our Women (HOW) is a group-level HIV risk-reduction intervention developed to address the role of prior sexual victimization in HIV risk and protective behaviors among HIV-positive women of color. This article describes the process of adapting HOW for transgender women of color in New York City in accordance with CDC guidance for the adaptation of efficacious interventions. Twenty-one transgender women were enrolled in a study to evaluate the acceptability and fidelity of the adapted intervention, and to assess HIV knowledge, depressive symptoms, coping, condom use self-efficacy, and condom use via pre- and post-intervention surveys. We found the adapted program to be feasible to implement and acceptable to participants. We also found significant decreases in depressive symptoms and increases in positive coping from pre- to post-intervention, although replication with a larger sample and a control group comparison is needed to determine efficacy with this population.
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Affiliation(s)
| | | | - Daphne S Hazel
- Planned Parenthood of New York City, and now an independent consultant, New York, New York
| | | | - Gail E Wyatt
- UCLA Semel Institute for Neuroscience and Behavior, University of California at Los Angeles
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Cohen AN, Hamilton AB, Ritchie M, Mittman BS, Kirchner JE, Wyatt GE, Fortney JC, Hellemann G, Liu H, Curran GM, Whelan F, Eccles AM, Parker LE, McNagny K, Hutchinson CS, Teague AB, Reist C, Young AS. Improving care quality through hybrid implementation/effectiveness studies: Best practices in design, methods, and measures. Implement Sci 2015. [PMCID: PMC4551814 DOI: 10.1186/1748-5908-10-s1-a29] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Liu H, Prause N, Wyatt GE, Williams JK, Chin D, Davis T, Loeb T, Marchand E, Zhang M, Myers HF. Development of a composite trauma exposure risk index. Psychol Assess 2015; 27:965-74. [PMID: 25984638 DOI: 10.1037/pas0000069] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The high burden of exposure to chronic life adversities and trauma is quite prevalent, but assessment of this risk burden is uncommon in primary care settings. This calls for a brief, multiple dimensional mental health risk screening tool in primary care settings. We aimed to develop such a screening tool named the University of California, Los Angeles (UCLA) Life Adversities Screener (LADS). Using pooled data across 4 studies from the UCLA Center for Culture, Trauma, and Mental Health Disparities, 5 domains of mental health risk including perceived discrimination, sexual abuse histories, family adversity, intimate partner violence, and trauma histories, were identified. Regression models for depression (Centers for Epidemiology Studies Depression Scale) and posttraumatic stress disorder (Posttraumatic Diagnostic Scale), controlling for demographic factors, were fitted to develop a weighted continuous scale score for the UCLA LADS. Confirmatory factor analysis supported the 5-domain structure, while item response theory endorsed the inclusion of each item. Receiver operating characteristic analysis indicated that the score was predictive for classifying subjects as reaching clinical threshold criteria for either depression (Beck Depression Inventory-II ≥ 14 or Patient Health Questionnaire-9 ≥ 10) or anxiety (Patient Health Questionnaire-13 ≥10). An optimal cut of 0.33 is suggested based on maximizing sensitivity and specificity of the LADS score, identifying patients at high risk for mental health problems. Given its predictive utility and ease of administration, the UCLA LADS could be useful as a screener to identify racial minority individuals in primary care settings who have a high trauma burden, needing more extensive evaluation.
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Affiliation(s)
- Honghu Liu
- School of Dentistry-Public Health, Department of Medicine, David Geffen School of Medicine, University of California
| | - Nicole Prause
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Gail E Wyatt
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - John K Williams
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Dorothy Chin
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Teri Davis
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Tamra Loeb
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Erica Marchand
- Center for Cancer Prevention and Control Research, School of Public Health and Jonsson Comprehensive Cancer Center, University of California, Los Angeles
| | - Muyu Zhang
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Hector F Myers
- Center for Medicine, Health, and Society, Vanderbilt University
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Myers HF, Wyatt GE, Ullman JB, Loeb TB, Chin D, Prause N, Zhang M, Williams JK, Slavich GM, Liu H. Cumulative burden of lifetime adversities: Trauma and mental health in low-SES African Americans and Latino/as. Psychol Trauma 2015; 7:243-51. [PMID: 25961869 PMCID: PMC4445692 DOI: 10.1037/a0039077] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This study examined the utility of a lifetime cumulative adversities and trauma model in predicting the severity of mental health symptoms of depression, anxiety, and posttraumatic stress disorder. We also tested whether ethnicity and gender moderate the effects of this stress exposure construct on mental health using multigroup structural equation modeling. A sample of 500 low-socioeconomic status African American and Latino men and women with histories of adversities and trauma were recruited and assessed with a standard battery of self-report measures of stress and mental health. Multiple-group structural equation models indicated good overall model fit. As hypothesized, experiences of discrimination, childhood family adversities, childhood sexual abuse, other childhood trauma, and chronic stresses all loaded on the latent cumulative burden of adversities and trauma construct (CBAT). The CBAT stress exposure index in turn predicted the mental health status latent variable. Although there were several significant univariate ethnic and gender differences, and ethnic and gender differences were observed on several paths, there were no significant ethnic differences in the final model fit of the data. These findings highlight the deleterious consequences of cumulative stress and trauma for mental health and underscore a need to assess these constructs in selecting appropriate clinical interventions for reducing mental health disparities and improving human health.
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Affiliation(s)
- Hector F Myers
- Center for Medicine, Health, & Society and Psychology, Vanderbilt University
| | - Gail E Wyatt
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | | | - Tamra B Loeb
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Dorothy Chin
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Nicole Prause
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Muyu Zhang
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - John K Williams
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology, University of California
| | - Honghu Liu
- School of Dentistry, University of California, Los Angeles
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Davhana-Maselesele M, Madu S, Wyatt GE, Williams JK, Makhado L, Wong LH. Comparison of trauma on survivors of sexual assault and intimate partner violence in Limpopo. Health SA 2014. [DOI: 10.4102/hsag.v19i1.683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Gender-based violence is a challenge in South Africa, despite available interventions. Caring for the survivors of both forms of violence is critical for ensuring their speedy recovery.Objectives: To compare the effects of trauma on female survivors of sexual assault versus those experienced by survivors of physical assault by their intimate partners.Method: A quantitative cross-sectional comparative study design was used to compare 30 sexually-assaulted women and 30 physically-assaulted women regarding depressive symptoms, posttraumatic stress disorder and coping styles three months after the incident. Semi-structured interviews were conducted with the survivors of both types of assault and the Beck Depression Inventory posttraumatic stress disorder checklist and Brief COPE Inventory were administered in order to obtain quantitative data. Both parametric and non-parametric statistics were employed. Ethical measures were adhered to throughout the research process.Results: A significantly-higher proportion of sexually-assaulted women disclosed the incident to family (p = 0.021). The majority of sexually- (90%) and physically- (86%) assaulted women were likely to recall the incident. Sexually-assaulted women had a significantly-higher mean for avoidance/numbness (p < 0.001) and physical-assaulted women in arousal (p > 0.051). About 41% of sexually-assaulted participants reported severe depression. Findings confirmed that sexual assault is more personal whilst physical assault is more interpersonal. If physically-assaulted women were removed from the perpetrators they recovered faster than sexually-assaulted women. Their stay with the perpetrators may perpetuate the violence.Conclusion: The need for counselling and support for the survivors of both traumas was recommended. All stakeholders should be educated to provide support to survivors of both traumas. Agtergrond: Ten spyte daarvan dat daar intervensies beskikbaar is, bly geslagsgebaseerde geweld ‘n uitdaging in Suid-Afrika. Die versorging van die oorlewendes geweld is van kritieke belang om die oorlewendes se spoedige herstel te verseker.Doelwitte: Die doel was om die gevolge van trauma op die vroulike slagoffers van seksuele aanranding te vergelyk met die trauma wat die oorlewendes van fisiese aanranding ervaar het.Metode: ‘n Kwantitatiewe dwarssnit ontwerp is gebruik om 30 seksueel aangerande vroue en 30 fisiek aangerande vroue te vergelyk sover dit depressiesimptome, posttroumatiese stresversteuring en coping styl betref drie maande na die voorval plaasgevind het. Semi-gestruktureerde onderhoude is gevoer met die oorlewendes van beide soorte aanvalle, terwyl die Beck depressie-inventaris, die kontrolelys vir posttroumatiese stresversteuring en die bondige COPE-inventaris afgeneem is om kwantitatiewe data te bekom. Sowel parametriese as nie-parametriese statistiek is gebruik. Etiese vereistes is regdeur die navorsingsproses nagekom.Resultate: ‘n Aansienlik hoër persentasie seksueel aangerande vrouens het hulle gesin oor die voorval ingelig (p = 0.021). Die meeste seksueel (90%) en fisiek (86%) aangerande vrouens het die voorval onthou. Seksueel aangerande vrouens toon ‘n aansienlik hoër gemiddelde vir vermyding of gevoelloosheid (p < 0.001) en fisiese aangerande vrouens het ‘n hoër gemiddelde vir opwekking (p > 0.051). Sowat 41% van die seksueel aangerande deelnemers meld erge depressie. Die studie bevestig dat seksuele aanranding persoonliker is, terwyl fisieke aanranding meer interpersoonlik is. As fisiek aangerand vroue van die oortreders verwyder word, herstel hulle vinniger as die seksueel aangerande vroue. As hulle by die oortreders bly, kan die geweld voortduur.Gevolgtrekking: Die noodsaak aan berading en ondersteuning vir beide groepe oorlewendes word aanbeveel. Alle belanghebbendes moet opgevoed word om ondersteuning aan oorlewendes te bied.
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Hamilton AB, Mittman BS, Williams JK, Liu HH, Eccles AM, Hutchinson CS, Wyatt GE. Community-based implementation and effectiveness in a randomized trial of a risk reduction intervention for HIV-serodiscordant couples: study protocol. Implement Sci 2014; 9:79. [PMID: 24950708 PMCID: PMC4085467 DOI: 10.1186/1748-5908-9-79] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 06/11/2014] [Indexed: 04/21/2024] Open
Abstract
Background The HIV/AIDS epidemic continues to disproportionately affect African American communities in the US, particularly those located in urban areas. Despite the fact that HIV is often transmitted from one sexual partner to another, most HIV prevention interventions have focused only on individuals, rather than couples. This five-year study investigates community-based implementation, effectiveness, and sustainability of ‘Eban II,’ an evidence-based risk reduction intervention for African-American heterosexual, serodiscordant couples. Methods/design This hybrid implementation/effectiveness implementation study is guided by organizational change theory as conceptualized in the Texas Christian University Program Change Model (PCM), a model of phased organizational change from exposure to adoption, implementation, and sustainability. The primary implementation aims are to assist 10 community-based organizations (CBOs) to implement and sustain Eban II; specifically, to partner with CBOs to expose providers to the intervention; facilitate its adoption, implementation and sustainment; and to evaluate processes and determinants of implementation, effectiveness, fidelity, and sustainment. The primary effectiveness aim is to evaluate the effect of Eban II on participant (n = 200 couples) outcomes, specifically incidents of protected sex and proportion of condom use. We will also determine the cost-effectiveness of implementation, as measured by implementation costs and potential cost savings. A mixed methods evaluation will examine implementation at the agency level; staff members from the CBOs will complete baseline measures of organizational context and climate, while key stakeholders will be interviewed periodically throughout implementation. Effectiveness of Eban II will be assessed using a randomized delayed enrollment (waitlist) control design to evaluate the impact of treatment on outcomes at posttest and three-month follow-up. Multi-level hierarchical modeling with a multi-level nested structure will be used to evaluate the effects of agency- and couples-level characteristics on couples-level outcomes (e.g., condom use). Discussion This study will produce important information regarding the value of the Eban II program and a theory-guided implementation process and tools designed for use in implementing Eban II and other evidence-based programs in demographically diverse, resource-constrained treatment settings. Trial registration NCT00644163
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Affiliation(s)
- Alison B Hamilton
- UCLA Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, 38-240 NPI, Box 175919, 90024-1759 Los Angeles, CA, USA.
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Koen N, Wyatt GE, Williams JK, Zhang M, Myer L, Zar HJ, Stein DJ. Intimate partner violence: associations with low infant birthweight in a South African birth cohort. Metab Brain Dis 2014; 29:281-99. [PMID: 24729207 PMCID: PMC4300125 DOI: 10.1007/s11011-014-9525-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 03/05/2014] [Indexed: 11/28/2022]
Abstract
Violence against women is a global public health problem. Exposure to intimate partner violence (IPV) during pregnancy has been associated with a number of adverse maternal and fetal outcomes, including delivery of a low birthweight (LBW) infant. However, there is a paucity of data from low-middle income countries (LMIC). We examined the association between antenatal IPV and subsequent LBW in a South African birth cohort. This study reports data from the Drakenstein Child Lung Health Study (DCLHS), a multidisciplinary birth cohort investigation of the influence of a number of antecedent risk factors on maternal and infant health outcomes over time. Pregnant women seeking antenatal care were recruited at two different primary care clinics in a low income, semi-rural area outside Cape Town, South Africa. Antenatal trauma exposure was assessed using the Childhood Trauma Questionnaire (CTQ) and an IPV assessment tool specifically designed for the purposes of this study. Potential confounding variables including maternal sociodemographics, pregnancy intention, partner support, biomedical and mental illness, substance use and psychosocial risk were also assessed. Bivariate and multiple regression analyses were performed to determine the association between IPV during pregnancy and delivery of an infant with LBW and/or low weight-for-age z (WAZ) scores. The final study sample comprised 263 mother-infant dyads. In multiple regression analyses, the model run was significant [r2 = 0.14 (adjusted r2 = 0.11, F(8, 212) = 4.16, p = 0.0001]. Exposure to physical IPV occurring during the past year was found to be significantly associated with LBW [t = -2.04, p = 0.0429] when controlling for study site (clinic), maternal height, ethnicity, socioeconomic status, substance use and childhood trauma. A significant association with decreased WAZ scores was not demonstrated. Exposure of pregnant women to IPV may impact newborn health. Further research is needed in this field to assess the relevant underlying mechanisms, to inform public health policies and to develop appropriate trauma IPV interventions for LMIC settings.
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Affiliation(s)
- Nastassja Koen
- Department of Psychiatry, Groote Schuur Hospital (J2), University of Cape Town, Cape Town, South Africa,
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Wyatt GE, Gómez CA, Hamilton AB, Valencia-Garcia D, Gant LM, Graham CE. The intersection of gender and ethnicity in HIV risk, interventions, and prevention: new frontiers for psychology. ACTA ACUST UNITED AC 2014; 68:247-60. [PMID: 23688092 DOI: 10.1037/a0032744] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This article articulates a contextualized understanding of gender and ethnicity as interacting social determinants of HIV risk and acquisition, with special focus on African Americans and Hispanics/Latinos--2 ethnic groups currently at most risk for HIV/AIDS acquisition in the United States. First, sex and gender are defined. Second, a conceptual model of gender, ethnicity, and HIV risk and resilience is presented. Third, a historical backdrop of gender and ethnic disparities is provided, with attention to key moments in history when notions of the intersections between gender, ethnicity, and HIV have taken important shifts. Finally, new frontiers in psychology are presented, with recommendations as to how psychology as a discipline can better incorporate considerations of gender and ethnicity as not only HIV risk factors but also as potential avenues of resilience in ethnic families and communities. Throughout the article, we promulgate the notion of a syndemic intersectional approach, which provides a critical framework for understanding and building the conditions that create and sustain overall community health by locating gendered lived experiences and expectations within the layered conceptual model ranging from the biological self to broader societal structures that define and constrain personal decisions, behaviors, actions, resources, and consequences. For ethnic individuals and populations, health disparities, stress and depression, substance abuse, and violence and trauma are of considerable concern, especially with regard to HIV risk, infection, and treatment. The conceptual model poses new frontiers for psychology in HIV policy, research, interventions, and training.
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Affiliation(s)
- Gail E Wyatt
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90024, USA.
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Payne JS, Galvan FH, Williams JK, Prusinski M, Zhang M, Wyatt GE, Myers HF. Impact of childhood sexual abuse on the emotions and behaviours of adult men from three ethnic groups in the USA. Cult Health Sex 2014; 16:10.1080/13691058.2013.867074. [PMID: 24393013 PMCID: PMC4083008 DOI: 10.1080/13691058.2013.867074] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Adult men of different ethnic backgrounds who experienced childhood sexual abuse (CSA) may vary in their reports of the psychological and behavioural impact of CSA on their lives. Empirical studies rarely examine the impact of race/ethnicity or cultural context on the psychological and behavioural struggles of adult male CSA survivors. This study utilised qualitative content analysis to examine the reported CSA-related psychological and behavioural challenges of 150 US men, with equal numbers of Blacks, Latinos and non-Latino Whites. Interview data revealed some ethnic differences: Black men more frequently denied having present day adverse effects than other groups. However, Black men who did report negative consequences of CSA discussed difficulties with substance use and hyper-sexualised behaviour more often than other ethnicities. Latino men reported anger, anxiety, hyper-vigilance, flashbacks and communication problems more often than the other two groups. Black and Latino men also discussed guilt/shame issues and sexual identity concerns more often than Whites did. In contrast, White men more frequently discussed issues related to low self-esteem, loneliness and isolation. These findings suggest that ethnically diverse men may respond differently to CSA experiences and that considerations need to be taken into account when providing healthcare to men with CSA histories.
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Affiliation(s)
| | - Frank H. Galvan
- Bienestar Human Services Research Division, Los Angeles, CA, USA
| | - John K. Williams
- Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioural Sciences, University of California Los Angeles (UCLA), CA, USA
| | - Missy Prusinski
- Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioural Sciences, University of California Los Angeles (UCLA), CA, USA
| | - Muyu Zhang
- Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioural Sciences, University of California Los Angeles (UCLA), CA, USA
| | - Gail E. Wyatt
- Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioural Sciences, University of California Los Angeles (UCLA), CA, USA
| | - Hector F. Myers
- Department of Psychology, University of California Los Angeles (UCLA), CA, USA
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Chin D, Myers HF, Zhang M, Loeb T, Ullman JB, Wyatt GE, Carmona J. Who Improved in a Trauma Intervention for HIV-Positive Women with Child Sexual Abuse Histories? Psychol Trauma 2014; 6:152-158. [PMID: 25202437 DOI: 10.1037/a0032180] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The Healing Our Women Program, an 11-week integrated trauma/HIV intervention designed for HIV-positive women with child sexual abuse histories, has been found to reduce psychological distress in treatment groups compared to wait-list controls (Chin et al., 2004; Wyatt et al., 2011). This study examines the characteristics of participants who improved vs. those who did not improve among participants who received the active intervention (N=78) at post, three-, and six-month follow-up. Logistic regression analyses conducted post-intervention and at three- and six-month followups examined demographic characteristics, treatment attendance, AIDS diagnosis, and total trauma burden as possible predictors of improvement. Results indicated that at post-test, total trauma burden was significantly associated with improvement. At three-month follow-up, none of the variables discriminated the groups. At six-month follow-up, total trauma burden was again significantly related to improvement. The results suggest that the intervention is most appropriate for women with high trauma burdens. Future HIV interventions should go beyond the "one size fits all" approach" and consider the "fit" between intervention and participants.
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Affiliation(s)
- Dorothy Chin
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles. Los Angeles, California
| | - Hector F Myers
- Department of Psychology, University of California at Los Angeles. Los Angeles, California
| | - Muyu Zhang
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles. Los Angeles, California
| | - Tamra Loeb
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles. Los Angeles, California
| | - Jodie B Ullman
- Department of Psychology, California State University, San Bernardino
| | - Gail E Wyatt
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles. Los Angeles, California
| | - Jennifer Carmona
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles. Los Angeles, California
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Loeb TB, Holloway IW, Galvan FH, Wyatt GE, Myers HF, Glover DA, Zhang M, Liu H. Associations between intimate partner violence and posttraumatic stress symptom severity in a multiethnic sample of men with histories of childhood sexual abuse. Violence Vict 2014; 29:451-463. [PMID: 25069149 DOI: 10.1891/0886-6708.vv-d-12-00166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Little research exists identifying risk factors for posttraumatic stress symptoms (PTSS) among men with histories of childhood sexual abuse (CSA) who have been exposed to intimate partner violence (IPV). METHODS One hundred and fifty African American, Latino and non-Latino White men with histories of CSA participated in this study. RESULTS An ordinary least squares regression model with race/ethnicity, HIV serostatus, and CSA severity treated as cofounders and with IPV as the predictor was fitted to predict level of PTSS. Higher levels of IPV were significantly associated with higher PTSS, as were higher levels of chronic stress, and being African American. CONCLUSIONS Mental health service providers should routinely screen for IPV in men who report histories of CSA and PTSS.
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