Sorvillo, F.; Smith, L.; Kerndt, P.; Ash, L.
Trichomonas vaginalis may be emerging as one of the most important cofactors in amplifying HIV transmission, particularly in African-American communities of the United States. In a person co-infected with HIV, the pathology induced by T. vaginalis infection can increase HIV shedding. Trichomonas infection may also act to expand the portal of entry for HIV in an HIV-negative person. Studies from Africa have suggested that T. vaginalis infection may increase the rate of HIV transmission by approximately twofold. Available data indicate that T. vaginalis is highly prevalent among African-Americans in major urban centers of the United States and is often the most common sexually transmitted infection in black women. Even if T. vaginalis increases the risk of HIV transmission by a small amount, this could translate into an important amplifying effect since Trichomonas is so common. Substantial HIV transmission may be attributable to T. vaginalis in African-American communities of the United States. PMID:11747718
... person’s chance of getting or transmitting HIV. The poverty rate is higher among African Americans than other racial/ethnic groups. The socioeconomic issues associated with poverty—including limited access to high-quality health care, ...
Cooper, Hannah L. F.; Osborne, Andrew H.
HIV continues to be transmitted at unacceptably high rates among African Americans, and most HIV-prevention interventions have focused on behavioral change. To theorize additional approaches to HIV prevention among African Americans, we discuss how sexual networks and drug-injection networks are as important as behavior for HIV transmission. We also describe how higher-order social structures and processes, such as residential racial segregation and racialized policing, may help shape risk networks and behaviors. We then discuss 3 themes in African American culture—survival, propriety, and struggle—that also help shape networks and behaviors. Finally, we conclude with a discussion of how these perspectives might help reduce HIV transmission among African Americans. PMID:19372519
Rao, Deepa; Molina, Yamile; Lambert, Nina; Cohn, Susan E.
Purpose In the present study, we validated a culturally adapted stigma scale designed to assess stigma among African Americans living with HIV. Methods We collected data on the scale using an audio computer assisted self-interview (ACASI) format. We validated the scale with a sample of 62 African American participants living with HIV. Results Findings demonstrated that stigma can be measured succinctly and effectively in a 14-item scale with two subscales measuring enacted and internalized stigma. Discussion We identified many advantages to using the scale, which demonstrated good psychometric properties when used with an audio computer assisted self-interview format and with an African American sample. We recommend this scale’s use in both clinical practice and research study of HIV-stigma reduction interventions with African American populations. PMID:27761520
Uhrig, Jennifer D.; Davis, Kevin C.; Rupert, Doug; Fraze, Jami
Objective: To examine whether there is an association between knowledge, attitudes and beliefs, reported intentions to get an HIV test, and reported HIV testing behaviour at a later date among a sample of African American women. Design: Secondary analysis of data collected from October 2007 through March 2008 for a randomized controlled experiment…
Polzer Casarez, Rebecca L; Miles, Margaret Shandor
The purpose of this study was to describe how spirituality affected the lives of African American mothers with Human Immunodeficiency Virus (HIV) in the context of coping. This qualitative descriptive study used secondary data of interviews from a larger longitudinal study of parental caregiving of infants seropositive for HIV. Participants were 38 African American mothers with HIV. Data from longitudinal semi-structured interviews were analyzed using content analysis. The women dealt with the stresses of HIV through a relationship with God. Two domains explain this relationship: God in control and God requires participation. The benefits of their relationship with God were a decrease in stress and worry about their own health and that of their infants. It is important for nurses working with mothers with HIV to acknowledge their spirituality and assess how spirituality helps them cope with and manage their illness.
Frye, Victoria; Bonner, Sebastian; Williams, Kim; Henny, Kirk; Bond, Keosha; Lucy, Debbie; Cupid, Malik; Smith, Stephen; Koblin, Beryl A.
In the United States, racial disparities in HIV/AIDS are stark. Although African Americans comprise an estimated 14% of the U.S. population, they made up 52% of new HIV cases among adults and adolescents diagnosed in 2009. Heterosexual transmission is now the second leading cause of HIV in the United States. African Americans made up a full…
Corneille, Maya A.; Zyzniewski, Linda E.; Belgrave, Faye Z.
Though HIV prevention efforts have focused on young adult women, women of all ages may engage in HIV risk behaviors and experience barriers to condom use. This article examines the effect of age on sexual risk and protective attitudes and behaviors among African American women. Unmarried heterosexual African American women between the ages of 18…
Jipguep, Marie-Claude; Sanders-Phillips, Kathy; Cotton, Lisa
This study tested a conceptual model that integrates structural and psychological determinants of HIV prevention for African American women. The sample consisted of African American mothers (N = 129) of children in Head Start programs. Higher levels of perceived stress were associated with higher levels of HIV risk; higher levels of perceived…
Kerr, Jelani C.; Valois, Robert F.; Diclemente, Ralph J.; Fletcher, Faith; Carey, Michael P.; Romer, Daniel; Vanable, Peter A.; Farber, Naomi
HIV-related stigma inhibits optimal HIV prevention and treatment among African-Americans. Regional differences in HIV/AIDS prevalence may be related to stigma among young African-Americans. Baseline data (N=1,606) from an HIV prevention intervention were used to investigate regional differences in HIV-related stigma and knowledge among African-American adolescents in four midsized cities in the Northeastern and Southeastern US. Analyses indicated greater HIV-related stigma among adolescents from the southeast relative to adolescents from the northeast (F=22.23;p<0.0001). Linear regression indicated a negative relationship between HIV stigma and HIV knowledge (b=−0.65;p<0.0001). Addressing HIV/AIDS in high prevalence locales should include efforts to reduce HIV-related stigma. PMID:24402690
Berkley-Patton, Jannette; Moore, Erin W.; Hawes, Starlyn M.; Thompson, Carole Bowe; Bohn, Alexandria
HIV continues to disproportionately impact communities of color, and more calls are being extended to African American churches to assist in HIV education and screening efforts. However, no studies have reported on the HIV testing practices of African American church-affiliated persons. This study examines demographic, social, and behavioral factors associated with ever receiving an HIV test and last 12-month HIV testing. Findings indicated not having insurance and condom use were predictors of ever receiving an HIV test. Predictors of HIV testing in the last 12 months included marital status (i.e., single, divorced, separated, or widowed) and intentions to get tested for HIV in the near future. These predictors should be considered when designing HIV education and screening interventions for African American church settings. PMID:22468975
Newsome, Valerie; Airhihenbuwa, Collins O.
Although literature suggests that African American women are no more likely to engage in risky sex than their White counterparts, they are more likely to have sex partners with higher HIV risk. Thus, it is not solely an individual’s behavior that determines their risk, but also the behavior of their partner and their position within a sexual network. For this reason, it is important to consider the dynamics of heterosexual relationships in the African American community. An important area of concern regarding African American heterosexual relationships is that of partner availability. A shortage of available African American men for potential partnerships exists and is reportedly due to poorer health and higher mortality rates. Some have argued that gender-ratio imbalance may be responsible for increased HIV vulnerability for African American women. This article reviews the literature on gender ratio imbalance and HIV risk in the African American community, and presents implications and suggestions for future research and intervention. PMID:23041754
Kelso, Gwendolyn A; Cohen, Mardge H; Weber, Kathleen M; Dale, Sannisha K; Cruise, Ruth C; Brody, Leslie R
Critical consciousness, the awareness of social oppression, is important to investigate as a buffer against HIV disease progression in HIV-infected African American women in the context of experiences with discrimination. Critical consciousness comprises several dimensions, including social group identification, discontent with distribution of social power, rejection of social system legitimacy, and a collective action orientation. The current study investigated self-reported critical consciousness as a moderator of perceived gender and racial discrimination on HIV viral load and CD4+ cell count in 67 African American HIV-infected women. Higher critical consciousness was found to be related to higher likelihood of having CD4+ counts over 350 and lower likelihood of detectable viral load when perceived racial discrimination was high, as revealed by multiple logistic regressions that controlled for highly active antiretroviral therapy (HAART) adherence. Multiple linear regressions showed that at higher levels of perceived gender and racial discrimination, women endorsing high critical consciousness had a larger positive difference between nadir CD4+ (lowest pre-HAART) and current CD4+ count than women endorsing low critical consciousness. These findings suggest that raising awareness of social oppression to promote joining with others to enact social change may be an important intervention strategy to improve HIV outcomes in African American HIV-infected women who report experiencing high levels of gender and racial discrimination.
Kelso, Gwendolyn A.; Cohen, Mardge H.; Weber, Kathleen M.; Dale, Sannisha K.; Cruise, Ruth C.; Brody, Leslie R.
Critical consciousness, the awareness of social oppression, is important to investigate as a buffer against HIV disease progression in HIV-infected African American women in the context of experiences with discrimination. Critical consciousness comprises several dimensions, including social group identification, discontent with distribution of social power, rejection of social system legitimacy, and a collective action orientation. The current study investigated self-reported critical consciousness as a moderator of perceived gender and racial discrimination on HIV viral load and CD4+ cell count in 67 African American HIV-infected women. Higher critical consciousness was found to be related to higher likelihood of having CD4+ counts over 350 and lower likelihood of detectable viral load when perceived racial discrimination was high, as revealed by multiple logistic regressions that controlled for highly active antiretroviral therapy (HAART) adherence. Multiple linear regressions showed that at higher levels of perceived gender and racial discrimination, women endorsing high critical consciousness had a larger positive difference between nadir CD4+ (lowest pre-HAART) and current CD4+ count than women endorsing low critical consciousness. These findings suggest that raising awareness of social oppression to promote joining with others to enact social change may be an important intervention strategy to improve HIV outcomes in African American HIV-infected women who report experiencing high levels of gender and racial discrimination. PMID:24077930
Brawner, Bridgette M.
Disproportionate HIV/AIDS rates among African American women have been examined extensively—primarily from an individually-centered focus. Beyond individual behaviors, factors such as the hyper-incarceration of African American men and geographically concentrated disadvantage may better explain inequitable disease burden. This paper proposes a conceptual model of individual, social, and structural factors that influence HIV transmission among African American women. The model can be used to develop comprehensive assessments and guide prevention programs in African American communities. PMID:25139057
Njie-Carr, Veronica; Sharps, Phyllis; Campbell, Doris; Callwood, Gloria
This qualitative study examined the experiences of HIV-positive African-American and African Caribbean childbearing women related to decisions about HIV testing, status disclosure, adhering to treatment, decisions about childbearing, and experiences in violent intimate relationships. Twenty-three women completed a 60-minute in-depth interview. Six themes emerged: perceived vulnerability to HIV infection; feelings about getting tested for HIV; knowledge, attitudes, and behaviors after HIV diagnosis; disclosure of HIV status; living with HIV (positivity, strength, and prayer); and, experiences with physical and sexual violence. Three women (13%) reported perinatal abuse and 10 women (n = 23, 43.4%) reported lifetime abuse. Positive experiences and resilience were gained from faith and prayer. Most important to the women were the perceived benefits of protecting the health of their baby. Findings suggest that policies supporting early identification of HIV-positive childbearing women are critical in order to provide counseling and education in forming their decisions for safety precautions in violent intimate partner relationships. PMID:23061166
McCord, Laneshia R
Understanding sexual-risk behaviours as defined by a culture presents new challenges for human service professionals. Older African American women constitute the fastest growing group of new cases of HIV in the USA. With heterosexual sex as the primary mode of transmission among this group, there exist minimal programmes that are culture and age-specific in terms of primary and secondary prevention. In an attempt to address this gap in knowledge, this study examined how a group of older African American women defined sexual-risk behaviour. A focus group was conducted with seven women age 45 and older, who were recruited from a community centre. This paper examines the way that sexual-risk behaviour was defined through thematic analysis and conceptualises the locus of sexual risk behaviour as defined by the participants. The major theme of the study was social prescription, how to behave sexually as an ageing adult. Underlying ideas that arose were that unprotected sex occurred out of habit, that impulsivity was associated with risky sex and that older women needed to be aware of warning signs and behaviours of potential mates. Micro- and macro-level implications for human service professionals are discussed.
Mason, Sally; Berger, Barbara; Ferrans, Carol Estwing; Sultzman, Vickey; Fendrich, Michael
Objectives: African American urban adolescents are one of the fastest growing groups of children affected by their mother's HIV status. These children experience HIV stigma by association with their HIV-positive mothers. Stigma may contribute to adverse outcomes for these teens. Methods: The authors describe a multistage process of scale…
Edwards, Lorece V.; Irving, Shalon M.; Hawkins, Anita S.
HIV/AIDS disease continues to be an escalating health problem, particularly among women. However, African American women are among the leading demographic groups for HIV prevalence in the United States. The typical woman with HIV/AIDS is young, in her late twenties, economically challenged, and of childbearing age. Participants were recruited from…
Lloyd, Stacey W.; Ferguson, Yvonne Owens; Corbie-Smith, Giselle; Ellison, Arlinda; Blumenthal, Connie; Council, Barbara J.; Youmans, Selena; Muhammad, Melvin R.; Wynn, Mysha; Adimora, Adaora; Akers, Aletha
Though African-American youth in the South are at high risk for HIV infection, abstinence until marriage education continues to be the only option in some public schools. Using community-based participatory research methods, we conducted 11 focus groups with African-American adults and youth in a rural community in North Carolina with high rates…
Butcher, Richard O.; Hood, Rodney G.; Jordan, Wilbert C.
HIV/AIDS is a disease that has a disproportionate negative impact on the African-American and Latino communities when compared with the general population. African Americans account for more than 50% of new AIDS cases, though they comprise only 12% of the general population. More than one-third of AIDS-related deaths in the United States have been among African Americans. Many factors contribute to the HIV/AIDS healthcare disparities seen in the African-American and Latino communities. These factors include medical issues (such as resistance to antiretroviral therapy, toxicities of medications and hepatitis-C coinfection) and social factors (such as a lack of faith in the healthcare system, cultural circumstances and poor access to healthcare services). Healthcare providers can take steps to improve HIV care for African Americans and Latinos. Distrust of the medical establishment can be addressed by increasing the number of culturally sensitive healthcare providers. Communication is the first step toward establishing the trust of patients and minimizing the devastating effects of perceived institutional bias that may lead many HIV patients to be diagnosed late in the course of the disease. Medical and cultural issues faced by African Americans and Latinos should also be addressed in treatment guidelines. When healthcare providers take steps to overcome the medical and cultural issues facing African Americans and Latinos, HIV patients will have access to more effective disease management. PMID:16173324
Voisin, Dexter R.; Bird, Jason D. P.
This study explored the beliefs of African American male adolescents concerning the high rates of HIV infection among their peers and their reasons for those beliefs. In-depth interviews were conducted with a sample of 16 male African Americans, and a thematic analysis of the data was conducted. Half of the participants believed that peers were…
Berkley-Patton, Jannette; Thompson, Carole Bowe; Moore, Erin; Hawes, Starlyn; Simon, Stephen; Goggin, Kathy; Martinez, David; Berman, Marcie; Booker, Alexandria
Background African Americans are disproportionately burdened by HIV. The African American church is an influential institution with potential to increase reach of HIV prevention interventions in Black communities. Purpose This study examined HIV testing rates in African American churches in the Taking It to the Pews pilot project. Using a community-engaged approach, church leaders delivered religiously-tailored HIV education and testing materials/activities (e.g., sermons, brochures/bulletins, testimonials) to church and community members. Methods Four African American churches (N=543 participants) located in the Kansas City metropolitan area were randomized to intervention and comparison groups. Receipt of an HIV test was assessed at baseline and 6 months. Results Findings indicated intervention participants were 2.2 times more likely to receive an HIV test than comparisons at 6 months. Church leaders delivered about 2 tools per month. Conclusions Church-based HIV testing interventions are feasible and have potential to increase HIV testing rates in African American communities. PMID:26821712
Peterson, John L; Miner, Michael H; Brennan, David J; Rosser, B R Simon
The association between HIV treatment optimism--beliefs about susceptibility to transmit HIV, motivation to use condoms, and severity of HIV--and sexual risk behavior was examined among HIV-positive African American men who have sex with men (MSM). Participants were 174 men recruited in four major metropolitan areas of the United States to participate in a weekend HIV risk reduction intervention. Baseline results revealed that beliefs in less susceptibility to transmit HIV and less motivation to use condoms were significantly associated with more unprotected anal intercourse among serodiscordant casual partners. Less motivation to use condoms also predicted more unprotected insertive and receptive anal sex and was more important than susceptibility beliefs in predicting these behaviors. Suggestions are offered of ways to better inform HIV-positive African American MSM about their misperceptions about HIV treatment and how their level of optimism about HIV treatment may diminish or encourage condom use.
Stewart, Jennifer M.; Dancy, Barbara L.
Having an HIV ministry within a church depends on the religious culture of that church. However, little is known about how a church’s religious culture influences an HIV ministry. This study’s purpose was to examine how an African American church’s religious culture supported the development, implementation, and maintenance of an HIV ministry within the church. An ethnographic case study research design was used. Data were collected through interviews, non-participant and participant observations, review of pertinent documents, and survey of congregants. Results revealed the following as important for an HIV ministry: (a) a belief in helping others and treating everyone with respect and dignity, (b) feelings of compassion toward individuals infected with HIV, and (c) HIV education. This information can assist in developing interventions to enhance the African American church movement toward HIV ministries. PMID:22212914
Okigbo, Charles; Okigbo, Carol A.; Hall, William B., Jr.; Ziegler, Dhyana
Both African states and African American communities can benefit from a new communication framework that the United Nations Global AIDS Program and the Pennsylvania State University developed to combat the HIV/AIDS pandemic. The framework contains five universal values recommended for AIDS intervention programs worldwide (government policies,…
Taylor, Sandra E.; Jones, Tara
This paper investigated African American college students' responses to a set of interview questions selected from a larger survey instrument in an exploratory study of basic attitudes about HIV/AIDS. Forty-two participants responded to an interview schedule in an investigation of student attitudinal domains regarding the HIV/AIDS epidemic.…
Presents findings from interviews conducted with 18 African American women living with HIV/AIDS. Presents their perceptions of ways in which their families function as a source of support and as a source of stress in their dealings with HIV/AIDS issues. Provides information on supportive aspects provided by family in emotional, concrete, and…
Johnson, Eboneé T.; Yaghmaian, Rana A.; Best, Andrew; Chan, Fong; Burrell, Reginald, Jr.
Purpose: The purpose of this study was to validate the 10-item version of the HIV Stigma Scale (HSS-10) in a sample of African Americans with HIV/AIDS. Method: One hundred and ten African Americans living with HIV/AIDS were recruited from 3 case management agencies in Baton Rouge, Louisiana. Measurement structure of the HSS-10 was evaluated using…
Lloyd, Stacey W; Ferguson, Yvonne Owens; Corbie-Smith, Giselle; Ellison, Arlinda; Blumenthal, Connie; Council, Barbara J; Youmans, Selena; Muhammad, Melvin R; Wynn, Mysha; Adimora, Adaora; Akers, Aletha
Though African-American youth in the South are at high risk for HIV infection, abstinence until marriage education continues to be the only option in some public schools. Using community-based participatory research methods, we conducted 11 focus groups with African-American adults and youth in a rural community in North Carolina with high rates of HIV infection with marked racial disparities. Focus group discussions explored participant views on contributors to the elevated rates of HIV and resources available to reduce transmission. Participants consistently identified the public schools' sex education policies and practices as major barriers toward preventing HIV infection among youth in their community. Ideas for decreasing youth's risk of HIV included public schools providing access to health services and sex education. Policymakers, school administrators, and other stakeholders should consider the public school setting as a place to provide HIV prevention education for youth in rural areas.
Stewart, Jennifer M.
Objective To assess the barriers and facilitators to using African American churches as sites for implementation of evidence-based HIV interventions among young African American women. Design Mixed methods cross-sectional design. Setting African American churches in Philadelphia, PA. Participants 142 African American pastors, church leaders, and young adult women ages 18 to 25. Methods Mixed methods convergent parallel design. Results The majority of young adult women reported engaging in high-risk HIV-related behaviors. Although church leaders reported willingness to implement HIV risk-reduction interventions, they were unsure of how to initiate this process. Key facilitators to the implementation of evidence-based interventions included the perception of the leadership and church members that HIV interventions were needed and that the church was a promising venue for them. A primary barrier to implementation in this setting is the perception that discussions of sexuality should be private. Conclusion Implementation of evidence-based HIV interventions for young adult African American women in church settings is feasible and needed. Building a level of comfort in discussing matters of sexuality and adapting existing evidence-based interventions to meet the needs of young women in church settings is a viable approach for successful implementation. PMID:25139612
Goparaju, Lakshmi; Warren-Jeanpiere, Lari
African American women are disproportionately affected by HIV. Some research has explored if non-disclosing men who have sex with men and women contribute to women's HIV risk. Popular media discourse tends to refer to these men as 'down low' or 'DL'. Six focus groups were conducted with 36 African American women in Washington, DC, to examine their knowledge, attitudes, beliefs and behaviours regarding DL men. Three of the focus groups were composed of HIV-positive women and three groups were composed of HIV-negative women. Data analysis reveals six central subcategories related to women's perspectives on the DL: awareness, suspicion, coping with partner infidelity (male versus female), sexual health communication, empathy and religion. No major differences were identified between the HIV-positive and HIV-negative focus groups. Findings from this study provide insight into African American women's perceptions of African American male sexuality and how these perceptions serve to influence interpersonal relationship factors and women's exposure to HIV risk.
Amutah, Ndidiamaka N.
In 2007, the estimated HIV and AIDS case rates among adult and adolescent African-American females in the United States was 60.6 per 100,000, as compared to 3.3 per 100,000 for adult and adolescent white American females. Women living with HIV or AIDS often face complex social problems that may inhibit them from accessing resources and healthcare…
Stewart, Jennifer M; Thompson, Keitra; Rogers, Christopher
The US National HIV AIDS strategy promotes the use of faith communities to lessen the burden of HIV in African American communities. One specific strategy presented is the use of these non-traditional venues for HIV testing and co-location of services. African American churches can be at the forefront of this endeavour through the provision of HIV testing and linkage to care. However, there are few interventions to promote the churches' involvement in both HIV testing and linkage to care. We conducted 4 focus groups (n = 39 participants), 4 interviews and 116 surveys in a mixed-methods study to examine the feasibility of a church-based HIV testing and linkage to care intervention in Philadelphia, PA, USA. Our objectives were to examine: (1) available assets, (2) challenges and barriers and (3) needs associated with church-based HIV testing and linkage to care. Analyses revealed several factors of importance, including the role of the church as an access point for testing in low-income neighbourhoods, challenges in openly discussing the relationship between sexuality and HIV, and buy-in among church leadership. These findings can support intervention development and necessitate situating African American church-based HIV testing and linkage to care interventions within a multi-level framework.
Kennedy, Bernice Roberts; Jenkins, Chalice C
African American women, including adolescents and adults, are disproportionately affected by the transmission of Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS). HIV/AID is a health disparity issue for African American females in comparison to other ethnic groups. According to data acquired from 33 states in 2005, 64% of women who have HIV/ AIDS are African American women. It is estimated that during 2001-2004, 61% of African Americans under the age of 25 had been living with HIV/AIDS. This article is an analytical review of the literature emphasizing sexual assertiveness of African American women and the gap that exists in research literature on this population. The multifaceted model of HIV risk posits that an interpersonal predictor of risky sexual behavior is sexual assertiveness. The critical themes extracted from a review of the literature reveal the following: (a) sexual assertiveness is related to HIV risk in women, (b) sexual assertiveness and sexual communication are related, and (c) women with low sexual assertiveness are at increased risk of HIV As a result of this comprehensive literature, future research studies need to use models in validating sexual assertiveness interventions in reducing the risk of HIV/AIDS in African American women. HIV/AIDs prevention interventions or future studies need to target reducing the risk factors of HIV/AIDS of African Americans focusing on gender and culture-specific strategies.
This paper reports baseline behavioral and biological data collected from a cohort of 535 African American HIV serodiscordant couples enrolled in the Eban study across four urban metro areas. Data were collected on (1) the prevalence of risky sexual behaviors that occur within a couple and with concurrent sexual partners, (2) the STD prevalence for each member of the couple and (3) the correlates of STDs in the male partner as well as in the female partner. Presentation of the sociodemographic characterization and HIV risk behavior profiles of African American HIV serodiscordant couples represents an important initial description of a hidden, vulnerable population. Future research should be conducted with diverse samples of African American couples (i.e., younger couples, non-stable couples) to explore other potential correlates of STD prevalence. PMID:20499152
This paper reports baseline behavioral and biological data collected from a cohort of 535 African American HIV serodiscordant couples enrolled in the Eban study across four urban metro areas. Data were collected on (1) the prevalence of risky sexual behaviors that occur within a couple and with concurrent sexual partners, (2) the STD prevalence for each member of the couple and (3) the correlates of STDs in the male partner as well as in the female partner. Presentation of the sociodemographic characterization and HIV risk behavior profiles of African American HIV serodiscordant couples represents an important initial description of a hidden, vulnerable population. Future research should be conducted with diverse samples of African American couples (i.e., younger couples, non-stable couples) to explore other potential correlates of STD prevalence.
Derose, Kathryn Pitkin; Kanouse, David E.; Bogart, Laura M.; Griffin, Beth Ann; Haas, Ann; Stucky, Brian D.; Williams, Malcolm V.; Flórez, Karen R.
Objectives Inform church-based stigma interventions by exploring dimensions of HIV stigma among African American and Latino religious congregants and how these are related to drug addiction and homosexuality stigmas and knowing someone HIV-positive. Methods In-person, self-administered surveys of congregants 18+ years old across two African American and three Latino churches (n=1235, response rate 73%) in a western US city with high HIV prevalence. Measures included 12 items that captured dimensions of HIV stigma, a 5-item scale that assessed attitudes towards people who are addicted to drugs, a 7-item scale assessing attitudes towards homosexuality, and questions regarding socio-demographics and previous communication about HIV. Results 63.8% of survey participants were women, mean age was 40.2 years, and 34.4% were African American, 16.8% were U.S.-born Latinos, 16.0% were foreign-born, English-speaking Latinos, and 32.9% were foreign-born, Spanish-speaking Latinos. Exploratory and confirmatory factor analyses identified four dimensions of HIV stigma – discomfort interacting with people with HIV (4 items, α=0.86), feelings of shame “if you had HIV” (3 items, α=0.78), fears of rejection “if you had HIV” (3 items, α=0.71) and feelings of blame towards people with HIV (2 items, α=0.65). Across all dimensions, after controlling for socio-demographic characteristics and previous communication about HIV, knowing someone with HIV was associated with lower HIV stigma, and greater stigma concerning drug addiction and homosexuality were associated with higher HIV stigma. Conclusions Congregation-based HIV stigma reduction interventions should consider incorporating contact with HIV-affected people. It may also be helpful to address attitudes toward drug addiction and sexual orientation. PMID:26213890
The design of effective behavioral interventions to prevent HIV infection among African American women requires a more complete understanding of the context and circumstances that precipitate infection with the virus. A descriptive study was designed to explore African American women's experiences of infection with HIV in the rural southeastern United States. Ten women living with HIV participated in interviews. All were infected through sex with a man or men; three had engaged in high-risk activities associated with HIV infection including sex trading; seven described themselves as at low risk for infection related to serial monogamy, no injection drug use, and no history of addiction. Participants reported that desire for intimacy coupled with inaccurate risk appraisal of sex partners contributed to their infection. These results provide insight into the role of intimacy in sexual risk taking. Inquiry into how women can be assisted to protect themselves in the context of intimate relationships may improve interventions to prevent HIV.
Paxton, Keisha C.; Williams, John K.; Bolden, Sherica; Guzman, Yesenia; Harawa, Nina T.
Background HIV continues to impact African American women at alarming rates. Yet, few researchers have examined the relationship factors promoting unprotected sex within African American communities, especially instances in which women are aware that their male partners are engaging in high risk behaviors. This qualitative study explored the sexual behaviors, relationship characteristics, and HIV prevention strategies utilized by African American women in relationships with African American men at-risk for HIV. Method To understand the issues that should be addressed in a sexual risk-reduction intervention, data were collected from three, two-hour focus group discussions (n=24) comprised primarily of low-income African American women with histories of at-risk male sex partners. At-risk partners included specifically men who had sex with other men or with transgender individuals, used crack cocaine or injection drugs, had lengthy incarceration periods, or an unknown sexual history. Discussion questions examined external factors affecting sexual risk behaviors such as societal pressures, peer norms, and financial vulnerability. Discussions were audiotaped, transcribed, and analyzed using a consensual qualitative research approach. Results Five themes, including self-esteem, social influences on behavior, relationship fidelity, sexual risk behavior, and partners' sexual behaviors, were identified as placing women at increased risk for HIV. Reasons for inconsistent condom use included concern for maintaining the relationship and substance use before and during sex. African American women also believed that men who have sex with men and women (MSMW) were dishonest about their sexuality due to stigma towards homosexuality/bisexuality. Despite these challenges, participants indicated that African American women have a strong sense of pride that can positively impact behaviors in relationships. Conclusion The findings of this study support that social and contextual factor
Singleton, Judith L; Raunig, Manuela; Brunsteter, Halley; Desmond, Michelle; Rao, Deepa
African American men have the highest rates of HIV in the USA, and research has shown that stigma, mistrust of health care, and other psychosocial factors interfere with optimal engagement in care with this population. In order to further understand reducing stigma and other psychosocial issues among African American men, we conducted qualitative interviews and focus groups with African American men in two metropolitan areas in the USA: Chicago and Seattle. We examined transcripts for relationships across variables of stigma, anonymity, self-identity, and space within the context of HIV. Our analysis pointed to similarities between experiences of stigma across the two cities and illustrated the relationships between space, isolation, and preferred anonymity related to living with HIV. The men in our study often preferred that their HIV-linked identities remain invisible and anonymous, associated with perceived and created isolation from physical community spaces. This article suggests that our health care and housing institutions may influence preferences for anonymity. We make recommendations in key areas to create safer spaces for African American men living with HIV and reduce feelings of stigma and isolation.
Singleton, Judith L.; Raunig, Manuela; Brunsteter, Halley; Desmond, Michelle; Rao, Deepa
African American men have the highest rates of HIV in the United States, and research has shown that stigma, mistrust of healthcare, and other psychosocial factors interfere with optimal engagement in care with this population. In order to further understand reducing stigma and other psychosocial issues among African American men, we conducted qualitative interviews and focus groups with African American men in two metropolitan areas in the United States: Chicago and Seattle. We examined transcripts for relationships across variables of stigma, anonymity, self-identity, and space within the context of HIV. Our analysis pointed to similarities between experiences of stigma across the two cities, and illustrated the relationships between space, isolation and preferred anonymity related to living with HIV. The men in our study often preferred their HIV-linked identities remain invisible and anonymous, associated with perceived and created isolation from physical community spaces. This article suggests that our healthcare and housing institutions may influence preferences for anonymity. We make recommendations in key areas to create safer spaces for African American men living with HIV and reduce feelings of stigma and isolation. PMID:26863561
Warren-Jeanpiere, Lari; Dillaway, Heather; Hamilton, Pilar; Young, Mary; Goparaju, Lakshmi
HIV chronicity has resulted in increased life expectancy for many African American women who acquired the disease during the epidemic’s peak years. As these women live longer and age, their social support needs may increase. Five focus groups were conducted in Washington, DC with 23 HIV-positive African American women aged 52–65 to explore women’s perceptions about how aging and HIV chronicity affects their social support needs. Participants were recruited from the longitudinal Women’s Interagency HIV Study (WIHS) participant pool. A constant comparison approach was applied during data analysis. Participants reported needing increased social support, especially emotional support from health care providers, family, and HIV-positive peers. The importance of providers and HIV-positive peers was discussed most frequently relative to meeting these needs. Health care providers in particular may need to increase their provision of emotional support when devising treatment plans to meet the social support needs of older HIV-positive African American women. PMID:28239009
Rose, Michelle A; Sharpe, Tanya Telfair; Raliegh, Kathleen; Reid, Laurie; Foley, Megan; Cleveland, Janet
The meeting, HIV/AIDS and African American Women: A Consultation Supporting CDC's Heightened National Response to the HIV/AIDS Crisis among African Americans, provided a forum to address gaps in prevention and HIV/AIDS infection for African American women. Health researchers, community-based organization leaders, and representatives from both healthcare and non-healthcare sectors took this opportunity to discuss and develop a variety of priorities and suggestions for HIV/AIDS prevention. Four focus areas were provided for meeting attendees to promote discussion and strategy development. The resulting list of priorities and suggestions for HIV/AIDS prevention may provide future steps for researchers, communities, and physicians to increase prevention and decrease infection rates. Novel, innovative, and participatory approaches are needed within and outside the public arena to decrease the gaps in HIV/AIDS prevention for African American women.
Essien, E James; Meshack, Angela F; Peters, Ronald J; Ogungbade, GO; Osemene, Nora I
Background African-American women are disproportionately affected by HIV, accounting for 60% of all cases among women in the United States. Although their race is not a precursor for HIV, the socioeconomic and cultural disparities associated with being African American may increase their risk of infection. Prior research has shown that interventions designed to reduce HIV infection among African-American women must address the life demands and social problems they encounter. The present study used a qualitative exploratory design to elicit information about strategies to prevent HIV transmission among young, low-income African-American women. Methods Twenty five low income African American women, ages 18–29, participated in five focus groups of five women each conducted at a housing project in Houston, Texas, a large demographically diverse metropolitan area that is regarded as one of the HIV/AIDS epicenters in the United States. Each group was audiotaped, transcribed, and analyzed using theme and domain analysis. Results The participants revealed that they had most frequently placed themselves at risk for HIV infection through drugs and drinking and they also reported drug and alcohol use as important barriers to practicing safer sex. The women also reported that the need for money and having sex for money to buy food or drugs had placed them at risk for HIV transmission. About one-third of the participants stated that a barrier to their practicing safe sex was their belief that there was no risk based on their being in a monogamous relationship and feeling no need to use protection, but later learning that their mate was unfaithful. Other reasons given were lack of concern, being unprepared, partner's refusal to use a condom, and lack of money to buy condoms. Finally, the women stated that they were motivated to practice safe sex because of fear of contracting sexually transmitted diseases and HIV, desire not to become pregnant, and personal experience with
Fletcher, Faith; Ingram, Lucy Annang; Kerr, Jelani; Buchberg, Meredith; Bogdan-Lovis, Libby; Philpott-Jones, Sean
African American women bear a disproportionate burden of HIV/AIDS in the United States. Although they constitute only 13% of the US population, African Americans account for nearly 65% of all new HIV infections among American women. In addition, this population suffers comparatively greater adverse health outcomes related to HIV status. African American women living with HIV in the South may be further burdened by HIV/AIDS stigma, which is comparatively more pronounced in this region. To further explore this burden, we used narrative data and the Social Ecological Model to explore how African American women living with HIV in the US South recount, conceptualize, and cope with HIV/AIDS stigma at interpersonal, community, and institutional levels. Our narrative analysis suggests that HIV-positive African American women living in the South are vulnerable to experiences of multilevel HIV stigma in various settings and contexts across multiple domains of life. Stigma subsequently complicated disclosure decisions and made it difficult for women to feel supported in particular social, professional and medical settings that are generally regarded as safe spaces for noninfected individuals. Findings suggest that the debilitating and compounded effect of multilevel HIV/AIDS stigma on HIV-positive African American women in the South warrants closer examination to tailor approaches that effectively address the unique needs of this population.
Painter, Julia E; Wingood, Gina M; DiClemente, Ralph J; Depadilla, Lara M; Simpson-Robinson, Lashun
African-American women are disproportionately affected by sexually transmitted infections (STIs), including HIV. The Theory of Gender and Power (TGP) posits that socioeconomic exposures, including educational attainment, place women at increased risk for STIs/HIV. This study examined the association between educational attainment and vulnerability to STIs/HIV, as well as potential TGP-driven mediators of this association, among African-American women. Baseline data were assessed from an STI/HIV prevention intervention for African-American women (n = 848) aged 18 to 29 recruited from three Kaiser Permanente Centers in Atlanta, Georgia. Data collection included a survey of demographic, psychosocial, and behavioral measures and self-collected, laboratory-confirmed vaginal swabs for STIs (trichomoniasis, chlamydia, gonorrhea, and human papillomavirus). Multiple regression analyses and multivariate mediation analyses were used to examine the association between educational attainment with a laboratory-confirmed STI and potential TGP mediators. Controlling for age and receipt of public assistance, the odds of an STI diagnosis were 73% lower among participants with a college degree or greater compared with participants who had not completed high school. There were also significant associations between educational attainment and multiple TGP mediators from the sexual division of power and the structure of cathexis. TGP constructs did not mediate the association between educational attainment and laboratory-confirmed STI. The current study suggests that graduating from college may lead to a beneficial reduction in vulnerability to STIs/HIV among African-American women. Findings from this study support expanding structural-level interventions, emphasizing both high school and college graduation, as a means of reducing vulnerability to STIs/HIV among African-American women.
Saleh, Lena D.; Chambers, Christopher S.; Operario, Don
Previous research has suggested a need to understand the social-psychological factors contributing to HIV risk among African American men who have sex with men (MSM). We conducted individual in-depth interviews with 34 adult African American MSM to examine their personal experiences about: (i) sources of social support, (ii) psychological responses to the presence or absence of social support, and (iii) influences of social support on sexual behaviors. The majority of participants described limited positive encouragement and lack of emotional support from family, as well as few meaningful personal relationships. Feelings of isolation and mistrust about personal relationships led many participants to avoid emotional intimacy and seek physical intimacy through sexual encounters. Findings highlight a need for multi-level interventions that enhance social support networks and address the social-psychological, emotional, and interpersonal factors that contribute to HIV risk among African American MSM. PMID:26588945
Saleh, Lena D; van den Berg, Jacob J; Chambers, Christopher S; Operario, Don
Previous research has suggested a need to understand the social-psychological factors contributing to HIV risk among African American men who have sex with men (MSM). We conducted individual in-depth interviews with 34 adult African American MSM to examine their personal experiences about: (i) sources of social support, (ii) psychological responses to the presence or absence of social support and (iii) influences of social support on sexual behaviours. The majority of participants described limited positive encouragement and lack of emotional support from family, as well as few meaningful personal relationships. Feelings of isolation and mistrust about personal relationships led many participants to avoid emotional intimacy and seek physical intimacy through sexual encounters. Findings highlight a need for multilevel interventions that enhance social support networks and address the social-psychological, emotional and interpersonal factors that contribute to HIV risk among African American MSM.
Klein, H; Sterk, CE; Elifson, KW
Purpose Race and HIV are intertwined in complex ways. African Americans, particularly those residing in the southern United States, are at great risk for contracting and subsequently transmitting HIV. Research on the extent to which members of this population understand the risks associated with engaging in specific behaviors is limited. This paper examines HIV knowledge among at-risk adult African American men and women and the factors associated with levels of HIV knowledge. Methods Based on a conceptual model derived from Social Disorganization Theory and Syndemics Theory, interviews were conducted between 2009 and 2011. Questionnaire-based interviews were conducted with 1,864 respondents from 80 strategically-chosen census block groups in Atlanta, Georgia. An innovative approach to assessing amount of HIV knowledge was implemented, to derive better estimates of the extent of knowledge. Results Overall, HIV knowledge was low (average=43.5% correct answers). Seven factors were identified as contributing uniquely to having higher levels of knowledge about HIV transmission: (1) younger age, (2) being educated beyond the high school level, (3) being gay, lesbian or bisexual, (4) experiencing sexual abuse during childhood and/or adolescence, (5) drinking alcohol less frequently, (6) knowing a larger number of HIV-infected persons and (7) knowing anyone currently living with “full blown” AIDS. Conclusion HIV educational and intervention programs targeting at-risk African American adults need to develop effective ways of bolstering a solid understanding of how HIV is/not transmitted. In particular, efforts need to be targeted toward older adults, those with lower levels of educational attainment and persons who are not acquainted with anyone who is HIV-infected. PMID:27891291
Objective To describe the Eban HIV/STD Risk Reduction Intervention being evaluated in the NIMH Multisite HIV/STD Prevention trial for heterosexual African American couples, including the integrated theoretical framework, the structure, core elements and procedures of the intervention and how the content was shaped by culturally congruent concepts to address the needs of the study target population. Design The Eban HIV/STD Risk Reduction Intervention is designed to address multilevel individual, interpersonal and community level factors that contribute to HIV/STD transmission risk behaviors among heterosexual African American couples who are HIV serodiscordant. Methods The Eban HIV/STD Risk Reduction Intervention employs a mixed modality, couples-based approach that is based on an integrated ecological framework incorporating social cognitive theory and uses an Afro-centric paradigm that is informed by previous evidence-based couples HIV prevention interventions. For this randomized controlled trial, African American serodiscordant couples were recruited from four urban sites (Atlanta, Los Angeles, New York and Philadelphia) and were randomized to either the Eban HIV/STD Risk Reduction Intervention (treatment condition) or a Health Promotion Intervention that served as an attentional control condition. Both interventions had 4 individual couple sessions and 4 group sessions, but only the treatment condition was focused on reducing HIV/STD risk behaviors. Behavioral and biological data were collected at baseline, immediately after the intervention, and at 6 and 12 months. The theoretical framework, core elements and content of each session are described and lessons learned from this intervention trial are discussed. Results An HIV prevention intervention combining couple and group sessions can be feasibly implemented with African American HIV serodiscordant couples who remain at high risk of HIV/STD transmission. The lessons learned from the trial suggest that the
Pinto, R. M.; McKay, M. M.
Grounded in a model of service utilization, this study conceptualizes attendance of African-American women at an HIV prevention intervention as associated with influences across three ecological domains--individual, service (program), and social network. First, the texts of responses to semistructured, open-ended elicitation interviews were…
Bogart, Laura M; Mutchler, Matt G; McDavitt, Bryce; Mutepfa, Kieta D; Risley, Brian
Background HIV-positive African Americans have been shown to have lower adherence to antiretroviral therapy (ART) than those of other races/ethnicities, yet adherence interventions have rarely been tailored to the needs of this population. Objective We developed and will evaluate a treatment education adherence intervention (called Rise) that was culturally adapted to address the needs of African Americans living with HIV. Methods This randomized controlled trial will examine the effects of the Rise intervention on ART adherence and HIV viral load. African Americans on ART who report adherence problems will be recruited from the community and randomly assigned to receive the intervention or usual care for 6 months. The intervention consists of 6-10 individual counseling sessions, with more sessions provided to those who demonstrate lower adherence. Primary outcomes include adherence as monitored continuously with Medication Event Monitoring Systems (MEMS) caps, and viral load data received from the participant’s medical provider. Survey assessments will be administered at baseline and month 6. Results The trial is ongoing. Conclusions If effective, the Rise intervention will provide community-based organizations with an intervention tailored to address the needs of African Americans for promoting optimal ART adherence and HIV clinical outcomes. Trial Registration Clinicaltrials.gov NCT01350544; https://clinicaltrials.gov/ct2/show/NCT01350544 (Archived by WebCite at http://www.webcitation.org/6fjqqnmn0). PMID:27025399
Harper, Gary W.; Dolcini, M. Margaret; Benhorin, Shira; Watson, Susan E.; Boyer, Cherrie B.
This article presents findings from a qualitative evaluation of an HIV/STI (sexually transmitted infection) prevention intervention for urban African American youth (Project ÒRÉ), which was delivered to groups of 3 to 8 adolescents who were members of the same friendship network. Sixteen focus groups (N = 63) were conducted with youth following…
Kogan, Steven M.; Brody, Gene H.; Gibbons, Frederick X.; Chen, Yi-fu; Grange, Christina M.; Simons, Ronald L.; Gerrard, Meg; Cutrona, Carolyn E.
A longitudinal model that tested mediating pathways between protective family processes and HIV-related behavior was evaluated with 195 African American youth. Three waves of data were collected when the youth were 13, 15, and 19 years old. Evidence of mediation and temporal priority were assessed for 3 constructs: academic engagement, evaluations…
Miller, Kim S.; Boyer, Cherrie B.; Cotton, Garnette
Sexually transmitted infections, including human immunodeficiency virus (HIV), disproportionately affect African American adolescents and young adults. Many of our current strategies and approaches have been inadequate in the promotion of risk reduction among youth and need to be reconceptualized. This article identifies issues that may guide…
Milhausen, Robin R.; Crosby, Richard; Yarber, William L.; DiClemente, Ralph J.; Wingood, Gina M.; Ding, Kele
Objective: To determine differences between African American adolescents on STD/HIV sexual-risk behaviors and precursors to these risk behaviors. Methods: Six hundred sixty-three rural and 3313 nonrural adolescents who completed the 1999 YRBS Survey were selected. Results: Rural females and males were more likely to report ever having coitus and…
Nunn, Amy; Cornwall, Alexandra; Thomas, Gladys; Callahan, Pastor Leslie; Waller, Pastor Alyn; Friend, Rafiyq; Broadnax, Pastor Jay; Flanigan, Timothy
African-Americans are disproportionately infected and affected by HIV/AIDS. Although faith-based institutions play critical leadership roles in the African-American community, the faith-based response to HIV/AIDS has historically been lacking. We explore recent successful strategies of a citywide HIV/AIDS awareness and testing campaign developed in partnership with 40 African-American faith-based institutions in Philadelphia, Pennsylvania, a city with some of the USA's highest HIV infection rates. Drawing on important lessons from the campaign and subsequent efforts to sustain the campaign's momentum with a citywide HIV testing, treatment and awareness programme, we provide a road map for engaging African-American faith communities in HIV prevention that includes partnering with faith leaders, engaging the media to raise awareness, destigmatising HIV/AIDS and encouraging HIV testing, and conducting educational and HIV testing events at houses of worship. African-American faith-based institutions have a critical role to play in raising awareness about the HIV/AIDS epidemic and reducing racial disparities in HIV infection.
Fairfax, Colita Nichols
This article is an initial exploration about the impact of ideological beliefs on helping services in the African American community. Newly infected HIV/AIDS cases place African Americans at 45% of such new cases, with African American women becoming infected at a rate 18 times that of Whites. Yet, helping services that are organic to African American women should be stronger through a discussion of cultural beliefs held in the community, where the genesis of helping services exists. Values and beliefs should be at the center of community partnerships, public media strategies, generalist-practice curricula in macro-level systems, and creating more space for relationship dialogue between African American men and women, which includes gender and racial distortions. Given the exponentially high numbers of HIV/AIDS cases in the African American community, a more earnest examination of values and beliefs is warranted.
Doty, Nathan; Hawkins, Linda A.; Gaskins, Clare S.; Beidas, Rinad; Rudy, Bret J.
Abstract Understanding the multiple forms of stigma experienced by young HIV-positive African American men who have sex with men and how they relate to sexual risk behaviors is essential to design effective HIV prevention programs. This study of 40 African American young MSM found that 90% of those surveyed experienced sexual minority stigma, 88% experienced HIV stigma, and 78% experienced dual stigma. Sexual minority stigma was characterized by experiences of social avoidance, and HIV stigma, by shame. Individuals with high HIV stigma were significantly more likely to engage in unprotected sex while high or intoxicated. Associations between stigma and sexual practices were examined; youth endorsing higher levels of sexual minority stigma engaged in less insertive anal intercourse. Individuals endorsing more HIV stigma reported more receptive anal intercourse. These findings support the development of stigma-informed secondary prevention interventions for African American HIV-positive young MSM. PMID:20673080
Stewart, Jennifer M.; Rogers, Christopher K.; Bellinger, Dawn; Thompson, Keitra
HIV/AIDS has a devastating impact on African Americans (AA), particularly women and young adults. We sought to characterize risks, barriers, content and delivery needs for a faith-based intervention to reduce HIV risk among AA women ages 18–25. In a convergent parallel mixed methods study we conducted four focus groups (n=38) and surveyed 71 young adult women. Data were collected across 4 AA churches for a total of 109 participants. We found the majority of women in this sample were engaged in behaviors that put them at risk for contracting HIV, struggled with religiously based barriers and matters of sexuality, and had a desire to incorporate their intimate relationships, parenting and financial burdens into faith-based HIV risk reduction interventions (RRIs). Incorporating additional social context related factors into HIV RRIs for young AA women is critical to adapting and developing HIV interventions to reduce risk among young adult women in faith settings. PMID:26879828
Belgrave, Faye Z.; Corneille, Maya; Hood, Kristina; Foster-Woodson, Julia; Fitzgerald, Angela
The enormous HIV/AIDS disparity among African American women and women in other ethnic groups dictates the need to implement the most effective HIV prevention interventions. This study examined the impact of perceived group support on HIV protective behaviors (i.e., attitudes and behaviors related to condom use, alcohol, and drugs) of African…
Dolcini, M. Margaret; Harper, Gary W.; Boyer, Cherrie B.; Pollack, Lance M.
There is an urgent need for continued innovation in the design of HIV/STI prevention interventions for African American females, a group at high risk for STIs and HIV. In particular, attention to social development and to culture is needed. The present study reports on a group randomized controlled trial of a friendship-based HIV/STI prevention…
Turner-Musa, Jocelyn O.; Rhodes, Warren A.; Harper, P. Thandi Hicks; Quinton, Sylvia L.
Substance use and HIV risk behaviors are increasing among African-American youth. Interventions that incorporate youth values and beliefs are needed to reduce this trajectory. Hip-hop plays an important role in the lives of many African-American youth and provides a context within which to prevent risky behaviors. The current study examines the…
Valle, Maribel; Levy, Judith
Theorists posit that personal decisions to disclose being HIV positive are made based on the perceived consequences of that disclosure. This study examines the perceived costs and benefits of self-disclosure among African American injection drug users (IDUs). A total of 80 African American IDUs were interviewed in-depth subsequent to testing HIV…
Gibbons, Maya A.
African American women are at the center of the discussion on health disparities, specifically disparities regarding HIV/AIDS and Sexually Transmitted Infections (STIs). Though there has been substantial research examining sexual risk behavior among low income African American women, little has been done to understand sexual behavior…
Fuqua, V; Scott, H; Scheer, S; Hecht, J; Snowden, J M; Raymond, H Fisher
African American men who have sex with men have been disproportionately affected by the HIV epidemic in the United States and remain to this day one of the groups with highest HIV prevalence and incidence. Our goal was to clarify the current state of HIV risk, sexual behaviors, and structural/network-network level factors that affect black MSM's population risk of HIV, enabling the formulation of targeted and up-to-date public health messages/campaigns directed at this vulnerable population. Our approach maximized the use of local data through a process of synthesis and triangulation of multiple independent and overlapping sources of information that are sometimes separately published and often not examined side-by-side. Among African American MSM, we observed stable HIV incidence despite increases in reported individual risk behavior and STDs. An increasing proportion of African American MSM are reporting HIV testing in the past 6 months and seroadaptive behaviors, which may play a role in this observed decline in HIV among MSM in San Francisco, California. Our analysis suggests that currently the HIV epidemic is stable among African American MSM in San Francisco. However, we suggest that the observed stability is due to factors prohibiting expansion of new infections rather than decreasing risks for HIV infection among African American MSM.
Nunn, Amy; Cornwall, Alexandra; Chute, Nora; Sanders, Julia; Thomas, Gladys; James, George; Lally, Michelle; Trooskin, Stacey; Flanigan, Timothy
In Philadelphia, 66% of new HIV infections are among African Americans and 2% of African Americans are living with HIV. The city of Philadelphia has among the largest numbers of faith institutions of any city in the country. Although faith-based institutions play an important role in the African American community, their response to the AIDS epidemic has historically been lacking. We convened 38 of Philadelphia's most influential African American faith leaders for in-depth interviews and focus groups examining the role of faith-based institutions in HIV prevention. Participants were asked to comment on barriers to engaging faith-based leaders in HIV prevention and were asked to provide normative recommendations for how African American faith institutions can enhance HIV/AIDS prevention and reduce racial disparities in HIV infection. Many faith leaders cited lack of knowledge about Philadelphia's racial disparities in HIV infection as a common reason for not previously engaging in HIV programs; others noted their congregations' existing HIV prevention and outreach programs and shared lessons learned. Barriers to engaging the faith community in HIV prevention included: concerns about tacitly endorsing extramarital sex by promoting condom use, lack of educational information appropriate for a faith-based audience, and fear of losing congregants and revenue as a result of discussing human sexuality and HIV/AIDS from the pulpit. However, many leaders expressed a moral imperative to respond to the AIDS epidemic, and believed clergy should play a greater role in HIV prevention. Many participants noted that controversy surrounding homosexuality has historically divided the faith community and prohibited an appropriate response to the epidemic; many expressed interest in balancing traditional theology with practical public health approaches to HIV prevention. Leaders suggested the faith community should: promote HIV testing, including during or after worship services and in
Nunn, Amy; Cornwall, Alexandra; Chute, Nora; Sanders, Julia; Thomas, Gladys; James, George; Lally, Michelle; Trooskin, Stacey; Flanigan, Timothy
In Philadelphia, 66% of new HIV infections are among African Americans and 2% of African Americans are living with HIV. The city of Philadelphia has among the largest numbers of faith institutions of any city in the country. Although faith-based institutions play an important role in the African American community, their response to the AIDS epidemic has historically been lacking. We convened 38 of Philadelphia’s most influential African American faith leaders for in-depth interviews and focus groups examining the role of faith-based institutions in HIV prevention. Participants were asked to comment on barriers to engaging faith-based leaders in HIV prevention and were asked to provide normative recommendations for how African American faith institutions can enhance HIV/AIDS prevention and reduce racial disparities in HIV infection. Many faith leaders cited lack of knowledge about Philadelphia’s racial disparities in HIV infection as a common reason for not previously engaging in HIV programs; others noted their congregations’ existing HIV prevention and outreach programs and shared lessons learned. Barriers to engaging the faith community in HIV prevention included: concerns about tacitly endorsing extramarital sex by promoting condom use, lack of educational information appropriate for a faith-based audience, and fear of losing congregants and revenue as a result of discussing human sexuality and HIV/AIDS from the pulpit. However, many leaders expressed a moral imperative to respond to the AIDS epidemic, and believed clergy should play a greater role in HIV prevention. Many participants noted that controversy surrounding homosexuality has historically divided the faith community and prohibited an appropriate response to the epidemic; many expressed interest in balancing traditional theology with practical public health approaches to HIV prevention. Leaders suggested the faith community should: promote HIV testing, including during or after worship services
Growing evidence suggests that drug and alcohol use are fueling the heterosexual transmission of HIV among African Americans. This study aims to examine the relative contribution of drug and alcohol use of male and female partners to risks of heterosexual transmission of HIV among 535 African American HIV serodiscordant couples (N = 1,070 participants) who participated in an HIV prevention trial. Associations found between use of drugs and alcohol by one or both partners and sexual risk indicators varied by type of substance and whether male or female partner or both partners reported use. The findings suggest multiple ways in which substance use of male and female partners may be contributing to the heterosexual transmission of HIV and other STDs among African Americans and underscore the need for HIV prevention strategies to address dyadic patterns of substance use that lead to sexual risks.
Growing evidence suggests that drug and alcohol use are fueling the heterosexual transmission of HIV among African Americans. This study aims to examine the relative contribution of drug and alcohol use of male and female partners to risks of heterosexual transmission of HIV among 535 African American HIV serodiscordant couples (N = 1,070 participants) who participated in an HIV prevention trial. Associations found between use of drugs and alcohol by one or both partners and sexual risk indicators varied by type of substance and whether male or female partner or both partners reported use. The findings suggest multiple ways in which substance use of male and female partners may be contributing to the heterosexual transmission of HIV and other STDs among African Americans and underscore the need for HIV prevention strategies to address dyadic patterns of substance use that lead to sexual risks. PMID:20499153
Surratt, Hilary L; Kurtz, Steven P
Foster care has been associated with increased HIV risk behaviors among youth, yet long-term association with HIV infection has not been examined. This study explored the associations between foster placement, victimization, mental health, onset of sex work and HIV infection among highly vulnerable female sex workers. 562 drug-involved African American women were enrolled into an intervention study to increase health services utilization and reduce HIV risk. Seventeen percent reported a history of foster placement. Foster history was associated with significantly lower educational attainment, higher victimization, and more severe mental health problems. Women with foster histories reported significantly earlier entry into paid sex work, with some 62% active in the sex trade before age 18. Multivariate analyses found that foster care was independently associated with HIV seropositivity, and that early sex work partially mediated this association. The potential long-term health vulnerabilities associated with foster placement are understudied and warrant additional research.
Horne, Sharon G; Levitt, Heidi M; Sweeney, Kristin Kay; Puckett, Julia A; Hampton, Martavius L
Gay families are constructed support networks that gay, bisexual, and transgender individuals of color form, often in response to societal marginalization and rejection from biological families. Research on these family structures has been scarce, with little focus on the experience of African American gay family networks in the South. The current grounded theory qualitative study focused on the experiences of 10 African American male and transgender individuals between the ages of 18 and 29 from gay families in the Mid-South, and explored the ways these families addressed safe-sex issues and human immunodeficiency virus (HIV) risk prevention. Results revealed that families can play a role in either increasing HIV risk (e.g., ignoring HIV issues, encouraging such unsafe behaviors as exchanging sex for money or drugs, stigmatizing HIV-positive people) or decreasing it (e.g., intensive, family-level prevention efforts at safe-sex practices and family support for HIV treatment adherence). The potential of these family networks for HIV prevention and adherence efforts is considered.
Burns, Myron J; Feaster, Daniel J; Mitrani, Victoria B; Ow, Christina; Szapocznik, José
This study examined the mechanism by which stressors, dissatisfaction with family, perceived control, social support, and coping were related to psychological distress in a sample of HIV-positive African American mothers. Additional analyses explored whether women who had a history of a drug abuse or dependence diagnosis differed either on levels of the study variables or the model pathways. The results indicated that HIV-positive African American mothers who had higher levels of stressors perceived their stressors as a whole to be less controllable. Coping resources, available social support and perceived control, were positively associated with active coping and negatively associated with psychological distress. Avoidant coping was the most important predictor of psychological distress. Furthermore, the effect of avoidant coping on psychological distress was stronger for mothers with a history of drug diagnosis. The implications of these findings for targeting interventions are discussed.
DeMarco, Rosanna F
It is challenging to develop and assess skills in a classroom setting, for graduate students particularly, in the area of quality improvement project plans that are real, relevant, and sensitive in a unique health care context. Although understanding significant issues related to palliative care needs of U.S. citizens through the interpretation of those who publish in this area is extremely helpful to students, it does not allow for an experience uniquely situated in realities faced by those living with life-threatening and chronic illness or in a time frame that is current. Graduate students in a Health Resources and Services Administration-funded program of study completed a secondary data analysis of digitally recorded conversations of African American women living with human immunodeficiency virus or acquired immune deficiency syndrome to identify consumer-driven palliative care needs and create possible quality improvement program solutions. This exercise supports the World Health Organization's advice to become palliative care leaders through engagement in clients' realities.
Wallace, Scyatta A.; McLellan-Lemal, Eleanor; Harris, Muriel J.; Townsend, Tiffany G.; Miller, Kim S.
A qualitative study examined perceptions of HIV testing and strategies to enhance HIV testing among HIV-negative African American heterosexual young adults (ages 18-25 years). Twenty-six focus groups (13 male groups, 13 female groups) were conducted in two low-income communities (urban and rural). All sessions were audio-recorded and transcribed.…
Gentry, Quinn M.; Elifson, Kirk; Sterk, Claire
The purpose of this study was to examine how various living conditions impact the context within which low-income African American women engage in a diverse range of high-risk behavior that increases their risk for HIV infection. The study, based on 2 years of ethnographic fieldwork, analyzed the living conditions of 45 African American women at…
Stewart, Jennifer M.
The African American church has promoted the health of African Americans through supporting interventions that target a wide variety of diseases, and it is a crucial community partner in the development of HIV prevention interventions. Although research has described the development of church-based HIV interventions, there is a significant lack of frameworks and approaches available to guide the implementation and maintenance of HIV interventions within church-based settings. A developing framework of a comprehensive church-based intervention, derived from an ethnographic study about the development, implementation, and maintenance of an HIV/AIDS Ministry within an African American church is presented. This approach can provide guidance to support the development, implementation, and maintenance of HIV interventions in faith settings. PMID:25702738
Clarke, Juanne N; McLellan, Lianne; Hoffman-Goetz, Laurie
Mainstream magazines and other media have been found to both reflect and influence existing values and beliefs regarding health and medicine. Little is known about how media directed toward specific cultural or other market groups may differ. The present study examined how HIV and AIDS are portrayed within a specific ethnocultural medium, the two highest circulating magazines directed toward African American and African Canadian readers. The portrayal of HIV/AIDS from January 1997 to October 2001 in Ebony and Essence magazines was examined through manifest and latent content analysis. African American people were described paradoxically both as powerless victims in the face of the disease and as members of a strong and identifiable community of "sisters" and "brothers" available to respond to prevent and cope with the disease. Polarization between Blacks and Whites was accomplished by frequent emphasis on the higher rates of HIV/AIDS amongst Black Americans. Both the church and spirituality were highlighted as means of prevention education and coping.
Saberi, Parya; Yuan, Patrick; John, Malcolm; Sheon, Nicolas; Johnson, Mallory O
Abstract Antiretroviral nonadherence is a strong determinant of virologic failure and is negatively correlated with survival. HIV-positive African American youth have lower antiretroviral adherence and treatment engagement than other populations. We assessed the feasibility and acceptability of a telehealth (remote videoconferencing) medication counseling intervention as an innovative approach to address these disparities. HIV-positive African American youth (18-29 years old) on antiretrovirals were enrolled in a telehealth medication counseling session, followed by a semi-structured qualitative interview to explore likes/dislikes of the format, modality, and content; potential impact on adherence; privacy issues; and interaction quality. Fourteen participants with a mean age of 24 years, who were 86% male, and had a mean self-reported adherence in the past month of 89%, were interviewed. Participants stated that they liked telehealth, would use it if offered in clinic/research settings, and indicated that their privacy was maintained. Participants described telehealth as convenient and efficient, with positive impact on their knowledge. Telehealth provided a modality to interact with providers that participants described as less intimidating than in-person visits. Telehealth is feasible and acceptable for delivering medication counseling to HIV-positive African American youth when conducted in a controlled clinical setting and may improve quality of patient-provider dialogue. Use of telehealth may lead to more disclosure of treatment difficulties, increased patient comfort, and improved health education.
Harawa, Nina T.; Ramamurthi, Hema Codathi; Bingham, Trista A.
Disproportionately high HIV/AIDS rates and frequent non-gay identification (NGI) among African American men who have sex with men or with both men and women (MSM/W) highlight the importance of understanding how HIV-positive African American MSM/W perceive safer sex, experience living with HIV, and decide to disclose their HIV status. Thirty predominately seropositive and non-gay identifying African American MSM/W in Los Angeles participated in three semi-structured focus group interviews, and a constant comparison method was used to analyze responses regarding condom use, sexual activity after an HIV diagnosis, and HIV serostatus disclosure. Condom use themes included its protective role against disease and pregnancy, acceptability concerns pertaining to aesthetic factors and effectiveness, and situational influences such as exchange sex, substance use, and suspicions from female partners. Themes regarding the impact of HIV on sexual activity included rejection, decreased partner seeking, and isolation. Serostatus disclosure themes included disclosure to selective partners and personal responsibility. Comprehensive HIV risk-reduction strategies that build social support networks, condom self-efficacy, communication skills, and a sense of collective responsibility among NGI African American MSM/W while addressing HIV stigma in the African American community as a whole are suggested. PMID:16736115
Nehl, Eric J.; Klein, Hugh; Sterk, Claire E.; Elifson, Kirk W.
The focus of this paper is on HIV sexual risk taking among a community-based sample of disadvantaged African American adults. The objective is to examine multiple factors associated with sexual HIV risk behaviors within a syndemic conceptual framework. Face-to-face, computer-assisted, structured interviews were conducted with 1,535 individuals in Atlanta, Georgia. Bivariate analyses indicated a high level of relationships among the HIV sexual risks and other factors. Results from multivariate models indicated that gender, sexual orientation, relationship status, self-esteem, condom use self-efficacy, sex while the respondent was high, and sex while the partner was high were significant predictors of condomless sex. Additionally, a multivariate additive model of risk behaviors indicated that the number of health risks significantly increased the risk of condomless sex. This intersection of HIV sexual risk behaviors and their associations with various other behavioral, socio-demographics, and psychological functioning factors helps explain HIV risk-taking among this sample of African American adults and highlights the need for research and practice that accounts for multiple health behaviors and problems. PMID:26188618
Nehl, Eric J; Klein, Hugh; Sterk, Claire E; Elifson, Kirk W
The focus of this paper is on HIV sexual risk taking among a community-based sample of disadvantaged African American adults. The objective is to examine multiple factors associated with sexual HIV risk behaviors within a syndemic conceptual framework. Face-to-face, computer-assisted, structured interviews were conducted with 1535 individuals in Atlanta, Georgia. Bivariate analyses indicated a high level of relationships among the HIV sexual risks and other factors. Results from multivariate models indicated that gender, sexual orientation, relationship status, self-esteem, condom use self-efficacy, sex while the respondent was high, and sex while the partner was high were significant predictors of condomless sex. Additionally, a multivariate additive model of risk behaviors indicated that the number of health risks significantly increased the risk of condomless sex. This intersection of HIV sexual risk behaviors and their associations with various other behavioral, socio-demographic, and psychological functioning factors help explain HIV risk-taking among this sample of African American adults and highlights the need for research and practice that accounts for multiple health behaviors and problems.
Kogan, Steven M.; Brody, Gene H.; Gibbons, Frederick X.; Chen, Yi-fu; Grange, Christina M.; Simons, Ronald L.; Gerrard, Meg; Cutrona, Carolyn E.
A longitudinal model that tested mediating pathways between protective family processes and HIV-related behavior was evaluated with 195 African American youth. Three waves of data were collected when the youth were 13, 15, and 19 years old. Evidence of mediation and temporal priority were assessed for three constructs: academic engagement, evaluations of prototypical risk-taking peers, and affiliations with risk-promoting peers. Structural equation modeling indicated that protective family processes assessed during early adolescence were associated with HIV-related behavior during emerging adulthood and that academic engagement, evaluations of prototypical risk-taking peers, and affiliations with risk-promoting peers accounted for this association. Evidence of a specific pathway emerged: protective family processes → academic engagement negative → evaluations of prototypical risk-taking peers→ affiliations with risk-promoting peers→ HIV-related behavior. Academic engagement also was a direct predictor of HIV-related risk behavior. PMID:21643492
Peltzer, Jill N; Domian, Elaine W; Teel, Cynthia S
This hermeneutic phenomenological study explored the lived experiences of young African American HIV-infected women. Eleven women between the ages of 21 and 35 participated. One pattern, Infected Lives, and three themes--Living Alone With HIV, Living With Unresolved Conflicts, and Living With Multiple Layers of Betrayal--emerged. The pattern and themes portray the very complex and challenging experiences faced by these young women living with HIV infection. They have experienced isolation, abandonment, betrayal, and discrimination in their interpersonal and social systems. They often dealt with conflicts of hope and anguish in the relationships with their children, and portraying strength, while feeling fragile. These complexities negatively influence the ability to fully engage in self-care activities. Implications for future research include further investigation about the experiences of psychological distress experienced post-diagnosis, development and evaluation of holistic nursing interventions, and evaluative research on mass media educational campaigns to reduce HIV-related stigma.
Brooks, Ronald A.; Lee, Sung-Jae; Stover, Gabriel N.; Barkley, Thomas W.
SUMMARY This study examined HIV testing behaviors, perceived vulnerability to HIV, and correlates of sexual risk behaviors of young adult Latino and African American male gang members in Los Angeles, California. Data were collected from 249 gang members ages 18–26 years old. The majority (59%) of gang members reported unprotected vaginal intercourse (UVI) in the past 12 months. Only one-third (33.2%) of gang members had ever been tested for HIV. In our multivariate analysis, gang members who reported UVI were more likely to have engaged in the following behaviors: had sex with someone they just met (Adjusted Odds Ratio [AOR] = 4.51), had sex with someone they think or know had an STD (AOR = 4.67), or had sex while incarcerated (AOR = 8.92). In addition, gang members with a higher perceived vulnerability to HIV were less likely to report UVI in the previous 12 months (AOR= 0.75). These findings offer implications for development of an HIV prevention intervention for young Latino and African American male gang members. PMID:21364062
Brooks, R A; Lee, S-J; Stover, G N; Barkley, T W
This study examined HIV testing behaviours, perceived vulnerability to HIV and correlates of sexual risk behaviours of young adult Latino and African American male gang members in Los Angeles, California. Data were collected from 249 gang members aged 18-26 years. The majority (59%) of gang members reported unprotected vaginal intercourse (UVI) in the past 12 months. Only one-third (33.2%) of gang members had ever been tested for HIV. In our multivariate analysis, gang members who reported UVI were more likely to have engaged in the following behaviours: had sex with someone they just met (adjusted odds ratio [AOR] = 4.51), had sex with someone they think or know had a sexually transmitted infection (STI; AOR = 4.67) or had sex while incarcerated (AOR = 8.92). In addition, gang members with a higher perceived vulnerability to HIV were less likely to report UVI in the previous 12 months (AOR = 0.75). These findings offer implications for development of an HIV prevention intervention for young Latino and African American male gang members.
Miles, Margaret Shandor; Isler, Malika Roman; Banks, Bahby B.; Sengupta, Sohini; Corbie-Smith, Giselle
We explored how community responses to HIV contribute to distress in African Americans living with HIV in the rural South of the United States. We listened to the voices of community members through focus groups and African Americans with HIV through interviews. Community avoidance of HIV, negative views of HIV, and discriminatory behavior powerfully affected the distress of people living with HIV (PLWH). Ongoing distress, coupled with limited support, led to a life in which many PLWH endured their pain in silence and experienced profound loneliness. We conceptualized their experiences as socioemotional suffering—the hidden emotional burden and inner distress of not only living with HIV, a complex serious illness, but also with the societal attitudes and behaviors that are imposed on the illness and on PLWH. To improve the quality of life and health of PLWH, we cannot focus solely on the individual, but must also focus on the local community and society as a whole. PMID:21041516
Farel, Claire E.; Parker, Sharon D.; Muessig, Kathryn E.; Grodensky, Catherine A.; Jones, Chaunetta; Golin, Carol E.; Fogel, Catherine I.; Wohl, David A.
Background Women who have been in prison carry a greater lifetime risk of HIV for reasons that are not well understood. This effect is amplified in the Southeastern United States, where HIV incidence and prevalence is especially high among African American (AA) women. The role of consensual sexual partnerships in the context of HIV risk, especially same-sex partnerships, merits further exploration. Methods We conducted digitally recorded qualitative interviews with 29 AA women (15 HIV-positive, 14 HIV-negative) within three months after entry into the state prison system. We explored potential pre-incarceration HIV risk factors, including personal sexual practices. Two researchers thematically coded interview transcripts and a consensus committee reviewed coding. Results Women reported complex sexual risk profiles during the six months prior to incarceration, including sex with women as well as prior sexual partnerships with both men and women. Condom use with primary male partners was low and a history of transactional sex work was prevalent. These behaviors were linked to substance use, particularly among HIV-positive women. Conclusions Although women may not formally identify as bisexual or lesbian, sex with women was an important component of this cohort’s sexuality. Addressing condom use, heterogeneity of sexual practices, and partner concurrency among at-risk women should be considered for reducing HIV acquisition and preventing forward transmission in women with a history of incarceration. PMID:24183410
Siddiqi, Azfar-e-Alam; Hu, Xiaohong; Hall, H Irene
A primary goal of the National HIV/AIDS Strategy is to reduce HIV-related health disparities, including HIV-related mortality in communities at high risk for human immunodeficiency virus (HIV) infection. As a group, persons who self-identify as blacks or African Americans (referred to as blacks in this report), have been affected by HIV more than any other racial/ethnic population. Forty-seven percent of persons who received an HIV diagnosis in the United States in 2012 and 43% of all persons living with diagnosed HIV infection in 2011 were black. Blacks also experienced a low 3-year survival rate among persons with HIV infection diagnosed during 2003-2008. CDC and its partners have been pursuing a high-impact prevention approach and supporting projects focusing on minorities to improve diagnosis, linkage to care, and retention in care, and to reduce disparities in HIV-related health outcomes. To measure trends in disparities in mortality among blacks, CDC analyzed data from the National HIV Surveillance System. The results of that analysis indicated that among blacks aged ≥13 years the death rate per 1,000 persons living with diagnosed HIV decreased from 28.4 in 2008 to 20.5 in 2012. Despite this improvement, in 2012 the death rate per 1,000 persons living with HIV among blacks was 13% higher than the rate for whites and 47% higher than the rate for Hispanics or Latinos. These data demonstrate the need for implementation of interventions and public health strategies to further reduce disparities in deaths.
Sutton, Madeline Y.; Hardnett, Felicia P.; Wright, Pierre; Wahi, Sagina; Pathak, Sonal; Warren-Jeanpiere, Lari; Jones, Sandra
Objective African American young adults are disproportionately affected by the HIV/AIDS epidemic and often unaware of their personal risk for HIV. Historically black colleges and universities (HBCUs) enroll 25% of college-educated African American young adults and can play an important role in HIV prevention. We examined HIV/AIDS knowledge of students at HBCUs to inform and strengthen our HIV prevention efforts at HBCUs. Methods African American undergraduate HBCU students completed online surveys assessing HIV/AIDS knowledge and behaviors, and we analyzed data to assess their knowledge and behaviors. Results A total of 1,051 of 1,230 surveys completed (85.4%) were analyzable. Eighty-two percent of students had average/high HIV knowledge scores. Seventy-nine percent of students surveyed perceived themselves to be at low risk for HIV infection; 64% of those who had at least two or more sex partners had not used a condom at last sex encounter. In the final model, significant independent effects were identified for average/high knowledge of HIV risk, including agreeing with assessing a potential partner's HIV risk by all of the five actions listed (adjusted odds ratio [AOR] = 2.7, 95% confidence interval [CI] 1.7, 4.3) and never using a needle to inject drugs (AOR=5.6, 95% CI 3.2, 9.7). Conclusions Educating students about effectively assessing sex partner risk will improve HIV knowledge and prevention efforts at HBCUs. PMID:21886325
MacMaster, Samuel A.; Rasch, Randolph F. R.; Kinzly, Mark L.; Cooper, R. Lyle; Adams, Susan M.
Significant health disparities in the rates of HIV infection primarily affect African American women. Although research has demonstrated that for some individuals HIV is connected to preventable high-risk behaviors related to substance use, a further examination of how these risks are perceived by the individuals involved in these activities is…
Kanekar, Amar; Sharma, Manoj
The HIV/AIDS epidemic has taken a tremendous toll on the population of the United States. College students, including African-Americans aged 13-24 years, across the nation are susceptible to contracting sexually transmitted diseases including HIV/AIDS as they participate in unsafe sex practices. The purpose of this article is to provide teaching…
Neufeld, Stewart; Berry, Rico; Luborsky, Mark
Abstract To date, only modest gains have been achieved in explaining adherence to medical regimens, limiting effective interventions. This is a particularly important issue for African Americans who are disproportionately affected by the HIV epidemic. Few studies have focused on intragroup variation among African Americans in adherence to ART. The aim of this study was to identify and describe the cultural rationales guiding African American patients' formulation and evaluation of adherence. Rationales are key features of purposeful human action. In-depth interviews with 80 seropositive African Americans were tape recorded, transcribed, and analyzed. Participant CD4, viral load and medical histories were collected at each data point. Analysis of four waves of panel data identified three types of adherence rationales: Authoritative Knowledge Rationale (AKR; n=29, 36.3%), Following Doctors' Orders Rationale (DOR; n=24, 30.0%) and Individualized Adherence Rationale (IAR; n=27, 33.8%). Differences in mean reported adherence between the rationale groups did not achieve statistical significance. However, the fraction reporting low adherence (<70%), although not different by rationale group at the first interview (T1), was significantly higher for the IAR group by the fourth interview (T4). Objective clinical markers (CD4 and viral load) improved over time (from T1 to T4) for AKR and DOR groups, but remained unchanged for the IAR group, yet self-reported adherence declined for all groups over the course of the four interviews. PMID:21777141
Schinke, Steven P.; Orlandi, Mario A.
The spread of the acquired immunodeficiency virus (AIDS) virus, human immunodeficiency virus (HIV) infection, is increasingly evident. Despite the attention that HIV infection has received, few effective prevention strategies have been developed. The present paper reviews the epidemiology of AIDS among African-American and Hispanic adolescents. From epidemiological data, the authors argue for preventive approaches to reduce the risks of HIV transmission among African-American and Hispanic adolescents. Emphasizing culturally sensitive prevention strategies, the authors describe an intervention for these adolescents that combines skills-based and interactive computer approaches. PMID:20589223
Schinke, Steven P; Orlandi, Mario A
The spread of the acquired immunodeficiency virus (AIDS) virus, human immunodeficiency virus (HIV) infection, is increasingly evident. Despite the attention that HIV infection has received, few effective prevention strategies have been developed. The present paper reviews the epidemiology of AIDS among African-American and Hispanic adolescents. From epidemiological data, the authors argue for preventive approaches to reduce the risks of HIV transmission among African-American and Hispanic adolescents. Emphasizing culturally sensitive prevention strategies, the authors describe an intervention for these adolescents that combines skills-based and interactive computer approaches.
Okoro, Olihe; Odedina, Folakemi
African American women bear a disproportionate burden of HIV disease. Socioeconomic and psycho-social factors while adding to the vulnerability of this population also contribute to non-adherence and consequently poor outcomes. The provider-patient relationship has the potential to enhance HIV medication adherence in this population. Using in-depth interviews, patient and provider perspectives are explored to identify specific elements of the provider-patient interaction that enhance patient satisfaction with care and consequently improve HIV medication adherence. Themes associated with provider attitudes and actions perceived as positively impacting care in this patient group include (1) physical touch, (2) treating (the patient) "as a person", (3) actively listening to the patient, (4) showing empathy, (5) being non-judgmental, and (6) being readily accessible. These findings suggest that the demonstration of care and commitment from the provider as perceived by the patient is important to African American women living with HIV and may significantly influence adherence behavior and enhance treatment outcomes in this population.
Frew, Paula M; Archibald, Matthew; Martinez, Nina; del Rio, Carlos; Mulligan, Mark J
The HIV/AIDS pandemic continues to challenge the African American community with disproportionate rates of infection, particularly among young women ages 25 to 34 years. Development of a preventive HIV vaccine may bring a substantial turning point in this health crisis. Engagement of the African American community is necessary to improve awareness of the effort and favorably influence attitudes and referent norms. The Theory of Reasoned Action (TRA) may be a useful framework for exploration of community engagement outcomes including future attendance, community mobilization, and study participation. Within the context of HIV vaccine outreach, we conducted a cross-sectional survey in early 2007 with 175 African-American adults (>/= 18 years). Confirmatory factor analysis and structural equation modeling were performed and the findings support the potential of the model in understanding behavioral intentions toward HIV vaccine research.
Frew, Paula M.; Archibald, Matthew; Martinez, Nina; del Rio, Carlos; Mulligan, Mark J.
The HIV/AIDS pandemic continues to challenge the African American community with disproportionate rates of infection, particularly among young women ages 25 to 34 years. Development of a preventive HIV vaccine may bring a substantial turning point in this health crisis. Engagement of the African American community is necessary to improve awareness of the effort and favorably influence attitudes and referent norms. The Theory of Reasoned Action (TRA) may be a useful framework for exploration of community engagement outcomes including future attendance, community mobilization, and study participation. Within the context of HIV vaccine outreach, we conducted a cross-sectional survey in early 2007 with 175 African-American adults (≥ 18 years). Confirmatory factor analysis and structural equation modeling were performed and the findings support the potential of the model in understanding behavioral intentions toward HIV vaccine research. PMID:20686675
Stein, E. M.; McMahon, D. J.; Shu, A.; Zhang, C. A.; Ferris, D. C.; Colon, I.; Dobkin, J. F.; Hammer, S. M.; Shane, E.
Summary We evaluated vitamin D status in HIV+ and HIV− postmenopausal African-American (AA) and Hispanic women. Most women (74–78%) had insufficient 25-hydroxyvitamin D (25OHD) levels, regardless of HIV status. 25OHD was lower in AA women and women lacking supplement use, providing support for screening and supplementation. Among HIV+ women, 25OHD was associated with current CD4 but not type of antiretroviral therapy. Introduction To evaluate vitamin D status and factors associated with vitamin D deficiency and insufficiency in HIV-infected (HIV+) postmenopausal minority women. Methods In this cross-sectional study, 89 HIV+ and 95 HIV− postmenopausal women (33% AA and 67% Hispanic) underwent assessment of 25OHD, 1,25-dihydroxyvitamin D, parathyroid hormone, markers of bone turnover and bone mineral density by dual energy X-ray absorptiometry. Results The prevalence of low 25OHD did not differ by HIV status; the majority of both HIV+ and HIV− women (74–78%) had insufficient levels (<30 ng/ml). Regardless of HIV status, 25OHD was significantly lower in AA subjects, and higher in subjects who used both calcium and multi-vitamins. In HIV+ women on antiretroviral therapy (ART), 25OHD was directly associated with current CD4 count (r= 0.32; p<0.01) independent of age, ethnicity, BMI, or history of AIDS-defining illness. No association was observed between 1,25(OH)2D and CD4 count or between serum 25OHD, 1,25(OH)2D or PTH and type of ART. Conclusions In postmenopausal minority women, vitamin D deficiency was highly prevalent and associated with AA race and lack of supplement use, as well as lower current CD4 cell count. These results provide support for screening and repletion of vitamin D in HIV+ patients. PMID:20585939
Gaskins, Susan W; Payne Foster, Pamela; Sowell, Richard L; Lewis, Timothy L; Gardner, Antonio; Parton, Jason M
The purpose of this study was to identify and describe the process of HIV disclosure for rural African American men-a population disproportionately affected by HIV/AIDS. Forty men were interviewed about their experience of making an HIV disclosure. Grounded theory methodology guided data collection and analysis. The core category or variable that emerged from the data was a process-Making Decisions: The Process of HIV Disclosure. Five categories accounted for variations in disclosures: (a) beliefs and knowledge about HIV/AIDS, (b) influencing factors, (c) disclosure decisions, (d) disclosure efficacy, and (e) outcomes of disclosure. Most of the men had disclosed to others; however, the disclosures were selective, and the decisions were iterative. The majority of the men did not disclose their diagnosis for several months to several years. The findings provide a framework of the many factors related to HIV disclosure that can guide health care providers in counseling persons living with HIV/AIDS in making disclosure decisions.
Young, Sean D; Szekeres, Greg; Coates, Thomas
This study explores the feasibility of recruiting minority men who have sex with men Facebook users for human immunodeficiency virus (HIV) prevention studies and notes demographic and sexual risk behaviours. Facebook-registered men who have sex with men (MSM; N = 118) were recruited using online and offline methods. Participants validated Facebook-user status through using a Facebook Connect (computer science) application. Participants were primarily Latino (60.2%) and African-American (28.0%), with 33.1% using social media to find sex partners. Black MSM social networking users reported engaging in a lower frequency (coefficient = -0.48, p < 0.05) of unprotected receptive anal intercourse compared to Latino MSM. Results suggest that minority social media users can be recruited for HIV studies and that sexual risk behavioural differences exist among minority social networking users. Findings highlight the importance of incorporating technologies into population-focused HIV interventions.
O'Daniel, Alyson J
In this article I examine variations in the ways in which low-income HIV-positive African American women in Midway, North Carolina engaged with and made meaningful laboratory-based knowledge of HIV disease. I highlight how women's engagement with "blood-work," as it was popularly called, reflected perceptions of survival with HIV disease and the material conditions and social relations in which these perceptions were embedded. Focusing less on the diagnostics themselves and more on the social contexts in which they became socially significant for study participants, I assert that "blood-work" provided a multiply constituted lens through which women expressed their subject positions and attendant material conditions within the context of a public health care program shaped by values associated with global neoliberalism.
De Jesus, Maria; Taylor, Juanita; Maine, Cathleen; Nalls, Patricia
Background To date, there are very few comparative US studies and none in DC that distinguish between US-born and foreign-born Black women to examine and compare their perceptions of HIV risk. This qualitative study, therefore, analyzes African American and East African women’s perceptions of HIV risk in the Washington DC Metropolitan area, which has the highest AIDS rate in the US. Methods Forty in-depth, semi-structured interviews and 10 cognitive interviews were conducted among a sample of 25 African American women and 25 East African born women between October 2012 and March 2013 to examine perceptions regarding HIV risk. The in-depth semi-structured interviews were preceded by the cognitive interviews and accompanying survey. Study protocol was reviewed and approved by the American University Institutional Review Board. Results Adopting Boerma and Weir’s Proximate Determinants conceptual framework to interpret the data, the results of the study demonstrate that African American and East African immigrant women have divergent perceptions of HIV risk. While African American women ascribe HIV risk to individual-level behaviors and choices such as unprotected sex, East African women attribute HIV risk to conditions of poverty and survival. Conclusions Study findings suggest that addressing HIV prevention and education among Black women in DC will require distinct and targeted strategies that are culturally and community-centered in order to resonate with these different audiences. PMID:26766523
Goparaju, Lakshmi; Warren-Jeanpiere, Lari
African American women are disproportionately affected by HIV. Some research has explored if non-disclosing men who have sex with men and women (MSMW) contribute to women’s HIV risk. Popular media discourse tends to refer to these men as “Down Low” or “DL”. Six focus groups were conducted with 36 African American women in Washington D.C. to examine their knowledge, attitudes, beliefs, and behaviours regarding “Down Low/DL” men. Three of the focus groups were composed of HIV positive women and three groups were composed of HIV negative women. Data analysis reveals six central subcategories related to women’s perspectives on the “DL”: awareness; suspicion; coping with partner infidelity: male vs. female; sexual health communication; empathy; and religion. No major differences were identified between the HIV positive and HIV negative focus groups. Findings from this study provide insight into African American women’s perceptions of African American male sexuality and how these perceptions serve to influence interpersonal relationship factors and women’s exposure to HIV risk. PMID:22804686
Williams, Michelle; Moneyham, Linda; Kempf, Mirjam-Colette; Chamot, Eric; Scarinci, Isabel
African American women have disproportionately high prevalence rates of HIV and cervical cancer. HIV-infected women are significantly less likely to obtain recommended cervical cancer screenings than HIV-uninfected women. The purpose of this study was to examine sociocultural and structural factors associated with cervical cancer screening among HIV-infected African American in Alabama. The PEN-3 Model and the Health Belief Model were used as theoretical frameworks. In-depth interviews were conducted with twenty HIV-infected African American women to identify perceptions, enablers, and nurturers, perceived susceptibility, perceived severity, and perceived benefits related to cervical cancer and screening. The most common positive perceptions, enablers, and nurturers that contributed to cervical cancer screening included internal motivation and awareness of the importance of HIV-infected women getting Pap tests due to their weakened immune system. Negative perceptions, enablers, and nurturers included lack of knowledge about cervical cancer and screening, and lack of perceived susceptibility to cervical cancer. The results of this study can be used to guide the development of culturally relevant cervical cancer and screening education interventions aimed at increasing cervical cancer screening adherence among HIV-infected African American women.
Kerr, Jelani; Jackson, Trinidad
The relationship between drug policy and HIV vulnerability is well documented. However, little research examines the links between racial/ethnic HIV disparities via the Drug War, sexual risk, and stigma. The Drug War HIV/AIDS Inequities Model has been developed to address this dearth. This model contends that inequitable policing and sentencing promotes sexual risks, resource deprivation, and ultimately greater HIV risk for African-Americans. The Drug War also socially marginalizes African Americans and compounds stigma for incarcerated and formerly incarcerated persons living with HIV/AIDS. This marginalization has implications for sexual risk-taking, access to health-promoting resources, and continuum of care participation. The Drug War HIV/AIDS Inequities Model may help illuminate mechanisms that promote increased HIV vulnerability as well as inform structural intervention development and targeting to address racial/ethnic disparities.
Derose, Kathryn Pitkin; Bogart, Laura M; Kanouse, David E; Felton, Alexandria; Collins, Deborah Owens; Mata, Michael A; Oden, Clyde W; Domínguez, Blanca X; Flórez, Karen R; Hawes-Dawson, Jennifer; Williams, Malcolm V
HIV-related stigma negatively affects prevention and care, and community-based interventions are needed. Here we describe the development of a multi-ethnic, faith-based intervention to reduce HIV stigma that included: educational workshops on HIV, testing, and stigma; peer leader workshops using role plays and drawing on principles of motivational interviewing; a pastor-delivered sermon on HIV that incorporated theological reflection and an imagined contact scenario; and congregation-based HIV testing events. Lessons learned include: partnership development is essential and requires substantial investment; tailoring intervention components to single race-ethnic groups may not be preferable in diverse community settings; and adapting testing processes to be able to serve larger numbers of people in shorter time frames is needed for congregational settings. This development process successfully combined the rigorous application of social science theory and community engagement to yield a multifaceted HIV stigma reduction intervention appropriate for Protestant and Catholic churches in African American and Latino communities.
Derose, Kathryn Pitkin; Bogart, Laura M.; Kanouse, David E.; Felton, Alexandria; Collins, Deborah Owens; Mata, Michael A.; Oden, Clyde W.; Domínguez, Blanca X.; Flórez, Karen R.; Hawes-Dawson, Jennifer; Williams, Malcolm V.
HIV-related stigma negatively affects prevention and care, and community-based interventions are needed. Here we describe the development of a multi-ethnic, faith-based intervention to reduce HIV stigma that included: educational workshops on HIV, testing, and stigma; peer leader workshops using role plays and drawing on principles of motivational interviewing; a pastor-delivered sermon on HIV that incorporated theological reflection and an imagined contact scenario; and congregation-based HIV testing events. Lessons learned include: partnership development is essential and requires substantial investment; tailoring intervention components to single race-ethnic groups may not be preferable in diverse community settings; and adapting testing processes to be able to serve larger numbers of people in shorter time frames is needed for congregational settings. This development process successfully combined the rigorous application of social science theory and community engagement to yield a multifaceted HIV stigma reduction intervention appropriate for Protestant and Catholic churches in African American and Latino communities. PMID:24450276
The Centers for Disease Control and Prevention (2010) reports that approximately 1 million people in the United States are living with HIV. African Americans comprise 12% of the population yet account for approximately 46% of the people living with HIV. The rising prevalence rate among African Americans is an anomaly given that the prevalence rate…
Gaston, Gina B; Alleyne-Green, Binta
Disparities in access to and retention of regular HIV medical treatment persist among African Americans living with HIV. Many scholars believe that the mistrust of health care held by many African Americans stems from a legacy of abuse, from medical experimentation on slaves to the unethical practices with patients in the Tuskegee Syphilis study. We performed a systematic appraisal of the literature, using several key terms, in order to understand how attitudes about HIV-related health care influence African Americans' engagement in care. We examined peer-reviewed studies published during the period January 2001 through May 2012. An initial search generated 326 studies. Sixteen descriptive studies met our inclusion criteria. Experiences of racism, conspiracy beliefs and the quality of provider relationships appeared to impact engagement. Providers should openly investigate personal beliefs that adversely affect their treatment decisions, listen to patient narratives, and share treatment decisions in order to create a transparent environment.
Walsh, Kate; McCauley, Jenna; Ruggiero, Kenneth J.; Brown, Jennifer L.; Sales, Jessica M.; Rose, Eve; Wingood, Gina M.; DiClemente, Ralph J.
Abstract Background: Latent class analysis (LCA) is a useful statistical tool that can be used to enhance understanding of how various patterns of combined sexual behavior risk factors may confer differential levels of HIV infection risk and to identify subtypes among African American adolescent girls. Methods: Data for this analysis is derived from baseline assessments completed prior to randomization in an HIV prevention trial. Participants were African American girls (n=701) aged 14–20 years presenting to sexual health clinics. Girls completed an audio computer-assisted self-interview, which assessed a range of variables regarding sexual history and current and past sexual behavior. Results: Two latent classes were identified with the probability statistics for the two groups in this model being 0.89 and 0.88, respectively. In the final multivariate model, class 1 (the “higher risk” group; n=331) was distinguished by a higher likelihood of >5 lifetime sexual partners, having sex while high on alcohol/drugs, less frequent condom use, and history of sexually transmitted diseases (STDs), when compared with class 2 (the “lower risk” group; n=370). The derived model correctly classified 85.3% of participants into the two groups and accounted for 71% of the variance in the latent HIV-related sexual behavior risk variable. The higher risk class also had worse scores on all hypothesized correlates (e.g., self-esteem, history of sexual assault or physical abuse) relative to the lower risk class. Conclusions: Sexual health clinics represent a unique point of access for HIV-related sexual risk behavior intervention delivery by capitalizing on contact with adolescent girls when they present for services. Four empirically supported risk factors differentiated higher versus lower HIV risk. Replication of these findings is warranted and may offer an empirical basis for parsimonious screening recommendations for girls presenting for sexual healthcare services. PMID
Bogart, Laura M.; Thorburn, Sheryl
Although prior research shows that substantial proportions of African Americans hold conspiracy beliefs, little is known about the subgroups of African Americans most likely to endorse such beliefs. We examined the relationship of African Americans' sociodemographic characteristics to their conspiracy beliefs about HIV/AIDS and birth control. Anonymous telephone surveys were conducted with a targeted random-digit-dial sample of 500 African Americans (15-44 years) in the contiguous United States. Respondents reported agreement with statements capturing beliefs in HIV/AIDS conspiracies (one scale) and birth control conspiracies (two scales). Sociodemographic variables included gender, age, education, employment, income, number of people income supports, number of living children, marital/cohabitation status, religiosity and black identity. Multivariate analyses indicated that stronger HIV/AIDS conspiracy beliefs were significantly associated with male gender, black identity and lower income. Male gender and lower education were significantly related to black genocide conspiracy beliefs, and male gender and high religiosity were significantly related to contraceptive safety conspiracy beliefs. The set of sociodemographic characteristics explained a moderately small amount of the variance in conspiracy beliefs regarding HIV/AIDS (R2 range=0.07-0.12) and birth control (R2 range=0.05-0.09). Findings suggest that conspiracy beliefs are not isolated to specific segments of the African-American population. PMID:16895286
Dunne, Eugene M; Dyer, Typhanye Penniman; Khan, Maria R; Cavanaugh, Courtenay E; Melnikov, Alex; Latimer, William W
Trading sex for money, drugs, goods, services, or a place to stay is prevalent among women who use drugs and has been associated with women's risk of HIV acquisition. There is evidence that trading sex for drugs only may be associated with elevated risk of HIV compared with trading sex for money. The purpose of this study was to assess whether HIV risk behaviors and HIV prevalence differ among African American drug using women (N = 92) who traded sex for drugs only, traded sex for economic resources (defined as money, shelter, or other resources) only, or traded sex for both economic resources and drugs. In this study, lower rates of condom use and higher rates of HIV were found among women who traded sex for drugs only compared to women who traded sex for economic resources or for economic resources and drugs. These findings suggest that African American women who trade sex for drugs only represent an understudied yet highly vulnerable group.
African American community leaders' policy recommendations for reducing racial disparities in HIV infection, treatment and care: results from a community-based participatory research project in Philadelphia, PA
Nunn, Amy; Sanders, Julia; Carson, Lee; Thomas, Gladys; Cornwall, Alexandra; Towey, Caitlin; Lee, Hwajin; Tasco, Marian; Shabazz-El, Waheedah; Yolken, Annajane; Smith, Tyrone; Bell, Gary; Feller, Sophie; Smith, Erin; James, George; Dunston, Brenda Shelton; Green, Derek
African Americans account for 45% of new HIV infections in the United States. Little empirical research investigates African American community leaders' normative recommendations for addressing these disparities. Philadelphia's HIV infection rate is five times the national average, nearly 70% of new infections are among African Americans, and 2% of African Americans in Philadelphia are living with HIV/AIDS. Using a community-based participatory research (CBPR) approach, we convened focus groups among 52 African American community leaders from diverse backgrounds to solicit normative recommendations for reducing Philadelphia's racial disparities in HIV infection. Leaders recommended: 1) Philadelphia's city government should raise awareness about HIV/AIDS with media campaigns featuring local leaders; 2) Local HIV prevention interventions should address social and structural factors influencing HIV risks rather than focus exclusively on mode of HIV transmission; 3) Resources should be distributed to the most heavily impacted neighborhoods of Philadelphia; and 4) Faith institutions should play a critical role in HIV testing, treatment and prevention efforts. We developed a policy memo highlighting these normative recommendations for how to enhance local HIV prevention policy. This policy memo led to Philadelphia City Council hearings about HIV/AIDS in October 2010 and subsequently informed local HIV/AIDS prevention policy and development of local HIV prevention interventions. This CBPR case study offers important lessons for effectively engaging community leaders in research to promote HIV/AIDS policy change. PMID:24879446
African American community leaders' policy recommendations for reducing racial disparities in HIV infection, treatment, and care: results from a community-based participatory research project in Philadelphia, Pennsylvania.
Nunn, Amy; Sanders, Julia; Carson, Lee; Thomas, Gladys; Cornwall, Alexandra; Towey, Caitlin; Lee, Hwajin; Tasco, Marian; Shabazz-El, Waheedah; Yolken, Annajane; Smith, Tyrone; Bell, Gary; Feller, Sophie; Smith, Erin; James, George; Shelton Dunston, Brenda; Green, Derek
African Americans account for 45% of new HIV infections in the United States. Little empirical research investigates African American community leaders' normative recommendations for addressing these disparities. Philadelphia's HIV infection rate is 5 times the national average, nearly 70% of new infections are among African Americans, and 2% of African Americans in Philadelphia are living with HIV/AIDS. Using a community-based participatory research approach, we convened focus groups among 52 African American community leaders from diverse backgrounds to solicit normative recommendations for reducing Philadelphia's racial disparities in HIV infection. Leaders recommended that (a) Philadelphia's city government should raise awareness about HIV/AIDS with media campaigns featuring local leaders, (b) local HIV-prevention interventions should address social and structural factors influencing HIV risks rather than focus exclusively on mode of HIV transmission, (c) resources should be distributed to the most heavily affected neighborhoods of Philadelphia, and (d) faith institutions should play a critical role in HIV testing, treatment, and prevention efforts. We developed a policy memo highlighting these normative recommendations for how to enhance local HIV prevention policy. This policy memo led to Philadelphia City Council hearings about HIV/AIDS in October 2010 and subsequently informed local HIV/AIDS prevention policy and development of local HIV prevention interventions. This community-based participatory research case study offers important lessons for effectively engaging community leaders in research to promote HIV/AIDS policy change.
Prado, Guillermo; Pratt, Indira Abraham; Feaster, Daniel J.; Robinson-Batista, Carleen; Smith, Lila; Charles, Marie; Szapocznik, José
This preliminary study explores differences in adjustment in lesbians and heterosexual women by examining three dimensions: psychological distress, major depression, and social support. Surveys were administered to 48 participants. HIV-positive African American lesbians experienced higher levels of psychological distress, anxiety, and current major depression than did their heterosexual counterparts. Lesbians reported less social support from their immediate family, but not from other sources such as friends, compared to the heterosexual women. Lesbians also reported less satisfaction with their social support network. The results presented here highlight the merit of future research to examine factors associated with the lack of family-based social support in HIV-infected lesbians and the potential of developing interventions that assess relationships with members of the immediate family, explore the possibility of repairing these relationships, and capitalize on social support from friends. PMID:16609748
Klein, Charles H; Card, Josefina J
This study translated SiHLE (Sisters Informing, Healing, Living, and Empowering), a 12-hour Centers for Disease Control and Prevention evidence-based group-level intervention for African American females 14-18 years of age, into a 2-hour computer-delivered individual-level intervention. A randomized controlled trial (n = 178) was conducted to examine the efficacy of the new Multimedia SiHLE intervention. Average condom-protected sex acts (proportion of vaginal sex acts with condoms, last 90 days) for sexually active participants receiving Multimedia SiHLE rose from M = 51% at baseline to M = 71% at 3-month follow-up (t = 2.06, p = .05); no statistically significant difference was found in the control group. Non-sexually active intervention group participants reported a significant increase in condom self-efficacy (t = 2.36, p = .02); no statistically significant difference was found in the control group. The study provides preliminary support for the efficacy of a computer-delivered adaptation of a proven HIV prevention program for African American teenage women. This is consistent with meta-analyses that have shown that computer-delivered interventions, which can often be disseminated at lower per-capita cost than human-delivered interventions, can influence HIV risk behaviors in positive fashion.
Abstract Clergy and lay leaders have a pivotal role in the development and maintenance of HIV Ministries within the African American church. However, little is known about the actual roles these men and women have, the barriers they face and the supports they have found in the development and maintenance of an HIV Ministry. The purpose of this study is to examine the role, barriers and supports clergy and lay leaders experienced in the development of a long-standing HIV ministry in an African American church. These data were gathered from a larger ethnographic study, which examined the role of religious culture in the development, implementation and maintenance of an HIV ministry. Data for this study were collected through in-depth semi-structured interviews. Results revealed that the primary role of clergy and lay leaders involved dispelling myths surrounding HIV and ensuring congregational support. The primary barrier to the development and maintenance was views regarding sexuality. The primary support was their relationships with congregants that lived with HIV and AIDS. This information can assist in developing interventions to enhance the African American church movement toward HIV ministries. PMID:22870846
Noar, Seth M.; Webb, Elizabeth M.; Van Stee, Stephanie K.; Redding, Colleen A.; Feist-Price, Sonja; Crosby, Richard; Troutman, Adewale
New prevention options are urgently needed for African-Americans in the United States given the disproportionate impact of HIV/AIDS on this group. This combined with recent evidence supporting the efficacy of computer technology-based interventions in HIV prevention led our research group to pursue the development of a computer-delivered individually tailored intervention for heterosexually active African-Americans—the tailored information program for safer sex (TIPSS). In the current article, we discuss the development of the TIPSS program, including (i) the targeted population and behavior, (ii) theoretical basis for the intervention, (iii) design of the intervention, (iv) formative research, (v) technical development and testing and (vi) intervention delivery and ongoing randomized controlled trial. Given the many advantages of computer-based interventions, including low-cost delivery once developed, they offer much promise for the future of HIV prevention among African-Americans and other at-risk groups. PMID:21257676
Using the resiliency model as a framework, this qualitative description study was designed to elicit the experiences of African American women living with HIV/AIDS serving as informal kinship care providers. Themes emerging from the interviews included (a) strengths of informal social supports, (b) benefits of living with HIV as opposed to women who are not HIV positive, and (c) negative experiences of child welfare services. Findings suggest a plethora of resources women accessed through community-based agencies because of their HIV/AIDS status, as opposed to child welfare agencies.
Fletcher, Faith; Ingram, Lucy Annang; Kerr, Jelani; Buchberg, Meredith; Richter, Donna L; Sowell, Richard
HIV disproportionately impacts African American women of childbearing age residing in the southern United States. Antiretroviral therapy has increased the quantity and quality of life for people living with HIV and produced viable and safe reproduction possibilities for women living with HIV. However, little is known about reproductive decision-making processes for African American women living with HIV. The overall goal of our study was to qualitatively explore perspectives related to reproduction and motherhood in HIV-infected African American women of childbearing capacity. HIV-infected African American women of childbearing capacity in South Carolina (N = 42) participated in in-depth interviews. Our respondents held positive views about pregnancy and motherhood, despite nonsupportive pregnancy messages from interpersonal influences, including health care providers. Study findings uncovered the need for programs and interventions to support women's reproductive autonomy and focus on reducing conception- and pregnancy-related transmission risks to infants and uninfected sexual partners.
Wright, Patricia B.; Stewart, Katharine E.; Curran, Geoffrey M.; Booth, Brenda M.
This qualitative study is about barriers to the utilization of HIV testing as perceived by African Americans who have recently used cocaine and who live in the rural Delta region of Arkansas. Affordability, physical accessibility, and geographic availability were not perceived as barriers to HIV testing in this sample, yet acceptability was still perceived as poor. Acceptability due to social mores and norms was a major barrier. Many said testing was unacceptable because of fear of social costs. Many were confident of being HIV-negative based on risky assumptions about testing and the notification process. Small-town social and sexual networks added to concerns about reputation and risk. System approaches may fail if they focus solely on improving access to HIV services but do not take into consideration deeply internalized experiences of rural African Americans as well as involvement of the community in developing programs and services. PMID:24039279
Lazaryan, Aleksandr; Song, Wei; Lobashevsky, Elena; Tang, Jianming; Shrestha, Sadeep; Zhang, Kui; Gardner, Lytt I; McNicholl, Janet M; Wilson, Craig M; Klein, Robert S; Rompalo, Anne; Mayer, Kenneth; Sobel, Jack; Kaslow, Richard A
The role of human leukocyte antigen (HLA) class I supertypes in controlling human immunodeficiency virus type 1 (HIV-1) infection in African Americans has not been established. We examined the effects of the HLA-A and HLA-B alleles and supertypes on the outcomes of HIV-1 clade B infection among 338 African American women and adolescents. HLA-B58 and -B62 supertypes (B58s and B62s) were associated with favorable HIV-1 disease control (proportional odds ratio [POR] of 0.33 and 95% confidence interval [95% CI] of 0.21 to 0.52 for the former and POR of 0.26 and 95% CI of 0.09 to 0.73 for the latter); B7s and B44s were associated with unfavorable disease control (POR of 2.39 and 95% CI of 1.54 to 3.73 for the former and POR of 1.63 and 95% CI of 1.08 to 2.47 for the latter). In general, individual alleles within specific B supertypes exerted relatively homogeneous effects. A notable exception was B27s, whose protective influence (POR, 0.58; 95% CI, 0.35 to 0.94) was masked by the opposing effect of its member allele B*1510. The associations of most B supertypes (e.g., B58s and B7s) were largely explained either by well-known effects of constituent B alleles or by effects of previously unimplicated B alleles aggregated into a particular supertype (e.g., B44s and B62s). A higher frequency of HLA-B genotypic supertypes correlated with a higher mean viral load (VL) and lower mean CD4 count (Pearson's r = 0.63 and 0.62, respectively; P = 0.03). Among the genotypic supertypes, B58s and its member allele B*57 contributed disproportionately to the explainable VL variation. The study demonstrated the dominant role of HLA-B supertypes in HIV-1 clade B-infected African Americans and further dissected the contributions of individual class I alleles and their population frequencies to the supertype effects.
Dalmida, Safiya George; Holstad, Marcia McDonnell; DiIorio, Colleen; Laderman, Gary
The purpose of this qualitative study was to explore the meaning and use of spirituality among African American (AA), predominantly Christian women with HIV. A nonrandom sample of 20 AA women from a large infectious disease clinic in Metro-Atlanta participated in the study. The study used focus groups and individual interviews to interview women about their lived spiritual experience. Content analysis and NUDIST software were used to analyze transcripts. The findings revealed the spiritual views and practices of AA women with HIV. The following themes (and subthemes) emerged: Spirituality is a process/journey or connection (connection to God, higher power, or spirit and HIV brought me closer to God), spiritual expression (religion/church attendance, prayer, helping others, having faith), and spiritual benefits (health/healing, spiritual support, inner peace/strength/ability to keep going, and here for a reason or purpose/a second chance). Findings highlight the importance of spirituality in health and well-being among AA women with HIV/AIDS. PMID:22566288
Dalmida, Safiya George; Holstad, Marcia McDonnell; DiIorio, Colleen; Laderman, Gary
The purpose of this qualitative study was to explore the meaning and use of spirituality among African American (AA), predominantly Christian women with HIV. A nonrandom sample of 20 AA women from a large infectious disease clinic in Metro-Atlanta participated in the study. The study used focus groups and individual interviews to interview women about their lived spiritual experience. Content analysis and NUDIST software were used to analyze transcripts. The findings revealed the spiritual views and practices of AA women with HIV. The following themes (and subthemes) emerged: Spirituality is a process/journey or connection (connection to God, higher power, or spirit and HIV brought me closer to God), spiritual expression (religion/church attendance, prayer, helping others, having faith), and spiritual benefits (health/healing, spiritual support, inner peace/strength/ability to keep going, and here for a reason or purpose/a second chance). Findings highlight the importance of spirituality in health and well-being among AA women with HIV/AIDS.
Attitudes, perceptions, and behaviors toward HIV testing among African American and East African immigrant women in Washington, D.C.: Implications for targeted HIV testing promotion and communication strategies
De Jesus, Maria; Carrete, Claudia; Maine, Cathleen; Nalls, Patricia
Objectives The objective of the study was to examine and compare the HIV testing attitudes, perceptions, and behaviors between African American and East African immigrant women in the Washington, D.C. Metropolitan area. Methods Adopting an inductive, qualitative methodological approach, we conducted a total of 40 in-depth, semi-structured interviews between October 2012 and March 2013. Qualitative thematic analysis was used to analyze the data. Results Overall, African American women held more favorable views toward HIV testing than East African immigrant women. Very few East African immigrant women sought HIV testing intentionally. The majority of East African participants were tested inadvertently, while others tested for immigration- or employment-related purposes. There were many barriers that impede women from seeking an HIV test including: negative assumptions (e.g., ‘Getting an HIV test implies that I am HIV positive’); negative emotions (e.g., ‘Fear of being diagnosed with HIV and what this will mean for me’); and potential negative reactions from partner or others (e.g., ‘Getting an HIV test can signal distrust, disrespect, or infidelity’). There were nuances in how each group articulated some of these barriers and East African women expressed unique concerns that originated from experiences in their home countries. Conclusions The study shed light into the complexity of factors that constrain women from presenting themselves voluntarily for an HIV test and highlighted the nuances between African American and East African perceptions. Implications of findings for effective targeted HIV screening promotion and communication strategies among these groups of women are discussed. PMID:25897146
Griffith, Derek M.; Pichon, Latrice C.; Campbell, Bettina; Allen, Julie Ober
Despite substantial federal, state, and local efforts to reduce the transmission of HIV/AIDS, African Americans experience higher rates of infection than any other ethnic or racial group in the United States. It is imperative to develop culturally and ecologically sensitive interventions to meet the sexual health needs of this population.…
Szapocznik, Jose; Feaster, Daniel J.; Mitrani, Victoria B.; Prado, Guillermo; Smith, Lila; Robinson-Batista, Carleen; Schwartz, Seth J.; Mauer, Magaly H.; Robbins, Michael S.
This study tests the efficacy of Structural Ecosystems Therapy (SET), a family-ecological intervention, in improving psychosocial functioning when compared with an attention-comparison person-centered condition and a community control condition. A sample of 209 HIV-seropositive, urban, low-income, African American women was randomized into 1 of…
Rikard, R V; Thompson, Maxine S; Head, Rachel; McNeil, Carlotta; White, Caressa
The rate of HIV infection among African Americans is disproportionately higher than for other racial groups in the United States. Previous research suggests that low level of health literacy (HL) is an underlying factor to explain racial disparities in the prevalence and incidence of HIV/AIDS. The present research describes a community and university project to develop a culturally tailored HIV/AIDS HL toolkit in the African American community. Paulo Freire's pedagogical philosophy and problem-posing methodology served as the guiding framework throughout the development process. Developing the HIV/AIDS HL toolkit occurred in a two-stage process. In Stage 1, a nonprofit organization and research team established a collaborative partnership to develop a culturally tailored HIV/AIDS HL toolkit. In Stage 2, African American community members participated in focus groups conducted as Freirian cultural circles to further refine the HIV/AIDS HL toolkit. In both stages, problem posing engaged participants' knowledge, experiences, and concerns to evaluate a working draft toolkit. The discussion and implications highlight how Freire's pedagogical philosophy and methodology enhances the development of culturally tailored health information.
Brooks, Ronald A.; Etzel, Mark A.; Hinojos, Ernesto; Henry, Charles L.; Perez, Mario
HIV-related stigma, discrimination, and homophobia impede community based efforts to combat HIV disease among Latino and African American gay and bisexual men. This commentary highlights ways to address these social biases in communities of color in Los Angeles from the perspectives of staff from HIV prevention programs. Information was collected from HIV prevention program staff participating in a two-day symposium. The outcomes from the symposium offer strategies for developing and implementing HIV prevention services for Latino and African American gay and bisexual men, which include: 1) addressing social biases present in a community that can hinder, and even prohibit, utilization of effective HIV prevention programs; 2) recasting HIV prevention messages in a broader social or health context; 3) developing culturally appropriate HIV prevention messages; 4) exploring new modalities and venues for delivering HIV prevention messages that are appropriate for gay and bisexual men of color and the communities in which they live; and 5) broadening the target of HIV prevention services to include service providers, local institutions and agencies, and the community at-large. These strategies underscore the need to consider the social and contextual factors of a community when designing and implementing HIV prevention programs. PMID:16283834
Suggests sources of information for African American History Month for library media specialists who work with students in grades four through eight. Gale Research's "African-American Reference Library," which includes "African-America Biography,""African-American Chronology," and "African-American Almanac,"…
Jemmott, L S
Adolescence is normally a healthy period of life. For some young people it is a period of experimentation with risky behavior. For others, it marks the development of habitual risk behaviors that persist into adulthood. Of special concern is adolescent involvement with sexual behaviors that increase the risk of infection with HIV and other sexually transmitted diseases (STDs). Nurses who work with adolescents are seeing an increase in STDs, including HIV infection occurring disproportionately among African-American adolescents. Although the use of condoms can reduce the risk of these sexually transmitted diseases, most sexually active adolescents do not consistently use condoms. This paper will discuss the scope of the problem of STDs, especially HIV infection among African-American adolescents. It will describe the Theory of Planned Behavior as a framework for designing interventions to reduce the sexual transmission of HIV and other STDs. Finally, it will provide strategies for nurses to intervene by empowering African-American adolescents to reduce their risk for sexually transmitted HIV infection.
Moore, DaKysha; Onsomu, Elijah O; Timmons, Shirley M; Abuya, Benta A; Moore, Christina
This study explores HIV/AIDS communication strategies among church leaders at predominately African American churches in a metropolitan city and surrounding areas in North Carolina. The church leaders contacted for the study are members of an interfaith-based HIV/AIDS program. The researchers used semi-standardized interviews to explore how church leaders address HIV/AIDS in the church. The findings indicate that the seven church leaders who participated in the study use a variety of communication channels to disseminate HIV/AIDS information for congregants and their surrounding communities, which include both interpersonal and mass media.
Albritton, Tashuna; Hodge-Sallah, Stepheria; Akers, Aletha; Blumenthal, Connie; O'Brien, Sarah; Council, Barbara; Muhammad, Melvin; Corbie-Smith, Giselle
We evaluated the fidelity and implementation of an HIV/AIDS and sexually transmitted infections intervention for rural African American youth. Using a community-based evaluation approach, community partners and researchers monitored four core process-evaluation components: reach, fidelity, dose delivered, and dose received. Researchers collected evaluation data through session observations, facilitator debriefing interviews, a youth focus group, and a satisfaction survey. For reach, more than half of the participants attended the 13 sessions. Participation varied between 62% and 100%. For fidelity, not all sessions were implemented as intended; multiple modifications occurred across sessions. For dose delivered, some lessons were missing materials and content was omitted; facilitators omitted content when there was insufficient time to complete a lesson. For dose received, engagement varied across lessons but youth reported high levels of satisfaction with the intervention. This formative process evaluation enabled us to identify and address multiple challenges to implementation. PMID:24939390
Ellen, J M; McCree, D H; Muvva, R; Chung, S-E; Miazad, R M; Arrington-Sanders, R; Jones, K; Burnett, P; Fichtenberg, C
To determine effectiveness of alternate venue testing (AVT), social network strategy (SNS) and provider referral (PR) for identifying previously undiagnosed HIV-infected 18-64-year-old African American men who have sex with men (AA MSM) by a health department. For AVT, staff used a mobile clinic to conduct HIV testing. For PR, staff solicited contact information from HIV-infected AA MSM, located contacts and offered HIV testing. For SNS, HIV-positive AA MSM recruited network associates for HIV testing. Two hundred and eighteen self-identified AA MSM were tested through AVT (25.2% HIV positivity) of whom 20 were newly identified HIV-positive. Fourteen HIV-positive men participated in SNS; 22 AA MSM contacts were recruited through SNS, eight (36.4%) were HIV positive and none were new positives. Two HIV-infected men participated in the PR strategy, yielding two AA MSM sex partners (one previously positive). The results suggest the need for health departments to consider using several complimentary strategies for identifying previously undiagnosed HIV infections in AA MSM in urban environments such as Baltimore.
Glover, Dorie A; Garcia-Aracena, Elena F; Lester, Patricia; Rice, Eric; Rothram-Borus, Mary Jane
Mothers living with HIV (MLH) are at high risk for acute and chronic stress, given challenges related to their HIV status, ethnicity, economic and urban living conditions. Biomarkers combined into a composite index show promise in quantifying psychosocial stress in healthy people, but have not yet been examined among MLH. According, we examined potential biomarker correlates of stress [cortisol and catecholamines from home-collected urine and basic health indicators (blood pressure, height and weight, waist-to-hip ratio) measured during an interview] among 100 poor African American and Latina mothers MLH and demographic-matched control mothers without HIV (n = 50). Participants had been enrolled in a randomized controlled trial about 18 months earlier and had either received (MLH-I) or were awaiting (MLH-W) the psychosocial intervention. Participation was high, biomarkers were correctly collected for 93% of cases, and a complete composite biomarker index (CBI) calculated for 133 mothers (mean age = 42). As predicted, MLH had a significantly higher CBI than controls, but there was no CBI difference across ethnicity or intervention group. CBI predicted CD4 counts independently after controlling for age, years since diagnosis, prior CD4 counts, medication adherence, and depression symptoms. The study demonstrates acceptability, feasibility and potential utility of community-based biomarker collections in evaluating individual differences in psychosocial stress.
Gentry, Quinn M; Elifson, Kirk; Sterk, Claire
The purpose of this study was to examine how various living conditions impact the context within which low-income African American women engage in a diverse range of high-risk behavior that increases their risk for HIV infection. The study, based on 2 years of ethnographic fieldwork, analyzed the living conditions of 45 African American women at risk for HIV infection in a high-risk neighborhood in Atlanta, Georgia. A black feminist perspective guided the study's analytical framework as a way to extend knowledge about the social conditions, the social interactions, and the meaning of high-risk behavior in the lives of African American women. Using black feminist theory and the constant comparison method, two groups emerged: "street" women and "house" women. Street women were defined as the absolute homeless, the rooming housed, and the hustling homeless. House women were defined as the family housed, the heads of household, and the steady-partner housed. Results reveal that various types of living arrangements place women at risk in different ways and suggest that low-income African American women at high risk for HIV infection-a group often considered homogeneous-have unique "within group" needs that must be addressed in HIV prevention intervention research.
Murry, Velma McBride; Berkel, Cady; Chen, Yi-fu; Brody, Gene H.; Gibbons, Frederick X.; Gerrard, Meg
AIDS is the leading killer of African Americans between the ages of 25 and 44, many of whom became infected when they were teenagers or young adults. The disparity in HIV infection rate among African Americans youth residing in rural Southern regions of the United States suggests that there is an urgent need to identify ways to promote early…
Davis, Kevin C; Uhrig, Jennifer; Rupert, Douglas; Fraze, Jami; Goetz, Joshua; Slater, Michael
"Take Charge. Take the Test." (TCTT), a media campaign promoting HIV testing among African American women, was piloted in Cleveland and Philadelphia from October 2006 to October 2007. This study assesses TCTT's effectiveness in promoting HIV testing information seeking among target audiences in each pilot city. The authors analyzed data on telephone hotlines promoted by the campaign and the www.hivtest.org Web site to examine trends in hotline calls and testing location searches before, during, and after the campaign. Cleveland hotline data were available from October 1, 2005, through February 28, 2008, for a total of 29 months (N = 126 weeks). Philadelphia hotline data were available from May 1, 2006, through February 28, 2008, for a total of 22 months (N = 96 weeks). The authors assessed the relation between market-level measures of the campaign's advertising activities and trends in hotline call volume and testing location searches. They found a significant relation between measures of TCTT advertising and hotline calls. Specifically, they found that increases in advertising gross ratings points were associated with increases in call volume, controlling for caller demographics and geographic location. The campaign had similar effects on HIV testing location searches. Overall, it appears the campaign generated significant increases in HIV information seeking. Results are consistent with other studies that have evaluated the effects of media campaigns on similar forms of information seeking. This study illustrates useful methods for evaluating campaign effects on information seeking with data on media implementation, hotline calls, and zip code-based searches for testing locations.
Turner-Musa, Jocelyn O; Rhodes, Warren A; Harper, P Thandi Hicks; Quinton, Sylvia L
Substance use and HIV risk behaviors are increasing among African-American youth. Interventions that incorporate youth values and beliefs are needed to reduce this trajectory. Hip-hop plays an important role in the lives of many African-American youth and provides a context within which to prevent risky behaviors. The current study examines the efficacy of a hip-hop based substance use and HIV preventive intervention that targets African-American middle-school youth. The sample consists of 68 middle-school students who completed baseline and 6-month follow-up assessments. Findings suggest that students in the intervention group were significantly more likely to have higher knowledge of perception of drug risk and more knowledge about HIV/AIDS compared to students in the comparison group at the 6-month post-intervention assessment. Discussion is centered on implications of hip-hop as a viable approach for preventing substance use and HIV within a high-risk group.
Robinson, LaShun R.; Braxton, Nikia D.; Er, Deja L.; Conner, Anita C.; Renfro, Tiffaney L.; Rubtsova, Anna A.; Hardin, James W.; DiClemente, Ralph J.
Objectives. We assessed the effectiveness of P4 for Women, a faith-based HIV intervention. Methods. We used a 2-arm comparative effectiveness trial involving 134 African American women aged 18 to 34 years to compare the effectiveness of the Centers for Disease Control and Prevention–defined evidence-based Sisters Informing Sisters about Topics on AIDS (SISTA) HIV intervention with P4 for Women, an adapted faith-based version of SISTA. Participants were recruited from a large black church in Atlanta, Georgia, and completed assessments at baseline and follow-up. Results. Both SISTA and P4 for Women had statistically significant effects on this study’s primary outcome—consistent condom use in the past 90 days—as well as other sexual behaviors. However, P4 for Women also had statistically significant effects on the number of weeks women were abstinent, on all psychosocial mediators, and most noteworthy, on all measures of religious social capital. Results were achieved by enhancing structural social capital through ministry participation, religious values and norms, linking trust and by reducing negative religious coping. High intervention attendance may indicate the feasibility of conducting faith-based HIV prevention research for African American women. Conclusions. P4 for Women enhanced abstinence and safer sex practices as well as religious social capital, and was more acceptable than SISTA. Such efforts may assist faith leaders in responding to the HIV epidemic in African American women. PMID:24134367
St Lawrence, Janet S.; Tarima, Sergey S.; DiFranceisco, Wayne J.; Amirkhanian, Yuri A.
Objectives. We examined correlates of condomless anal intercourse with nonmain sexual partners among African American men who have sex with men (MSM). Methods. We recruited social networks composed of 445 Black MSM from 2012 to 2014 in Milwaukee, Wisconsin; Cleveland, Ohio; and Miami Beach, Florida. Participants reported past-3-month sexual behavior, substance use, and background, psychosocial, and HIV-related characteristics. Results. Condomless anal intercourse outside main concordant partnerships, reported by 34.4% of MSM, was less likely in the case of no alcohol and marijuana use in the past 30 days, and higher risk-reduction behavioral intentions. High frequency of condomless anal intercourse acts with nonmain partners was associated with high gay community participation, weak risk-reduction intentions, safer sex not being perceived as a peer norm, low condom-use self-efficacy, and longer time since most recent HIV testing. Conclusions. Condomless anal intercourse with nonmain partners among Black MSM was primarily associated with gay community participation, alcohol and marijuana use, and risk-reduction behavioral intentions. PMID:26562130
Moizel, Jennifer; Panos, Stella E.; Patel, Sapna M.; Byrd, Desiree A.; Myers, Hector F.; Wyatt, Gail E.; Hinkin, Charles H.
Abstract Modest or even occasional nonadherence to combined antiretroviral therapy (cART) can result in adverse clinical outcomes. African Americans demonstrate lower rates of adherence than Caucasians or Latinos. Identifying factors that influence medication adherence among African Americans is a critical step toward reducing HIV/AIDS disease progression and mortality. In a sample of 181 African American (n=144) and Caucasian (n=37) HIV-positive drug-using individuals [age (M=42.31; SD=6.6) education (M=13.41; SD=2.1)], we examined the influence of baseline drug use, literacy, neurocognition, depression, treatment-specific social support, and patient satisfaction with health care provider on medication adherence averaged over the course of 6 months (study dates 2002–2006). Our findings suggest differential baseline predictors of medication adherence for African Americans and Caucasians, such that patient satisfaction with provider was the strongest predictor of follow-up medication adherence for African Americans whereas for Caucasians depressive symptoms and treatment-specific social support were predictive of medication adherence (after controlling for duration of drug use). PMID:22889235
Murray, Ashley; Toledo, Lauren; Brown, Emma Ej; Sutton, Madeline Y
HIV testing for some African American men remains a challenge, and effective interventions are lacking. We explored facilitators and barriers associated with HIV testing among heterosexual African American men in rural Florida. We conducted focus group interviews with 67 African American men who were low-income, and HIV-uninfected based on prior testing or had unknown HIV status. Using computer-assisted thematic analyses, we examined transcribed focus group responses for main themes. Thematic analyses revealed three main themes regarding facilitators of HIV testing: 1) using preferred HIV testing community locations (park, library, gym); 2) receiving incentives (food or money); and 3) the importance of peer-led messaging for free, rapid HIV testing. Barriers included HIV testing at the local health department, and perceived social and emotional consequences to testing and the possibility of receiving a positive result. Effective HIV testing interventions for heterosexual African American men in rural Florida may need to incorporate suggested facilitators and reduce perceived barriers in order to improve HIV testing strategies.
Whiters, David L; Santibanez, Scott; Dennison, David; Clark, H Westley
This case study examined programmatic data from a federally funded faith-based rapid HIV testing initiative. In 2004, Recovery Consultants of Atlanta, Inc. (RCA, Inc.) began providing rapid HIV testing in collaboration with six Atlanta-based African-American churches. Of the 1,947 persons tested from January 2004 to July 2005, 1,872 (96.1%) were African-American, 1,247 (64%) were male, and 1,612 (82.8%) were between the age of 26 and 56. A total of 85 HIV-infected individuals were identified and 72 were identified as previously undiagnosed cases (positivity rate of 3.7%). This case study highlights and promotes rapid HIV testing offered in partnership with African American churches as a strategy for raising HIV awareness among inner-city substance users.
Whitehead, Nicole Ennis; Hearn, Lauren E; Burrell, Larry
By 2015, half of those living with HIV in the United States will be ≥50 years of age. Research suggests that perceived social support is an important factor in maintaining positive health behaviors in this population. The present study examined the relationship between depressive symptoms and trait anger on perceived social support in a sample of low-income HIV positive (HIV+) African Americans ≥50 years of age. Additionally, we examined life stressors moderated the relationship between mental health and perceived support. This study includes 95 HIV+ men and women ≥50 years of age who identify as black/African American. As expected, depressive symptoms and trait anger showed a strong inverse relationship with perceived support resources. Furthermore, life stressors also showed a strong inverse relationship with perceived support. However, life stressors did not moderate the relationship between depressive symptoms and anger. Instead life stressors demonstrated a strong independent relationship with perceived support. The association between depressive symptoms, trait anger, life stressors, and lower perceived support suggests that these factors play a role in one's ability to access needed support resources. Greater perceived support is associated with improved health in HIV+ persons, and may be especially important in tailoring interventions for those ≥50 years of age.
Boekeloo, B; Geiger, T; Wang, M; Ishman, N; Quinton, S; Allen, G; Ali, B; Snow, D
African American/Black (Black) women suffer disproportionately to other women from HIV. An HIV prevention intervention combining two previous evidenced-based intervention programs; "Coping with Work and Family Stress" and "Hip Hop 2 Prevent Substance Abuse and HIV", was evaluated in a diverse sample of Black women (n = 205). Study participants at ten recruitment sites were assigned non-randomly to either the intervention or comparison group and then surveyed at baseline, immediate posttest, and 6-month follow-up. General Estimating Equation modeling revealed that participants in the comparison group reported less unprotected sex at immediate post-test and the intervention group less unprotected sex at 6-month follow-up. Despite the initial drop in reported unprotected sex in the comparison group, this study suggests that an HIV risk reduction intervention tailored to address Black women's socio-cultural stress and enhance their coping may reduce their unprotected sex at 6-months.
Brown, Emma J; Hill, Mary Angelique
HIV/AIDS disproportionately affects African Americans, yet knowledge gaps exist regarding their views of risks and effective prevention strategies. This focus group study of rural and small city African Americans who use drugs sought to assess these perceptions. Common views of HIV risks included drug use, physical appearance as an indicator of HIV status, intentional transmission, having multiple partners, unprotected sex, bisexuality, and unfounded trust. Trading sex for drugs and unprotected sex when high were seen as drug use/HIV risk links, while HIV education and condom use were identified as ways to decrease risk. Perceptions of effective strategies included community-based programs, gender specific groups, providing food or other incentives, and making the program fun. Healthcare professionals and parents were viewed as the best people to promote HIV prevention. Based on the findings, effective intervention for this target group should encompass ethnocentric community-based strategies that focus on HIV education, condom use skills, and drug risk reduction.
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Tobin, Karin; Kuramoto, Satoko J.; German, Danielle; Fields, Errol; Spikes, Pilgrim S.; Patterson, Jocelyn; Latkin, Carl
Unity in Diversity was a randomized controlled trial of a culturally tailored HIV prevention intervention for African American men who have sex with men. The intervention condition was six group-based sessions and one individual session. The control condition was a single-session HIV prevention review. Participants were aged 18 years or older,…
Crosby, Richard A.; DiClemente, Ralph J.; Wingood, Gina M.; Harrington, Kathy
Investigated whether living in a supportive family was an HIV/STD-protective factor for at-risk African American adolescent girls. Surveys supported the association between living in perceived supportive families and HIV/STD protective benefits. Supportive families enhanced girls' confidence in their ability to negotiate condom use and helped them…
Arnold, Emily A; Bailey, Marlon M
This article focuses on the construction of homes and families within the ballroom community, a prominent feature of urban GLBTQ communities of color in cities across the United States. Based on two ethnographic studies with ballroom communities in the San Francisco Bay Area, California, and Detroit, Michigan, we explore the importance of gender and sexual identity in informing community practice around HIV prevention and treatment. As a community, the ballroom scene provides African American queer youth with support for same-sex desire and identity, along with multiple forms of support for HIV prevention. Our study of the ballroom community documents current forms of "intravention" occurring within the community and the importance of the gender-sex system in organizing these practices. We also offer recommendations for community-based organizations to partner with the ballroom community, making use of existing social structures within the community and the salient concepts of home and family, to provide HIV-related services and support. We argue for HIV-prevention interventions to take a more culturally appropriate, nuanced approach to reaching African American youth at risk, utilizing community and family structures, in whatever forms these may take.
Griffith, Derek M; Pichon, Latrice C; Campbell, Bettina; Allen, Julie Ober
Despite substantial federal, state, and local efforts to reduce the transmission of HIV/AIDS, African Americans experience higher rates of infection than any other ethnic or racial group in the United States. It is imperative to develop culturally and ecologically sensitive interventions to meet the sexual health needs of this population. Capitalizing on the assets, resources, and strengths of faith-based organizations, YOUR Blessed Health (YBH) is a community-based participatory research project developed to increase HIV/AIDS awareness and reduce HIV-related stigma among the African American faith community in Flint, Michigan. This article describes the historical context and development of YBH, discusses the results of the pilot study, and illustrates how YBH grew into a community mobilization effort led by faith leaders and their congregations to address HIV/AIDS. YBH highlights the importance of developing and testing intervention models that originate from community-based organizations to address complex and sensitive health issues among marginalized populations.
HIV/AIDS prevention, faith, and spirituality among black/African American and Latino communities in the United States: strengthening scientific faith-based efforts to shift the course of the epidemic and reduce HIV-related health disparities.
Sutton, Madeline Y; Parks, Carolyn P
Black/African American and Latino communities are disproportionately affected by the domestic HIV/AIDS epidemic. Blacks/African Americans and Latinos are also more likely to report a formal, religious, or faith affiliation when compared with non-Hispanic whites. As such, faith leaders and their institutions have been identified in the National HIV/AIDS Strategy as having a vital role to serve in reducing: (1) HIV-related health disparities and (2) the number of new HIV infections by promoting non-judgmental support for persons living with and at risk for HIV/AIDS and by serving as trusted information resources for their congregants and communities. We describe faith doctrines and faith-science partnerships that are increasing in support of faith-based HIV prevention and service delivery activities and discuss the vital role of these faith-based efforts in highly affected black/African American and Latino communities.
Traditional healing remains an important aspect of many people's engagement with healthcare and, in this, responses to the treatment of HIV/AIDS are no different. However, given the gravity of the global HIV/AIDS pandemic, there has been much debate as to the value of traditional healing in this respect. Accordingly, this paper explores the extent to which meaningful accommodation between the biomedical and traditional sectors is possible (and/or even desirable). It does this through a consideration of Native American and South African experiences, looking at how the respective groups, in which medical pluralism is common, have addressed the issue of HIV/AIDS. The paper points to the importance of developing "culturally appropriate" forms of treatment that emphasise complementary rather than adversarial engagement between the traditional and biomedical systems and how policymakers can best facilitate this.
Traditional healing remains an important aspect of many people’s engagement with healthcare and, in this, responses to the treatment of HIV/AIDS are no different. However, given the gravity of the global HIV/AIDS pandemic, there has been much debate as to the value of traditional healing in this respect. Accordingly, this paper explores the extent to which meaningful accommodation between the biomedical and traditional sectors is possible (and/or even desirable). It does this through a consideration of Native American and South African experiences, looking at how the respective groups, in which medical pluralism is common, have addressed the issue of HIV/AIDS. The paper points to the importance of developing “culturally appropriate” forms of treatment that emphasise complementary rather than adversarial engagement between the traditional and biomedical systems and how policymakers can best facilitate this. PMID:25903057
The Black community continues to be ravished by HIV/AIDS infection despite the marked expenditures utilized to reduce incidence among this cohort. Efforts to produce culturally appropriate programs that work continues to elude officials and HIV/AIDS has become endemic among specific subgroups in this cohort (e.g., Black men who have sex with men). Large-scale prevention programs have not worked and although community-based interventions have proven to be effective in eliciting behavior change, the numbers that they have been producing have not been enough to make a substantial impact on HIV incidence. The purpose of this exploratory article is to rehash how HIV/AIDS infection continues to devastate the African American community in an effort to elicit renewed vigilance in combating the disease in this community, describe the elements that continue to impede prevention and risk reduction efforts, and present a potential framework that may work to decrease incidence in this community. This article presents a multi-pronged approach to addressing the epidemic of HIV/AIDS in the African American community.
Sznitman, Sharon; DiClemente, Ralph; Salazar, Laura F.; Vanable, Peter A.; Carey, Michael P.; Hennessy, Michael; Brown, Larry K.; Valois, Robert F.; Stanton, Bonita F.; Fortune, Thierry; Juzang, Ivan
The evidence base and theoretical frameworks for mass media HIV-prevention campaigns in the United States are not well-developed. We describe an intervention approach using culturally sensitive mass media messages to enhance protective beliefs and behavior of African American adolescents at risk for HIV. This approach exploits the potential that mass media messages have, not only to reach a large segment of the adolescent population and thereby support normative change, but also to engage the most vulnerable segments of this audience to reduce HIV-associated risk behaviors. The results from an ongoing HIV-prevention trial implemented in 2 medium-sized cities in the United States illustrate the effectiveness of this intervention approach. PMID:19833995
Shrestha, Sadeep; Wiener, Howard W.; Aissani, Brahim; Song, Wei; Shendre, Aditi; Wilson, Craig M.; Kaslow, Richard A.; Tang, Jianming
Background Immunological and clinical outcomes can vary considerably at the individual and population levels during both treated and untreated HIV-1 infection. Cytokines encoded by the interleukin-10 gene (IL10) family have broad immunomodulatory function in viral persistence, and several SNPs in the IL10 promoter sequence have been reported to influence pathogenesis or acquisition of HIV-1 infection. Methodology/Principal Findings We examined 104 informative SNPs in IL10, IL19, IL20, IL24, IL10RA and IL10RB among 250 HIV-1 seropositive and 106 high-risk seronegative African American adolescents in the REACH cohort. In subsequent evaluation of five different immunological and virological outcomes related to HIV-1 infection, 25 SNPs were associated with a single outcome and three were associated with two different outcomes. One SNP, rs2243191 in the IL19 open reading frame (Ser to Phe substitution) was associated with CD4+ T-cell increase during treatment. Another SNP rs2244305 in IL10RB (in strong linkage disequilibrium with rs443498) was associated with an initial decrease in CD4+ T-cell by 23±9% and 29±9% every 3 months (for AA and AG genotypes, respectively, compared with GG) during ART-free period. These associations were reversed during treatment, as CD4+ T-cell increased by 31±0.9% and 17±8% every 3 months for AA and AG genotype, respectively. Conclusions/Significance In African Americans, variants in IL10 and related genes might influence multiple outcomes of HIV-1 infection, especially immunological response to HAART. Fine mapping coupled with analysis of gene expression and function should help reveal the immunological importance of the IL10 gene family to HIV-1/AIDS. PMID:20976276
McLaren, Paul J; Ripke, Stephan; Pelak, Kimberly; Weintrob, Amy C; Patsopoulos, Nikolaos A; Jia, Xiaoming; Erlich, Rachel L; Lennon, Niall J; Kadie, Carl M; Heckerman, David; Gupta, Namrata; Haas, David W; Deeks, Steven G; Pereyra, Florencia; Walker, Bruce D; de Bakker, Paul I W
A small proportion of human immunodeficiency virus-1 (HIV-1) infected individuals, termed HIV-1 controllers, suppress viral replication to very low levels in the absence of therapy. Genetic investigations of this phenotype have strongly implicated variation in the class I major histocompatibility complex (MHC) region as key to HIV-1 control. We collected sequence-based classical class I HLA genotypes at 4-digit resolution in HIV-1-infected African American controllers and progressors (n = 1107), and tested them for association with host control using genome-wide single nucleotide polymorphism data to account for population structure. Several classical alleles at HLA-B were associated with host control, including B*57:03 [odds ratio (OR) = 5.1; P= 3.4 × 10(-18)] and B*81:01 (OR = 4.8; P= 1.3 × 10(-9)). Analysis of variable amino acid positions demonstrates that HLA-B position 97 is the most significant association with host control in African Americans (omnibus P = 1.2 × 10(-21)) and explains the signal of several HLA-B alleles, including B*57:03. Within HLA-B, we also identified independent effects at position 116 (omnibus P= 2.8 × 10(-15)) in the canonical F pocket, position 63 in the B pocket (P= 1.5 × 10(-3)) and the non-pocket position 245 (P= 8.8 × 10(-10)), which is thought to influence CD8-binding kinetics. Adjusting for these HLA-B effects, there is evidence for residual association in the MHC region. These results underscore the key role of HLA-B in affecting HIV-1 replication, likely through the molecular interaction between HLA-B and viral peptides presented by infected cells, and suggest that sites outside the peptide-binding pocket also influence HIV-1 control.
McLaren, Paul J.; Ripke, Stephan; Pelak, Kimberly; Weintrob, Amy C.; Patsopoulos, Nikolaos A.; Jia, Xiaoming; Erlich, Rachel L.; Lennon, Niall J.; Kadie, Carl M.; Heckerman, David; Gupta, Namrata; Haas, David W.; Deeks, Steven G.; Pereyra, Florencia; Walker, Bruce D.; de Bakker, Paul I. W.
A small proportion of human immunodeficiency virus-1 (HIV-1) infected individuals, termed HIV-1 controllers, suppress viral replication to very low levels in the absence of therapy. Genetic investigations of this phenotype have strongly implicated variation in the class I major histocompatibility complex (MHC) region as key to HIV-1 control. We collected sequence-based classical class I HLA genotypes at 4-digit resolution in HIV-1-infected African American controllers and progressors (n = 1107), and tested them for association with host control using genome-wide single nucleotide polymorphism data to account for population structure. Several classical alleles at HLA-B were associated with host control, including B*57:03 [odds ratio (OR) = 5.1; P= 3.4 × 10–18] and B*81:01 (OR = 4.8; P= 1.3 × 10−9). Analysis of variable amino acid positions demonstrates that HLA-B position 97 is the most significant association with host control in African Americans (omnibus P = 1.2 × 10−21) and explains the signal of several HLA-B alleles, including B*57:03. Within HLA-B, we also identified independent effects at position 116 (omnibus P= 2.8 × 10−15) in the canonical F pocket, position 63 in the B pocket (P= 1.5 × 10−3) and the non-pocket position 245 (P= 8.8 × 10−10), which is thought to influence CD8-binding kinetics. Adjusting for these HLA-B effects, there is evidence for residual association in the MHC region. These results underscore the key role of HLA-B in affecting HIV-1 replication, likely through the molecular interaction between HLA-B and viral peptides presented by infected cells, and suggest that sites outside the peptide-binding pocket also influence HIV-1 control. PMID:22718199
McCurdy, Sheryl; Ratliff, Eric A.; Timpson, Sandra; Williams, Mark L.
BACKGROUND Financial compensation for participating in research is controversial, especially when participants are recruited from economically disadvantaged and/or marginalized populations such as drug users. Little is known about these participants’ own views regarding payment for research participation. OBJECTIVE The objective of the study was to elicit underserved minority drug users’ views about monetary payments for participating in research. DESIGN Semi-structured in-depth interview study of motivations for and perceptions of participation in research was used. PARTICIPANTS Thirty-seven adult, economically disadvantaged African-American crack cocaine smokers were the participants of the study. APPROACH Participants were recruited from among those taking part in three HIV prevention studies. Interviews were conducted at one of 2 research field offices located in underserved minority neighborhoods in Houston, Texas. Interviews lasting 30–45 min were recorded, transcribed, coded, and analyzed for categories and themes using both conventional and directed qualitative content analysis. This report addresses themes under the broad category of financial motivations for participating in research. RESULTS Participants viewed monetary payment for research as essential to attract participation and desirable to provide optional income. Payment for research participation was perceived as one potential income source among others. Participants considered self-determination a prerogative for themselves and others. They rejected the notion of payment for participation as encouraging drug use or as inducing risk taking. CONCLUSIONS Research regulators should consider participants’ views of their desires and capacity for autonomous decisions about financial compensation for research rather than assume participants’ diminished capacity due to poverty and/or drug use. Payment for research participation appears to be part of the “informal economy” that has been
Mays, Vickie M.; Cochran, Susan D.; Zamudio, Anthony
Two decades of HIV prevention efforts with men who have sex with men (MSM) have not eliminated the risk of new HIV infections in this vulnerable population. Indeed, current incidence rates in African American MSM are similar to those usually only seen in developing countries. A review of the existing literature suggests that the prevention research agenda for Black MSM could benefit from reframing conceptualization of risk as a function of individual properties to a broad consideration of social and interpersonal determinants. Studies that investigate dyadic and social-level influences on African American MSM’s relationships are needed. This includes research explicating the diversity existing within the categorizations of Black MSM with respect to perceived identity (gay, bisexual, “men on the down low,” “homo thugz”), constructions of masculinity, sexual scripts, sources of social support, and perceived norms and expectations. Recommendations are proposed for a research agenda focusing on linkages between interpersonal and social-structural determinants of HIV risk. PMID:20041036
Murry, Velma McBride; Berkel, Cady; Chen, Yi-Fu; Brody, Gene H; Gibbons, Frederick X; Gerrard, Meg
AIDS is the leading killer of African Americans between the ages of 25 and 44, many of whom became infected when they were teenagers or young adults. The disparity in HIV infection rate among African Americans youth residing in rural Southern regions of the United States suggests that there is an urgent need to identify ways to promote early preventive intervention to reduce HIV-related risk behavior. The Strong African American Families (SAAF) program, a preventive intervention for rural African American parents and their 11-year-olds, was specially designed to deter early sexual onset and the initiation and escalation of alcohol and drug use among rural African American preadolescents. A clustered-randomized prevention trial was conducted, contrasting families who took part in SAAF with control families. The trial, which included 332 families, indicated that intervention-induced changes occurred in intervention-targeted parenting, which in turn facilitated changes in youths' internal protective processes and positive sexual norms. Long-term follow up assessments when youth were 17 years old revealed that intervention-induced changes in parenting practices mediated the effect of intervention-group influences on changes in the onset and escalation of risky sexual behaviors over 65 months through its positive influence on adolescents' self-pride and their sexual norms. The findings underscore the powerful effects of parenting practices among rural African American families that over time serve a protective role in reducing youth's risk behavior, including HIV vulnerable behaviors.
This study reports the prevalence of child (CSA) and adult (ASA) sexual abuse among 535 African American HIV serodiscordant couples from four major United State cities, and its relationship to personal and couple related vulnerabilities and HIV risk factors. As part of a randomized, clinical trial, CSA and ASA histories were obtained through face-to-face interviews. Results indicate that HIV positive women were significantly more likely to report one kind of abuse (32.32%), either before or since age 18 or both (32.6%). HIV-positive men (34.9%) were significantly more likely to report CSA than HIV-negative men (22.0%). Overall, 72% of couples reported that one or both had CSA histories. These findings underscore the heightened emotional vulnerability, and STI and HIV transmission risk taking practices, associated with sexual abuse. Sexual abuse histories among couples should be assessed to better understand how these histories may contribute to couples dynamics and risk-taking practices.
St. Lawrence, Janet S.; And Others
Randomly assigned 246 African American adolescents either to an educational program or to an 8-week intervention that combined education with behavior skills training. Results indicate that, compared with the education program, youth in behavioral skills training lowered their infection risk to a greater degree, maintained risk reduction changes…
Eyre, Stephen L.; Flythe, Michelle; Hoffman, Valerie; Fraser, Ashley E.
In this study, we used an exploratory methodology to determine what cultural models African American emerging adults use to understand infidelity/cheating. Cultural models are defined as "cognitive schema[s] that [are] intersubjectively shared by a social group" (D'Andrade, 1987, p. 112). We interviewed 144 participants ages 19-22 from three…
Jennings, Larissa; Rompalo, Anne M; Wang, Jing; Hughes, James; Adimora, Adaora A; Hodder, Sally; Soto-Torres, Lydia E; Frew, Paula M; Haley, Danielle F
Knowledge of sexual partners' HIV infection can reduce risky sexual behaviors. Yet, there are no published studies to-date examining prevalence and characteristics associated with knowledge among African-American women living in high poverty communities disproportionately affected by HIV. Using the HIV Prevention Trial Network's (HPTN) 064 Study data, multivariable logistic regression was used to examine individual, partner, and partnership-level determinants of women's knowledge (n = 1,768 women). Results showed that women's demographic characteristics alone did not account for the variation in serostatus awareness. Rather, lower knowledge of partner serostatus was associated with having two or more sex partners (OR = 0.49, 95 % CI 0.37-0.65), food insecurity (OR = 0.68, 95 % CI 0.49-0.94), partner age >35 years (OR = 0.68, 95 % CI 0.49-0.94), and partner concurrency (OR = 0.63, 95 % CI 0.49-0.83). Access to financial support (OR = 1.42, 95 % CI 1.05-1.92) and coresidence (OR = 1.43, 95 % CI 1.05-1.95) were associated with higher knowledge of partner serostatus. HIV prevention efforts addressing African-American women's vulnerabilities should employ integrated behavioral, economic, and empowerment approaches.
Tobin, Karin; Kuramoto, Satoko J; German, Danielle; Fields, Errol; Spikes, Pilgrim S; Patterson, Jocelyn; Latkin, Carl
Unity in Diversity was a randomized controlled trial of a culturally tailored HIV prevention intervention for African American men who have sex with men. The intervention condition was six group-based sessions and one individual session. The control condition was a single-session HIV prevention review. Participants were aged 18 years or older, identified as African American/Black race, reported having at least two sex partners in the prior 90 days (at least one of whom must be a male partner), unprotected anal sex with male partner in the prior 90 days, and willing to test for HIV. Retention exceeded 95% at 3-month follow-up. Results of multivariate logistic regression analysis adjusting for baseline risk, HIV status, and health insurance indicate intervention efficacy in decreasing the number of male sex partners and marginal effects on condom use with male partners and HIV-negative/unknown partners. Specifically, intervention condition was associated with increased odds of zero male sex partners (adjusted odds ratio [AOR] = 3.03, 95% confidence interval [CI] = 1.26-7.28), condom use with male partners (AOR = 2.64, 95% CI = 0.95-7.36), and HIV-negative/unknown status partners (AOR = 3.19, 95% CI = 0.98-10.38) at follow-up. These results contribute to the limited number of culturally appropriate models of HIV prevention intervention that are urgently needed for African American men who have sex with men to address their persistently high rates of HIV.
Valois, Robert F.; DiClemente, Ralph J.; Carey, Michael P.; Stanton, Bonita; Romer, Daniel; Fletcher, Faith; Farber, Naomi; Brown, Larry K.; Vanable, Peter A.; Salazar, Laura F.; Juzang, Ivan; Fortune, Thierry
Abstract HIV-related stigma undermines HIV prevention, testing, and treatment. Multipronged risk-reduction strategies may reduce stigma among African American adolescents. To test the effectiveness of a risk-reduction strategy in addressing stigma, 1613 African American adolescents from four mid-sized cities participated in a randomized control trial. Participants received a sexual-risk reduction [Focus on Youth (FOY)] or general health curriculum [Promoting Health Among Teens (PHAT)]. Two cities received a culturally-tailored media intervention. Participants completed baseline, 3-, 6-, and 12-month surveys to measure HIV-related stigma and knowledge. Analysis of covariance tested for stigma and knowledge differences by media city status and curriculum/media city status (PHAT media vs. PHAT non-media, FOY media vs. FOY non-media; FOY media vs. PHAT media; FOY non-media vs. PHAT non-media) at each measurement. Hierarchical linear modeling (HLM) determined stigma and knowledge differences over time. Media participants demonstrated greater HIV-related knowledge (p<0.10) at 6 months and lower stigma at 3 months (p<0.10). FOY media participants had lower 3-month (p<0.05) and 12-month (p<0.10) stigma scores than non-media FOY participants. FOY media and non-media participants had greater knowledge than PHAT for all intervals after baseline. FOY media had lower stigma than PHAT media after baseline for all intervals after baseline. HLM indicated greater knowledge slopes for the media group (p<0.05). FOY media participants had greater knowledge slopes (p<0.05) relative to non-media FOY participants and media PHAT participants (p<0.01). A combination of a HIV risk-reduction curriculum and culturally-tailored media demonstrated some effectiveness in reducing stigma. Future use of media in HIV-prevention should include and evaluate effects on stigma. PMID:25738952
Matthews, Alicia K; Conrad, Megan; Kuhns, Lisa; Vargas, Maria; King, Andrea C
This study examined the feasibility, acceptability, and outcomes of a culturally tailored smoking cessation intervention for HIV-positive African American male smokers. Eligible smokers were enrolled in a seven-session group-based treatment combined with nicotine patch. The mean age of participants was M=46 years. The majority were daily smokers (71%), smoked a mentholated brand (80%), and averaged 8.6 (standard deviation [SD]=8.1) cigarettes per day. Baseline nicotine dependency scores (M=5.8) indicated a moderate to high degree of physical dependence. Of the 31 participants enrolled, the majority completed treatment (≥3 sessions; 68%), 1-month follow-up (74%), and 3-month follow-up (87%) interviews. Program acceptability scores were strong. However, adherence to the patch was low, with 39% reporting daily patch use. The majority of participants (80%, n=24) made a quit attempt. Furthermore, over the course of the intervention, smoking urge, cigarettes smoked, nicotine dependence, withdrawal symptoms, and depression scores all significantly decreased. Follow-up quit rates at 1 and 3 months ranged from 6% to 24%, with treatment completers having better outcomes. This first of its kind intervention for HIV-positive African American male smokers was feasible, acceptable, and showed benefit for reducing smoking behaviors and depression scores. Smoking cessation outcomes were on par with other similar programs. A larger trial is needed to address limitations and to confirm benefits.
Garett, Renee; Smith, Justin; Chiu, Jason; Young, Sean D
The recent increase in social media use allows these technologies to rapidly reach communities with higher HIV prevalence, such as African-American and Latino men who have sex with men (MSM). However, no studies have looked at HIV/AIDS stigma among social media users from African-American and Latino MSM communities, or the association between stigma and social media use among these groups. This study sought to assess the level of HIV/AIDS stigma among a sample of social media-using African-American and Latino MSM from Los Angeles. A total of 112 (primarily African-American and Latino, n = 98, 88%) MSM Facebook users completed a survey on demographics, online social network use, and HIV/AIDS stigma. A composite stigma score was created by taking the cumulative score from a 15-item stigma questionnaire. Cumulative logistic models were used to assess the association between HIV/AIDS stigma and online social network use. In general, participants reported a low level of HIV/AIDS stigma (mean = 22.2/75, SD = 5.74). HIV/AIDS stigma composite score was significantly associated with increased time spent on online social networks each day (Adjusted odds ratios (AOR): 1.07, 95% CI: 1.00, 1.15). Among this diverse sample of MSM online social network users, findings suggest that HIV/AIDS stigma is associated with usage of social media. We discuss the implications of this work for future HIV prevention.
Andrasik, Michele Peake; Clad, Rachel; Bove, Joanna; Tsegaselassie, Solomon; Morris, Martina
We evaluate an innovative grassroots community-based campaign in Seattle, WA focused on educating African American and African-born communities about concurrent partnerships and HIV transmission. Respondents completed a short self-administered questionnaire on a handheld personal digital assistant to evaluate the reach, acceptability and preliminary efficacy of the campaign. Of those who remembered seeing the campaign materials (82 %), social networks were the most common source of exposure (80 %). Respondents rated campaign materials very visually attractive (86 %), very interesting (91 %), and very important for themselves (90 %) and their community (93 %). Respondents reported that the campaign increased their knowledge about concurrency (84 %), changed their attitudes about it (77 %), and 65 % said it was likely or very likely that they would change their behavior as a result. This inexpensive grassroots campaign demonstrated extensive reach in the local black community and was able to move beyond individual exposure and into social networks.
Boekeloo, B; Geiger, T; Wang, M; Ishman, N; Quinton, S; Allen, G; Ali, B; Snow, D
African American/Black (Black) women suffer disproportionately to other women from HIV. An HIV prevention intervention combining two previous evidenced-based HIV intervention programs; “Coping with Work and Family Stress” and “Hip Hop 2 Prevent Substance Abuse and HIV”, was evaluated in a diverse sample of Black women (n=205). Study participants at 10 recruitment sites were assigned non-randomly to either the intervention or comparison group and then surveyed at baseline, immediate posttest, and 6-month follow-up. General Estimating Equation modeling revealed that participants in the comparison group reported less unprotected sex at immediate post-test and the intervention group less unprotected sex at 6-month follow-up. Despite the initial drop in reported unprotected sex in the comparison group, this study suggests that an HIV risk reduction intervention tailored to address Black women’s socio-cultural stress and enhance their coping may reduce their unprotected sex at 6-months. PMID:25645327
Seth, Puja; Wingood, Gina M.; Robinson, LaShun S.; Raiford, Jerris L.; DiClemente, Ralph J.
Background Intimate partner violence (IPV) is associated with risky sexual behavior and STIs among diverse groups of women. IPV was examined as a moderator of efficacy for an HIV/STI intervention. Methods 848 African American women, 18-29, were randomly assigned to an HIV/STI intervention or control condition. Participants completed measures on sociodemographics, IPV, risky sexual behavior and received STI testing. Results IPV predicted inconsistent condom use and a risky sexual partner over 12-month follow-up. A significant interaction indicated that among women who experienced IPV, those in the intervention were more likely to test positive for Trichomonas vaginalis (TV). Among intervention participants, those who experienced IPV were more likely to test TV-positive than those who did not. Discussion In an HIV intervention that did not specifically address IPV, women in the control were less likely to acquire TV than those in the intervention. Consideration of contextual/interpersonal factors is essential when developing HIV intervention programs. PMID:25399033
Tufts, Kimberly Adams; Johnson, Kaprea F; Shepherd, Jewel Goodman; Lee, Ju-Young; Bait Ajzoon, Muna S; Mahan, Lauren B; Kim, Miyong T
The purpose of this systematic review was to assess the quality of interventions using mobile health (mHealth) technology being developed for and trialed with HIV-infected African American (AA) women. We aimed to assess rigor and to ascertain if these interventions have been expanded to include the broad domain of self-management. After an extensive search using the PRISMA approach and reviewing 450 records (411 published studies and 39 ongoing trials at clinicaltrials.gov), we found little completed research that tested mHealth HIV self-management interventions for AA women. At clinicaltrials.gov, we found several mHealth HIV intervention studies designed for women in general, forecasting a promising future. However, most studies were exploratory in nature and focused on a single narrow outcome, such as medication adherence. Given that cultural adaptation is the key to successfully implementing any effective self-management intervention, culturally relevant, gender-specific mHealth interventions focusing on HIV-infected AA women are warranted for the future.
Bell, Edward Earl
The purpose of this study was to assess the socialization skills, self-esteem, and academic readiness of African American males in a school environment. Discussions with students and the School Perceptions Questionnaire provided data for this investigation. The intended targets for this investigation were African American students; however, there…
This collection for children tells the stories of 16 African Americans who helped make America what it is today. African Americans can take pride in the heritage of these contributors to society. Biographies are given for the following: (1) Sojourner Truth, preacher and abolitionist; (2) Frederick Douglass, abolitionist; (3) Harriet Tubman, leader…
Mashburn, Andrew J.; Peterson, John L.; Bakeman, Roger; Miller, Robin L.; Clark, Leslie F.
This study examined the influence of demographic characteristics, risk behaviors, knowledge, and psychosocial variables on HIV testing among a sample (n = 551) of young African-American men who have sex with men (MSM) from three cities--Atlanta (n = 241), Birmingham (n = 174), and Chicago (n = 136). Among the entire sample of young men, age,…
Sales, J. M.; DiClemente, R. J.; Davis, T. P.; Sullivan, S.
Human immunodeficiency virus (HIV) interventions can significantly reduce risky sexual behaviors among vulnerable populations. However, not everyone exposed to an intervention will reduce their sexual risk behavior. This qualitative study sought to identify factors associated with young African American females' lack of increase in condom use…
Davantes Heckman, Bernadette
Context: Acquired immunodeficiency syndrome (AIDS) prevalence rates are increasing rapidly in rural areas of the United States. As rural African Americans are increasingly affected by human immunodeficiency virus (HIV), it is important to identify psychosocial factors unique to this group so that AIDS mental health interventions can be culturally…
Robinson, Beatrice E.; Galbraith, Jennifer S.; Lund, Sharon M.; Hamilton, Autumn R.; Shankle, Michael D.
We describe the process of adapting a community-level, evidence-based behavioral intervention (EBI), Community PROMISE, for HIV-positive African American men who have sex with men (AAMSM). The Centers for Disease Control and Prevention (CDC) Map of the Adaptation Process (MAP) guided the adaptation process for this new target population by two…
MacMaster, Samuel A.; Jones, Jenny L.; Rasch, Randolph F. R.; Crawford, Sharon L.; Thompson, Stephanie; Sanders, Edwin C., II
Objective: This article provides an evaluation of a federally funded faith-based program that serves African Americans who use heroin and cocaine and are at risk for HIV/AIDS in Nashville, Tennessee. Methods: Data were collected from 163 individuals at baseline and 6- and 12-month follow-up interviews. A subset of participants (n = 51) completed…
Kisler, Kimberly A.; Williams, John K.
Background HIV prevention has rarely explored the impact of childhood sexual abuse (CSA) across health domains among African American men who have sex with men and women (MSMW). Early sexual experiences may influence perceptions of gender roles, sexual identity, and risks for HIV/AIDS. The attribute of masculinity is commonly associated with strength and success. However, a legacy of racism and oppression may pose challenges for African American men in achieving gender-based milestones. Instead, proxies for success may include masculinity constructs with hypersexual posturing and prowess that contradict sexual health messages. Methods Two groups, each meeting twice for 90-minutes, of HIV-positive African American MSMW participated in discussions focusing on masculinity and sexual experiences. Participants were bisexual HIV-positive African American men who engaged in unprotected sex and had histories of CSA. Discussions were recorded, transcribed, and analyzed using consensual qualitative research and a constant comparison qualitative method. Results Participant mean age was 40.5 years (n=16). Majority had a high school education (69%), half were unemployed, and almost two-thirds earned less than $20,000 annually. Three themes, each with two subthemes, emerged that described the sociocultural context for engaging in high-risk sexual behaviors, and included: 1) the importance of inhabiting a “traditional” masculine gender role with: a) general and b) sexual masculine traits; 2) the influence of conceptions of masculinity on sexual identity with the associations: a) between being gay and being effeminate and b) between being gay and being HIV-positive, and; 3) CSA experiences with: a) appraisal of CSA and b) early sexual experiences as rites of passage. Conclusion Attempts to be masculine may contribute to high-risk sexual behaviors. Research needs to explore how early sexual experiences shape perceptions of masculinity and masculinity's influence on receiving
Khan, Maria R; El-Bassel, Nabila; Golin, Carol E; Scheidell, Joy D; Adimora, Adaora A; Coatsworth, Ashley M; Hu, Hui; Judon-Monk, Selena; Medina, Katie P; Wohl, David A
Incarceration is thought to influence HIV transmission by disrupting partnerships that provide support and protect against sex risk-taking. Current correctional facility-based family-strengthening programs focus on marital partnerships, a minority of inmates' partnerships. Research on the sex partnerships of incarcerated African-American men and the types of partnerships most likely to protect against HIV-related sex risk is limited. Improved understanding can inform expansion of correctional facility-based family-strengthening programs to a greater proportion of protective partnerships and HIV risk reduction programs to partnerships vulnerable to sex risk. Project DISRUPT is a cohort study of African-American men being released from prison in North Carolina who were in committed heterosexual partnerships at prison entry. Using baseline survey data (N = 189), we conducted latent class analysis (LCA) to identify subgroups of participants with distinct relationship profiles and measured associations between relationship characteristics and multiple partnerships of inmates and their partners in the six months before incarceration. LCA indicated a two-class solution, with relationships distinguished by satisfaction/stability (satisfied/stable class: 58.0%; dissatisfied/unstable class: 42.0%); each class had comparable relationship length and levels of marriage and cohabitation. Dissatisfied/unstable relationships were associated with multiple partnerships among participants (AOR 2.93, 95% CI 1.50, 5.72) and partners (AOR 4.95, 95% CI 1.68, 14.58). Satisfaction indicators-versus length, marriage, or cohabitation-were the strongest independent correlates of inmates' and partners' multiple partnerships. Pre-incarceration economic deprivation, mental disorder symptoms, substance use, and violence in relationships were associated with dissatisfaction/instability. Prison-based programs designed to maintain healthy partnerships, strengthen relationship skills, and reduce
Hall, Naomi M; Peterson, Jennifer; Johnson, Malynnda
Young African Americans are disproportionately affected by sexually transmitted infections, including HIV. The purpose was to identify reasons that African American college students at a historically Black college/university (HBCU) identified as barriers to HIV testing, and how these barriers can be removed. Fifty-seven heterosexual-identified undergraduate students (ages 18-25) attending an HBCU in the southeastern US participated in a mixed method study. Latent content analytic techniques were used to code the transcripts for themes and categories, and representative quotations were used in the findings. Quantitative data indicates high levels of perceived knowledge about HIV transmission, low perception of risk and concern of contracting HIV, yet continued sexual risk behavior. Qualitative data indicates three main themes used to avoid testing and three themes to encourage testing. Students were forthcoming in discussing the themes around avoidance of HIV testing (being scared to know, preferring not to know, and lack of discussion about HIV) and encouraging testing (group testing, increasing basic knowledge, and showing the reality of HIV). It is important for college healthcare professionals, researchers, and officials to identify appropriate ways to encourage HIV testing, and promote testing as part of overall health.
Udell, Wadiya; Donenberg, Geri; Emerson, Erin
We investigated the relationship between religiosity, mental health problems, and two sexual risk behaviors – condom use and number of partners. Participants were 80 sexually active African American girls in psychiatric care and their caregivers. Results indicated differential relationships, depending on parent versus youth report. Mother’s religiosity, was positively related to girls’ condom use and not to girls’ number of partners. Controlling for other predictors in the models, mother’s religiosity explained as much as 15% of the variance in girls’ condom use. Whereas, parent and adolescent reports of girls’ depression/anxiety and rule-breaking were positively associated with number of partners, reports of aggression was associated with having fewer partners. Neither parent nor youth report of girls’ mental health problems were associated with condom use. Controlling for other predictors in the models, girls’ mental health problems accounted for as much as 31% of the variance in number of partners. Findings underscore of the importance of adopting an ecological framework to understand both the risk and promotive factors for sexual risk taking among troubled girls. The roles of specific aspects of psychopathology and religiosity in relation to sexual risk behavior among African American girls in psychiatric care are discussed. PMID:21604846
Ferguson, Y Owens; Quinn, S Crouse; Eng, E; Sandelowski, M
African American women are at increased risk of HIV transmission through heterosexual contact. HIV/AIDS is the leading cause of death among African American women between 25 to 34 years of age, and many of these women were likely infected while in college. Four focus groups were conducted with African American students attending Historically Black Colleges and Universities (HBCUs) in order to learn about the college dating environment and how it influenced women's risk of HIV infection. We used constant comparison techniques and visual display matrixes to analyse the data. Students identified the gender ratio imbalance of more women to men on campus as a key element of the campus dating environment and described how it places women at an increased risk for HIV infection. Primary consequences of this gender ratio imbalance were men having multiple female sexual partners during the same time period and women complying with men's condom use preferences. HIV preventive intervention programmes at HBCUs must address the gender ratio imbalance and its consequences to reduce women's risk of contracting the infection.
Seth, Puja; Wingood, Gina M.; Robinson, LaShun S.; DiClemente, Ralph J.
The impact of alcohol use on the efficacy of an HIV/STI intervention designed for young African-American women in predicting STIs was examined. Eight hundred forty-eight African-American women, 18–29 years, were randomly assigned to either the HIV/STI intervention or a control condition. Participants were assessed on alcohol use and provided two vaginal swab specimens for STI testing. Women in the intervention who consumed alcohol were less likely to test STI-positive than women in the control and abstainers (AOR = 2.47, 95 % CI = 1.01–6.22). STI risk factors may vary across different populations. Further research on heavy drinking and HIV intervention efficacy is needed. PMID:23979497
Lanier, Latrona; DeMarco, Rosanna
The challenges that face African American women living with HIV are immense. African American women continue to be disproportionately infected and affected by this chronic and life-threatening infection in a complex context of individual experience, interactions with the environment, formal and informal support systems, and cultural belief systems. This article identifies the Theory of Silencing the Self (STS) and a widely known model, the Social Ecological Model (SEM), as a synthesized explanatory framework in helping nurses understand how to address research questions and clinical care that is congruent with the experience of African American women living with HIV infection. In synthesizing the components of these two frameworks, an explanation of the relationship between disempowerment and depression in this population will be uncovered as a key component to making relationships at the individual, family, and community level better. Helping African American women living with HIV infection to explore and address how choosing to be silent across their life systems will advance healthcare adherence as we currently know it to improved self-management of a chronic, gender-specific, culturally-bound experience of depression.
Whiteley, Laura B; Brown, Larry K; Swenson, Rebecca R; Valois, Robert F; Vanable, Peter A; Carey, Michael P; DiClemente, Ralph; Salazar, Laura F; Romer, Daniel
Minority adolescents are affected disproportionately by HIV and STIs, and the Internet is a popular venue to meet sex partners. Little is known about the risks of this behavior for minority adolescents. The majority of studies that have examined sexual risk behavior online or STI/HIV prevention programs online have been among adult MSM. In this study, data from 1,045 African American youth found that 6% met sex partners online and in chat rooms. Odds ratios, adjusting for gender, found this behavior was associated with alcohol (AOR = 2.33, 95% CI [1.1, 4.7]) and drug use (AOR = 3.45, 95% CI [1.9, 6.1]), unprotected vaginal (AOR = 4.71, 95% CI [1.9, 8.4]) and anal sex (AOR = 4.77, 95% CI [1.3,17.1]) in the last 90 days, more lifetime vaginal (AOR = 3.65, 95% CI [2.0, 6.8]) and anal sex (AOR = 2.74, 95% CI [1.5, 4.8]), greater sexual sensation seeking (AOR = 2.92, 95% CI [1.5, 5.7]) and greater depression (AOR = 2.06, 95% CI [1.2, 3.6]. A final multiple logistic regression analyses found that male gender (AOR = 3.13, 95% CI [1.7, 5.8]), drug use at last sex (AOR = 2.41, 95% CI [1.3, 4.5]), lifetime history of vaginal (AOR = 2.90, 95% CI [1.5, 5.5]) and anal sex (AOR = 2.09, 95% CI [1.2, 3.6]), and cocaine use (AOR = 8.53, 95% CI [2.7, 27.3]) were independently associated with having sex with a partner met online. Meeting sex partners online is associated with a variety of risks among African American youth; however, the Internet may be an opportunity for intervention.
Stockman, Jamila K.; Lucea, Marguerite B.; Draughon, Jessica E.; Sabri, Bushra; Anderson, Jocelyn C.; Bertrand, Desiree; Campbell, Doris W.; Callwood, Gloria B.; Campbell, Jacquelyn C.
Despite progress against intimate partner violence (IPV) and HIV/AIDS in the past two decades, both epidemics remain major public health problems, particularly among women of color. The objective of this study was to assess the relationship between recent IPV and HIV risk factors (sexual and drug risk behaviors, STIs, condom use and negotiation) among women of African descent. We conducted a comparative case-control study in women’s health clinics in Baltimore, Maryland and St. Thomas and St. Croix, US Virgin Islands (USVI). Women aged 18–55 years who experienced physical and/or sexual IPV in the past two years (Baltimore, n=107; USVI, n=235) were compared to women who never experienced any form of abuse (Baltimore, n=207; USVI, n=119). Logistic regression identified correlates of recent IPV by site. In both sites, having a partner with concurrent sex partners was independently associated with a history of recent IPV (Baltimore, AOR: 3.91, 95% CI:1.79–8.55 and USVI, AOR: 2.25, 95% CI:1.11–4.56). In Baltimore, factors independently associated with recent IPV were lifetime casual sex partners (AOR: 1.99, 95% CI: 1.11–3.57), exchange sex partners (AOR: 5.26, 95% CI:1.92–14.42), infrequent condom use during vaginal sex (AOR: 0.24, 95% CI:0.08–0.72), and infrequent condom use during anal sex (AOR: 0.29, 95% CI:0.09–0.93). In contrast, in the USVI, having a concurrent sex partner (AOR: 3.33, 95% CI:1.46–7.60), frequent condom use during vaginal sex (AOR: 1.97, 95% CI:1.06–3.65), frequent condom use during anal sex (AOR: 6.29, 95% CI:1.57–25.23), drug use (AOR: 3.16, 95% CI:1.00–10.06), and a past-year STI (AOR: 2.68, 95% CI:1.25–5.72) were associated with recent IPV history. The divergent results by site warrant further investigation into the potential influence of culture, norms, and intentions on the relationships examined. Nonetheless, study findings support a critical need to continue the development and implementation of culturally tailored
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Bell, Edward E.
Background: Schools across America spend money, invest in programs, and sponsor workshops, offer teacher incentives, raise accountability standards, and even evoke the name of Obama in efforts to raise the academic achievement of African American males. Incarceration and college retention rates point to a dismal plight for many African American…
St. Lawrence, Janet S.; Kelly, Jeffrey A.; Dickson-Gomez, Julia; Owczarzak, Jill; Amirkhanian, Yuri A.; Sitzler, Cheryl
Contemporary antiretroviral therapy (ART) can produce viral suppression of HIV, maintain health, and prevent onward HIV transmission from infected persons to their sexual partners, giving rise to the concept of treatment as prevention. Successful implementation of test-and-treat strategies rests on the early detection of HIV infection through voluntary counseling and testing (VCT) followed by entry and retention in care, ART initiation and adherence, and subsequent viral suppression. In the United States, African American men who have sex with men (MSM) bear a disproportionate burden of HIV and have high rates of undetected and untreated HIV infection. However, little research has examined racial minority MSM’s views about HIV testing. In this study, in-depth interviews were conducted with 96 key informants knowledgeable about racial minority MSM as well as 100 African American MSM community members in Milwaukee, Cleveland, and Miami. Most men in the sample were aware of the availability of testing and knew testing locations, but many voiced great personal ambivalence about being tested, feared knowing their HIV status, expressed concern about stigma and loss of confidentiality, and held beliefs indicative of medical mistrust. Participants did not spontaneously cite benefits of being tested, risk reduction behavior changes made as a consequence of testing, nor the benefits of testing to get early medical care for HIV infection. There is a gap between the public health field’s perception of testing benefits and the beliefs about testing held by racial minority MSM in this sample. To increase the desired outcomes from VCT for minority MSM, VCT promotion should address the concerns of African American MSM and underscore the benefits of early entry into medical care. PMID:26010312
Tobin, K; Kuramoto, SJ; German, D; Fields, E; Spikes, PS; Patterson, J; Latkin, C
Unity in Diversity was a randomized controlled trial of a culturally tailored HIV prevention intervention for African American men who have sex with men (AA MSM). The intervention condition was six group-based sessions and one individual session. The control condition was a single-session HIV prevention review. Participants were aged 18 years or older, identified as African American/black race, reported having at least two sex partners in the prior 90 days (at least one of whom must be a male partner), unprotected anal sex with male partner in the prior 90 days and willing to test for HIV. Retention exceeded 95% at 3 month follow-up. Results of multivariate logistic regression analysis adjusting for baseline risk, HIV status and health insurance indicate intervention efficacy in decreasing the number of male sex partners and marginal effects on condom use with male partners and HIV negative/unknown partners. Specifically, intervention condition was associated with increased odds of zero male sex partners (AOR=3.03, 95%CI=1.26–7.28), condom use with male partners (AOR=2.64, 95%CI=0.95–7.36) and HIV negative/unknown status partners (AOR=3.19, 95%CI=0.98–10.38) at follow-up. These results contribute to the limited number of culturally appropriate models of HIV prevention intervention that are urgently needed for African American men who have sex with men to address their persistently high rates of HIV. PMID:22984216
McKee, Laura; Jones, Deborah J; Roland, Erin; Coffelt, Nicole; Rakow, Aaron; Forehand, Rex
This study was designed to examine interactions between psychosocial risk (i.e., maternal depressive symptoms) and protective (i.e., child coping skills and mother-child relationship quality) correlates of depressive symptoms among inner-city African American children of mothers with and without HIV/AIDS. Two primary hypotheses were tested: (a) whether these correlates interact differently in HIV-infected and noninfected samples and (b) whether child coping skills and a positive mother-child relationship interact to protect children from developing depressive symptoms in the context of maternal HIV infection. Results indicated that (a) a positive mother-child relationship, but not child coping skills, was protective in the HIV-infected sample when maternal depressive symptoms were high and (b) the combination of a positive mother-child relationship and child coping skills was associated with the lowest level of child depressive symptoms in the HIV-infected sample. These findings highlight the differential importance of various risk and protective mechanisms for HIV-infected and noninfected African American samples and, as such, have preventative implications for children of HIV-infected women.
Hoover, Matthew A; Green, Harold D; Bogart, Laura M; Wagner, Glenn J; Mutchler, Matt G; Galvan, Frank H; McDavitt, Bryce
We examined how functional social support, HIV-related discrimination, internalized HIV stigma, and social network structure and composition were cross-sectionally associated with network members' knowledge of respondents' serostatus among 244 HIV-positive African Americans in Los Angeles. Results of a generalized hierarchical linear model indicated people in respondents' networks who were highly trusted, well-known to others (high degree centrality), HIV-positive, or sex partners were more likely to know respondents' HIV serostatus; African American network members were less likely to know respondents' serostatus, as were drug-using partners. Greater internalized stigma among respondents living with HIV was associated with less knowledge of their seropositivity within their social network whereas greater respondent-level HIV discrimination was associated with more knowledge of seropositivity within the network. Additional research is needed to understand the causal mechanisms and mediating processes associated with serostatus disclosure as well as the long-term consequences of disclosure and network members' knowledge of respondents' serostatus.
Billings, Douglas W; Leaf, Samantha L; Spencer, Joy; Crenshaw, Terrlynn; Brockington, Sheila; Dalal, Reeshad S
The aim of this study was to develop and test a cost-effective, scalable HIV behavioral intervention for African American women. Eighty-three African American women were recruited from a community health center and randomly assigned to either the web-based Safe Sistah program or to a delayed HIV education control condition. The primary outcome was self-reported condom use. Secondary measures assessed other aspects of the gender-focused training included in Safe Sistah. Participants completed self-report assessments prior to randomization, 1- and 4-months after their program experience. Across the entire study period, women in the experimental condition significantly increased their condom use relative to controls (F = 5.126, p = 0.027). Significant effects were also found for sexual communication, sex refusal, condom use after alcohol consumption, and HIV prevention knowledge. These findings indicate that this web-based program could be an important component in reducing the HIV disparities among African American women.
Desmond, Michelle; Andrasik, Michele; Rasberry, Tonya; Lambert, Nina; Cohn, Susan E.; Simoni, Jane
Abstract Observational studies have examined the prevalence and impact of internalized stigma among African American women living with HIV, but there are no intervention studies investigating stigma reduction strategies in this population. Based on qualitative data previously collected, we adapted the International Center for Research on Women's HIV Stigma Toolkit for a domestic population of African American women to be consistent with Corrigan's principles of strategic stigma change. We implemented the intervention, led by an African American woman living with HIV, as a workshop across two afternoons. The participants discussed issues “triggered” by videos produced specifically for this purpose, learned coping mechanisms from each other, and practiced them in role plays with each other. We pilot tested the intervention with two groups of women (total N=24), measuring change in internalized stigma with the Stigma Scale for Chronic Illness before and after workshop participation. Sixty-two percent of the participants self-reported acquiring HIV through heterosexual sexual contact, 17% through intravenous drug use, 4% in utero, and 13% did not know the route of transmission. The intervention was feasible, enthusiastically accepted by the women, and led to decreased stigma from the start of the workshop to the end (p=0.05) and 1 week after (p=0.07) the last session of workshop. Findings suggest the intervention warrants further investigation. PMID:22984780
Danielson, Carla Kmett; McCauley, Jenna L.; Gros, Kirstin Stauffacher; Jones, Andrea M.; Barr, Simone C.; Borkman, April L.; Bryant, Brittany G.; Ruggiero, Kenneth J.
African-American adolescent girls are at disproportionate risk for HIV infection. Although numerous evidence-based risk-reduction interventions exist, dissemination and implementation resources remain limited, and prevention services remain notably inaccessible to the very populations at highest risk for HIV infection. Internet delivery of HIV risk-reduction programming has promise as a mechanism for extending the reach of existing prevention efforts and overcoming barriers associated with traditional service delivery. This article: (1) details the development process for the creation of SiHLEWeb, a web-adapted version of an evidence-based, culturally-informed HIV prevention program traditionally delivered to female African-American adolescents via an in-person group format; and (2) presents findings from quantitative and qualitative usability testing conducted among 18 African-American girls (13–18). Results suggest that users found the website improved knowledge and learning, was helpful, efficient to use, and generally attractive. Users reported some concerns about website navigation. Implications for internet delivery of health prevention programming are discussed. PMID:25167865
Billings, Douglas W.; Leaf, Samantha L.; Spencer, Joy; Crenshaw, Terrlynn; Brockington, Sheila; Dalal, Reeshad S.
The aim of this study was to develop and test a cost-effective, scalable HIV behavioral intervention for African American women. Eighty-three African American women were recruited from a community health center and randomly assigned to either the web-based Safe Sistah program or to a delayed HIV education control condition. The primary outcome was self-reported condom use. Secondary measures assessed other aspects of the gender-focused training included in Safe Sistah. Participants completed self-report assessments prior to randomization, 1- and 4-months after their program experience. Across the entire study period, women in the experimental condition significantly increased their condom use relative to controls (F = 5.126, p = 0.027). Significant effects were also found for sexual communication, sex refusal, condom use after alcohol consumption, and HIV prevention knowledge. These findings indicate that this web-based program could be an important component in reducing the HIV disparities among African American women. PMID:25616838
Dickson-Gomez, Julia; Owczarzak, Jill; Lawrence, Janet St.; Sitzler, Cheryl; Quinn, Katherine; Pearson, Broderick; Kelly, Jeffrey A.; Amirkhanian, Yuri A.
African American men who have sex with men (AAMSM) are disproportionately burdened by new and existing HIV infections. In spite of this, few HIV prevention interventions have been developed that meet the specific needs of AAMSM and that are culturally appropriate and build on strengths and resources. In this paper, we examine constructed families, including those who belong to houses and those who do not, from a three city sample of 196 AAMSM. Results show that the majority of AAMSM who belong to constructed families do not participate in houses or balls. Both house and non-house affiliated constructed families are important sources of social support among AAMSM. Participants reported limited success in spreading HIV messages at ball events, but talk about HIV within their constructed families. Social network approaches to HIV prevention may capitalize on existing social ties within constructed families to promote safer sexual behaviors. PMID:24980248
Kubicek, Katrina; Beyer, William; Weiss, George; Kipke, Michele D.
Objectives HIV rates for African American young men who have sex with men (AAYMSM) have reached as much as 14.7%, compared to 2.5% and 3.5% among Caucasian and Latino YMSM. However, there remains a lack HIV prevention interventions for this population. This study describes the use of Photovoice in the adaptation process of an evidence-based intervention (Adult Identity Mentoring) to make it developmentally and culturally appropriate for AAYMSM. Methods Thirty-six AAYMSM (ages 18–24) participated in weekly working group sessions to conduct a community, youth and data-driven adaptation process. Photovoice was used as a technique to facilitate guided discussions on topics that were identified for the new curriculum. Results Through Photovoice discussions, we identified a new focus for the adapted intervention, Young Men’s Adult Identity Mentoring (YM-AIM): development and maintenance of healthy intimate relationships. This new focus and resulting curriculum are rooted in the voices and perceptions of the target population. Conclusions Including youth was integral to the adaptation process and the use of techniques such as Photovoice helped ensure that the resulting adaptation was relevant to the target population. PMID:21460254
Kerrigan, Deanna; Andrinopoulos, Katherine; Johnson, Raina; Parham, Patrice; Thomas, Tracey; Ellen, Jonathan M
This paper explores adolescents' definitions of what it means to be a man and a woman, the psycho-social context surrounding the formation of gender ideologies and their relationship to HIV/STI prevention. Semi-structured, in-depth interviews were conducted with fifty African-American adolescents living in Baltimore, Maryland. Female gender ideologies included economic independence, emotional strength and caretaking. Male gender ideologies emphasized financial responsibility, toughness and sexual prowess. Findings suggest that stronger adherence to male gender ideologies related to toughness and sexual prowess is influenced by male participants' perceived inability to fulfill their primary gender role as economic providers and the importance of gaining approval from male peers in the absence of adult male role models. Stronger adherence to female gender ideologies related to emotional strength and caretaking may be linked to a heightened desire for male intimacy and tolerance of male sexual risk behavior. Implications of the gender ideologies documented and their commonalities are discussed in terms of HIV/STI prevention.
Robinson, Allysha C.; Knowlton, Amy R.
Objective Research suggests gender differences exist in achieving undetectable viral load (UVL) among persons living with HIV (PLHIV), and that social and behavioral health factors may play a role. Method Data were from African-American PLHIV in the BEACON study. Participants completed self-report surveys and gave biomarker data. Poisson regression with robust standard errors was implemented. Results Men with moderate religious activity had 1.3 times the likelihood of UVL as men with low religious activity (p<.10; N=199). Men with 1-2 mental illness diagnoses had 1.3 times the likelihood of UVL as men with none (p<.05). Women using 1-2 substances had 28% lower likelihood of UVL than non-using women (N=122; p<.10). Finally, women with frequent doctor-patient communication had 35% higher likelihood of UVL as women with less doctor-patient communication (p<.05). Conclusions Results suggest that social support, substance use, and mental illness function differently among men and women. Healthcare professionals should employ gender-specific interventions to address and improve HIV health outcomes. PMID:26143248
Mitchell, Mary M; Nguyen, Trang Q; Maragh-Bass, Allysha C; Isenberg, Sarina R; Beach, Mary Catherine; Knowlton, Amy R
Among disadvantaged persons living with HIV/AIDS (PLHIV), patient-provider engagement, which has been defined as patient-provider relationships that promote the use of health care services and are characterized by active listening and supportive decision making, has been associated with antiretroviral therapy (ART) maintenance and viral suppression. However, chronic pain, depression, and substance use, all of which are prevalent in this population, can reduce the quality of patient-provider engagement. We hypothesized a model in which chronic pain, depression, and substance use would be associated with poorer patient-provider engagement, which would be positively associated with adherence, with the latter associated positively with viral suppression. We analyzed data from the BEACON study, which included surveys from 383 PLHIV who were primarily African American, on ART, and had histories of drug use. Due to six missing cases on the chronic pain variable, we used data from 377 respondents in a structural equation model. Chronic pain and depressive symptoms were significantly associated with poorer patient-provider engagement, while substance use was associated with better engagement. Patient-provider engagement in turn was associated with better ART adherence, which was associated with higher viral suppression. Results suggest the role of chronic pain in poor patient-physician engagement in this population, which has potential implications for quality of HIV patient care and health outcomes. Findings suggest the need for attention to patient-provider engagement in PLHIV.
Dale, Sannisha K; Bogart, Laura M; Galvan, Frank H; Wagner, Glenn J; Pantalone, David W; Klein, David J
In a sample of HIV-positive African-American men who have sex with men (MSM), we examined neighborhood factors that may contextualize perceived discrimination from three intersecting stigmatized characteristics: race, HIV status, and sexual orientation. HIV-positive African-American MSM (N = 162, mean age = 44, SD = 8) provided information on neighborhood-related stressors and discrimination experiences related to being Black, HIV-positive, or perceived as gay. Residential ZIP codes and US Census data were used to determine neighborhood poverty rates. Regressions, controlling for socio-demographics, indicated that (1) higher neighborhood poverty was significantly related to more frequent experiences with hate crimes (Gay-related: b = 1.15, SE = .43, p < .008); and (2) higher neighborhood-related stressors were significantly related to more frequent discrimination (Black-related: b = .91, SE = .28, p = .001; gay-related: b = .71, SE = .29, p = .01; and HIV-related: b = .65, SE = .28, p = .02) and hate crimes (Gay-related: b = .48, SE = .13, p = .001; and Black-related: b = .28, SE = .14, p = .04). For HIV-positive African-American MSM, higher neighborhood poverty and related stressors are associated with experiencing more discrimination and hate crimes. Interventions for this group should promote individual- and neighborhood-level socioeconomic empowerment and stigma reduction.
Cederbaum, Julie A.
Mother-daughter communication plays an influential role in adolescent development. The impact of maternal HIV infection on family communication is not clear. This study explores how living with HIV impacts sexual risk communication between mothers and daughters and whether maternal HIV status influences adolescent choices about engagement in HIV…
Drugs, Alcohol and HIV/AIDS A Consumer Guide Drugs & Alcohol What do drugs and alcohol have to do with HIV? Drug and alcohol use can ... behavior that can increase your exposure to HIV/AIDS. For example, using or sharing needles or other ...
Khan, MR; Golin, CE; Friedman, SR; Scheidell, JD; Adimora, AA; Judon-Monk, S; Hobbs, MM; Dockery, G; Griffin, S; Oza, KK; Myers, D; Hu, H; Medina, KP; Wohl, DA
African Americans face disproportionate sexually transmitted infection including HIV (STI/HIV), with those passing through a correctional facility at heightened risk. There is a need to identify modifiable STI/HIV risk factors among incarcerated African Americans. Project DISRUPT is a cohort study of incarcerated African American men recruited from September 2011 through January 2014 from prisons in North Carolina who were in committed partnerships with women at prison entry (N=207). During the baseline (in-prison) study visit, participants responded to a risk behavior survey and provided a urine specimen, which was tested for STIs. Substantial proportions reported multiple partnerships (42%), concurrent partnerships (33%), and buying sex (11%) in the six months before incarceration, and 9% tested positive for an STI at baseline (chlamydia: 5.3%, gonorrhea: 0.5%, trichomoniasis: 4.9%). Poverty and depression appeared to be strongly associated with sexual risk behaviors. Substance use was linked to prevalent STI, with binge drinking the strongest independent risk factor (adjusted odds ratio (AOR): 3.79, 95% CI: 1.19–12.04). There is a continued need for improved prison-based STI testing, treatment, and prevention education as well as mental health and substance use diagnosis. PMID:25863467
DiClemente, Ralph J; Davis, Teaniese L; Swartzendruber, Andrea; Fasula, Amy M; Boyce, Lorin; Gelaude, Deborah; Gray, Simone C; Hardin, James; Rose, Eve; Carry, Monique; Sales, Jessica M; Brown, Jennifer L; Staples-Horne, Michelle
Few HIV/STI interventions exist for African American adolescent girls in juvenile detention. The objective was to evaluate the efficacy of an intervention to reduce incident STIs, improve HIV-preventive behaviors, and enhance psychosocial outcomes. We conducted a randomized controlled trial among African American adolescent girls (13-17 years, N = 188) in juvenile detention from March 2011 to May 2012. Assessments occurred at baseline and 3- and 6-months post-randomization and included: audio computer-assisted self-interview, condom skills assessment, and self-collected vaginal swab to detect Chlamydia and gonorrhea. The Imara intervention included three individual-level sessions and four phone sessions; expedited partner therapy was offered to STI-positive adolescents. The comparison group received the usual care provided by the detention center: STI testing, treatment, and counseling. At the 6-month assessment (3-months post-intervention), Imara participants reported higher condom use self-efficacy (p < 0.001), HIV/STI knowledge (p < 0.001), and condom use skills (p < 0.001) compared to control participants. No significant differences were observed between trial conditions in incident Chlamydia or gonorrhea infections, condom use, or number of vaginal sex partners. Imara for detained African American adolescent girls can improve condom use skills and psychosocial outcomes; however, a critical need for interventions to reduce sexual risk remains.
DiClemente, Ralph J.; Davis, Teaniese L.; Swartzendruber, Andrea; Fasula, Amy M.; Boyce, Lorin; Gelaude, Deborah; Gray, Simone C.; Hardin, James; Rose, Eve; Carry, Monique; Sales, Jessica M.; Brown, Jennifer L.; Staples-Horne, Michelle
Background Few HIV/STI interventions exist for African American adolescent girls in juvenile detention. Objective The objective was to evaluate the efficacy of an intervention to reduce incident STIs, improve HIV-preventive behaviors, and enhance psychosocial outcomes. Methods We conducted a randomized controlled trial among African American adolescent girls (13-17 years, N=188) in juvenile detention from March 2011 to May 2012. Assessments occurred at baseline and 3- and 6-months post-randomization and included: audio computer-assisted self-interview, condom skills assessment, and self-collected vaginal swab to detect Chlamydia and gonorrhea. Intervention The Imara intervention included three individual-level sessions and four phone sessions; expedited partner therapy was offered to STI-positive adolescents. The comparison group received the usual care provided by the detention center: STI testing, treatment and counseling. Results At the 6-month assessment (3-months post-intervention) Imara participants reported higher condom use self-efficacy (p<0.001), HIV/STI knowledge (p<0.001), and condom use skills (p<0.001) compared to control participants. No significant differences were observed between trial conditions in incident Chlamydia or gonorrhea infections, condom use, or number of vaginal sex partners. Conclusions Imara for detained African American adolescent girls can improve condom use skills and psychosocial outcomes; however, a critical need for interventions to reduce sexual risk remains. PMID:25190056
Khan, M R; Golin, C E; Friedman, S R; Scheidell, J D; Adimora, A A; Judon-Monk, S; Hobbs, M M; Dockery, G; Griffin, S; Oza, K K; Myers, D; Hu, H; Medina, K P; Wohl, D A
African Americans face disproportionate sexually transmitted infection including HIV (STI/HIV), with those passing through a correctional facility at heightened risk. There is a need to identify modifiable STI/HIV risk factors among incarcerated African Americans. Project DISRUPT is a cohort study of incarcerated African American men recruited from September 2011 through January 2014 from prisons in North Carolina who were in committed partnerships with women at prison entry (N = 207). During the baseline (in-prison) study visit, participants responded to a risk behavior survey and provided a urine specimen, which was tested for STIs. Substantial proportions reported multiple partnerships (42 %), concurrent partnerships (33 %), and buying sex (11 %) in the 6 months before incarceration, and 9 % tested positive for an STI at baseline (chlamydia: 5.3 %, gonorrhea: 0.5 %, trichomoniasis: 4.9 %). Poverty and depression appeared to be strongly associated with sexual risk behaviors. Substance use was linked to prevalent STI, with binge drinking the strongest independent risk factor (adjusted odds ratio: 3.79, 95 % CI 1.19-12.04). There is a continued need for improved prison-based STI testing, treatment, and prevention education as well as mental health and substance use diagnosis.
Coatsworth, Ashley M; Scheidell, Joy D; Wohl, David A; Whitehead, Nicole E; Golin, Carol E; Judon-Monk, Selena; Khan, Maria R
We evaluated the association between social support received from significant others, family, and friends and HIV-related sexual risk behaviors among African American men involved in the criminal justice system. Project DISRUPT is a cohort study among African American men released from prison in North Carolina (N = 189). During the baseline (in-prison) survey, we assessed the amount of support men perceived they had received from significant others, family, and friends. We measured associations between low support from each source (
... Minority Population Profiles > Black/African American > Mental Health Mental Health and African Americans Poverty level affects mental health ... compared to 120% of non-Hispanic whites. 1 MENTAL HEALTH STATUS Serious psychological distress among adults 18 years ...
Kawai, Makoto; O'Hara, Ruth; Einen, Mali; Lin, Ling; Mignot, Emmanuel
Study Objectives: Although narcolepsy affects 0.02–0.05% of individuals in various ethnic groups, clinical presentation in different ethnicities has never been fully characterized. Our goal was to study phenotypic expression across ethnicities in the United States. Design/Setting: Cases of narcolepsy from 1992 to 2013 were identified from searches of the Stanford Center for Narcolepsy Research database. International Classification of Sleep Disorders, Third Edition diagnosis criteria for type 1 and type 2 narcolepsy were used for inclusion, but subjects were separated as with and without cataplexy for the purpose of data presentation. Information extracted included demographics, ethnicity and clinical data, HLA-DQB1*06:02, polysomnography (PSG), multiple sleep latency test (MSLT) data, and cerebrospinal fluid (CSF) hypocretin-1 level. Patients: 182 African-Americans, 839 Caucasians, 35 Asians, and 41 Latinos with narcolepsy. Results: Sex ratio, PSG, and MSLT findings did not differ across ethnicities. Epworth Sleepiness Scale (ESS) score was higher and age of onset of sleepiness earlier in African Americans compared with other ethnicities. HLA-DQB1*06:02 positivity was higher in African Americans (91.0%) versus others (76.6% in Caucasians, 80.0% in Asians, and 65.0% in Latinos). CSF hypocretin-1 level, obtained in 222 patients, was more frequently low (≤ 110 pg/ml) in African Americans (93.9%) versus Caucasians (61.5%), Asians (85.7%) and Latinos (75.0%). In subjects with low CSF hypocretin-1, African Americans (28.3%) were 4.5 fold more likely to be without cataplexy when compared with Caucasians (8.1%). Conclusions: Narcolepsy in African Americans is characterized by earlier symptom onset, higher Epworth Sleepiness Scale score, higher HLA-DQB1*06:02 positivity, and low cerebrospinal fluid hypocretin-1 level in the absence of cataplexy. In African Americans, more subjects without cataplexy have type 1 narcolepsy. Citation: Kawai M, O'Hara R, Einen M, Lin L
Bryan, Angela; Robbins, Reuben N; Ruiz, Monica S; O'Neill, Dennis
Prisons and prison inmates present important targets for HIV/AIDS prevention interventions. Inmates often have histories of high-risk behavior that place them in danger of contracting HIV/AIDS, and rates of HIV/AIDS tend to be much higher in this population. The goal of this study was to assess the effectiveness of a prison-based HIV/AIDS intervention to change attitudes toward HIV prevention, norms supporting HIV prevention, perceived behavioral control (i.e., self-efficacy) for HIV prevention behaviors, and intentions to engage in HIV prevention behaviors postrelease. The intervention also had the goal of encouraging inmates to become HIV/AIDS peer educators. The intervention appeared most successful at influencing beliefs and behaviors related to peer education and somewhat successful at influencing beliefs and intentions related to condom use. Analyses also showed some significant differences in effectiveness by race/ethnicity. Results are discussed from the perspectives of both research and practice with regard to prison-based HIV prevention efforts.
Ruddy, Barbara E.; Mayer, Anita P.; Ko, Marcia G.; Labonte, Helene R.; Borovansky, Jill A.; Boroff, Erika S.; Blair, Janis E.
Coccidioidomycosis is caused by Coccidioides species, a fungus endemic to the desert regions of the southwestern United States, and is of particular concern for African Americans. We performed a PubMed search of the English-language medical literature on coccidioidomycosis in African Americans and summarized the pertinent literature. Search terms were coccidioidomycosis, Coccidioides, race, ethnicity, African, black, and Negro. The proceedings of the national and international coccidioidomycosis symposia were searched. All relevant articles and their cited references were reviewed; those with epidemiological, immunologic, clinical, and therapeutic data pertaining to coccidioidomycosis in African Americans were included in the review. Numerous studies documented an increased predilection for severe coccidioidal infections, coccidioidomycosis-related hospitalizations, and extrapulmonary dissemination in persons of African descent; however, most of the published studies are variably problematic. The immunologic mechanism for this predilection is unclear. The clinical features and treatment recommendations are summarized. Medical practitioners need to be alert to the possibility of coccidioidomycosis in persons with recent travel to or residence in an area where the disease is endemic. PMID:21193657
HIV/AIDS are affecting increasingly complex, more diverse populations, particularly communities of color. Despite National prevention efforts designed to speak to marginal experience, these communities continue to be disproportionately affected, especially in rural areas of the country which are difficult to access with communication about HIV. A…
Reviews the opportunities available in the field of agriculture for African American students and notes efforts of the 136 colleges of agriculture to publicize their offerings and recruit students. Profiles six black leaders in agriculture, highlighting their achievements in research and aid to developing countries. A table provides data on annual…
The SISTA pilot project: understanding the training and technical assistance needs of community-based organizations implementing HIV prevention interventions for African American women--implications for a capacity building strategy.
Fuller, Taleria R; Brown, Mari; King, Winifred; Prather, Cynthia; Cazaubon, Janine; Mack, Justin; Russell, Brandi
The disproportionate rates of HIV/AIDS among African American women in the U.S. signify the ongoing need for targeted HIV prevention interventions. Additionally, building the capacity of service providers to sustain prevention efforts is a major concern. The Centers for Disease Control and Prevention (CDC) conducted a pilot project to disseminate the Sisters Informing Sisters about Topics on AIDS (SISTA), an HIV prevention intervention designed for African American women. The project was to inform the diffusion process and examine the training and technical assistance needs of participating community-based organizations. Results demonstrated a need for extensive pre-planning and skills-building prior to implementation.
Hill, Mandy; Granado, Misha; Stotts, Angela
HIV continues to be a major public health problem for African-American (AA) women, and the burden of new cases to our society is significant because each case is at risk of infecting others. Substance use worsens the risk of HIV transmission to AA women. We provide specific recommendations to move the concept of tailoring HIV prevention interventions for substance users forward by focusing on young, sexually active, substance-using AA women and applying a culturally relevant revision to existing theoretical frameworks to include the Sexual Script Theory and the Theory of Gender and Power. We encourage use of these theories to guide adaptation of interventions to demonstrate efficacy within this hard-to-reach population. Consistent use of theories designed to exploit powerlessness and sexual scripts as barriers to adoption of protective sexual behaviors has potential to permeate sexual and substance use networks among African-Americans. This recommendation is being made because this theoretical framework has not been used in HIV prevention interventions targeting young, sexually active, substance-using AA women.
Fisher, Holly H; Patel-Larson, A; Green, K; Shapatava, E; Uhl, G; Kalayil, E J; Moore, A; Williams, W; Chen, B
There is limited knowledge about whether the delivery of evidence-based, HIV prevention interventions in 'real world' settings will produce outcomes similar to efficacy trial outcomes. In this study, we describe longitudinal changes in sexual risk outcomes among African American and Hispanic participants in the Video Opportunities for Innovative Condom Education and Safer Sex (VOICES/VOCES) program at four CDC-funded agencies. VOICES/VOCES was delivered to 922 high-risk individuals in a variety of community settings such as substance abuse treatment centers, housing complex centers, private residences, shelters, clinics, and colleges. Significant risk reductions were consistently observed at 30- and 120-days post-intervention for all outcome measures (e.g., unprotected sex, self-reported STD infection). Risk reductions were strongest for African American participants, although Hispanic participants also reported reducing their risky behaviors. These results suggest that, over a decade after the first diffusion of VOICES/VOCES across the U.S. by CDC, this intervention remains an effective tool for reducing HIV risk behaviors among high-risk African American and Hispanic individuals.
Danielson, Carla Kmett; McCauley, Jenna L; Jones, Andrea M; Borkman, April L; Miller, Stephanie; Ruggiero, Kenneth J
The current study examined the feasibility of an HIV/STI prevention intervention for African American female adolescents. The intervention SiHLEWeb is a web-based adaptation of the evidence-based intervention, Sistas, Informing, Healing, Living, and Empowering (SiHLE). Participants were 41 African American girls aged 13 to 18 years, recruited in collaboration with community partners (local high schools, Department of Juvenile Justice, child advocacy center, medical university). Results support the feasibility of recruitment, screening, and follow-up retention methods. The majority (63.4%) of recruited participants completed the intervention, taking an average of 4.5 (SD = 3.63) site visits. Completers of SiHLEWeb demonstrated increases in knowledge regarding HIV/STI risks and risk reduction behavior [t(18) = 4.74, p < .001], as well as significant increases in condom use self-efficacy [t(16) = 2.41, p = .03]. Findings provide preliminary support for the large-scale, randomized-controlled trial of the efficacy of SiHLEWeb to reduce high-risk sexual behavior among female African American adolescents.
Baytop, Chanza; Royal, Scott; Hubbard McCree, Donna; Simmons, Ron; Tregerman, Rebecca; Robinson, Carolyn; Johnson, Wayne D; McLaughlin, Mike; Price, Cristofer
This paper presents results from a study conducted to compare the relative effectiveness of three strategies - alternate venue testing (AVT), the social network strategy (SNS), and partner counseling and referral services (PCRS; standard care) - for reaching and motivating previously undiagnosed, African-American men who have sex with men (AA MSM) to be tested for HIV. Data were collected between June 2008 and February 2010 at a gay-identified, community-based organization (CBO) serving AA MSM in Washington, DC. Men were eligible to participate if they were 18-64 years old, self-identified as black or African-American, were biologically male, and self-reported oral or anal sex with a man in the past six months. Fisher's exact test of independence was used to assess differences in demographics, testing history, HIV status and sexual behaviors across the three strategies. The final sample included 470 men who met all eligibility requirements. There were no statistically significant differences in HIV positivity rates across the three strategies. However, relative to standard care, the SNS, and (to a lesser degree) the AVT strategies were more successful in recruiting men that had never been tested. Additionally, the results indicate that each strategy recruited different subgroups of men. Specifically, heterosexually identified men and men who reported engaging in unprotected sex were most likely to be recruited via SNS. Bisexually identified men and older men were most likely to be recruited via AVT or SNS, while standard care tended to reach greater proportions of young men and homosexually identified men. These findings suggest that a combination of strategies may be the best approach for engaging African-American MSM in HIV testing.
O’Leary, Ann; Jemmott, John B.; Stevens, Robin; Rutledge, Scott Edward; Icard, Larry D.
The present study sought to replicate effects of the number of syndemic psychosocial health conditions on sexual risk behavior and HIV infection among a sample of high-risk African American men who have sex with men (MSM) and to identify resilience factors that may buffer these effects. We used baseline data from an HIV risk-reduction trial to examine whether a higher number of syndemic conditions was associated with higher rates of self-reported sexual risk behavior and HIV infection. Using logistic regression models, we tested for interactions between number of syndemic conditions and several potential resilience factors to identify buffering effects. Replicating previous studies, we found significant associations between numbers of syndemic conditions and higher rates of sexual risk behavior and HIV infection. Surprisingly, we also replicated a previous finding (Stall et al., 2003) that the effects of syndemic burden on HIV status fell off at the highest levels of syndemic conditions. Among a variety of potential resilience factors, two--optimism and education--buffered the syndemic effect on HIV prevalence. This is, to our knowledge, the first paper to identify resilience factors buffering against syndemic effects among MSM. It also constitutes a significant contribution to the literature regarding prevention among black MSM. These results point to the need to identify HIV-positive black MSM and provide effective treatment for them and to develop interventions addressing both syndemic and resilience factors. PMID:24705710
Arnold, Emily A; Sterrett-Hong, Emma; Jonas, Adam; Pollack, Lance M
The House Ball Community (HBC) is an understudied network of African American men who have sex with men and transgender women, who join family-like houses that compete in elaborate balls in cities across the United States. From 2011 to 2012, we surveyed 274 recent attendees of balls in the San Francisco Bay Area, focusing on social networks, social support, and HIV-related behaviours. Participants with a high percentage of alters who were supportive of HIV testing were significantly more likely to have tested in the past six months (p = .02), and less likely to have engaged in unprotected anal intercourse (UAI) in the past three months (p = .003). Multivariate regression analyses of social network characteristics, and social support, revealed that testing in the past six months was significantly associated with social support for safer sex, instrumental social support, and age. Similarly, UAI in the past three months was significantly associated with social support for safer sex, homophily based on sexual identity and HIV status. HIV-related social support provided through the HBC networks was correlated with recent HIV testing and reduced UAI. Approaches utilising networks within alternative kinship systems, may increase HIV-related social support and improve HIV-related outcomes.
O'Leary, Ann; Jemmott, John B; Stevens, Robin; Rutledge, Scott Edward; Icard, Larry D
The present study sought to replicate effects of the number of syndemic psychosocial health conditions on sexual risk behavior and HIV infection among a sample of high-risk African American men who have sex with men (MSM) and to identify resilience factors that may buffer these effects. We used baseline data from an HIV risk-reduction trial to examine whether a higher number of syndemic conditions was associated with higher rates of self-reported sexual risk behavior and HIV infection. Using logistic regression models, we tested for interactions between number of syndemic conditions and several potential resilience factors to identify buffering effects. Replicating previous studies, we found significant associations between numbers of syndemic conditions and higher rates of sexual risk behavior and HIV infection. Surprisingly, we also replicated a previous finding (Stall et al., Am J Public Health, 93(6):939-942, 2003) that the effects of syndemic burden on HIV status fell off at the highest levels of syndemic conditions. Among a variety of potential resilience factors, two-optimism and education-buffered the syndemic effect on HIV prevalence. This is, to our knowledge, the first paper to identify resilience factors buffering against syndemic effects among MSM. It also constitutes a significant contribution to the literature regarding prevention among black MSM. These results point to the need to identify HIV-positive black MSM and provide effective treatment for them and to develop interventions addressing both syndemic and resilience factors.
Jones, Rachel; Lacroix, Lorraine J
Love, Sex, and Choices is a 12-episode soap opera video series created as an intervention to reduce HIV sex risk. The effect on women's HIV risk behavior was evaluated in a randomized controlled trial in 238 high risk, predominately African American young adult women in the urban Northeast. To facilitate on-demand access and privacy, the episodes were streamed to study-provided smartphones. Here, we discuss the development of a mobile platform to deliver the 12-weekly video episodes or weekly HIV risk reduction written messages to smartphones, including; the technical requirements, development, and evaluation. Popularity of the smartphone and use of the Internet for multimedia offer a new channel to address health disparities in traditionally underserved populations. This is the first study to report on streaming a serialized video-based intervention to a smartphone. The approach described here may provide useful insights in assessing advantages and disadvantages of smartphones to implement a video-based intervention.
Hickson, DeMarc A.; Truong, Nhan L.; Smith-Bankhead, Neena; Sturdevant, Nikendrick; Duncan, Dustin T.; Schnorr, Jordan; Gipson, June A.; Mena, Leandro A.
Background This paper describes the rationale, design, and methodology of the Ecological Study of Sexual Behaviors and HIV/STI among African American Men Who Have Sex with Men (MSM) in the Southeastern United States (U.S.; known locally simply as the MARI Study). Methods Participants are African American MSM aged 18 years and older residing in the deep South. Results Between 2013 and 2015, 800 African American MSM recruited from two study sites (Jackson, MS and Atlanta, GA) will undergo a 1.5-hour examination to obtain anthropometric and blood pressure measures as well as to undergo testing for sexually transmitted infections (STI), including HIV. Intrapersonal, interpersonal, and environmental factors are assessed by audio computer-assisted self-interview survey. Primary outcomes include sexual risk behaviors (e.g., condomless anal sex) and prevalent STIs (HIV, syphilis, gonorrhea, and Chlamydia). Conclusion The MARI Study will typify the HIV environmental 'riskscape' and provide empirical evidence into novel ecological correlates of HIV risk among African American MSM in the deep South, a population most heavily impacted by HIV. The study's anticipated findings will be of interest to a broad audience and lead to more informed prevention efforts, including effective policies and interventions, that achieve the goals of the updated 2020 U.S. National HIV/AIDS Strategy. PMID:26700018
Gaston, Gina B
Most studies of cultural competence in healthcare examine healthcare providers' definitions of cultural competence practices. This study is unique in that it examines the relationship between African-American patients' perceptions of the cultural competence of their HIV healthcare providers and the adherence of these patients to medical self-care and antiretroviral therapy (ART). This cross-sectional, exploratory, descriptive study was conducted at the Ruth Rothstein CORE Center in Chicago, Illinois. The sample consisted of 202 HIV-positive African-Americans who completed surveys during clinic visits. Multiple measures were used, including the Patient Assessments of Cultural Competency survey instrument developed by the Department of Health and Human Services Agency for Healthcare Research and Quality. Medical self-care was measured using the advice and instructions scale and the self-care symptom management for people living with HIV/AIDS categorical scale. ART adherence was measured using the Adherence Behaviors Self-Report and Adherence Self-Report scales. The data revealed many significant correlations between variables. The more patients believed that providers should integrate culture in HIV treatment; the better their reported health (F1,138=0.151, P=0.05) and the more they followed their provider's advice and instructions (medical self-care; F1,138=0.029, P=0.05). Participants who trusted their providers engaged in more medical self-care (F1,138=0.280, P=0.01). More shared treatment decisions were reported among participants who had higher levels of education (F1,127=0.337, P=0.05). Findings of this study indicate the need for increased attention to the role of cultural competence in HIV/AIDS care. Understanding patient perceptions of provider cultural competence has the potential to improve HIV treatment adherence and health outcomes.
A series of initiatives was established to invest $156 million in efforts to fight HIV/AIDS in minority populations, where AIDS is still a leading cause of death among men and women between 25 and 44 years of age. The initiatives will target specific communities and includes technical assistance and increased access to care. Specific goals of the initiatives are discussed.
Reid, Allecia E.; Dovidio, John F.; Ballester, Estrellita; Johnson, Blair T.
Interventions to improve public health may benefit from consideration of how environmental contexts can facilitate or hinder their success. We examined the extent to which efficacy of interventions to improve African Americans’ condom use practices was moderated by two indicators of structural stigma—Whites’ attitudes toward African Americans and residential segregation in the communities where interventions occurred. A previously published meta-analytic database was re-analyzed to examine the interplay of community-level stigma with the psychological processes implied by intervention content in influencing intervention efficacy. All studies were conducted in the United States and included samples that were at least 50% African American. Whites’ attitudes were drawn from the American National Election Studies, which collects data from nationally representative samples. Residential segregation was drawn from published reports. Results showed independent effects of Whites’ attitudes and residential segregation on condom use effect sizes. Interventions were most successful when Whites’ attitudes were more positive or when residential segregation was low. These two structural factors interacted: Interventions improved condom use only when communities had both relatively positive attitudes toward African Americans and lower levels of segregation. The effect of Whites’ attitudes was more pronounced at longer follow-up intervals and for younger samples and those samples with more African Americans. Tailoring content to participants’ values and needs, which may reduce African Americans’ mistrust of intervention providers, buffered against the negative influence of Whites’ attitudes on condom use. The structural factors uniquely accounted for variance in condom use effect sizes over and above intervention-level features and community-level education and poverty. Results highlight the interplay of social identity and environment in perpetuating intergroup
McNeil, J. I.
Cultural competency is an area in which physicians of all races must work to insure they are giving their patients the best possible care. Perhaps nowhere is this better demonstrated than in the struggle to provide culturally appropriate care to black patients who are infected with HIV. The BESAFE model for cultural competency suggested by the National Minority AIDS Education and Training Center will assist healthcare providers in fostering a relationship of mutuality and health promotion. PMID:12656426
African-American men who have sex with men (MSM) are at increased risk of HIV infection, as are individuals with severe mental illness. This study was conducted at the behest of members of the African-American MSM community in Cleveland, Ohio, to assess the co-occurrence of HIV risk and bipolar disorder among African-American MSM. A sample of 125 participants was recruited via flyers and word of mouth at venues used by members of this community. Individuals were assessed for HIV risk and severe mental illness. Various ethical issues were presented, including participant capacity and voluntariness and the risk-benefit ratio. Divergent perspectives of the local institutional review board and the community advisory group with respect to the risks and benefits of participation required reconciliation before the study could proceed. Solutions for the resolution of such conflicts are discussed.
The Relationship Between Online Social Network Use, Sexual Risk Behaviors, and HIV Sero-Status Among a Sample of Predominately African American and Latino Men Who have Sex with Men (MSM) Social Media Users.
Chiu, ChingChe J; Young, Sean D
Social networking technologies have emerged as potential platforms to reach HIV(+) MSM in HIV interventions. This study sought to compare use of online social networking sites (SNSs) and sexual risk behaviors between HIV(+) and HIV(-) individuals among a sample of predominately African American and Latino SNS-using MSM. A total of 112 MSM Facebook users were recruited online and offline and completed an online survey. We performed regression models to assess the association between HIV status, SNS use, and sexual risk behaviors. After adjusting for age, race, and employment status, being HIV positive was significantly associated with a greater number of sexual partners (ARR = 2.84, p = 0.0017) and lower comfort levels of discussing HIV/STI status on SNSs (AOR: 0.23, p = 0.011). Findings suggest that HIV status is associated with sexual risk behaviors and SNS use among SNS-using MSM. We discuss the implications for online HIV prevention.
Robinson, Melissa L.; Holmbeck, Grayson N.; Paikoff, Roberta
A sample of 146 African American adolescents living in impoverished neighborhoods with high HIV rates participated in the Chicago HIV Prevention and Adolescent Mental Health Project (CHAMP), a longitudinal study of adolescent HIV risk exposure. The current study examined self-reported reasons why African American adolescents may participate in…
... African-Americans are at a higher risk for Alzheimer's disease. Many Americans dismiss the warning signs of Alzheimer's, ... two times more likely to develop late-onset Alzheimer's disease than whites and less likely to have a ...
Foster, Michael L; Arnold, Emily; Rebchook, Gregory; Kegeles, Susan M
Young black men who have sex with men account for 48% of 13-29-year-old HIV-positive men who have sex with men in the USA. It is important to develop an effective HIV prevention approach that is grounded in the context of young men's lives. Towards this goal, we conducted 31 interviews with 18-30-year-old men who have sex with men in the San Francisco-Oakland Bay Area. This paper examines the roles of religion and spirituality in men who have sex with men's lives, which is central in the lives of many African Americans. Six prominent themes emerged: (1) childhood participation in formal religious institutions, (2) the continued importance of spirituality among men who have sex with men, (3) homophobia and stigmatisation in traditional black churches, (4) tension between being a man who has sex with men and being a Christian, (5) religion and spirituality's impact on men's sense of personal empowerment and coping abilities and (6) treatment of others and building compassion. Findings suggest that integrating spiritual practice into HIV prevention may help programmes be more culturally grounded, thereby attracting more men and resonating with their experiences and values. In addition, faith-based HIV/AIDS ministries that support HIV-positive men who have sex with men may be particularly helpful. Finally, targeting pastors and other church leaders through anti-stigma curricula is crucial.
Foster, Michael L.; Arnold, Emily; Rebchook, Gregory
Young black men who have sex with men (YBMSM) account for 48% of 13–29 year old HIV-positive men who have sex with men (MSM) in the USA. It is important to develop an effective HIV prevention approach that is grounded in the context of young men’s lives. Towards this goal, we conducted 31 interviews with 18–30 year old YBMSM in the San Francisco-Oakland Bay Area. This paper examines the roles of religion and spirituality in YBMSM’s lives, which is central in the lives of many African Americans. Six prominent themes emerged: (1) childhood participation in formal religious institutions; (2) the continued importance of spirituality among YBMSM; (3) homophobia and stigmatisation in traditional black churches; (4) tension between being an MSM and Christian; (5) religion and spirituality’s impact on men’s sense of personal empowerment and coping abilities; and (6) treatment of others and building compassion. Findings suggest that integrating spiritual practice into HIV prevention may help programmes be more culturally grounded, thereby attracting more men and resonating with their experiences and values. In addition, faith-based HIV/AIDS ministries that support HIV-positive YBMSM may be particularly helpful. Finally, targeting pastors and other church leaders through anti-stigma curricula is crucial. PMID:21824017
Tobin, K E; Cutchin, M; Latkin, C A; Takahashi, L M
This qualitative study utilized a time-geography framework to explore the daily routines and daily paths of African American men who have sex with men (AA MSM) and how these shape HIV risk. Twenty AA MSM aged 18 years and older completed an in-depth interview. Findings revealed (1) paths and routines were differentiated by indicators of socio-economic status, namely employment and addiction, and (2) risk was situated within social and spatial processes that included dimensions of MSM disclosure and substance use. This study highlights the critical need for future research and interventions that incorporate the social and spatial dimensions of behavior to advance our ability to explain racial disparities in HIV and develop effective public health responses.
Bouris, Alida; Guilamo-Ramos, Vincent; Jaccard, James; McCoy, Wanda; Aranda, Diane; Pickard, Angela; Boyer, Cherrie B
The purpose of the present study was to examine the feasibility of conducting a parent-based intervention in a pediatric health clinic to prevent HIV, sexually transmitted infections (STIs), and unintended pregnancies among urban African American and Latino youth. Eight focus groups were conducted with health care providers, adolescent patients and the mothers of adolescent patients (n = 41) from December 2007 to February 2008. All participants were recruited from a community-based pediatric health clinic in the Bronx, New York. Content analysis of focus group transcripts identified results in three primary areas: (1) the role of parents and providers in preventing HIV, STDs and unintended pregnancies among adolescents, (2) feasibility of the intervention in the clinic setting; and (3) optimal recruitment, retention and intervention delivery strategies. Study results suggest that a parent-based intervention delivered in a community-based pediatric health clinic setting is feasible. Focused recommendations for intervention recruitment, delivery, and retention are provided.
Tauriac, Jesse J.; Scruggs, Natoschia
Perceptions of extreme, moderate, and mild forms of elder abuse among African-American women (n=25) and men (n=10) were examined. African-American respondents emphasized physical abuse when giving examples of extremely abusive behavior. Along with physical abuse, verbal abuse was the most frequently identified form of abuse, and was significantly…
Wright, Dianne; Taylor, Janice D.; Burrell, Charlotte; Stewart, Gregory
This article explores the issues of African American participation in the administrative ranks of the academy. The authors find that African Americans tend to hold positions that are marginal in academic organizations, lacking power and influence, and that not much has changed over recent decades. Forces influencing this condition are explored,…
Sigmon, Scott B.
To better serve people in a counseling relationship, it is useful to understand them not only culturally, but demographically as well. This paper traces historical, religious, demographic aspects and treatment of alcohol abuse in African Americans. Historically, alcohol abuse and alcohol dependence have varied for African Americans. During the…
Reed, E; Santana, M C; Bowleg, L; Welles, S L; Horsburgh, C R; Raj, A
This study aimed to examine racial discrimination and relation to sexual risk for HIV among a sample of urban black and African American men. Participants of this cross-sectional study were black and African American men (N = 703) between the ages of 18 and 65 years, recruited from four urban clinical sites in the northeast. Multivariate logistic regression models were used to analyze the relation of reported racial discrimination to the following: (1) sex trade involvement, (2) recent unprotected sex, and (3) reporting a number of sex partners in the past 12 months greater than the sample average. The majority of the sample (96%) reported racial discrimination. In adjusted analyses, men reporting high levels of discrimination were significantly more likely to report recent sex trade involvement (buying and/or selling) (adjusted odds ratio (AOR) range = 1.7-2.3), having recent unprotected vaginal sex with a female partner (AOR = 1.4, 95% confidence interval (CI), 1.1-2.0), and reporting more than four sex partners in the past year (AOR = 1.4, 95% CI, 1.1-1.9). Findings highlight the link between experiences of racial discrimination and men's sexual risk for HIV.
Sudenga, Staci L; Wiener, Howard W; Shendre, Aditi; Wilson, Craig M; Tang, Jianming; Shrestha, Sadeep
Our work aimed to examine the potential influence of variants in interleukin/interleukin receptors genes on high-risk (HR-HPV) HPV clearance. Clearance of genital HR-HPV infection was evaluated for 134 HIV-1 seropositive African-American female adolescents from the Reaching for Excellence in Adolescent Care and Health (REACH) cohort. Genotyping targeted 225 single nucleotide polymorphisms (SNPs) within the exons, 5' untranslated region (UTR) and 3' UTR sequences of 27 immune-related candidate genes encoding interleukin family of cytokines. Cox proportional hazard models were used to determine the association of type-specific HPV clearance adjusting for time-varying CD4+ T-cell count and low-risk (LR-HPV) HPV co-infections. HR-HPV clearance rates were significantly (p < 0.001) associated with five SNPs (rs228942, rs419598, rs315950, rs7737000, and rs9292618) mapped to coding and regulatory regions in three genes (IL2RB, IL1RN, and IL7R). These data suggest that the analyzed genetic variants in interleukin family of cytokines modulate HR-HPV clearance in HIV-1 seropositive African-Americans that warrants replication.
Robbins, Michael; Szapocznik, José; Tejeda, Manuel; Samuels, Deanne; Ironson, Gail; Antoni, Michael
This study examined the role of family functioning and social support in protecting HIV-positive African American women from the adverse psychological consequences associated with deterioration in their CD4 cell count. Participants were 38 African American HIV-positive women who had recently given birth. Results demonstrated that changes in CD4 cell counts were inversely predictive of psychological distress and were moderated by family functioning and social support satisfaction. Women with good family functioning were less affected by changes in their CD4 cell counts, and women with poor family functioning were more emotionally responsive to changes in CD4 cell count. Unexpectedly, women from families where conflicts tended to be clearly laid out and discussed were also more responsive to both changes in CD4 cell counts. Interventions are recommended that increase a client’s social support satisfaction, foster an adaptive level of connectedness to family, and enhance the family’s range of conflict resolution styles. PMID:16609750
Latham, Teaniese P; Sales, Jessica M; Renfro, Tiffaney L; Boyce, Lorin S; Rose, Eve; Murray, Colleen C; Wingood, Gina M; DiClemente, Ralph J
This manuscript assesses priorities and challenges of adolescent females by conducting a meeting with teen advisory board (TAB) members to collect information regarding their lives and experiences pre-, during and post-incarceration in a juvenile detention facility. Multiple themes emerged regarding the impact of incarceration on young African-American females, including experiencing a loss of personal liberties, the importance of making money upon release, unfaithfulness by partners on the 'outside', substance use and lack of control over their environment upon release, including parents, peers and male sexual partners. Based on feedback from TAB members, unique barriers and challenges were identified that suggested areas where adaptations to an evidenced-based HIV/sexually transmitted disease (STD) intervention would be justified to more adequately meet the needs of this particular subgroup of young African-American women. Adaptations to the evidence-based interventions included enhancing activities related to goal setting, emotion regulation skills, decision-making, recognizing and utilizing support networks and addressing the relationship between substance use and risky sexual behavior. Future health education efforts focusing on either the creation of new HIV/STD interventions or adaptations to existing interventions should consider utilizing advisory boards with members of the priority population at the earliest stages of intervention planning.
Ghafoor, Asma; Jemal, Ahmedin; Cokkinides, Vilma; Cardinez, Cheryll; Murray, Taylor; Samuels, Alicia; Thun, Michael J
The American Cancer Society provides estimates on the number of new cancer cases and deaths, and compiles health statistics on African Americans in a biennial publication, Cancer Facts and Figures for African Americans. The compiled statistics include cancer incidence, mortality, survival, and lifestyle behaviors using the most recent data on incidence and survival from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) program, mortality data from the National Center for Health Statistics (NCHS), and behavioral information from the Behavior Risk Factor Surveillance System (BRFSS), Youth Risk Behavior Surveillance System (YRBSS), and National Health Interview Survey (NHIS). It is estimated that 132,700 new cases of cancer and 63,100 deaths will occur among African Americans in the year 2003. Although African Americans have experienced higher incidence and mortality rates of cancer than whites for many years, incidence rates have declined by 2.7 percent per year in African-American males since 1992, while stabilizing in African-American females. During the same period, death rates declined by 2.1 percent and 0.4 percent per year among African-American males and females, respectively. The decrease in both incidence and death rates from cancer among African-American males was the largest of any racial or ethnic group. Nonetheless, African Americans still carry the highest cancer burden among US racial and ethnic groups. Most cancers detectable by screening are diagnosed at a later stage and survival rates are lower within each stage of disease in African Americans than in whites. The extent to which these disparities reflect unequal access to health care versus other factors is an active area of research.
Chiu, ChingChe J; Young, Sean D
High levels of HIV stigma are one of the main difficulties in engaging African-American and Latino men who have sex with men (MSM) in HIV testing. The availability of home HIV test and the possibility of self-testing in private may improve uptake and counteract stigma. This paper sought to determine the correlates of requesting home HIV test kits among a sample of MSM social media users. The odds of participants requesting a test kit were significantly associated with using social networks to seek sexual partners (aOR: 2.47, 95% CI: 1.07-6.06) and thinking it is easier to use social networks for seeking sexual partners (1.87, 1.2-3.12), uncertain HIV status (4.29, 1.37-14.4), and having sex under the influence of alcohol (2.46, 1.06-5.77). Participants who had not been tested for more than 6 months were more likely to request a test kit than those who were tested in the past 6 months (2.53, 1.02-6.37). Participants who frequently talked to others about having sex with men online were less likely to request a test kit (0.73, 0.56-0.92). By reaching people over social media and offering them access to test kits, we were able to reach at-risk individuals who were uncertain about their HIV status and had not been regularly tested. The findings of the study will help to inform future HIV testing interventions.
Stephens, T; Braithwaite, R L; Taylor, S E
Currently little attention has been directed, with the exception of peer education efforts, to constructively develop new and innovative ways to promote HIV/AIDS primary prevention among African American (AA) adolescents and young adults. With this in mind, the aim of this conceptual effort is to present a HIV/AIDS preventive counseling protocol developed for use with AA young adults that makes use of hip-hop music, a form of music popularized by young AAs. The author contend that an increased understanding of the relationships that many AA young adults have with hip-hop music may be used by disease prevention personnel to educate these populations about protective factors for HIV. Making use of hip-hop music is one strategy for integrating counseling in prevention and health maintenance. The overall implications of using hip-hop music in health promotion are unlimited. First, this method makes use of cultural relevant materials to address the educational and health needs of the target community. Second, it is grounded in an approach that serves to stimulate cooperative learning based on peer developed content. Moreover, the use of this medium can be applied to other health promotion activities such as violence/harm reduction and substance abuse prevention, upon reviews of songs for appropriate content. The authors contend that such an approach holds heuristic value in dealing with HIV/AIDS prevention among AA young adults. Additional testing of the intervention is warranted in the refinement of this innovative intervention.
Funnyé, Allen S; Akhtar, Abbasi J; Biamby, Gisele
The purpose of this study was to determine if older African Americans are disproportionately affected by acquired immunodeficiency syndrome (AIDS), and to review the clinical impact of AIDS and the importance of prevention and treatment efforts. A review of the literature and statistics was obtained using Medline and the AIDS Public Information Data Set offered by the Centers for Disease Control and Prevention. Twenty-seven percent of the U.S. population is above the age of 50, and the number of AIDS cases in this group is growing, with African Americans accounting for the highest proportion of cases and deaths. Testing for HIV may be delayed and symptoms attributed to other illnesses. Though 5% of new cases occur in those over 50, prevention programs, testing, and the perception of risk by providers may be insufficient. There are few research studies on HIV treatment in older patients and no specific guidelines for antiretroviral treatments available. Although death rates for AIDS has been declining, adults over 50 still have the highest mortality rate. Co-morbid conditions, such as heart disease and hypertension, may require taking multiple drugs, which may complicate treatment. Increasing heterosexual transmission rates and a lack of information on HIV reinforces the need for specific prevention programs targeted toward older African Americans.
Sales, Jessica M; DiClemente, Ralph J; Brody, Gene H; Philibert, Robert A; Rose, Eve
Not everyone exposed to an efficacious human immunodeficiency virus (HIV) intervention will reduce sexual risk behaviors, yet little is known about factors associated with "failure to change" high-risk sexual behaviors post-intervention. History of abuse and polymorphisms in the serotonin transporter gene (5-HTT) may be associated with non-change. The current study sought to identify genetic, life history, and psychosocial factors associated with adolescents' failure to change condom use behaviors post-participation in an HIV prevention intervention. A sub-set of participants from a clinic-based sample of adolescent African-American females (N = 254) enrolled in a randomized trial of an HIV-prevention was utilized for the current study. Forty-four percent did not increase their condom use from baseline levels 6 months after participating in the sexually transmitted infection (STI)/HIV prevention intervention. In multivariable logistic regression analysis, an interaction between abuse and 5-HTTLPR group was significantly associated with non-change status, along with partner communication frequency scores at follow-up. Follow-up tests found that having a history of abuse was significantly associated with greater odds of non-change in condom use post-intervention for only those with the s allele. For those with ll allele, participants with higher partner communication frequency scores were at decreased odds of non-change in condom use post-intervention. Thus, STI/HIV interventions for adolescent females may consider providing a more in-depth discussion and instruction on how to manage and overcome fear or anxiety related to being assertive in sexual decisions or sexual situations. Doing so may improve the efficacy of STI/HIV prevention programs for adolescent women who have experienced abuse in their lifetime.
Taylor-Brown, Susan; And Others
Conducted a retrospective chart review utilizing Norwood's model on the families of the 83 infants whose cord blood was positive for maternal HIV antibodies or who were congenitally infected with HIV. Discusses implications for permanency planning in the context of their impact on the African-American community. (KS)
Himelhoch, Seth; Mohr, David; Maxfield, Jennifer; Clayton, Sara; Weber, Elyssa; Medoff, Deborah; Dixon, Lisa
Given the burden of depression among those with HIV, and the impact of HIV on urban minority communities there is an urgent need to assess innovative treatment interventions that not only treat depression but do so in a way that allows for increased access to mental health care. This single site, uncontrolled, pilot study sought to determine the feasibility and depression outcomes of an 11-session telephone-based cognitive behavioral therapy intervention delivered over 14 weeks targeting low-income, urban-dwelling, HIV-infected African-American people with major depression. The diagnosis of major depression was made using the Mini International Neuropsychiatric Interview. The primary outcome was the Hamilton Depression Rating Scale (HAM-D) and the secondary outcome was the Quick Inventory of Depression Symptomatology-Self Report (QIDS-SR). Feasibility and satisfaction were also assessed. Assessments occurred at baseline, midpoint and at study conclusion (14 weeks). Fifteen people were screened for the study. Six HIV-infected, low-income, African-American people individuals (five females and one male) were eligible and participated in the study. All patients finished the study. On average, participants completed nine sessions. The sessions lasted for an average of 48 min (SD = 11.5). Compared to mean HAM-D score at baseline (HAM-D = 22.8 (SD = 3.1), the mean HAM-D score was significantly reduced at study conclusion (HAM-D = 9.8 (SD = 7.4); (t (5) = 4.6, p = 0.006); (Cohen d = 1.9)). Compared to the mean QIDS-SR score at baseline (QIDS-SR = 15.5 (SD = 4.2) the mean QIDS score was significantly reduced at study conclusion (QIDS = 7.0 (SD = 5.4);(t (5) = 3.2, p = 0.02); (Cohen d = 1.3)).The mean satisfaction scores across all participants at post-treatment was 5.7 (SD = 0.3) with of a maximum score of 6. Telephone-based CBT can be delivered to low-income, urban-dwelling ethnic minority HIV-infected people resulting in significant reductions in depression symptoms with
Himelhoch, Seth; Mohr, David; Maxfield, Jennifer; Clayton, Sara; Weber, Elyssa; Medoff, Deborah; Dixon, Lisa
Given the burden of depression among those with HIV, and the impact of HIV on urban minority communities there is an urgent need to assess innovative treatment interventions that not only treat depression but do so in a way that allows for increased access to mental health care. This single site, uncontrolled, pilot study sought to determine the feasibility and depression outcomes of an 11 session telephone based cognitive behavioral therapy intervention delivered over 14 weeks targeting low income, urban dwelling, HIV infected African-Americans with major depression. The diagnosis of major depression was made using the Mini International Neuropsychiatric Interview. The primary outcome was the HAM-D and the secondary outcome was the Quick Inventory of Depression Symptomatology -Self Report (QIDS-SR). Feasibility and satisfaction were also assessed. Assessments occurred at baseline, midpoint and at study conclusion (14 weeks). Fifteen people were screened for the study. Six HIV infected, low-income, African American individuals (5 Female, 1 Male) were eligible and participated in the study. All patients finished the study. On average, participants completed 9 sessions. The sessions lasted for an average of 48 minutes (SD=11.5). Compared to mean HAM-D score at baseline (HAM-D= 22.8 (SD =3.1), the mean HAM-D score was significantly reduced at study conclusion (HAM-D= 9.8 (SD =7.4);(t (5) =4.6, p=.006);(Cohen d=1.9)). Compared to the mean QIDS-SR score at baseline (QIDS-SR=15.5 (SD =4.2) the mean QIDS score was significantly reduced at study conclusion (QIDS=7.0 (SD =5.4);(t (5) = 3.2, p=.02); (Cohen d=1.3)). The mean satisfaction scores across all participants at post treatment was 5.7 (SD=.3) with of a maximum score of 6. Telephone based CBT can be delivered to low-income, urban dwelling ethnic minority HIV infected people resulting in significant reductions in depression symptoms with high satisfaction. The efficacy of this intervention will be assessed in a planned
Reddy, Priscilla; Taylor, Sandra E; Sifunda, Sibusiso
This article examines a partnership between researchers from the United States who are involved in corrections health issues and scientists from South Africa who conduct prison health research, a previously underresearched area in South Africa. The article discusses some of the challenges as well as opportunities for knowledge and skills exchange via capacity building and collaboration strategies. Through historical and contemporary perspectives, it also discusses barriers and benefits of collaboration when forging links between researchers from developed and less developed nations. A focus on conducting public health research in South Africa, and on HIV/AIDS studies in particular, is placed within the context of the 2001 document of the Council on Health Research for Development. The South African prison health study represents a collaborative between the South African National Health Promotion Research and Development Group of the Medical Research Council, the South African Department of Correctional Services, and Emory University in Atlanta, Georgia. The article illuminates the process of adapting a model for a postapartheid prison study from one designed for use in the American correctional system.
Valois, Robert F; Kerr, Jelani C; Hennessy, Michael; DiClemente, Ralph J; Brown, Larry K; Carey, Michael P; Vanable, Peter A; Farber, Naomi B; Salazar, Laura F; Romer, Daniel
Research on the relationship between adolescent health risk behaviors, sexual risk behaviors in particular, and perceived life satisfaction is emerging. Some researchers suggest that life satisfaction has been a neglected component of adolescent health research. African American adolescents aged 13-18 (n = 1,658) from four matched, mid-sized cities in the northeastern and southeastern USA, completed a self-report questionnaire via Audio Computer Assisted Self-Interview. Analyses were conducted to examine relationships between perceived difficulty in performing HIV/AIDS preventive behavior and perceived life satisfaction, while controlling for socioeconomic status. Results suggest that perceived life satisfaction is related to perceived difficulty in performing HIV/AIDS preventive behaviors, for both males and females, with variability in the magnitude of associations by gender. Further research is necessary to identify the particular characteristics of youth and specific aspects of adolescent life satisfaction associated with perceived difficulty in performing HIV/AIDS preventive behavior to develop gender-appropriate and culturally-sensitive quality of life/health promotion programs.
Saab, Sammy; Jackson, Christian; Nieto, Jose; Francois, Fritz
The care of hepatitis C virus (HCV) in African Americans represents an opportunity to address a major health disparity in medicine. In all facets of HCV infection, African Americans are inexplicably affected, including in the prevalence of the virus, which is higher among them compared with most of the racial and ethnic groups. Ironically, although fibrosis rates may be slow, hepatocellular carcinoma and mortality rates appear to be higher among African Americans. Sustained viral response (SVR) rates have historically significantly trailed behind Caucasians. The reasons for this gap in SVR are related to both viral and host factors. Moreover, low enrollment rates in clinical trials hamper the study of the efficacy of anti-viral therapy. Nevertheless, the gap in SVR between African Americans and Caucasians may be narrowing with the use of direct-acting agents. Gastroenterologists, hepatologists, primary care physicians, and other health-care providers need to address modifiable risk factors that affect the natural history, as well as treatment outcomes, for HCV among African Americans. Efforts need to be made to improve awareness among health-care providers to address the differences in screening and referral patterns for African Americans.
Newman, Lori M; Berman, Stuart M
This article reviews the epidemiology of sexually transmitted disease (STD) disparities for African American communities in the United States. Data are reviewed from a variety of sources such as national case reporting and population-based studies. Data clearly show a disproportionately higher burden of STDs in African American communities compared with white communities. Although disparities exist for both viral and bacterial STDs, disparities are greatest for bacterial STDs such as gonorrhea, chlamydia, and syphilis. Gonorrhea rates among African Americans are highest for adolescents and young adults, and disparities are greatest for adolescent men. Although disparities for men who have sex with men (MSM) are not as great as for heterosexual populations, STD rates for both white and African American MSM populations are high, so efforts to address disparities must also include African American MSM. Individual risk behavior and sociodemographic characteristics of African Americans do not seem to account fully for increased STD rates for African Americans. Population-level determinants such as sexual networks seem to play an important role in STD disparities. An understanding of the epidemiology of STD disparities is critical for identifying appropriate strategies and tailoring strategies for African American communities. Active efforts are needed to reduce not only the physical consequences of STDs, such as infertility, ectopic pregnancy, chronic pelvic pain, newborn disease, and increased risk of HIV infection, but also the social consequences of STDs such as economic burden, shame, and stigma.
Hawes, Starlyn M.; Berkley-Patton, Jannette Y.
African Americans are disproportionately burdened by STDs and HIV in the US. This study examined the relationships between demographics, religiosity, and sexual risk behaviors among 255 adult African American church-based participants. Although participants were highly religious, they reported an average of seven lifetime sex partners and most inconsistently used condoms. Several demographic variables and religiosity significantly predicted lifetime HIV-related risk factors. Taken together, findings indicated that this population is at risk for HIV. Future research should continue to identify correlates of risky sexual behavior among African American parishioners to facilitate the development of HIV risk reduction interventions in their church settings. PMID:23054481
Harvey, S Marie; Bird, Sherly Thorburn
Because of the importance of relationship power and cultural norms on women's ability to protect themselves from HIV/STDs, effective interventions must address power differentials among men and women. These programs need to be informed by and adapted to the cultural values of the target population. Accordingly, we conducted exploratory interviews with 22 young African American women at risk of HIV/ STDs and unintended pregnancy and their male partners regarding the meaning of power in heterosexual relationships, what makes a woman feel powerful in a relationship with a man, and who makes sexual and reproductive decisions in their relationships. Content analyses suggested that relationship power was linked to control and decision-making for most participants; yet, others appeared to associate power with positive relationship qualities such as respect and security. In addition, most participants reported that they shared decision-making about sexual and reproductive matters with their partners. Subsequently, interviews were conducted with another 40 women to explore and identify cultural beliefs regarding what makes women feel powerful in their relationships with their husbands or partners. Cultural consensus analysis was performed and results indicated that the participants comprise a cultural group with shared beliefs about what makes women feel powerful in their relationships. Participants believed that women's sense of power in their relationships came from (1) knowing what they want and having autonomy and control; (2) the quality of their relationships; (3) having resources to provide for their families; and (4) physical attractiveness and sexual factors.
Robinson, Allysha C; Knowlton, Amy R; Gielen, Andrea C; Gallo, Joseph J
We evaluated a synergistic epidemic (syndemic) of substance use, mental illness, and familial conflict non-negotiation among HIV-positive injection drug users (IDU). Baseline BEACON study data was utilized. Latent class analyses identified syndemic classes. These classes were regressed on sex, viral suppression, and acute care non-utilization. Females were hypothesized to have higher syndemic burden, and worse health outcomes than males. Nine percent of participants had high substance use/mental illness prevalence (Class 4); 23 % had moderate levels of all factors (Class 3); 25 % had high mental illness (Class 2); 43 % had moderate substance use/mental illness (Class 1; N = 331). Compared to Classes 1-3, Class 4 was mostly female (p < .05), less likely to achieve viral suppression, and more likely to utilize acute care (p < .05). Interventions should target African-American IDU females to improve their risk of negative medical outcomes. Findings support comprehensive syndemic approaches to HIV interventions, rather than singular treatment methods.
Gwadz, Marya; Cleland, Charles M.; Belkin, Mindy; Ritchie, Amanda; Leonard, Noelle; Riedel, Marion; Banfield, Angela; Colon, Pablo; Elharrar, Vanessa; Kagan, Jonathan; Mildvan, Donna
African American/Black and Hispanic persons living with HIV/AIDS (“AABH-PLHA”) are under-represented in HIV/AIDS medical studies (HAMS). This paper evaluates the efficacy of a social/behavioral intervention to increase rates of screening for and enrollment into HAMS in these populations. Participants (N=540) were enrolled into a cluster randomized controlled trial of an intervention designed to overcome multi-level barriers to HAMS. Primary endpoints were rates of screening for and enrollment into therapeutic/treatment-oriented and observational studies. Intervention arm participants were 30 times more likely to be screened than controls (49.3% vs. 3.7%; p < .001). Half (55.5%) of those screened were eligible for HAMS, primarily observational studies. Nine out of ten found eligible enrolled (91.7%), almost all into observational studies (95.2%), compared to no enrollments among controls. Achieving appropriate representation of AABH-PLHA in HAMS necessitates modification of study inclusion criteria to increase the proportion found eligible for therapeutic HAMS, in addition to social/behavioral interventions. PMID:24961193
Rhodes, S D; Yee, L J; Hergenrather, K C
Because the southeastern USA is experiencing a disproportionate HIV infection rate compared to other regions of the country, we explored HIV behavioural risk disparities by race/ethnicity among self-identifying gay men. Conceived and implemented as a community-based participatory research (CBPR) study, this rapid assessment collected demographic and HIV risk-behaviour data from men in five gay bars in the northwestern part of the state of North Carolina, using an assessment available in English and Spanish. Of 719 participants, 34.8% reported inconsistent condom use during anal intercourse in the past three months, 11.4% reported ever having had a sexually transmitted disease (STD), 3.6% reported being HIV-seropositive and 26% reported illicit drug use during the past 30 days. Compared to white participants, African American/black and Hispanic/Latino participants were more likely to report inconsistent condom use during anal intercourse with multiple partners during the past three months. African American/black participants were more likely to report illicit drug use during the past 30 days. Hispanic/Latino participants were more likely to have never been tested for HIV. Rates of HIV risk behaviours among gay men remain high and racial/ethnic differences indicate the need for targeted and tailored prevention strategies.
... accounted for 83.8% of Caucasian elderly suicides. • Firearms were the predominant method of suicide among African ... per 100,000 annually. Source: Centers for Disease Control and Prevention. National Vital Statistics System. Mortality Data. ...
Deardorff, Julianna; Suleiman, Ahna Ballonoff; Dal Santo, Teresa S.; Flythe, Michelle; Gurdin, J. Barry; Eyre, Stephen L.
African American young women exhibit higher risk for sexually transmitted infections, including HIV/AIDS, compared with European American women, and this is particularly true for African American women living in low-income contexts. We used rigorous qualitative methods, that is, domain analysis, including free listing ("n" = 20),…
Whitfield, Tracy N.
The qualitative research study explored the organizational characteristics necessary in addressing the low concentration of African American technical consultants employed in the information technology industry. Using research participants' professional experience, participants responded to a developed questionnaire. African American technical…
Yancy, Clyde W
The demographics of the United States are changing, and in the next few decades there will no longer be a racial/ethnic majority population. Increased awareness of cardiovascular disease (CVD) in special populations is warranted as these populations increase. Heart failure carries a substantial burden on those affected, particularly African Americans, who have a disproportionate burden of heart disease. Current treatments for heart failure include angiotensin-converting enzyme inhibitors, beta-blockers, angiotensin II-receptor antagonists, and vasodilating agents. This review discusses the unique characteristics of CVD in African Americans and addresses the need for targeted treatments to reduce the excess burden found in this population.
Han, Chong-suk; Ayala, George; Paul, Jay P; Boylan, Ross; Gregorich, Steven E; Choi, Kyung-Hee
The deleterious effects of racism on a wide range of health outcomes, including HIV risk, are well documented among racial/ethnic minority groups in the United States. However, little is known about how men of color who have sex with men (MSM) cope with stress from racism and whether the coping strategies they employ buffer against the impact of racism on sexual risk for HIV transmission. We examined associations of stress and coping with racism with unprotected anal intercourse (UAI) in a sample of African American (N = 403), Asian/Pacific Islander (N = 393), and Latino (N = 400) MSM recruited in Los Angeles County, CA during 2008-2009. Almost two-thirds (65 %) of the sample reported being stressed as a consequence of racism experienced within the gay community. Overall, 51 % of the sample reported having UAI in the prior 6 months. After controlling for race/ethnicity, age, nativity, marital status, sexual orientation, education, HIV serostatus, and lifetime history of incarceration, the multivariate analysis found statistically significant main effects of stress from racism and avoidance coping on UAI; no statistically significant main effects of dismissal, education/confrontation, and social-support seeking were observed. None of the interactions of stress with the four coping measures were statistically significant. Although stress from racism within the gay community increased the likelihood of engaging in UAI among MSM of color, we found little evidence that coping responses to racism buffered stress from racism. Instead, avoidance coping appears to suggest an increase in UAI.
Sznitman, Sharon; Stanton, Bonita F; Vanable, Peter A; Carey, Michael P; Valois, Robert F; Brown, Larry K; DiClemente, Ralph; Hennessy, Michael; Salazar, Laura F; Romer, Daniel
We examined the long-term effects of two interventions designed to reduce sexual risk behavior among African American adolescents. African American adolescents (N = 1383, ages 14-17) were recruited from community-based organizations over a period of 16 months in two northeastern and two southeastern mid-sized U.S. cities with high rates of sexually transmitted infection (STI). Participants were screened for three STIs (gonorrhea, chlamydia, and trichomoniasis) and completed an audio computer-assisted attitude, intention, and behavior self-interview. Youth who tested positive for an STI (8.3%) received treatment and risk reduction counseling. In addition, television and radio HIV-prevention messages were delivered during the recruitment period and 18 months of follow-up in one randomly selected city in each region. Analyses determined effects of the media program for those receiving a positive versus negative STI test result on number of sexual partners and occurrence of unprotected sex. Adolescents who tested STI-positive reduced their number of vaginal sex partners and the probability of unprotected sex over the first 6 months. However, in the absence of the mass media program, adolescents returned to their previously high levels of sexual risk behavior after 6 months. Adolescents who tested STI-positive and received the mass media program showed more stable reductions in unprotected sex. Community-based STI treatment and counseling can achieve significant, but short-lived reductions in sexual risk behavior among STI-positive youth. A culturally sensitive mass media program has the potential to achieve more stable reductions in sexual risk behavior and can help to optimize the effects of community-based STI screening.
Jeffries, Rhonda Baynes
This paper discusses the role of matriarchs in African-American culture, explaining that traditionally, African-American matriarchs arise from a combination of African norms and American social positions that naturally forces them to assume leadership conditions. The roles these women assume are a response to the desire to survive in a society…
Peterson, Elizabeth A., Ed.
This book contains six chapters by various authors about the history of African Americans' contributions and participation in adult education. The book reports on how some African American leaders saw the connection between education and the eventual freedom or uplift of the African American people. Following a foreword (Phyllis M. Cunningham) and…
Wallen, Jacqueline; Randolph, Suzanne; Carter-Pokras, Olivia; Feldman, Robert; Kanamori-Nishimura, Mariano
Background: African Americans are disproportionately exposed to and targeted by prosmoking advertisements, particularly menthol cigarette ads. Though African Americans begin smoking later than whites, they are less likely to quit smoking than whites. Purpose: This study was designed to explore African American smoking cessation attitudes,…
Much has been written concerning the challenges many teachers face in engaging African American males in reading practices. While much of this extant scholarship focuses on African American males at the pre-adolescent stage of development and beyond, little has been written regarding increasing reading engagement in African American boys in P-5…
Corbie-Smith, Giselle; Akers, Aletha; Blumenthal, Connie; Council, Barbara; Wynn, Mysha; Muhammad, Melvin; Stith, Doris
Southeastern states are among the hardest hit by the HIV epidemic in this country, and racial disparities in HIV rates are high in this region. This is particularly true in our communities of interest in rural eastern North Carolina. Although most recent efforts to prevent HIV attempt to address multiple contributing factors, we have found few…
Day-Vines, Norma L.; Holcomb-McCoy, Cheryl
Although there are various definitions of wellness, few conceptual definitions have addressed the contextual dimensions of wellness relative to African American counselors. The authors present an overview of generic models of wellness, discuss factors that both inhibit and promote wellness, offer some culture-specific models of wellness, and…
Cuyjet, Michael J., Ed.
This book is a much-needed resource that includes examples of real-world programs and activities to enhance academic success in the college environment for African American men. The examples are collected from a variety of institutions across the country. With contributions from leading practitioners and scholars in the field, this book explores…
Brown, Jennifer L.; Young, April M.; Sales, Jessica M.; DiClemente, Ralph J.; Rose, Eve S.; Wingood, Gina M.
This study examined if relationship power, sex refusal self-efficacy, and/or fear of condom negotiation mediated the relationship between abuse history and consistent condom use (CCU) among African-American female adolescents (n=593). Participants with an abuse history (58%) were less likely to report CCU (p=.003). Women with an abuse history reported less relationship power (p=.006) and self-efficacy for refusing sex (p<.001), and more fear of condom negotiation (p=.003), none of which independently or jointly mediated the association between abuse and CCU. Notably, history of abuse was associated with CCU across mediator models (p=.037 to p=.067), despite inclusion of psychosocial mediators. This study demonstrates the importance of understanding adolescents’ condom use behaviors within the context of their life experiences, especially past abuse history. PMID:25505369
Brown, Jennifer L; Young, April M; Sales, Jessica M; DiClemente, Ralph J; Rose, Eve S; Wingood, Gina M
This study examined if relationship power, sex refusal self-efficacy, and/or fear of condom negotiation mediated the relationship between abuse history and consistent condom use (CCU) among African-American female adolescents (n=593). Participants with an abuse history (58%) were less likely to report CCU (p=.003). Women with an abuse history reported less relationship power (p=.006) and self-efficacy for refusing sex (p<.001), and more fear of condom negotiation (p=.003), none of which independently or jointly mediated the association between abuse and CCU. Notably, history of abuse was associated with CCU across mediator models (p=.037 to p=.067), despite inclusion of psychosocial mediators. This study demonstrates the importance of understanding adolescents' condom use behaviors within the context of their life experiences, especially past abuse history.
Newlin, Kelley; Knafl, Kathleen; Melkus, Gail D'Eramo
Culturally competent care for African Americans requires sensitivity to spirituality as a component of the cultural context. To foster understanding, measurement, and delivery of the spiritual component of culturally competent care, this article presents an evolutionary concept analysis of African-American spirituality. The analysis is based on a sample of multidisciplinary research studies reflecting spirituality of African Americans. Findings indicate that African-American spirituality involves quintessential, internal, external, consoling, and transformative attributive dimensions. Findings are considered in relation to previous conceptual analyses of spirituality and suggest that defining attributes of African-American spirituality are both global and culturally prominent. Implications for practice and research are discussed.
Yates, Eleanor Lee
During the 1980s and into the '90s, HIV and AIDS primarily affected gay White men. The rates of HIV/AIDS stabilized in the 1990s in the United States, but today the numbers are soaring again. This time around, victims are more likely to be Black and heterosexual. Dr. Adaora Adimora, an HIV/AIDS researcher and associate professor of medicine at the…
Connor, Carol McDonald; Craig, Holly K.
Purpose: This study examined the relation between African American preschoolers' use of African American English (AAE) and their language and emergent literacy skills in an effort to better understand the perplexing and persistent difficulties many African American children experience learning to read proficiently. Method: African American…
Hunter, Teressa Sanders
African-American women between 25 and 34 years of age are disproportionately affected by HIV/AIDS. Current prevention techniques, including education, have not had a significant influence on decreasing the rates of HIV and increasing safer sexual practices among some African-American women. This pilot study is one step towards increasing the understanding of this serious problem and developing effective interventions to stem the tide of HIV infection in African-American women. A grounded theory approach was used to address the process that unmarried, heterosexual, African-American women used to negotiate condom use with their sexual partner. Major concepts, connections between the categories, and theoretical codes are identified in this study and can be used to predict, speculate, explain, and understand the reported behavior of African-American women in negotiating condom use with their sexual partner.
Kanekar, Amar; Sharma, Manoj
Safer sex is important for protection against STDs and HIV/AIDS. Most of the HIV-related research is targeted towards high-risk groups such as prostitutes, gays and substance abusers there is evidence that HIV/AIDS is increasing in college students particularly among African-American college students. The purpose of this study was to study…
Richardson, Joseph B., Jr.; Van Brakle, Mischelle; St. Vil, Christopher
Research indicates that inner-city neighborhood effects are correlated with school dropout, substance abuse, crime, violence, homicide, HIV risk related behaviors, and incarceration for adolescent African American males. Parents of adolescent African American males face many challenges as they try to keep their children safe in high-risk…
Funnyé, A. S.; Ganesan, K.; Yoshikawa, T. T.
This study examined the clinical characteristics and outcome of pulmonary tuberculosis in African Americans hospitalized in a teaching hospital in south-central Los Angeles from May 1992 through April 1994. The charts of 41 African Americans with culture-positive Mycobacterium tuberculosis were reviewed. Predisposing factors for pulmonary tuberculosis were identified in nearly half of cases. Cough and fever were the most common symptoms. Seventy-six percent had positive acid-fast bacilli (AFB) smears. Nine patients were human immunodeficiency virus (HIV)-positive, and 6 of 9 HIV-positive patients had positive AFB smears whereas 17 of 19 HIV-negative patients had positive AFB smears. Radiographic changes were not significantly different between HIV-positive and HIV-negative patients. Drug resistance was identified in nine of 31 patients (29%). Eight of 41 patients (19.5%) died, with 2 being drug resistant. Human immunodeficiency virus infection was a major predisposing factor for tuberculosis, and no statistical differences were found in radiographic features or AFB smear positivity between HIV-positive and HIV-negative patients. Drug resistance and mortality were disproportionately high. These results indicate that HIV infection and drug resistance are major problems that predispose for tuberculosis infection and make its treatment difficult. PMID:9510620
Cooke, Ian J; Jeremiah, Rohan D; Moore, Nataka J; Watson, Karriem; Dixon, Michael A; Jordan, Gregory L; Murray, Marcus; Keeter, Mary K; Hollowell, Courtney M P; Murphy, Adam B
In the United States, African-Americans' (AAs) HIV infection rates are higher than any other racial group, and AA men who have sex with women (MSW) are a significant proportion of new cases. There is little research into AA MSW HIV/AIDS knowledge, barriers, and facilitators of HIV testing in Chicago. We enrolled a convenience sample of AA MSW from a community health clinic who completed self-administered surveys assessing HIV knowledge and testing-related barriers and facilitators. The survey was a combination of questions from several validated instruments, and additional questions were written based on key informant interviews with social scientists to tailor the questionnaire for AA men living on the South Side of Chicago. We recruited 20 AA MSW (mean age 47.4 years). Sixty-five percent had incomes <$10,000/year, 30% were insured, and 50% had post-secondary education. Despite low socioeconomic status, their HIV literacy was relatively high. The identified major barriers to testing were low perceived HIV risk, concerns over privacy, and external stigma at testing sites. Future efforts should focus on educating AA MSW on actual risk for HIV and address issues of privacy and stigma at testing sites.
Interpretations of the differences between the African American child and the Caucasian child in North America follow two major trends. In one the differences in the African American child are viewed as deviance from the Euro-American norm and therefore inferior or pathological. In the other, the differences are viewed as deviant but adaptive…
Mitchell, Mary M; Knowlton, Amy
While informal caregivers play an important role in improving the health of disadvantaged persons living with HIV/AIDS (PLHAs) in the United States, caregiver role overload has the potential for distress. We used latent profile analysis (LPA) to classify caregivers based on their perceived level of support and structural equation modeling (SEM) to examine the relationships among role overload, perceived support, caregiver demographic characteristics, and social network members' characteristics in a sample of 215 predominantly low-income, African-American informal caregivers. The LPA resulted in two classes of caregivers with higher and lower perceived support. The SEM results indicated that caregiver role overload was associated with being in the less supported class, younger age, and limited physical functioning, while social support class was associated with being female and being HIV seropositive in addition to support network characteristics. Interventions should address the support needs of HIV caregivers to reduce their potential for distress.
Burrow, Rufus, Jr.
Presents views of Frederick Douglass, W. E. B. Du Bois, Malcolm X, and James Hal Cone (African-American male leaders) toward African-American women in the United States. Discusses the role of African-American men in addressing and eradicating sexism in African-American churches and the African-American community. (SLD)
Tishkoff, Sarah A; Reed, Floyd A; Friedlaender, Françoise R; Ehret, Christopher; Ranciaro, Alessia; Froment, Alain; Hirbo, Jibril B; Awomoyi, Agnes A; Bodo, Jean-Marie; Doumbo, Ogobara; Ibrahim, Muntaser; Juma, Abdalla T; Kotze, Maritha J; Lema, Godfrey; Moore, Jason H; Mortensen, Holly; Nyambo, Thomas B; Omar, Sabah A; Powell, Kweli; Pretorius, Gideon S; Smith, Michael W; Thera, Mahamadou A; Wambebe, Charles; Weber, James L; Williams, Scott M
Africa is the source of all modern humans, but characterization of genetic variation and of relationships among populations across the continent has been enigmatic. We studied 121 African populations, four African American populations, and 60 non-African populations for patterns of variation at 1327 nuclear microsatellite and insertion/deletion markers. We identified 14 ancestral population clusters in Africa that correlate with self-described ethnicity and shared cultural and/or linguistic properties. We observed high levels of mixed ancestry in most populations, reflecting historical migration events across the continent. Our data also provide evidence for shared ancestry among geographically diverse hunter-gatherer populations (Khoesan speakers and Pygmies). The ancestry of African Americans is predominantly from Niger-Kordofanian (approximately 71%), European (approximately 13%), and other African (approximately 8%) populations, although admixture levels varied considerably among individuals. This study helps tease apart the complex evolutionary history of Africans and African Americans, aiding both anthropological and genetic epidemiologic studies.
Rozie-Battle, Judith L
The research on the psychosocial development of African American girls is limited. Information that is available focuses on teen pregnancy and health issues such as nutrition and physical activity. African American girls are facing challenges, including poverty, crime, poor self-esteem, and peer pressure. Despite some of the negative characteristics attributed to African American girls, many are achieving some success. Policy makers and service providers need to recognize the resiliency and unique needs of African American girls and develop services that ensure their needs are being fully met.
Rohrich, Rod J; Muzaffar, Arshad R
Because of the increasing popularity of rhinoplasty in the African-American patient, we delineate how a rhinoplasty surgeon can perform this challenging technique to obtain uniform and consistent results. First, we address how one can appreciate and analyze the various aesthetic concepts of beauty and the unique anatomic characteristics of the African-American nose. Second, we present a pragmatic, systematic analysis of the African-American nose. Last, we describe the techniques consistently used to modify the African-American nose while achieving or maintaining facial harmony using the open approach to rhinoplasty. Specific case analyses are presented to demonstrate utilization of the technique.
Muhammad, Rhonda K.
This qualitative study examined the instructional practices of an experienced African American mathematics teacher to determine his perceived capabilities in augmenting academic proficiency for his African American male students. Provided in this descriptive case study are the lived experiences of an African American male teacher working to move…
Senn, Theresa E; Carey, Michael P; Vanable, Peter A; Seward, Derek X
Power in intimate relationships is an important predictor of sexual risk behavior. The purpose of this study was to better understand African American men's perceptions of interpersonal power. A total of 20 African American men participated in focus groups to elicit their perceptions of power in intimate relationships; their responses were analyzed using grounded theory. From this analysis, a conceptual framework was developed that, among African American men, power in relationships was largely determined by the contribution of financial resources, and/or withholding sex. These findings were then considered in light of existing social-psychological theories of power in relationships. Future research should consider how to incorporate this understanding of interpersonal power into current theories of sexual risk behavior in order to develop more effective HIV risk reduction programs.
Coleman, Ben C.
This revised version of a lecture on the relationship of African language and Hispano-American literature illustrates the historical influence of the African slave on representative literature and modern culture of the Caribbean Islands. Introductory remarks focus on the migratory patterns of the African slaves. The concept of negritude is then…
Gant, Zanetta; Gant, Larry; Song, Ruiguang; Willis, Leigh; Johnson, Anna Satcher
Background HIV disproportionately affects black men in the United States: most diagnoses are for black gay, bisexual, and other men who have sex with men (collectively referred to as MSM). A better understanding of the social conditions in which black men live and work may better explain why HIV incidence and diagnosis rates are higher than expected in this population. Methods Using data from the National HIV Surveillance System and the US Census Bureau's American Community Survey, we examined the relationships of HIV diagnosis rates and 5 census tract–level social determinants of health variables for 21,948 black MSM and non-MSM aged ≥15 years residing in 17 areas in the United States. We examined federal poverty status, marital status, education level, employment status, and vacancy status and computed rate ratios (RRs) and prevalence odds ratios (PORs), using logistic regression with zero-inflated negative binomial modeling. Results Among black MSM, HIV diagnosis rates decreased as poverty increased (RR: 0.54). At the time of HIV diagnosis, black MSM were less likely than black non-MSM to live in census tracts with a higher proportion below the poverty level (POR: 0.81) and with a higher proportion of vacant houses (POR: 0.86). In comparison, housing vacancy was positively associated with HIV diagnosis rates among black non-MSM (RR: 1.65). HIV diagnosis rates were higher for black MSM (RR: 2.75) and non-MSM (RR: 4.90) whose educational level was low. Rates were significantly lower for black MSM (RR: 0.06) and non-MSM (RR: 0.26) as the proportion unemployed and the proportion married increased. Conclusions This exploratory study found differences in the patterns of HIV diagnosis rates for black MSM and non-MSM and provides insight into the transmission of HIV infection in areas that reflect substantial disadvantage in education, housing, employment, and income. PMID:25268831
Harris, Violet J.
Traces and analyzes the history of African American children's literature defined as "culturally conscious," an authentic body of literature written about and for African American children. Discusses the current status of this literature and indicates a change in focus in the last century. Authors' perspectives, and the implications for…
This study examines the academic library experiences of African American undergraduates attending a research university in the Midwest. Data collection techniques included questionnaires and ethnographic observations. The results indicated that African American undergraduates are using the academic library primarily to read and to study with their…
Ahluwalia, Jasjit S.
Because the smoking behavior of African Americans differs considerably from that of other groups, researchers examined differences between African Americans who did and did not use the nicotine patch as an adjunct to counseling and education for smoking cessation. Results indicated the nicotine patch significantly improved six-month cessation…
Cannon Dawson, Candice
This dissertation is a narrative inquiry research project that focuses on the collegiate experiences of African American students at both historically black colleges and universities (HBCUs) and predominantly white institutions (PWIs). I look at how African American college students who engage in race or culturally specific activities, the degree…
Green, Aundria Chephan
The purpose of this study was to explore the reasons that African-American alumni from a historically Black university (HBCU) and a predominantly White university (PWI) chose to attend, remain in, and graduate from college. The central research question was how do African Americans describe their college experiences? The secondary research…
Background/Context: Historical studies examine aspects of African American education in and out of school in detail (Woodson 1915, 1933, Bullock 1970, Anderson 1988, Morris 1982, Rachal 1986, Rose 1964, Webber 1978, Williams 2005). Scholars of African American literacy have noted ways that education intersects other arenas such as religion and…
Nash, Gary B.
Discusses five topics on African Americans that are essential to studying United States History in the years between 1760 and 1830: (1) African Americans in the Revolutionary War ; (2) the rise of free black communities; (3) early abolitionism; (4) the spread of slavery; and (5) black resistance to slavery. (CMK)
Hunn, Vanessa Lynn; Craig, Carlton David
The authors discuss depression in African American women from a sociocultural perspective, including aspects of oppression and racism that affect symptom manifestation. The authors highlight John Henryism as a coping mechanism, the history and continuing role of the African American church as a safe haven, and strategies for culturally competent…
AWARD NUMBER: W81XWH-11-1-0566 TITLE: Prostate Cancer Genetics in African Americans PRINCIPAL INVESTIGATOR: Henry T. Lynch, MD CONTRACTING...W81XWH-11-1-0566 November 2015 Final 15Aug2011 - 14Aug2015 Prostate Cancer Genetics in African Americans Henry T. Lynch Nothing listed 36
Mims, Adrian B.
This case study evaluated the significance of implementing an enrichment mathematics course during the summer to rising African American ninth graders entitled, "Geometry Honors Preview." In the past, 60 to 70 percent of African American students in this school district had withdrawn from Geometry Honors by the second academic quarter. This study…
Kersten, Andrew E.
Focuses on the experience of African Americans during World War II on the homefront and in the armed forces. States that African Americans not only fought fascism overseas but also apartheid in the United States, also known as the "Double V." (CMK)
Parikh, Nirzari; Dampier, Will; Feng, Rui; Passic, Shendra R.; Zhong, Wen; Frantz, Brian; Blakey, Brandon; Aiamkitsumrit, Benjamas; Pirrone, Vanessa; Nonnemacher, Michael R.; Jacobson, Jeffrey M.; Wigdahl, Brian
Background This study evaluated the relationship between illicit drug use and HIV-1 disease severity in HIV-1-infected patients enrolled in the DrexelMed HIV/AIDS Genetic Analysis Cohort. Since, cocaine is known to have immunomodulatory effects, the cytokine profiles of preferential nonusers, cocaine users, and multidrug users were analyzed to understand the effects of cocaine on cytokine modulation and HIV-1 disease severity. Methods Patients within the cohort were assessed approximately every 6 months for HIV-1 clinical markers and for history of illicit drug, alcohol, and tobacco use. The Luminex human cytokine 30-plex panel was used for cytokine quantitation. Analysis was performed using a newly developed biostatistical model. Results Substance abuse was common within the cohort. Utilizing the drug screens at the time of each visit, the subjects in the cohort were categorized as preferential nonusers, cocaine users, or multidrug users. The overall health of the nonuser population was better than that of the cocaine users, with peak and current viral loads in nonusers substantially lower than those in cocaine and multidrug users. Among the 30 cytokines investigated, differential levels were established within the 3 populations. The T-helper 2 cytokines, interleukin-4 and -10, known to play a critical role during HIV-1 infection, were positively associated with increasing cocaine use. Clinical parameters such as latest viral load, CD4+ T-cell counts, and CD4:CD8 ratio were also significantly associated with cocaine use, depending on the statistical model used. Conclusions Based on these assessments, cocaine use appears to be associated with more severe HIV-1 disease. PMID:24732878
Campbell, Doris Williams; Sharps, Phyllis W; Gary, Faye A; Campbell, Jacquelyn C; Lopez, Loretta M
Violence against African American women, specifically intimate partner abuse, has a significant impact on their health and well being. Intimate partner femicide and near fatal intimate partner femicide are the major causes of premature death and disabling injuries for African American women. Yet, despite this, there is a paucity of research and interventions specific and culturally relevant for these women. This article focuses on issues relevant to intimate partner violence and abuse against African American women by examining existing empirical studies of prevalence and health outcomes of intimate partner violence against women in general, plus what limited research there is about African American women, specifically. It includes a discussion of specific recommendations for research, practice, education, and policy to reduce and prevent intimate partner violence against African American women.
The African American community's response to the AIDS epidemic has reflected the profound mistrust of the medical establishment which many African Americans feel. Among African Americans, the belief that the epidemic originated in a genocidal plot is widespread. It is thought that organized medicine has been significantly involved in this plot. If we look at African Americans' historical relationship to the medical establishment from the era of slavery to the recent past, the suspicious attitudes which make such beliefs possible can be seen as an intelligible response to a new disease which disproportionately affects African Americans. Successful medical and public health responses to the epidemic have depended and will continue to depend upon overcoming the historical legacy of suspicion and gaining the trust of the community.
Briscoe, Forrest; Konrad, Thomas R.
OBJECTIVES: To assess the level and determinants of African-American physicians' employment in health maintenance organizations (HMOs), particularly early in their careers. METHODS: We analyzed data from the 1991 and 1996 Young Physicians Surveys to assess racial differences in the likelihood of HMO employment (n = 3,705). Using multinomial logistic regression, we evaluated four explanations for an observed relationship between African-American physicians and HMO employment: human capital stratification among organizations, race-based affinity between physicians and patients, financial constraints due to debt burden, and different organizational hiring practices. Using binomial logistic regression, we also evaluated differences in the odds of being turned down for a prior practice position, of subsequently leaving the current practice organization and of later having career doubts. RESULTS: Without any controls, African-American physicians were 4.52 times more likely to practice in HMOs than Caucasian physicians. After controlling for human capital stratification, racial concordance and financial constraints, African-American physicians remained 2.48 times more likely to practice in HMOs than Caucasian physicians. In addition, 19.2% of African-American physicians in HMOs reported being turned down for another job, far more than any other racial/ethnic group in the HMO setting and any racial/ethnic group, including African-American physicians in the non-HMO setting (including all other practice locations). Five years later, those same African-American physicians from HMOs also reported significantly more turnover (7.50 times more likely than non-HMO African-American physicians to leave their current practice) and doubt about their careers (2.17 times more likely than non-HMO African-American physicians to express serious career doubts). CONCLUSIONS: African-American physicians were disproportionately hired into HMO settings, impacting their subsequent careers. PMID
Sankar, A.; Luborsky, M.; Schuman, P.; Roberts, G.
Low adherence is the single most important challenge to controlling HIV through the use of high acting anti-retrovirals (HAART). Non-adherence poses an immediate threat to individuals who develop resistant forms of the virus as well as a public health threat if those individuals pass on treatment-resistant forms of the virus. To understand the concerns and perceptions that promote or deter adherence to antiretroviral medication by HIV-positive African-American women, we conducted in-depth interviews with 15 African-American women taking HAART. We focused on the discourse and narratives women use in talking about their adherence practice. Discourse analysis was utilized to identify and explore the sources of influence used by these women in describing their adherence practice. Roughly a third of the sample fell into each of the three self-assessed adherence categories: always adherent, mostly adherent and somewhat adherent. Among the ‘always adherent’, 80% of the sources of influence cited supported adherence, while only 48% and 47% of the authoritative sources cited by women in the ‘mostly’ and ‘somewhat’ categories supported adherence. Each self-assessed adherence group was characterized by its own distinctive discourse style. Findings suggest that adherence to HAART among African-American HIV-positive women would be improved by identifying those influences undermining adherence. Focused study of the ‘always adherent’ types is recommended. PMID:11940279
Im, Eun-Ok; Lim, Hyun-Ju; Clark, Maresha; Chee, Wonshik
Although very little is known about African American cancer patients' pain experience, a few studies have indicated that their cancer pain experience is unique and somewhat different from that of other ethnic groups. The purpose of the study reported in this article was to explore African American cancer patients' pain experience using an online forum. This study was a qualitative online forum designed from a feminist perspective and conducted among 11 African American cancer patients who were recruited through both Internet and real settings. Nine online forum topics were used to administer the 6-month online forum, and the data were analyzed using thematic analysis. Four themes emerged through the data analysis process. First, participants viewed cancer as a challenge in life that they should fight against. Second, cancer pain was differentiated from ordinary pain because cancer was stigmatized in their culture. Third, participants viewed that African Americans, especially women, were culturally raised to be strong, and this African American cultural heritage inhibited cancer patients from expressing pain and seeking help for pain management. Finally, the findings indicated certain changes in perspectives among African American cancer patients during the disease process, which might make them tolerate pain through praying to God and reading the Bible. Based on the findings, we suggest further studies among diverse groups of African American cancer patients, with a focus on cultural attitudes toward cancer pain and influences of family on cancer pain experience.
O'Brien, T R; Polon, C; Schable, C A; VanDevanter, N; Rayfield, M A; Wallace, D; Stuart, A; Holmberg, S D
HIV-2 is endemic in West Africa but rare elsewhere. In the USA there have been 18 reported cases of HIV-2 infection; most identified people have been West Africans. We recently diagnosed the first case of HIV-2 infection in a native-born US citizen, a woman whose serum was found to be reactive to anti-HIV-1 enzyme immunoassay (EIA) when she attempted to donate blood in 1986. Although both HIV-1- and HIV-2-specific EIAs were reactive, the anti-HIV-2 Western blot (WB) was positive, while the anti-HIV-1 WB was positive or indeterminate on different occasions. Synthetic peptide testing was reactive for HIV-2 but not HIV-1. HIV-2 DNA was detected using the polymerase chain reaction procedure. Although she had travelled to West Africa, it is unclear how she became infected with HIV-2.
Coombs, Catherine C; Falchi, Lorenzo; Weinberg, J Brice; Ferrajoli, Alessandra; Lanasa, Mark C
Chronic lymphocytic leukemia (CLL) is the most prevalent leukemia in the United States with almost 4390 attributable deaths per year. Epidemiologic data compiled by the Surveillance, Epidemiology and End Results (SEER) program identifies important differences in incidence and survival for African Americans with CLL. Although the incidence of CLL is lower among African Americans than among Caucasians (4.6 and 6.2 per 100 000 men, respectively), age-adjusted survival is inferior. African American patients with CLL are almost twice as likely to die from a CLL-related complication in the first 5 years after diagnosis as are Caucasian patients with CLL. The biologic basis for these observations is almost entirely unexplored, and a comprehensive clinical analysis of African American patients with CLL is lacking. This is the subject of the present review.
Campbell, Patricia Shehan
Describes the role and influence of Mellonee Burnim on U.S. music education. Discusses the origins and impact of African American gospel music. Includes a list of selected resources and two lesson plans featuring gospel music. (CFR)
... HIV/AIDS: The Basics Black Americans and HIV/AIDS: The Basics Feb 07, 2017 Facebook Twitter LinkedIn ... Black Americans have been disproportionately affected by HIV/AIDS since the epidemic’s beginning, and that disparity has ...
Pimpleton, Asher M.
Sexually transmitted diseases have reached epidemic proportions, especially among African Americans. However, African American women have emerged as being one of the hardest hit groups by the most fatal of sexually transmitted diseases--the Human Immunodeficiency Virus (HIV) and the Acquired Immune Deficiency Syndrome (AIDS). Although there has…
This article discusses how Adlerian counseling can be used as a form of school counseling for African American adolescents. Moreover, school counseling for African American adolescents is discussed within the context of African American culture. Due to the strength-based nature of Adlerian approach, it can capitalize on African American…
Wells, Tesia Denis
This quantitative study sought to explore African American pastors' beliefs and actions regarding childhood incest in the African American community and their decisions to inform the proper authorities. This exploratory study was developed in order to draw both public and academic attention to the understudied phenomenon of childhood incest within…
Watkins, Audrey P.
This qualitative study of how parents teach their children to excel academically in the African American community seeks to establish the validity of the pedagogical practices of working class African American families by investigating the educational leadership of two families on Chicago's south side. The study acknowledges the significance of…
Proctor, Adele; Yairi, Ehud; Duff, Melissa C.; Zhang, Jie
Purpose: In this study, the authors sought to determine the prevalence of stuttering in African American (AA) 2- to 5-year-olds as compared with same-age European Americans (EAs). Method: A total of 3,164 children participated: 2,223 AAs and 941 EAs. Data were collected using a 3-pronged approach that included investigators' individual…
Thomas, Erik R.; Lass, Norman J.
Past studies have shown that listeners can distinguish most African American and European American voices, but how they do so is poorly understood. Three experiments were designed to investigate this problem. Recordings of African American and European American college students performing various reading tasks were used as the basis for stimuli in all three. In the first experiment, stimuli were subjected to monotonization, lowpass filtering at 660 Hz, and no modification. In the second, stimuli featuring certain ethnically diagnostic vowels and control stimuli were subjected to monotonization, conversion of vowels to schwa, or no modification. In the third, stimuli featuring diagnostic vowels and control stimuli were modified so that the intonation of paired African American and European American speakers was swapped. In all three experiments, African American and European American listeners in North Carolina and European American listeners in West Virginia identified the ethnicity of the speaker of each stimulus. Vowel quality emerged as the most consistent cue for identifications. However, listeners accessed other cues differently for male and female speakers. Breathiness was correlated with identifications of male speakers but not of female speakers. F0-related factors proved more important for female speakers than for male speakers. [Work supported by NSF.
DeSantis, Carol; Naishadham, Deepa; Jemal, Ahmedin
In this article, the American Cancer Society estimates the number of new cancer cases and deaths for African Americans and compiles the most recent data on cancer incidence, mortality, survival, and screening prevalence based upon incidence data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. It is estimated that 176,620 new cases of cancer and 64,880 deaths will occur among African Americans in 2013. From 2000 to 2009, the overall cancer death rate among males declined faster among African Americans than whites (2.4% vs 1.7% per year), but among females, the rate of decline was similar (1.5% vs 1.4% per year, respectively). The decrease in cancer death rates among African American males was the largest of any racial or ethnic group. The reduction in overall cancer death rates since 1990 in men and 1991 in women translates to the avoidance of nearly 200,000 deaths from cancer among African Americans. Five-year relative survival is lower for African Americans than whites for most cancers at each stage of diagnosis. The extent to which these disparities reflect unequal access to health care versus other factors remains an active area of research. Overall, progress in reducing cancer death rates has been made, although more can and should be done to accelerate this progress through ensuring equitable access to cancer prevention, early detection, and state-of-the-art treatments.
Smith, Eva C.
African American educational leadership has long been part of American education and African American activism to resist oppression. However, the field of educational leadership has rarely included the contributions of African American leaders, particularly women leaders, into mainstream leadership theory and practices. This omission is difficult…
Anderson Goins, Johnell Roxann
Retaining African American students, specifically African American males, is an issue that plagues the American higher education system. Research shows that African American male students are the lowest represented group in the gifted studies programs (Ford, 2010). Lockie and Burke (1999); Chen and DeJardins (2010) and Bell (2010a) found that…
Jenkins, Chalice C; Kennedy, Bernice Roberts
The transmission of HIV/AIDS among African American women through heterosexual sex is an epidemic. Critical themes extracted from the HIV/AIDS sexual assertiveness literature revealed that: (a) sexual assertiveness is related to HIV risk, (b) sexual assertiveness is related to communication, and (c) women with low sexual assertiveness are at risk for HIV. This descriptive study sought to answer the following research question: What do young adult college attending African American women self-report about asking information about their partner's sexual history? The multifaceted model of HIV risk is the theoretical framework which guided this descriptive study. A basic tenet of the multifaceted model of HIV risk is that there is no single predictor of women's HIV risk behavior. Results revealed that 104 young adult college attending African American women who volunteered to attend a one day HIV prevention training overall scored high on a Sexual Assertive Scale on subscales of Information Communication, Refusal, and Pregnancy/STD Prevention Subscale, and scored in the medium range on the Initiation Subscales. The Information Communication and Pregnancy/ STD Prevention Subscale received the highest scores. More research is needed targeting diverse African American females with different socioeconomic status, various locations, and educated to determine their sexual assertiveness with partners which are essential in developing specific programs for diverse groups of African American females.
Cornelius, L. J.; Okundaye, J. N.; Manning, M. C.
This study draws attention to the demographic shift in the population of HIV-infected African Americans from young, low-income, unmarried homosexual, and injecting drug users to female, heterosexual, higher income, and older persons. We used data from the 1995 Survey of Family Growth, sponsored by the National Center for Health Statistics, to examine the patterns of HIV-related risk behavior (consistent condom use, number of sexual partners, sex education in birth control methods) among African-American females. We found that only 33.3% of the African-American females had indicated that their partners always used condoms; 23.8% had seven or more lifetime sexual partners; and nearly 30% did not have any sex education in birth control methods, sexually transmitted diseases, or abstinence. In addition, African-American females who had partners who had not used condoms in the last 12 months were less likely than those who reported occasional condom use to perceive that they were infected with HIV (21.1% vs. 33.1%). These risk factors were prevalent among low-income African-American females with low socioeconomic status (SES) as well as black women with higher SES who lived in smaller cities and suburbs. These results highlight the need for HIV prevention strategies that cut across socioeconomic class, gender, sexual orientation, and place of residence. PMID:10976175
Williams, Renee; White, Pascale; Nieto, Jose; Vieira, Dorice; Francois, Fritz; Hamilton, Frank
This review is an update to the American College of Gastroenterology (ACG) Committee on Minority Affairs and Cultural Diversity's paper on colorectal cancer (CRC) in African Americans published in 2005. Over the past 10 years, the incidence and mortality rates of CRC in the United States has steadily declined. However, reductions have been strikingly much slower among African Americans who continue to have the highest rate of mortality and lowest survival when compared with all other racial groups. The reasons for the health disparities are multifactorial and encompass physician and patient barriers. Patient factors that contribute to disparities include poor knowledge of benefits of CRC screening, limited access to health care, insurance status along with fear and anxiety. Physician factors include lack of knowledge of screening guidelines along with disparate recommendations for screening. Earlier screening has been recommended as an effective strategy to decrease observed disparities; currently the ACG and American Society of Gastrointestinal Endoscopists recommend CRC screening in African Americans to begin at age 45. Despite the decline in CRC deaths in all racial and ethnic groups, there still exists a significant burden of CRC in African Americans, thus other strategies including educational outreach for health care providers and patients and the utilization of patient navigation systems emphasizing the importance of screening are necessary. These strategies have been piloted in both local communities and Statewide resulting in notable significant decreases in observed disparities. PMID:27467183
Ferdinand, Keith C; Armani, Annemarie M
The prevalence of hypertension in blacks in the United States is among the highest in the world. Compared with whites, blacks develop hypertension at an earlier age, their average blood pressures are much higher and they experience worse disease severity. Consequently, blacks have a 1.3 times greater rate of nonfatal stroke, 1.8 times greater rate of fatal stroke, 1.5 times greater rate of heart disease death, 4.2 times greater rate of end-stage kidney disease, and a 50% higher frequency of heart failure; overall, mortality due to hypertension and its consequences is 4 to 5 times more likely in African Americans than in whites. The increased prevalence of hypertension and excessive target organ damage is due to a combination of genetic and, most likely, environmental factors. There are no clinical trial data at present to suggest that lower-than-usual BP targets should be set for high-risk demographic groups such as African Americans. The primary means of prevention and early treatment of hypertension in African Americans will be the appropriate use of lifestyle modification. The International Society of Hypertension in Blacks guidelines realize that most patients will require combination therapy, many of them first-line, to reach appropriate BP goals. Although certain classes and combinations of antihypertensive agents have been well-established to be effective, the choice of drugs for combination therapy in African American patients may be different. Within the African American group, the responsiveness to monotherapy with ACE inhibitors, angiotensin receptor blockers, and beta blockers may be less than the responsiveness to diuretics and calcium channel blockers, but these differences are corrected when diuretics are added to the neurohormonal antagonists. Of note, African American patients with systolic BP >15 mm Hg or a diastolic BP >10 mm Hg above goal should be treated with first-line combination therapy.
ANSWERS by heart Lifestyle + Risk Reduction High Blood Pressure What About African Americans and High Blood Pressure? The prevalence of high blood pressure in African Americans is among the highest in ...
Smith, Tanyka K.
The heterosexual transmission of HIV has affected middle-age African American women at alarming rates; yet there is a paucity of research and interventions focused on this population. This study used a qualitative approach to understand middle-age urban African American women’s experiences with HIV-related sexual risk behaviors and to identify the sexual protective strategies they employed to reduce their risk for HIV infection. Ten African American women, ages 45 to 56, were recruited from low-income neighborhoods in New York City. Data were collected using in-depth interviews and analyzed using content analysis. Investigator triangulation and member checking were used to ensure rigor. Five salient themes emerged that highlighted the individual, gender/relationship power factors, and the sociocultural elements that influenced sexual protection or risk-taking behavior. Findings provide new insight into the complexities of HIV sexual risk behavior and can guide future HIV prevention interventions for middle-age, African American, urban women. PMID:26194973
Dodd, Virginia J.; Watson, Jennifer M.; Choi, Youjin; Tomar, Scott L.; Logan, Henrietta L.
Objectives: To explore factors underlying African Americans' perceptions of oral cancer and the oral cancer exam. Study findings were used to guide development of oral cancer messages designed to increase oral cancer exams among African Americans. Methods: Focus groups were conducted to understand African Americans' attitudes and expectations…
Pope-Davis, Donald B.; Liu, William M.; Ledesma-Jones, Shannon; Nevitt, Jonathan
Examines the relationship between acculturation and racial identity among African Americans. One hundred eighty-seven African American students completed the Black Racial Identity Attitude Scale and the African American Acculturation Scale (AAAS). Acculturation was associated with three of the five AAAS subscales: Dissonance, Immersion, and…
The marketing of alcohol products in African-American communities has, on occasion, stirred national controversy and met with fierce resistance from African Americans and others. Despite occasional media and community spotlights on the marketing of alcohol products in the African-American community, there has been no systematic review of the…
Pittman, Chavella T.
This study was an examination of how African American faculty discussed their coping with racially stressful classrooms. Despite aims for racial equality in higher education, the classroom has been a significant site of racial stressors for African American facility. Analysis of interviews with 16 (8 women, 8 men) African American faculty at a…
McNeal, CoSandra; Perkins, Isaac; Lyons, Shenia
Research on African American men's health is limited. Perception and knowledge of health may have a significant effect on health seeking behavior and self care. This study was designed to examine factors that may influence health perception and knowledge among African American males. This is a cross-sectional study of 343 African American males…
Bent-Goodley, Tricia B.
Although empirical research has accumulated over the past 20 years regarding African Americans and domestic violence, many questions remain about African American perceptions of domestic violence. This article explores African American women's perceptions about domestic violence through three focus groups held at a New York social services agency.…
... Documents#0;#0; ] Proclamation 8776 of January 31, 2012 National African American History Month, 2012 By the... for the better. During National African American History Month, we celebrate the rich legacy of... African American women are not limited to those recorded and retold in our history books. Their impact...
... February 4, 2011 Part II The President Proclamation 8627--National African American History Month, 2011 #0..., 2011 National African American History Month, 2011 By the President of the United States of America A... breaking down barriers. During National African American History Month, we celebrate the vast...
Bates, Marcie Ann
Social challenges tear at the fabric of the African American family, revealing complexities that identify a de facto leader, the African American woman. She exists in a chasm of overt circumstances which heavily influences her successes. The purpose of this study is to identify factors that motivated seven female African American community college…
Washington, Karla T.; Bickel-Swenson, Denise; Stephens, Nathan
The present review was undertaken to explore recent evidence in the professional literature pertaining to use of hospice services by African Americans. The article addresses the research methods that have been used to study African American hospice use, obstacles to African American participation in hospice that have been identified, and…
African American males face numerous challenges to their physical and psychological well-being. This project is a survey of the literature and trends relative to African American males from 1987 to the present. In reviewing the fifteen years since Parham and McDavis published their now famous article on African American men as an endangered…
Schocker, Jessica B.; Woyshner, Christine
This article addresses the dearth of African American women in high school U.S. history textbooks. The authors conducted a content analysis of the images in an African American history textbook and found that black women are underrepresented. Women are found in less than 15 percent of the images in the African American history text, while they…
Holcomb-McCoy, Cheryl C.
Although the author wanted to read Bemak, Chung, and Siroskey-Sabdo's article in an objective sense, her response to their article is most likely influenced by her own experiences as an African American female and mother of an African American daughter. To her, the paramount issue facing African American females is the double and sometimes triple…
Okwumabua, Theresa M.; Walker, Kristin M.; Hu, Xiangen; Watson, Andrea
The current work presents exploratory research findings concerning African American students' attitudes toward online learning. The Online Tutoring Attitudes Scale (OTAS; Graff, 2003) was administered to 124 African American students in a positive youth development program. Findings suggest that African American students' attitudes toward…
Randolph, Schenita D; Coakley, Tanya; Shears, Jeffrey; Thorpe, Roland J
African-American males ages 13 through 24 are disproportionately affected by sexually transmitted infections (STIs) and human immunodeficiency virus (HIV), accounting for over half of all HIV infections in this age group in the United States. Clear communication between African-American parents and their youth about sexual health is associated with higher rates of sexual abstinence, condom use, and intent to delay initiation of sexual intercourse. However, little is known about African-American fathers' perceptions of what facilitates and inhibits sexual health communication with their preadolescent and adolescent sons. We conducted focus groups with 29 African-American fathers of sons ages 10-15 to explore perceived facilitators and barriers for father-son communication about sexual health. Participants were recruited from barbershops in metropolitan and rural North Carolina communities highly affected by STIs and HIV, and data were analyzed using content analysis. Three factors facilitated father-son communication: (a) fathers' acceptance of their roles and responsibilities; (b) a positive father-son relationship; and (c) fathers' ability to speak directly to their sons about sex. We also identified three barriers: (a) fathers' difficulty in initiating sexual health discussions with their sons; (b) sons' developmental readiness for sexual health information; and (c) fathers' lack of experience in talking with their own fathers about sex. These findings have implications for father-focused prevention interventions aimed at reducing risky sexual behaviors in adolescent African-American males. © 2017 Wiley Periodicals, Inc.
Stevens, Robin; Bernadini, Stephen; Jemmott, John B.
More prevention effort is required as the HIV epidemic increases among gay and transgender African American youth. Using ecological systems theory and an integrative model of behaviour change, this study examines the sexual behaviour of gay and transgender African American young people as embedded within the unique social and structural environments affecting this population. Also examined is the important role played by mobile technology in the social and sexual lives of individuals. Seven focus groups were conducted with 54 African American young adults in a northeastern U.S. city. The findings provide a rich examination of the social and sexual lives of gay and transgender African American youth, focusing on the social environment and the impact of the environment on sexual risk behaviour. PMID:23889233
Stevens, Robin; Bernadini, Stephen; Jemmott, John B
More prevention effort is required as the HIV epidemic increases among gay and transgender African American youth. Using ecological systems theory and an integrative model of behaviour change, this study examines the sexual behaviour of gay and transgender African American young people as embedded within the unique social and structural environments affecting this population. Also examined is the important role played by mobile technology in the social and sexual lives of individuals. Seven focus groups were conducted with 54 African American young adults in a northeastern US city. The findings provide a rich examination of the social and sexual lives of gay and transgender African American youth, focusing on the social environment and the impact of the environment on sexual-risk behaviour.
Chang, Edward Taehan
Presents a lesson plan that examines the economic, cultural, and ideological factors that influence Korean and African American relations. Discusses how the two groups perceive each other and situates the role of race and class in this relationship. Includes informational handouts and discussion questions. (MJP)
Zulu, Itibari M.
Examines and describes 30 African-American centered quotation and motivational books, all but one of which were published between 1993 and 1997. The books articulate a diversity of genres and themes. Annotations are divided into: (1) general quotation; (2) daily words and meditation/motivation sources; (3) religion and theology; and (4)…
Braithwaite, Harold, Jr.; And Others
Focuses on how African American students define self-concept, and whether there is a specific black self-concept. Questionnaires completed by 60 undergraduates at a historically black college provide insight into student self-esteem and support the existence of a specific black self-concept. (SLD)
Thompson, Vetta L. Sanders; Akbar, Maysa D.; Bazile, Anita
The attitudes and beliefs about utilization of mental health services of 201 African Americans, 18 years and older, are explored. One hundred and thirty-four females and 66 males participated in mixed sex focus groups conducted in an urban, Midwestern city. Discussion probes addressed participant perceptions of psychotherapists and psychotherapy,…
Irvine, Jacqueline Jordan, Ed.; Foster, Michele, Ed.
Contributors to this volume use their own stories to demonstrate success of one institution, the Catholic school system, in educating many African Americans who have gone on to make important contributions to the community. Their own experiences are the starting points for their reflections on the historical and sociological treatment of the…
Marion, Michelle S.; Range, Lillian M.
To examine the relationships buffers may have with suicide ideation, 300 African American female college students completed measures of suicide ideation and buffers. Three variables accounted for a significant and unique portion of the variance in suicide ideation: family support, a view that suicide is unacceptable, and a collaborative religious…
Knowles, Debora; Bryant, Rhonda M.
Given their tremendous professional responsibilities, professional counselors face daunting challenges to remaining healthy and avoiding role stress and overload. This article explores the intersection of race, gender, wellness, and spirituality in the self-care of African American women counselors. The authors give particular attention to…
In the Early Space Exploration Conference Center at the KSC Visitor Complex, Dr. Julian M. Earls (left), deputy director for Operations, Glenn Research Center, receives a plaque from astronaut Joan Higginbotham (right) during the 2000 African American History Month Celebration Luncheon. Dr. Earls was guest speaker at the luncheon.
In the Early Space Exploration Conference Center at the KSC Visitor Complex, the planning committee for the 2000 African American History Month Celebration Luncheon gather in the lobby. At the far left is Mack McKinney, chief, Programs Resources Management, who was chairperson for the event.
Mack McKinney (left), chief, Programs Resources Management, and Delores Abraham (right), with the Astronaut office, flank one of the posters decorating the Early Space Exploration Conference Center at the KSC Visitor Complex for the 2000 African American History Month Celebration Luncheon. McKinney is chairperson for the event.
Explores the development of behaviors by using Erik Erikson's psychosocial developmental theory, with emphasis on adolescents. Examines factors, such as identity versus identity diffusion, that may be contributing to increasing acts of violence by African American adolescents. Other factors are examined that may contribute to increased violence.…
Johnson, Bernadeia H.
Six African American female superintendents who had served as superintendents in at least 2 school districts were interviewed to understand ways in which they responded to barriers and adversity in their roles, with a particular emphasis on issues related to sexism and racism. Study participants shared that they work to engage the community and…
Green, Robert L.
This paper analyzes the relationship between levels of educational attainment and outcomes for African American males, in particular the likelihood of conflict with the criminal justice system. The analysis begins with a look at society's belief system and political and economic forces, and argues that these have combined to promote failure among…
The purpose of this study was to examine communication/reasoning, behavioral control, and trust as predictors of resourcefulness among African American children during middle childhood (6-12 years of age). Mothers who practice promotive socialization strategies are more likely to rear children who are socially competent and well adjusted. Multiple…
Allen, William D.; Olson, David H.
Developed a marital typology based on a nonrandom, national sample of 415 African American couples who took the Enriching Relationship Issues, Communication and Happiness (ENRICH) marital assessment inventory. Five marriage types were labeled as vitalized; harmonious; traditional; conflicted; and devitalized. Results were similar to findings in…
Despite a significant increase in scholarly interest for homeschooling, some of its most critical aspects, such as instructional daily practices, remain grossly understudied. This essay thus seeks to fill that void by presenting empirical evidence regarding the homeschooling practices of a specific group, African Americans. Most specifically, the…
Cazers, Gunars; Curtner-Smith, Matthew
Purpose: The purpose was to reconstruct the historical and legendary contribution of one exemplary African American physical education teacher educator who lived and worked in the Deep South prior to and immediately following the 1954 Brown v. Board of Education court case. The following questions guided data collection and analysis: To what…
Discusses the lack of African American biographies for elementary school libraries and reports the results of a study that surveyed publishers from the Children's Book Council. Examines book reviews, discusses the number of sports figures included, and considers problems with a lack of appropriate materials to support the curriculum. (LRW)
Green, Lisa J.
How do children acquire African American English? How do they develop the specific language patterns of their communities? Drawing on spontaneous speech samples and data from structured elicitation tasks, this book explains the developmental trends in the children's language. It examines topics such as the development of tense/aspect marking,…
Beale, Tyson J.
This study explored the family dynamics of persistent African American college men. These students were typical Black males, not those pre-categorized as high-achieving or unprepared for college. The stories of participants revealed their strength, ambition, and intentions to successfully gain a baccalaureate degree. In general Black males are…
Kwate, Naa Oyo A; Meyer, Ilan H
Recent theoretical and empirical studies of the social determinants of health inequities have shown that economic deprivation, multiple levels of racism, and neighborhood context limit African American health chances and that African Americans' poor health status is predicated on unequal opportunity to achieve the American Dream. President Obama's election has been touted as a demonstration of American meritocracy-the belief that all may obtain the American Dream-and has instilled hope in African Americans. However, we argue that in the context of racism and other barriers to success, meritocratic ideology may act as a negative health determinant for African Americans.
Brown, Anthony L.
Drawing from ethnographic data, this paper explores how African American male teachers working with African American male students performed their pedagogy. This paper highlights how teachers' understanding of African American males social and educational needs shaped their pedagogical performance. Interestingly however, teachers' performance was…
Andrasik, Michele P.; Nguyen, Hong V.; George, William H.; Kajumulo, Kelly F.
Although links between low mate availability and increased HIV and STI risk for African American women have been documented in the literature, we know little about the impact of limited mate choices on the quality of relationships between Black men and women and how these relationship dynamics impact risk for young Black women. We conducted a qualitative study with African American female young adults (N=12) to explore the perceived impact of structural forces on African American female young adults’ dating and sexual behavior. Participants reported (1) perceptions of Black men as untrustworthy and manipulative, (2) the limited and often negative roles for Black men in the larger Black community, and (3) heterosexual relationships in the Black community as increasingly influenced by economics and commerce. Recommendations for HIV prevention interventions that include micro and macro level approaches are discussed. PMID:27182463
Ross, L J
The history of African-American women's efforts to control their fertility is largely unknown. From slavery to the present, the growth rate of the African-American population has been cut in half. Demographers and historians frequently attribute this change to external factors such as poverty, disease, and coerced birth control, rather than the deliberate agency of African-American women. This essay assembles a brief historical record of the ways African-American women have sought to control their fertility through the use of abortion and birth control. It also examines the activism of African-American women in the establishment of family planning clinics and in defense of abortion rights.
Bluthenthal, Ricky N.; Flynn, Neil M.; Anderson, Rachel L.; Kral, Alex H.
Latinos in the United States are an ethnically diverse group disproportionately affected by HIV/AIDS. We describe HIV seroprevalence, HIV risk behaviors and utilization of health services among Mexican American injection drug users (IDUs) in California (n = 286) and compare them to White (n = 830) and African American (n = 314) IDUs. Study participants were recruited from syringe exchange programs (n = 24) in California. HIV seroprevalence among Mexican Americans (0.5%) was dramatically lower than Whites (5%) and African Americans (8%). Mexican Americans reported fewer sex-related risks than Whites and African Americans though injection-related risks remained high. Compared to Whites, Mexican Americans were more likely to participate in drug treatment during a 6 month period (AOR 1.5, 95% CI 1.1, 2.0) but less likely to receive any health care (AOR 0.6, 95% CI 0.5, 0.8). Exploring cultural and structural factors among Mexican American IDUs may offer new insights into how to maintain low rates of HIV seroprevalence and reduce barriers to health care utilization. PMID:20020194
Kim, Kwang Chung, Ed.
The essays in this collection examine relationships between the Korean American and African American communities in Los Angeles, Chicago, and New York. The contrast between the economic power and lack of political power of Korean Americans and the political power and lack of economic power of African Americans is traced. Essays 2-5 cover Los…
Towner, Senna L.; Dolcini, M. Margaret; Harper, Gary W.
Relationship dynamics develop early in life and are influenced by social environments. STI/HIV prevention programs need to consider romantic relationship dynamics that contribute to sexual health. The aim of this study was to examine monogamous patterns, commitment, and trust in African American adolescent romantic relationships. The authors also…
Murray, Ashley; Ellis, Monica U.; Castellanos, Ted; Gaul, Zaneta; Sutton, Madeline Y.; Sneed, Carl D.
We examined approaches used by African-American mothers and mothers of Latino descent for informal sex-related discussions with their children to inform sexually transmitted infection (STI)/HIV intervention development efforts. We recruited mothers (of children aged 12-15) from youth service agencies and a university in southern California.…
Donenberg, Geri R.; Emerson, Erin; Mackesy-Amiti, Mary Ellen
Objective: To examine the associations among mental health problems, maternal monitoring and permissiveness, mother-daughter communication and attachment, and sexual behaviors among African American girls receiving outpatient psychiatric care. Youths with mental health problems report higher rates of HIV-risk behavior than do their peers, and…
Clothed in her traditional African garb, Michelle Amos, mistress of ceremonies, welcomes the audience on Feb. 3 at the kick-off of African-American History Month. The theme for this year's observation is 'Heritage and Horizons: The African-American Legacy and the Challenges of the 21st Century.' February is designated each year as a time to celebrate the achievements and contributions of African Americans to Kennedy Space Center, NASA and the nation.
Old lesbians of African descent have experienced racism, heterosexism, homophobia, and ageism. This article explores the topics of aging, ageism, heterosexism, and minority stress among older African-American lesbians. The narratives and subsequent analysis offer significant contributions to the dialogue regarding Black aging lesbians in the aging and lesbian, gay, bisexual, and transgender (LGBT) communities generally and in the African-American and African-American lesbian communities specifically.
White, Michael J.; Vandiver, Beverly J.; Becker, Maria L.; Overstreet, Belinda G.; Temple, Linda E.; Hagan, Kelly L.; Mandelbaum, Emily P.
Studied the perceptions of 55 African American undergraduates about Black English. Students identified as not having a committed Black identity evaluated Black English as lower in status than those students with a committed Black identity. Black English was not perceived as reflecting higher social solidarity. (SLD)
Willie, Charles V., Ed.; Garibaldi, Antoine M., Ed.; Reed, Wornie L., Ed.
In 1987 a project was undertaken to assess the status of African Americans in the United States in the topical areas to be addressed by the National Research Council's Study Committee on the Status of Black Americans: education, employment, income and occupations, political participation and the administration of justice, social and cultural…
Ard, Jamy D; Skinner, Celette Sugg; Chen, Chuhe; Aickin, Mikel; Svetkey, Laura P
Acculturation has been associated with health-related behaviors in African Americans. We sought to determine if there is a relationship between acculturation and dietary intake in African Americans. African Americans in the PREMIER trial completed the African American Acculturation Scale (AAAS) and 2 nonconsecutive 24-h dietary recalls (n = 238). Analysis of variance (ANOVA) and canonical correlation were used to assess relationships between acculturation and dietary intakes. Canonical correlation (p = 0.05) showed that traditional African Americans had lower intakes of fruits/vegetables and milk/dairy with higher intakes of fats, meat, and nuts. This pattern was supported by differences in the ANOVA. African American acculturation is related to dietary intake. These findings have implications for the design of cancer-related public health messages targeted to African Americans.
Frye, Victoria; Williams, Kim; Bond, Keosha T; Henny, Kirk; Cupid, Malik; Weiss, Linda; Lucy, Debbie; Koblin, Beryl A
African Americans are overrepresented among heterosexual cases of HIV/AIDS in the USA. Inconsistent condom use and concurrent partnering are two sexual behaviors driving the heterosexual HIV epidemic in the African American community. To inform the development of an HIV prevention behavioral intervention to decrease concurrent partnering and increase condom use among African American heterosexual men, we conducted formative research, including 61 structured interviews, 5 focus groups with 25 men, and 30 in-depth qualitative interviews between July and December 2009. We used a grounded theoretical approach and categorizing strategies to code and analyze the qualitative data. Results around condom use confirmed earlier findings among heterosexual men in general: condoms diminish pleasure, interfere with erection, and symbolize infidelity. Although valued by some as a form of disease prevention and pregnancy prevention, condoms are often used only with specific types of female partners, such as new or casual partners, or due to visual risk assessment. Sex partner concurrency was described as normative and ascribed to men's "natural" desire to engage in a variety of sexual activities or their high sex drive, with little recognition of the role it plays in the heterosexual HIV epidemic. Fatherhood emerged among many men as a crucial life event and compelling motivation for reducing sexual risk behavior. Based on these results, we conclude that existing HIV prevention efforts to improve attitudes towards and motivate use of condoms either have not reached or have not been successful with African American heterosexual men. In designing behavioral interventions to decrease concurrent partnering and increase condom use, addressing negative attitudes towards condoms and partner risk assessment is critical, as is integrating novel motivational approaches related to identity as fathers and men in the African American community.
Smith, W; Burns, C
In Africa, the ancestral home of most African Americans, hair is viewed as the epitome of beauty. However, when Africans were brought to America as slaves, they were unable to care for their hair and skin adequately and were exposed to the predominant white culture, which valued straight hair and light skin. As a result, many African Americans lost self-esteem because of the characteristics of their hair and skin. In this article we examine the anatomic and physiologic features of African American hair and skin and typical African American hair and skin care practices. Common African American hair and skin disorders and their management are discussed. The goal of this article is to help primary care providers understand the special hair and skin care required for African American children (as well as other dark-skinned patients). With good patient education, understanding one's own hair and skin characteristics can also support positive self-esteem.
Amankwaa, Linda Clark
The purpose of this qualitative study was to describe the nature of postpartum depression (PPD) among African-American women. Twelve women, who had experienced PPD within the last three years, were interviewed for approximately one hour at two intervals. Nudist-4 software and the constant comparative method were used to analyze the data. Five themes "Stressing Out," "Feeling Down," "Losing It," "Seeking Help," and "Feeling Better" represented aspects of PPD as experienced by the participants. The last theme, "Dealing with It," represented the cultural ways in which African-American mothers managed their depression. These included Keeping the Faith, Trying to Be a Strong Black Woman, Living with Myths, and Keeping Secrets. Suggestions for future directions in nursing research are included.
Emerson, Erin; Donenberg, Geri R; Wilson, Helen W
African American girls in psychiatric care are at increased risk for HIV and sexually transmitted infection (STI) through sexual risk taking. Adolescent sexual behavior often reflects peer norms and behavior. Secure attachment patterns with mothers and peers might lessen the effects of negative peer influences and reduce sexual risk taking among African American girls. This study examined the relationships among mother-daughter and peer attachment, peer norms, and sexual-risk behaviors in African American girls seeking outpatient psychiatric care. A group of 12-16-year-old African American girls (N = 262; M age = 14.45 years) reported on their attachment to their mothers and peers, peer risk-taking and dating behaviors, peer pressure, and sexual-risk behaviors (e.g., number of partners, high-risk partners, and condom use). Structural equation modeling examined whether peer attachment and peer norms mediated the relationship between mother attachment and sexual risk. Findings supported peer norms, but not peer attachment, as a mediator of mother attachment and girls' sexual-risk behaviors. Findings revealed important family and peer factors for African American girls in psychiatric care. HIV prevention programs may be strengthened by improving mother-daughter relationships, addressing the importance of peer relationships, and emphasizing how secure mother-daughter relationships can temper the impact of peer norms.
Starr, Lisa R; Donenberg, Geri R; Emerson, Erin
The current study examines longitudinal associations between light and heavy sexual experiences and psychiatric symptoms in African American adolescent girls receiving mental health care. Research supports bidirectional associations between adolescent romantic and sexual behaviors and depression and other mental health problems, but this finding has not been examined among African American youth or in clinical samples. African American girls in psychiatric treatment suffer disparities in HIV/AIDS vulnerability, and understanding the context of girls' risk-taking (and how psychological symptoms contribute) may aid prevention efforts. Two-hundred-sixty-five African American girls seeking psychiatric care were assessed for mental health symptoms and light and heavy sexual behaviors. Participants completed a 6-month follow-up. Baseline light sexual activity predicted increased internalizing and externalizing symptoms and substance use at follow-up. Internalizing and externalizing symptoms predicted increased heavy sexual behaviors over time, including HIV-risk behaviors. Results support the association between romantic involvement and depression. Psychological symptoms may play a key role in the emergence of risky sexual behaviors among African American adolescent girls in psychiatric care and should be considered in prevention program development.
grant from the U.S. Department of Defense to study the role heredity plays in prostate cancer among African Americans. "Prostate cancer is the...visit our website at: www.creighton.edu. Creighton gets grant to study heredity -cancer link - Houston Chronicle Coogle offers Google Offers Deals on...traffic Nahan & world Politics Health News bizarre Deaths Hurncanes Creighton gets grant to study heredity -cancer link Published 04 :40a.m., Monday
Broaddus, Michelle; Owczarzak, Jill; Pacella, Maria; Pinkerton, Steven; Wright, Cassandra
The majority of research on risky sexual behavior in African American women has examined global associations between individual-level predictors and behavior. However, this method obscures the potentially significant impact of the specific relationship or relationship partner on risky sexual behavior. To address this gap, we conducted partnership-level analysis of risky sexual behavior among 718 African American women recruited from HIV counseling, testing, and referral sites in four states. Using mixed model regressions, we tested relationships between condomless vaginal intercourse with men and variables drawn from the Theory of Planned Behavior, Theory of Gender and Power, and previous research specifically on sexual risks among African American women. Significant associations with risky sexual behavior indicate the need for continued emphasis on condom attitudes, condom negotiation behaviors, and overcoming partner resistance to condoms within both main and non-main partnerships when implementing interventions designed to address HIV and sexually transmitted infection risks among African American women.
Wayland, J; Rawlins, R
The purpose of this study was to describe the childbearing African American teens' perceptions of parenting based on their own experiences. Focus group discussions were held with 17 teens in their school setting for 50 minutes each week. Group discussions were audiotaped, tapes were transcribed, and then analyzed for common themes. The unmarried teens ranged in age from 15 to 18 years. Findings indicated that the teens depended on grandmothers to provide child care and for information about parenting. The teens identified parenting problems including crying, discipline, and conflicts dealing with grandmothers and the child's father. Teens wanted more information about breastfeeding and minor childhood diseases. The researchers identified that teens lacked information about their children's growth and development and safety issues. Findings have implications for nurses who care for childbearing teens and their children; and those involved in planning and implementing parent education programs for African American teen mothers and their families. Further research is indicated with larger samples of African American teens; and to explore the context of family relationships in which teen mothers and grandmothers share parenting for the teens' children.
Lampley-Dallas, V. T.
Neuropsychological tests are instruments used to diagnose a variety of cognitive conditions. This article will review a few of the brief scales commonly used in screening for dementia. It will also discuss the properties of and problems with some of the brief scales that are commonly used to screen African Americans for dementia, highlighting the various biases. The Mini-Mental State Examination (MMSE) is the most widely known and utilized cognitive impairment instrument in the United States. Whether or not it is biased to race after adjusting the scores for educational attainment remains controversial. The Blessed Information-Memory-Concentration Test (BIMC), Blessed Orientation-Memory-Concentration Test (BOMC), Short Portable Mental Status Questionnaire (SPMSQ), and Neurobehavioral Cognitive Status Examination (NCSE) are other screening tests used to diagnose dementia. Some of these tests have been found to misclassify many more African Americans as demented compared to the proportion of whites that are misclassified. The Cambridge Cognitive Examination (CAMCOG) is the only brief neuropsychological scale designed to actually diagnose early dementia, but it is not known if it is biased for African Americans. PMID:11560287
Mahadevan, Meena; Fisher, Celia B.
The toll of HIV/AIDS and drug abuse on economically disadvantaged women of color in the United States is a public health problem of epidemic proportions. Malnutrition, believed to be pervasive in this population, exacerbates the devastating health effects of addiction and HIV. This study documented dietary deficiencies in this population and…
Broaddus, Michelle R.; Dickson-Gomez, Julia
African American young adults are at high risk of HIV infection during their lifetimes, and the male condom remains the best method of prevention. Efforts to increase condom use should address the barrier of condom negotiation. We conducted a thematic analysis of qualitative, semi-structured interviews with African American young adults to examine their use of text messaging for requesting Human Immunodeficiency Virus (HIV) or sexually transmitted infection (STI) testing and condom use within the larger context of general sexual communication using text messages. Text messaging gave participants a level of comfort and disinhibition to discuss sexual topics and negotiate sexual safety. Benefits of text messages included ease of communication, privacy, and increased ability to express condom desires. Difficulties reflected the potential relationship implications of suggesting HIV/STI testing and condom use. Condom negotiation strategies using text messages also mirrored those used found to be used in face-to-face communication. PMID:24045286
Widman, Laura; Noar, Seth M.; Golin, Carol E.; Willoughby, Jessica Fitts; Crosby, Richard
Given dramatic racial disparities in rates of HIV/STDs among African Americans, understanding broader structural factors that increase the risk for HIV/STDs is crucial. This study investigated incarceration history and unstable housing as two structural predictors of HIV risk behavior among 293 African Americans (159 men/134 women, Mage=27). Participants were recruited from an urban STD clinic in the southeastern U.S. Approximately half the sample had been incarcerated in their lifetime (54%), and 43% had been unstably housed in the past 6 months. Incarceration was independently associated with number of sex partners and the frequency of unprotected sex. Unstable housing was independently associated with the frequency of unprotected sex. However, these main effects were qualified by significant interactions: individuals with a history of incarceration and more unstable housing had more sex partners and more unprotected sex in the past three months than individuals without these structural barriers. Implications for structural-level interventions are discussed. PMID:24060677
Watkins, Daphne C.; Hudson, Darrell L.; Caldwell, Cleopatra Howard; Siefert, Kristine; Jackson, James S.
Purpose: This study examines the influence of discrimination and mastery on depressive symptoms for African American men at young (18-34), middle (35-54), and late (55+) adulthood. Method: Analyses are based on responses from 1,271 African American men from the National Survey of American Life (NSAL). Results: Discrimination was significantly…
... Documents#0;#0; #0; #0;Title 3-- #0;The President ] Proclamation 8832 of June 1, 2012 African-American Music... piece of American culture, music offers a vibrant soundtrack to the story of our people and our Union... tradition, and during African-American Music Appreciation Month, we pay special tribute to...
...#0;#0; #0; #0;Title 3-- #0;The President ] Proclamation 8684 of May 31, 2011 African-American Music Appreciation Month, 2011 By the President of the United States of America A Proclamation The music of our...-American Music Appreciation Month, we honor the rich musical traditions of African-American musicians...
Mitri, Souraya Mansour; Terry, Nicole Patton
The purpose of this study was to examine African American children's performance on a phonological awareness task that included items reflecting differences between African American English (AAE) and mainstream American English. The relationship between spoken production of AAE forms and performance on phonological awareness, vocabulary, and…
Smalls, Ruth R.
An academic achievement gap exists between European American and African American students in the United States elementary educational system. At present, the achievement gap is currently being measured by local, state, and national standardized assessments and reveals that there is a great disparity among African American and European American…
Congressional Task Force on the Future of African-Americans, Washington, DC.
This study considers the present condition of African-Americans and makes projections for the year 2000, emphasizing the relative conditions of European-Americans and African-Americans, and considering the public and private policy implications of these projections. Section 1, an overview of the subject, covers the following topics: (1) "The…
Assistance from informal caregivers such as family members, friends, or neighbors is crucial to adequately managing the complex care of heart failure (HF) patients. This study examined the lived experience of African American caregivers caring for African American patients with HF. Purposive sampling was used to recruit 10 participants who were formally interviewed. The interviews, analyzed using Colaizzi's steps, revealed six themes: layers of support, realization of self-neglect, experiencing the "blues," connecting with healthcare providers, unmet financial needs, and perception of nonadherence. The information regarding the experience of African American caregivers of HF patients obtained through this research will inform the delivery of culturally competent support to caregivers, thereby improving quality of life for both the HF patients and their caregivers.
Marks, Jay B.; Tonso, Karen L.
This essay argues that offering African American students an African-centered education is one way to promote social justice in public education. We begin with a summary of the inadequate educations offered to many African American students, and then use philosophical interpretations of equal educational opportunity to delineate the requirements…
Zhang, Amy Y.; Gary, Faye; Zhu, Hui
Background Accurately assessing depression in African American cancer patients is difficult because of the similarities of physical symptoms observed in cancer and depression. Aim To identify universal and distinctive depressive symptoms in African American cancer patients. Methods Seventy-four cancer patients (34 depressed and 23 nondepressed African Americans, and 17 depressed Whites) were interviewed. Qualitative and quantitative analyses were conducted. Results Compared to nondepressed African Americans, depressed African Americans reported irritability, social isolation, insomnia, fatigue, and crying (p ≤ .05) more frequently over time. Compared to depressed Whites, they reported sadness, frustration, and intrusive thoughts less frequently (p ≤ .05), but insomnia and fatigue more frequently (p ≤ .05) during cancer treatment. There was little racial difference at the time of interview. Conclusion Depressed African American cancer patients may benefit from more culturally sensitive depression measures that consider symptoms of irritability, social isolation, and altered expressions of depressive mood. PMID:25564890
Thompson, V L
The author clarified the African American racial-group identification process by addressing the issue of salience and its relationship to racial-group attitudes. A sample of 409 African American adults responded to surveys pertaining to their racial-group salience, racial-group attitudes, racial socialization, racial-group interaction, political activism, experiences of discrimination, and demographic data (e.g., sex, age, and income). The author tested 3 hypotheses: (a) Racial socialization and interaction with other African Americans are predictive of African American racial-identity salience; (b) discriminatory experiences are predictive of African American racial-identity salience; and (c) racial-identity salience is a stronger predictor of African American racial-group identification than are previously identified predictive variables (D. H. Demo & H. Hughes, 1990; V. L. Thompson Sanders, 1991, 1995). The results supported the 1st and 3rd hypotheses.
Ijaduola, T. G.; Smith, E. B.
This study reviews the current understanding of the pattern of breast cancer among whites, African Americans, and West Africans who have never immigrated to the US to find better ways of improving the prevention, early detection, and care of breast cancer world-wide. In the United States, the behavior pattern of breast cancer in African-American women differs from that of white women. Among the three populations, breast cancer appears to be least common in nonimmigrant West-African women. The peak incidence in African Americans and West Africans occurs around the premenopausal period while it occurs postmenopausal period in whites. Also, unlike white women, West-African and African-American women present late for treatment with a greater cancer burden and consequently lower survival rates. The predominant histological type is infiltrating ductal carcinoma in the three groups but the highest percentage (33%) of infiltrating poorly differentiated anaplastic carcinoma occurs in West Africans. Menstrual and obstetric history, obesity, and high body mass index status appear to be greater specific risk factors among African Americans than among West Africans. African Americans and West Africans have three "Ls" in common: late stage in seeking treatment, lower age at peak incidence with severe tumor burden, and consequently lower survival rates. There is a need for more detailed population-based research at molecular levels to elucidate the basis for some of these features. PMID:9770955
Michelle Amos, mistress of ceremonies for the kick-off of African-American History Month, works with the audience to assist them in the pronunciation of a few token words in native Swahili. The theme for this year's observation is 'Heritage and Horizons: The African-American Legacy and the Challenges of the 21st Century.' February is designated each year as a time to celebrate the achievements and contributions of African Americans to Kennedy Space Center, NASA and the nation.
cancer syndromes that are prevalent among African Americans? Little information exists about other familial cancer syndromes unique to African...Americans but two African-American families with Cowden’s syndrome have been reported (Fackenthal et al, 2000). The same germline p53 coding mutation and...familial syndromes based on pedigree analysis, calculation of risk estimates, and effective communication of risk status at a level that the patient can
Nava, Gerardo M; Carbonero, Franck; Ou, Junhai; Benefiel, Ann C; O'Keefe, Stephen J; Gaskins, H Rex
Reduced susceptibility to sporadic colorectal cancer in native Africans (NA) is correlated with low consumption of animal products and greater microbial production of colonic methane. In this context, two hydrogenotrophic microbial groups are of interest, methanogenic Archaea (MA) utilizing H2 to produce methane and sulfate-reducing bacteria (SRB) generating hydrogen sulfide, which has been linked with chronic inflammatory disorders of the colon. In the present study, stool samples from NA, consuming a diet high in resistant starch and low in animal products, and from African Americans (AA) and European Americans (EA), both consuming a typical Western diet, were examined for genetic diversity and structure of Archaea, MA and SRB communities. In general, a greater proportion of NA than AA and EA harboured the full range of targeted hydrogenotrophic groups. Terminal restriction fragment length polymorphism analysis of 16S rRNA genes and specific functional genes, combined with multivariate statistical analyses, revealed that NA harboured more diverse and different Archaea and MA populations than AA and EA. Also, NA harboured significantly distinct SRB populations compared with AA and EA. Taken together, these data are consistent with diet selecting for distinct hydrogenotrophic microbiota.
Bender, Melinda; Clark, Maresha; Guevara, Enrique; Chee, Wonshik; Im, Eun-Ok
Health care inequities continue to plague African Americans. For African American cancer patients these inequities include access to health care, availability of treatment modalities, support groups, and participation in nursing cancer research. A support group setting is better for recruitment than a clinical setting. Referrals to the researcher from individuals who personally know the African American cancer patients generated the best response rates. If the researcher has no previous connection with the potential participant, interest in the study may be generated but recruitment is minimal or absent. Ethnically sensitive recruitment of African American cancer patients is therefore essential to improving participatory responses in cancer nursing research.
Davis, S P
This historical reconstruction of the experiences of African American women in America from slavery to the present exposes the prevailing and enduring system of White male domination. From White men having control of their reproductive choices, to conspiracy to withhold the right to vote, African American women were victims of both sexism and racism. Later, as a result of the myth conceived by White sociologists of the super African American woman, further divisiveness became apparent in the African American home. As African American women took advantage of educational opportunities only to find that there was a dearth of similarly educated African American males to marry, increasing numbers of African American men were reported as parties to violent acts, drugs or illness. All of these variables are conjectured as impacting on the African American woman's experience. Lastly, data were presented depicting the increasing trend of African American women marrying White men, and the emergence of a more diverse workforce. It was concluded that economics serve as a catalyst for this change in human relations.
Payton, Erica; Thompson, Amy; Price, James H; Sheu, Jiunn-Jye; Dake, Joseph A
Firearm mortality is the leading cause of death for young African American males, however, few studies have focused on racial/ethnic minority populations and firearm violence. The National Black Caucus of State Legislators advocates for legislation that promotes the health of African Americans. Thus, the purpose of this study was to collect baseline data on African American legislators' perceptions regarding firearm violence in the African American community. A cross-sectional study of African American legislators (n = 612) was conducted to investigate the research questions. Of the 612 questionnaires mailed, 12 were not deliverable, and 170 were returned (28%). Utilizing a three wave mailing process, African American legislators were invited to participate in the study. The majority (88%) of respondents perceived firearm violence to be very serious among African Americans. Few (10%) legislators perceived that addressing legislative issues would be an effective strategy in reducing firearm violence among African Americans. The majority (72%) of legislators perceived the most effective strategy to reducing firearm violence in the African American community should focus on addressing societal issues (e.g. crime and poverty). After adjusting for the number of perceived barriers, the number of perceived benefits was a significant predictor of legislators' perceived effectiveness of firearm violence prevention legislation for 8 of the 24 potential firearm violence prevention legislative bills.
Plowden, Keith O; Thompson Adams, Linda; Wiley, Dana
Depression is a common mental disorder affecting individuals. Although many strides have been made in the area of depression, little is known about depression in special populations, especially African American men. African American men often differ in their presentation of depression and are often misdiagnosed. African American men are at greater risk for depression, but they are less likely to participate in mental health care. This article explores depression in African American by looking at environmental factors, sigma, role, and other unique to this populations, such as John Henryism. Interventions to encourage early screening and participation in care are also discussed.
Guda, Kishore; Veigl, Martina L.; Varadan, Vinay; Nosrati, Arman; Ravi, Lakshmeswari; Lutterbaugh, James; Beard, Lydia; Willson, James K. V.; Sedwick, W. David; Wang, Zhenghe John; Molyneaux, Neil; Miron, Alexander; Adams, Mark D.; Elston, Robert C.; Markowitz, Sanford D.; Willis, Joseph E.
We used whole-exome and targeted sequencing to characterize somatic mutations in 103 colorectal cancers (CRC) from African Americans, identifying 20 new genes as significantly mutated in CRC. Resequencing 129 Caucasian derived CRCs confirmed a 15-gene set as a preferential target for mutations in African American CRCs. Two predominant genes, ephrin type A receptor 6 (EPHA6) and folliculin (FLCN), with mutations exclusive to African American CRCs, are by genetic and biological criteria highly likely African American CRC driver genes. These previously unsuspected differences in the mutational landscapes of CRCs arising among individuals of different ethnicities have potential to impact on broader disparities in cancer behaviors. PMID:25583493
Hinch, Anjali G.; Tandon, Arti; Patterson, Nick; Song, Yunli; Rohland, Nadin; Palmer, Cameron D.; Chen, Gary K.; Wang, Kai; Buxbaum, Sarah G.; Akylbekova, Meggie; Aldrich, Melinda C.; Ambrosone, Christine B.; Amos, Christopher; Bandera, Elisa V.; Berndt, Sonja I.; Bernstein, Leslie; Blot, William J.; Bock, Cathryn H.; Boerwinkle, Eric; Cai, Qiuyin; Caporaso, Neil; Casey, Graham; Cupples, L. Adrienne; Deming, Sandra L.; Diver, W. Ryan; Divers, Jasmin; Fornage, Myriam; Gillanders, Elizabeth M.; Glessner, Joseph; Harris, Curtis C.; Hu, Jennifer J.; Ingles, Sue A.; Isaacs, Williams; John, Esther M.; Kao, W. H. Linda; Keating, Brendan; Kittles, Rick A.; Kolonel, Laurence N.; Larkin, Emma; Le Marchand, Loic; McNeill, Lorna H.; Millikan, Robert C.; Murphy, Adam; Musani, Solomon; Neslund-Dudas, Christine; Nyante, Sarah; Papanicolaou, George J.; Press, Michael F.; Psaty, Bruce M.; Reiner, Alex P.; Rich, Stephen S.; Rodriguez-Gil, Jorge L.; Rotter, Jerome I.; Rybicki, Benjamin A.; Schwartz, Ann G.; Signorello, Lisa B.; Spitz, Margaret; Strom, Sara S.; Thun, Michael J.; Tucker, Margaret A.; Wang, Zhaoming; Wiencke, John K.; Witte, John S.; Wrensch, Margaret; Wu, Xifeng; Yamamura, Yuko; Zanetti, Krista A.; Zheng, Wei; Ziegler, Regina G.; Zhu, Xiaofeng; Redline, Susan; Hirschhorn, Joel N.; Henderson, Brian E.; Taylor, Herman A.; Price, Alkes L.; Hakonarson, Hakon; Chanock, Stephen J.; Haiman, Christopher A.; Wilson, James G.; Reich, David; Myers, Simon R.
Recombination, together with mutation, is the ultimate source of genetic variation in populations. We leverage the recent mixture of people of African and European ancestry in the Americas to build a genetic map measuring the probability of crossing-over at each position in the genome, based on about 2.1 million crossovers in 30,000 unrelated African Americans. At intervals of more than three megabases it is nearly identical to a map built in Europeans. At finer scales it differs significantly, and we identify about 2,500 recombination hotspots that are active in people of West African ancestry but nearly inactive in Europeans. The probability of a crossover at these hotspots is almost fully controlled by the alleles an individual carries at PRDM9 (P<10−245). We identify a 17 base pair DNA sequence motif that is enriched in these hotspots, and is an excellent match to the predicted binding target of African-enriched alleles of PRDM9. PMID:21775986
Hinch, Anjali G; Tandon, Arti; Patterson, Nick; Song, Yunli; Rohland, Nadin; Palmer, Cameron D; Chen, Gary K; Wang, Kai; Buxbaum, Sarah G; Akylbekova, Ermeg L; Aldrich, Melinda C; Ambrosone, Christine B; Amos, Christopher; Bandera, Elisa V; Berndt, Sonja I; Bernstein, Leslie; Blot, William J; Bock, Cathryn H; Boerwinkle, Eric; Cai, Qiuyin; Caporaso, Neil; Casey, Graham; Cupples, L Adrienne; Deming, Sandra L; Diver, W Ryan; Divers, Jasmin; Fornage, Myriam; Gillanders, Elizabeth M; Glessner, Joseph; Harris, Curtis C; Hu, Jennifer J; Ingles, Sue A; Isaacs, William; John, Esther M; Kao, W H Linda; Keating, Brendan; Kittles, Rick A; Kolonel, Laurence N; Larkin, Emma; Le Marchand, Loic; McNeill, Lorna H; Millikan, Robert C; Murphy, Adam; Musani, Solomon; Neslund-Dudas, Christine; Nyante, Sarah; Papanicolaou, George J; Press, Michael F; Psaty, Bruce M; Reiner, Alex P; Rich, Stephen S; Rodriguez-Gil, Jorge L; Rotter, Jerome I; Rybicki, Benjamin A; Schwartz, Ann G; Signorello, Lisa B; Spitz, Margaret; Strom, Sara S; Thun, Michael J; Tucker, Margaret A; Wang, Zhaoming; Wiencke, John K; Witte, John S; Wrensch, Margaret; Wu, Xifeng; Yamamura, Yuko; Zanetti, Krista A; Zheng, Wei; Ziegler, Regina G; Zhu, Xiaofeng; Redline, Susan; Hirschhorn, Joel N; Henderson, Brian E; Taylor, Herman A; Price, Alkes L; Hakonarson, Hakon; Chanock, Stephen J; Haiman, Christopher A; Wilson, James G; Reich, David; Myers, Simon R
Recombination, together with mutation, gives rise to genetic variation in populations. Here we leverage the recent mixture of people of African and European ancestry in the Americas to build a genetic map measuring the probability of crossing over at each position in the genome, based on about 2.1 million crossovers in 30,000 unrelated African Americans. At intervals of more than three megabases it is nearly identical to a map built in Europeans. At finer scales it differs significantly, and we identify about 2,500 recombination hotspots that are active in people of West African ancestry but nearly inactive in Europeans. The probability of a crossover at these hotspots is almost fully controlled by the alleles an individual carries at PRDM9 (P value < 10(-245)). We identify a 17-base-pair DNA sequence motif that is enriched in these hotspots, and is an excellent match to the predicted binding target of PRDM9 alleles common in West Africans and rare in Europeans. Sites of this motif are predicted to be risk loci for disease-causing genomic rearrangements in individuals carrying these alleles. More generally, this map provides a resource for research in human genetic variation and evolution.
Pugh, Sandra Lyniece
An increase in the Mexican American population within the predominantly African American community and school was the basis of this qualitative study. The purpose of the study was to introduce African American second grade students to authentic Mexican and Mexican American children's literature. Interactive read-alouds of nonfiction and realistic…
Hankerson, Sidney H.; Lee, Young A; Brawley, David K.; Braswell, Kenneth; Wickramaratne, Priya J.; Weissman, Myrna M.
Introduction Substantial racial/ethnic disparities exist in the identification and management of major depression.1 Faith-Based Health Promotion interventions reduce disparities in health screenings for numerous medical conditions.2 However, the feasibility of systematically screening for depression in faith-based settings has not been investigated. The purpose of this study was to assess the feasibility of using a validated instrument to screen for depression in African American churches. Methods Participants were recruited between October and November 2012 at three predominantly African American churches in New York City. A participatory research approach was used to determine screening days. The Patient Health Questionnaire-9 (PHQ-9) was administered to 122 participants. Positive depression screen was defined as a PHQ-9 score ≥10. Descriptive statistics were used to report sample characteristics, prevalence of participants who screened positive, and history of help seeking. Logistic regression analyses were conducted to determine the association of positive depression screen and sociodemographic characteristics. Initial analyses were conducted in 2013, with additional analyses in 2014. Results The prevalence estimate for positive depression screen was 19.7%. More men (22.5%) screened positive than women (17.7%). Total household income was inversely related to positive depression screen. A similar percentage of respondents had previously sought help from primary care providers as from clergy. Conclusions It was feasible to screen for depression with the PHQ-9 in African American churches. The prevalence of positive depression screen was high, especially among black men. Churches may be an important setting in which to identify depressive symptoms in this underserved population. PMID:26232907
Anthony, Jean Spann; Morris, Edith; Collins, Charles W; Watson, Albert; Williams, Jennifer E; Ferguson, Bʼnai; Ruhlman, Deborah L
Many African Americans (AAs) use clergy as their primary source of help for depression, with few being referred to mental health providers. This study used face-to-face workshops to train AA clergy to recognize the symptoms and levels of severity of depression. A pretest/posttest format was used to test knowledge (N = 42) about depression symptoms. Results showed that the participation improved the clergy's ability to recognize depression symptoms. Faith community nurses can develop workshops for clergy to improve recognition and treatment of depression.
Brim, Hassan; Ashktorab, Hassan
Genome-wide studies are increasingly becoming a must, especially for complex diseases such as cancer where multiple genes and diverse molecular mechanisms are known to be involved in genes’ function alteration. In this review, we report our latest genomic and epigenomic findings in African-American colorectal cancer patients. This population suffers a higher burden of the disease and most investigators in this field are looking for the underlying genetic and epigenetic targets that might be responsible for this disparity. We here report genome-wide copy number variations, single nucleotide mutations and DNA methylation findings that might be specific to this population. PMID:27917406
Baharian, Soheil; Barakatt, Maxime; Gignoux, Christopher R; Shringarpure, Suyash; Errington, Jacob; Blot, William J; Bustamante, Carlos D; Kenny, Eimear E; Williams, Scott M; Aldrich, Melinda C; Gravel, Simon
We present a comprehensive assessment of genomic diversity in the African-American population by studying three genotyped cohorts comprising 3,726 African-Americans from across the United States that provide a representative description of the population across all US states and socioeconomic status. An estimated 82.1% of ancestors to African-Americans lived in Africa prior to the advent of transatlantic travel, 16.7% in Europe, and 1.2% in the Americas, with increased African ancestry in the southern United States compared to the North and West. Combining demographic models of ancestry and those of relatedness suggests that admixture occurred predominantly in the South prior to the Civil War and that ancestry-biased migration is responsible for regional differences in ancestry. We find that recent migrations also caused a strong increase in genetic relatedness among geographically distant African-Americans. Long-range relatedness among African-Americans and between African-Americans and European-Americans thus track north- and west-bound migration routes followed during the Great Migration of the twentieth century. By contrast, short-range relatedness patterns suggest comparable mobility of ∼15-16km per generation for African-Americans and European-Americans, as estimated using a novel analytical model of isolation-by-distance.
Barakatt, Maxime; Gignoux, Christopher R.; Errington, Jacob; Blot, William J.; Bustamante, Carlos D.; Kenny, Eimear E.; Williams, Scott M.; Aldrich, Melinda C.; Gravel, Simon
We present a comprehensive assessment of genomic diversity in the African-American population by studying three genotyped cohorts comprising 3,726 African-Americans from across the United States that provide a representative description of the population across all US states and socioeconomic status. An estimated 82.1% of ancestors to African-Americans lived in Africa prior to the advent of transatlantic travel, 16.7% in Europe, and 1.2% in the Americas, with increased African ancestry in the southern United States compared to the North and West. Combining demographic models of ancestry and those of relatedness suggests that admixture occurred predominantly in the South prior to the Civil War and that ancestry-biased migration is responsible for regional differences in ancestry. We find that recent migrations also caused a strong increase in genetic relatedness among geographically distant African-Americans. Long-range relatedness among African-Americans and between African-Americans and European-Americans thus track north- and west-bound migration routes followed during the Great Migration of the twentieth century. By contrast, short-range relatedness patterns suggest comparable mobility of ∼15–16km per generation for African-Americans and European-Americans, as estimated using a novel analytical model of isolation-by-distance. PMID:27232753
Harawa, Nina T; McCuller, William J; Chavers, Constance; Janson, Mike
We examined the frequencies of HIV-related risk factors among women reporting and not reporting sex with a man who has sex with men and women (MSMW).We used data from 15,625 visits of Black and Hispanic/Latina females, ages 15–64 years, to Los Angeles County HIV testing sites (2007–2008). The following risk factors were associated with reporting an MSMW partner: number of sex partners, use of party drugs, anal sex, and sexual partners with other risk factors. Overall, females who reported an MSMW partner differed little in their likelihood of testing HIV positive (0.93%) compared to those who did not (0.58%, p value = 0.19). Among females reporting one male sex partner, having an MSMW partner was strongly associated with HIV (2.8 vs. 0.63%, p = 0.03). Interventions targeting women who report other risky behaviors may reach many who have been with MSMW. Women with one partner are an important focus of such efforts.
McCuller, William J.; Chavers, Constance
We examined the frequencies of HIV-related risk factors among women reporting and not reporting sex with a man who has sex with men and women (MSMW). We used data from 15,625 visits of Black and Hispanic/Latina females, ages 15–64 years, to Los Angeles County HIV testing sites (2007–2008). The following risk factors were associated with reporting an MSMW partner: number of sex partners, use of party drugs, anal sex, and sexual partners with other risk factors. Overall, females who reported an MSMW partner differed little in their likelihood of testing HIV positive (0.93%) compared to those who did not (0.58%, p value =0.19). Among females reporting one male sex partner, having an MSMW partner was strongly associated with HIV (2.8 vs. 0.63%, p = 0.03). Interventions targeting women who report other risky behaviors may reach many who have been with MSMW. Women with one partner are an important focus of such efforts. PMID:22290608
Oliva, Geraldine; Rienks, Jennifer; Udoh, Ifeoma; Smith, Carla Dillard
Through forming a collaborative relationship to develop, pilot and evaluate an innovative bio-psycho-behavioral (BPB) HIV prevention intervention, capacity was built in developing an effective intervention and conducting community based research at both the California Prostitutes Prevention and Education Project (CAL-PEP) and the University of…
Edberg, Mark C.; Collins, Elizabeth; Harris, Meredith; McLendon, Hedda; Santucci, Patricia
In order to address evolving risk factors among youth in Washington, DC (District of Columbia), with respect to HIV/AIDS, sexually transmitted infections (STIs), substance abuse, and hepatitis, a targeted, community-needs assessment was conducted through a partnership between the Department of Prevention and Community Health at George Washington…
Pals, Sherri L.; Beaty, Brenda L.; Posner, Samuel F.; Bull, Sheana S.
Studies designed to evaluate HIV and STD prevention interventions often involve random assignment of groups such as neighborhoods or communities to study conditions (e.g., to intervention or control). Investigators who design group-randomized trials (GRTs) must take the expected intraclass correlation coefficient (ICC) into account in sample size…
Cooke, Ian J.; Jeremiah, Rohan D.; Moore, Nataka J.; Watson, Karriem; Dixon, Michael A.; Jordan, Gregory L.; Murray, Marcus; Keeter, Mary K.; Hollowell, Courtney M. P.; Murphy, Adam B.
In the United States, African-Americans’ (AAs) HIV infection rates are higher than any other racial group, and AA men who have sex with women (MSW) are a significant proportion of new cases. There is little research into AA MSW HIV/AIDS knowledge, barriers, and facilitators of HIV testing in Chicago. We enrolled a convenience sample of AA MSW from a community health clinic who completed self-administered surveys assessing HIV knowledge and testing-related barriers and facilitators. The survey was a combination of questions from several validated instruments, and additional questions were written based on key informant interviews with social scientists to tailor the questionnaire for AA men living on the South Side of Chicago. We recruited 20 AA MSW (mean age 47.4 years). Sixty-five percent had incomes <$10,000/year, 30% were insured, and 50% had post-secondary education. Despite low socioeconomic status, their HIV literacy was relatively high. The identified major barriers to testing were low perceived HIV risk, concerns over privacy, and external stigma at testing sites. Future efforts should focus on educating AA MSW on actual risk for HIV and address issues of privacy and stigma at testing sites. PMID:28097120
Fossett, Judith Jackson, Ed.; Tucker, Jeffrey A., Ed.
This collection of essays represents new scholarship in African American studies, drawing lessons from the past and providing insights into current intellectual trends. Topics such as the culture of America as a culture of race, legacies of slavery and colonialism, crime and welfare politics, and African American cultural studies are addressed.…
Fergus, Stevenson; Zimmerman, Marc A.; Caldwell, Cleopatra H.
Little is known of smoking trajectories or of the correlates of smoking trajectories among African American youth. Ninth-grade African American adolescents (n = 566) were interviewed in Year 1 and then were subsequently interviewed annually for 3 additional years. Five trajectories of cigarette smokers were identified: abstainers,…
Jones, Martin H.; Mueller, Christian E.; Royal, Kenneth D.; Shim, Sungok Serena; Hart, Caroline O.
Little extant research attempts to understand why rural African Americans engage in social relationships with peers in school. This is somewhat surprising as rural students' peer interactions often affect their scholastic desires, and peers can alter African Americans' academic performance. Hence, the current study examined both the presence and…
Baruth, M.; Addy, C. L.; Wilcox, S.; Dowda, M.
Objectives: Individuals may engage in more than one risk behaviour at any given time. The extent to which risk behaviours cluster among African American adults has been largely unexplored. This study examined the prevalence and clustering of three risk behaviours among African American church members: smoking; low moderate-to-vigorous intensity…
Lynch, Elizabeth B.; Holmes, Shane
Objective: Describe lay food group categories of low-income African American women and assess the overlap of lay food groups and MyPyramid food groups. Design: A convenience sample of African American mothers from a low-income Chicago neighborhood performed a card-sorting task in which they grouped familiar food items into food groups. Setting:…
There is more to Black History Month than honoring Martin Luther King Jr. Black History Month is a time to honor the significant contributions of African-Americans throughout history. This article presents 20 super-achievers new generation of African-Americans heroes students should meet: (1) Kimberly Oliver; (2) John Lewis; (3) Rita Dove; (4)…
Rivers, Celeste A.
For many decades, society has struggled with academic underachievement, particularly among African American males. Although a myriad of studies have identified significant causal factors of African American academic underachievement from the perspectives and circumstances of the student, limited studies focus on this problem from the perspective…
Moore-Thomas, Cheryl; Day-Vines, Norma L.
Religion and spirituality are deeply rooted in traditional African American culture. Data suggest that African American adolescents maintain higher baseline rates of religious activities and beliefs than their peers (Bachman, Johnston, & O'Malley, 2005; Smith, Faris, Denton, & Regnerus, 2003). Recognizing these data, this article examines…
The education of African American ministers in the United States has been little researched. Numerous books address the profession of ministry and the education of Blacks in general, but most do not specifically address issues pertaining to the professional education of Black ministers. The majority of the hurdles African Americans faced were…
Discusses an interview in which Marcyliena Morgan elaborates on the necessity to analyze both microlinguistic issues of grammar and phonology as well as larger issues of discourse pragmatics and language ideology. The interview touches on African American poetry, the convergence of African American and standard English, and oases and indirectness.…
Rowles, Joanna; Duan, Changming
Racial discrimination has negatively affected African Americans in the United States for centuries and produced one of the most publicly recognized histories of social oppression. Extensive research has shown the deleterious effects of racism on African American people and clearly demonstrated that perceived racism and discrimination may…
Adenika-Morrow, T. Jean
Two reasons African American females do not pursue science careers are the need for immediate employment and lack of tools to negotiate the racism and sexism that undermine their aspirations for success. This article describes intervention strategies in an Afrocentric school and a medical magnet school that encourage African American girls to…
Love, Keisha McGhee
African American college students attending predominately White institutions often encounter stressors that their Caucasian peers do not experience. Because of these unique stressors, African American students are more prone to experience psychological distress. Identifying factors that counteract psychological distress among these students is…
Boyd-Franklin, Nancy; Franklin, A. J.
This guide to rearing African American boys offers simple and effective strategies for problem-solving, improving communication, and instilling a positive racial identity. The book draws on strong African American family values and cultural and spiritual strengths. The chapters are: (1) "You Must Act As If It Is Impossible To Fail: Challenges…
McGee, Zina T.
Reviews types of reported problems among African American youth exposed to violence and victimization. A substantial number of African American youth reported being exposed to direct victimization while in transit to and from school. Discusses the impact of violence on mental health status, in that subjects exposed to violence exhibited…
Mwachofi, Ari K.
The purpose of this study was to determine changes in African Americans' access to occasional rehabilitation (VR) services subsequent to landmark legislative and judicial antidiscrimination provisions of the mid-20th century. This study compared African American VR access before the antidiscrimination legislation in 1937 and after the legislation…
Lamme, Linda Leonard; Astengo, Be; Lowery, Ruth McCoy; Masla, Diane; Russo, Roseanne; Savage, Debbie; Shelton, Nancy Rankie
Exciting stories about African Americans in recently published historical fiction books for children concern Pea Island Life-Station, a private school for African American girls, a biracial slave, a black woman who homesteads for land in 1889, and an orphan who travels on his own to Flint, Michigan, during the Depression. Much of this history…
Moore, Penelope J.; Hazell, LaVone V.; Honeyghan, Edna M.
Bereavement educators, counselors, clergy, and other specialists have observed that African Americans tend to under-utilize end-of-life palliative care services and general bereavement resources. The literature suggests that involving clergy in outreach to the African American community may be a viable strategy for developing bereavement supports.…
Pringle, Beverley E.; Lyons, James E.; Booker, Keonya C.
African American high school students are performing behind their White classmates regardless of whether they are in majority or minority populations at school. Teacher expectations, among school-related factors that can impact the academic achievement of African American high school students, are the focus of this study. Interviews were conducted…
Ryujin, Donald H.; Abitia, Fred B.
Self-esteem may be an issue for certain minority groups more than others. In particular, given their long and difficult history, this issue may be of more relevance to minorities of African-American descent. To assess whether renewed signs of racism at a college were negatively affecting the self-esteem of African-American students the Race…
Day-Vines, Norma L.; Barto, Heather H.; Booker, Beverly L.; Smith, Kim V.; Barna, Jennifer; Maiden, Brian S.; Zegley, Linda; Felder, Monique T.
African American English (AAE) refers to the systematic, rule-governed linguistic patterns of found among African Americans. This article provides an overview of AAE. More specifically, the article enumerates the historical underpinnings associated with AAE, identifies a representative set of AAE characteristics, reviews relevant research, and…
Hunter, Herbert M.
Examines African American employment trends compared with increases or decreases in economic growth and Federal welfare spending during the 1970s and 1980s, focusing primarily on unemployment and labor force participation rates among African American youth. Studies the impact of structural unemployment, racial discrimination, and immigration on…
Griffin, Tiffany Monique; Chavous, Tabbye; Cogburn, Courtney; Branch, LaToya; Sellers, Robert
Drawing from existing literature, the authors conceptualized a two-dimensional framework of African American students' academic contingencies of self-worth. The results from exploratory and confirmatory factor analyses with a sample of African American college freshmen (N = 330) supported this prediction. Self-Worth Dependent academic…
Sapp, Marty; Hitchcock, Kim
The purpose of this study was to assess the reliability of the General Dissociation Scale with African American college students, and provide additional data on how to assess hypnotizability with these students. Two-hundred and two undergraduate African American college students participated in this study. Students completed the HGSHS:A, a measure…
Shropshire, Delia F. B.
The purpose of the study was to determine to what extent teaching style relates to third grade African American male academic achievement. The problem in this study addressed the factors affecting the academic achievement of the African American third grade male. This problem led the researcher to investigate the teaching styles of the…
The first plenary of the EPEC-O (Education in Palliative and End-of-Life Care for Oncology) Self-Study: Cultural Considerations When Caring for African Americans explores the many factors that lead to inequalities in cancer care outcomes for African Americans.
The sixteenth module of the EPEC-O (Education in Palliative and End-of-Life Care for Oncology) Self-Study: Cultural Considerations When Caring for African Americans explores the importance of spirituality in the lived experience of most African Americans, and how they utilize spirituality and religion to cope with serious stressors such as life-threatening illness.
Kang, Haijun; Yang, Yang
This study examines how various life factors and personal attributes affect African American adult learners' use of the three types of learning interaction-learner-content, learner-instructor, and learner-learner. Multivariate multiple regression analyses were used. The aggregate effect of life factors on African American adult learners' use of…
Watson, Jeffrey A.; Randolph, Suzanne M.; Lyons, James L.
More than 18,000 adolescents die each year in the United States from bicycle, motorcycle, car, and truck accidents. This study sought to understand the role of African-American grandmothers as prevention-oriented health educators in the family. Full Model Fitted Regression Analyses were conducted on a sample of African-American grandmothers (N =…
The long road of slavery from generation to generation has left a legacy in the mind of African American students that has impacted their achievements in schools. In this project, the struggle of African American students in the public school education will be analyzed from the historical standpoint of view and its impact on their achievements.…
Marbley, Aretha Faye; Rouson, Leon
For the African-American family, life ain't been no crystal stair. The African-American family has trotted for over 400 years through a wilderness of racism, poverty, discrimination of all kinds, crossing seas of monsters and forests of demons. Yet, despite the numerous obstacles and attacks that society has mounted against it since slavery, the…
When the author proposed a spring course on major topics in African-American history, drawing a large enrollment was her chief concern. She had previously taught the course under a different title at the University of Illinois at Urbana-Champaign, a campus with a sizable African-American presence among students and faculty members. She now teaches…
Snowden, Lonnie R
African Americans' poverty and deep-poverty rates are higher than those of Whites, and African Americans' poverty spells last longer. Furthermore, nonpoor African Americans are especially likely to slip into poverty, and over the course of a lifetime, very many African Americans will experience poverty. Accordingly, African Americans are disproportionately likely to be assisted by safety net programs providing income support and health and social assistance. When mental health-related outcomes are assessed, U.S.-focused and international studies of safety net programs sometimes find that adults and children show a decline in symptoms of mental illness after participating. All things being equal, these improvements can disproportionately benefit African Americans' mental health. Safety net programs' mental health-related impact should be routinely assessed when evaluating the programs' economic and social outcomes and the impact they have on African Americans' mental health. Policy research of this kind can help us to understand whether these very large interventions show society-wide mental health-related improvement in the disproportionately large number of African Americans who participate in them.
President Obama signed the "White House Initiative on Educational Excellence for African Americans" on July 26, 2012. This executive order recognizes that many "African Americans lack equal access to highly effective teachers and principals, safe schools, and challenging college preparatory classes, and disproportionately experience…
Combs, Dennis R.; Penn, David L.; Cassisi, Jeffrey; Michael, Chris; Wood, Terry; Wanner, Jill; Adams, Scott
Recent theoretical models suggest that perceived racism acts as a stressor for African Americans and may be associated with a variety of negative psychological consequences, notably paranoia. Paranoia among African Americans is believed to reflect the lower end of the paranoia continuum based on experiences with racism. Thus, it may be beneficial…
Thomas, Janet L.; Stewart, Diana W.; Lynam, Ian M.; Daley, Christine M.; Befort, Christie; Scherber, Robyn M.; Mercurio, Andrea E.; Okuyemi, Kolawole S.; Ahluwalia, Jasjit S.
Objectives: To examine social support needs of obese and overweight African American women for weight loss. Methods: Focus groups were conducted with overweight and obese African American women. Data were analyzed using standard grounded theory text analysis. Results: Our middle-aged (45.7 years; SD = 12.6) women (N = 66) were interested in…
Ratute, Ashley; Marcketti, Sara B.
Educating students to embrace diversity and value all people is a core value of educators in family and consumer sciences (FCS). For instructors in FCS, integrating the contributions of African Americans--particularly in textiles and clothing--can be an inclusive learning opportunity. The authors compiled resources on African Americans and…
This paper describes an effort to provide prospective teachers opportunities to better understand African American male students and better focus on how they learn mathematics. Prospective teachers spent 15 hours over an eight week span mentoring and tutoring African American males without the guise of practicing teachers. Qualitative data drawn…
... Documents#0;#0; ] Proclamation 8930 of January 31, 2013 National African American History Month, 2013 By the... beginnings or the circumstances of your birth, you can make it if you try. Yet, for many and for much of our Nation's history, that dream has gone unfulfilled. For African Americans, it was a dream denied until...
Jackson, Sondra, Ed.; Brissett-Chapman, Sheryl, Ed.
This collection brings together articles by African American authors who are committed to research, policies, and programs affecting African American children and families. The articles are grouped into sections on policy, research, and practice issues; clinical techniques and treatment models; and new perspectives in child welfare. The following…
Keyes, Angela W.; Smyke, Anna T.; Middleton, Melissa; Black, Corey L.
The legacy of slavery in the United States has impacted generations of African Americans, especially parents who must prepare their children to face the challenges associated with being a person of color in this country. The authors explore aspects of racism, White privilege, racial socialization, and African American parents' fears as they equip…
Mazama, Ama; Lundy, Garvey
Homeschooling, and academic interest in this phenomenon, have increased tremendously over the last decade. The surge of African American involvement in the homeschool movement has also become noticeable. However, there continues to be a general paucity of research on the motivations of African American parents that choose homeschooling. In order…
Black Issues in Higher Education, 2004
African Americans have a significantly lower response rate to treatment for chronic hepatitis C than non-Hispanic Whites, according to a new study led by Duke University Medical Center researchers. Some African Americans--19 percent--did respond to the drug combination of peginterferon alfa-2b and ribavirin. But in non-Hispanic Whites with the…
Scott, Kimberly Ann
For an African American female researcher whose race, class, and gender work as oppressive intersecting units shaping my contextualized experiences, meaning-making, and self-definition, the implications of my work with African American communities are complicated. In this article, I draw on culturally sensitive research practices, critical race…
Clardy, Pauline; Cole-Robinson, Cynthia; Jones, Terrence O'C.; Michie, Gregory
In studying urban schools, researchers have identified several critical curriculum issues related to the miseducation and alienation of African American students. This paper looks at three such issues: the disconnection between the school curriculum and African American students' cultural backgrounds and environments (e.g., black dialect versus…
Intergenerational kinship and multigenerational families (three or more generations) have been a source of strength for African Americans. This article presents a culturally responsive intergenerational practice model for working with African American families that draws on this legacy. The model looks at intergenerational kinship and…
Although academic performance is a concern, African American students represent less than 8 percent of California's K-12 students, and at times get lost in California policy debates about improving student performance. Findings of this study indicate that: (1) California's African American students are concentrated in relatively few counties and…
Dickens, Manuel Dewayne
The purpose of this qualitative case study that consists of six African American male participants is to examine, describe, and analyze African American male persistence factors at a community college in the midwest of the United States. The study uses qualitative content analysis as a research method that provides a systematic and objective means…
... June 6, 2013 Part III The President Proclamation 8992--African-American Music Appreciation Month, 2013... May 31, 2013 African-American Music Appreciation Month, 2013 By the President of the United States of... lasting freedom. Through every generation, music has reflected and renewed our national...
...#0;#0; #0; #0;Title 3-- #0;The President ] Proclamation 8527 of May 28, 2010 African-American Music Appreciation Month, 2010 By the President of the United States of America A Proclamation Music can tell a story..., music unites individuals through a shared heritage. During African-American Music Appreciation Month,...
Early laws prohibited African Americans from learning to read and write in the United States. The right to an education has produced a significant number of African American women acquiring higher education. Racial and gender diversity at the presidential level in higher education 4-year institutions appears to be changing rapidly. The data…
Johnson, James H., Jr.
Presents a geographical analysis of African American migration estimates compiled by the Census Bureau for the 1980-85 period. Argues that structural changes in employment opportunities and the housing affordability crisis in some of the nation's largest metropolitan areas are the dominant forces influencing current African American population…
Ennis, Willie, Jr.; Ennis, Willie, III; Durodoye, Beth A.; Ennis-Cole, Demetria; Bolden, Vernie L.
In this article the authors describe a model counseling ministry within an African American church and discuss how the larger body of professional counselors can interface with similar programs and institutions that are a source of strength for many African Americans. Implications of the model for professional counselors are also discussed. The…
relationship between affective eating and depressive symptoms  has been found in Caucasian females. Cultural dietary practices, body weight ideals, and...dissatisfaction among Caucasian compared to African American college students ; however, African American subsamples including postpartum [16...reported history of heart disease, uncontrolled hypertension, thyroid disease, diabetes, tobacco use, mental health disorder diagnosis, anti- depressant
Schiele, Jerome H.
Surveyed 300 African-American social work faculty concerning their scholarly productivity in terms of published journal articles. Found that African-American social work doctorates publish just as much as do other social work doctorates and that younger age (31-40) for receiving the doctorate is associated with higher publication rates. (KS)
Disparities in asthma management are a burden on African American youth. The objective of this study is to describe and compare the discourses of asthma management disparities (AMDs) in African American adolescents in Seattle to existing youth-related asthma policies in Washington State. Adolescents participated in a three-session photovoice…
Kusimo, Patricia S.
This paper examines the interests, perceptions, and participation of 16 African American girls in a program designed to improve girls' persistence in science, mathematics, and technology (SMT). The girls are among 33 African American and 73 total original participants in "Rural and Urban Images: Voices of Girls in Science, Mathematics, and…
Goodman, Diane J.
Focuses on the experiences of African-American women; and considers the interaction of sex and race in the development of sense of self, sense of self in relation to others, and ontology through interviews with 12 African-American women. Similarities among women across race are suggested. (SLD)
Examines pressures facing the African American press by focusing on its coverage of the 1991 nomination of Clarence Thomas to the United States Supreme Court. Discusses the dilemma these newspapers faced in choosing between supporting African Americans and supporting civil rights, with their mixed coverage of the story reflecting this dilemma. (SR)
Komarraju, Meera; Cokley, Kevin O
The current study examined ethnic differences in horizontal and vertical dimensions of individualism and collectivism among 96 African American and 149 European American college students. Participants completed the 32-item Singelis et al. (1995) Individualism/Collectivism Scale. Multivariate analyses of variance results yielded a main effect for ethnicity, with African Americans being significantly higher on horizontal individualism and European Americans being higher on horizontal collectivism and vertical individualism. A moderated multiple regression analysis indicated that ethnicity significantly moderated the relationship between individualism and collectivism. Individualism and collectivism were significantly and positively associated among African Americans, but not associated among European Americans. In addition, collectivism was related to grade point average for African Americans but not for European Americans. Contrary to the prevailing view of individualism-collectivism being unipolar, orthogonal dimensions, results provide support for individualism-collectivism to be considered as unipolar, related dimensions for African Americans.
Vinci, Debra M; Philipp, Steven F
This descriptive study compares African Americans' and Euro-Americans' perceived value of food selection pertaining to cost, portion size, and meal satisfaction when eating away from home. A stratified sample was drawn from a southern U.S. metropolitan area (N= 1,011; 486 African American, 525 Euro-American). Analysis showed no difference between African-American and Euro-American adults by sex or how often they dined out. These two groups significantly differed across years of education, age, and answering 14 of 18 rated statements on value perceptions. African-Americans' value perceptions were influenced more by lower cost foods and larger portion sizes than those of Euro-Americans. For meal satisfaction, African Americans were more likely to agree with statements that indicate preferring foods high in energy and low in essential micronutrient density. This study supports the need for more investigation.
Bryc, Katarzyna; Auton, Adam; Nelson, Matthew R; Oksenberg, Jorge R; Hauser, Stephen L; Williams, Scott; Froment, Alain; Bodo, Jean-Marie; Wambebe, Charles; Tishkoff, Sarah A; Bustamante, Carlos D
Quantifying patterns of population structure in Africans and African Americans illuminates the history of human populations and is critical for undertaking medical genomic studies on a global scale. To obtain a fine-scale genome-wide perspective of ancestry, we analyze Affymetrix GeneChip 500K genotype data from African Americans (n = 365) and individuals with ancestry from West Africa (n = 203 from 12 populations) and Europe (n = 400 from 42 countries). We find that population structure within the West African sample reflects primarily language and secondarily geographical distance, echoing the Bantu expansion. Among African Americans, analysis of genomic admixture by a principal component-based approach indicates that the median proportion of European ancestry is 18.5% (25th-75th percentiles: 11.6-27.7%), with very large variation among individuals. In the African-American sample as a whole, few autosomal regions showed exceptionally high or low mean African ancestry, but the X chromosome showed elevated levels of African ancestry, consistent with a sex-biased pattern of gene flow with an excess of European male and African female ancestry. We also find that genomic profiles of individual African Americans afford personalized ancestry reconstructions differentiating ancient vs. recent European and African ancestry. Finally, patterns of genetic similarity among inferred African segments of African-American genomes and genomes of contemporary African populations included in this study suggest African ancestry is most similar to non-Bantu Niger-Kordofanian-speaking populations, consistent with historical documents of the African Diaspora and trans-Atlantic slave trade.
Bell, N H
Important differences exist in the metabolism of bone and mineral and the vitamin D endocrine system between whites and African Americans and include rate o f skeletal remodeling, bone mass, and vitamin D metabolism. A higher bone mineral density (BMD) in African Americans is associated with a diminished incidence o f osteoporosis and fractures. Serum 17beta-estradiol and the rate of GH secretion are higher in black than in white men, but there is no racial difference in women in this regard. The mechanisms for reduced rate o f skeletal remodeling and for greater BMD in blacks are not known, but diminished rate of skeletal remodeling could be a contributing factor for greater bone mass. Reduction in serum 25-hydroxyvitamin D in blacks is attributed to increased skin pigment and to diminished dermal production of vitamin D(3) and consequent decreased hepatic synthesis o f the metabolite. There is no evidence that alteration of the vitamin D endocrine system contributes to or is responsible for racial differences in skeletal remodeling and bone mass. Black infants, however, are at risk for developing vitamin D-deficient rickets, particularly when breast-fed.
Morales, Dawn A.; Coyne-Beasley, Tamera; St. Lawrence, Janet
Sexual schemas are cognitive representations of oneself as a sexual being and aid in the processing of sexually relevant information. We examined the relationship between sociosexuality (attitudes about casual sex), masculine ideology (attitudes toward traditional men and male roles), and cultural centrality (strength of identity with racial group) as significant psychosocial and sociocultural predictors in shaping young, heterosexual African American men's sexual schemas. A community sample (n=133) of men in a southeastern city of the United States completed quantitative self-report measures examining their attitudes and behavior related to casual sex, beliefs about masculinity, racial and cultural identity, and self-views of various sexual aspects of themselves. Results indicated that masculine ideology and cultural centrality were both positively related to men's sexual schemas. Cultural centrality explained 12 % of the variance in level of sexual schema, and had the strongest correlation of the predictor variables with sexual schema (r=.36). The need for more attention to the bidirectional relationships between masculinity, racial/cultural identity, and sexual schemas in prevention, intervention, and public health efforts for African American men is discussed. PMID:24031118
Slavinsky, J.; Rosenberg, D. M.; DiCarlo, R. P.; Kissinger, P.
The known link between sexually transmitted diseases (STD) and human immunodeficiency virus (HIV), coupled with the increasing prevalence of HIV in African-American men, makes understanding STD transmission trends in this group important for directing future preventive measures. The goal of this study was to determine if self-reported behavioral factors are predictive of incident sexually transmitted diseases in a group of high risk, HIV-negative African-American men. Five hundred and sixty-two "high risk" (defined as having four or more partners in the last year or having been diagnosed with an STD in the last year) HIV-negative African-American men were administered a baseline behavioral survey and followed to detect an incident STD. Overall, 19% (n = 108) of the patients acquired an incident STD during the study period. In multivariate Cox proportional hazards analysis, the only factor associated with an incident STD was age < or = 19 (hazard ratio, 2.16; 95% confidence interval, 1.03 to 4.54). No other risk factors were statistically significant. In conclusion, self-reported behavioral factors, such as substance use and sexual practices, do not seem to be a good measure of STD risk among a group of high risk, HIV-negative, African-American men. PMID:10946531
VanTyler, Samaya; Sheilds, Laurene
In this study researchers explored the daily experiences of HIV+ women living in Kibera, Kenya. Using a convergence of narrative, feminist, and indigenous approaches, we engaged in individual in-depth interviews with nine HIV+ women. Interpretive storylines include the following: Being an African woman; If I sit there, that 10 bob won't come; If I die, who will take care of my children?; I am stigma; They just come to you; Being up, feeling down, and stress-up; and Living with HIV is a challenge. We present our findings to provide evidence-based insights to better support HIV+ women living in poverty.
Murrock, Carolyn J.; Gary, Faye A.
This article provides evidence of a culturally specific dance intervention to decrease obesity as measured by body fat and body mass index (BMI) in African American women. A community partnership was formed with two African American churches to develop an intervention to address the issue of obesity. The culturally specific dance intervention was delivered two times per week for 8 weeks, choreographed to gospel music selected by the experimental group participants, and taught by an African American woman. Body fat and BMI were assessed at three time points and revealed significant differences between the two groups. Attending a minimum of 7 classes was enough to show an observed dose effect and the intervention was found to be culturally specific by understanding their roles as African American women. This community partnership was an effective way to promote a church-based, culturally specific dance intervention to improve the health of African American women. PMID:19098267