Straight Talk: HIV Prevention for African-American Heterosexual Men: Theoretical Bases and Intervention Design

PubMed Central

Frye, Victoria; Bonner, Sebastian; Williams, Kim; Henny, Kirk; Bond, Keosha; Lucy, Debbie; Cupid, Malik; Smith, Stephen; Koblin, Beryl A.

2016-01-01

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 two-thirds of all heterosexually acquired HIV/AIDS cases between 2005 and 2008. Few demonstrated efficacious HIV prevention interventions designed specifically for adult, African-American heterosexual men exist. Here, we describe the process used to design a theory-based HIV prevention intervention to increase condom use, reduce concurrent partnering, and increase HIV testing among heterosexually active African-American men living in high HIV prevalence areas of New York City. The intervention integrated empowerment, social identity, and rational choices theories and focused on four major content areas: HIV/AIDS testing and education; condom skills training; key relational and behavioral turning points; and masculinity and fatherhood. PMID:23016501

Evaluating leadership training in African American HIV prevention organizations.

PubMed

Coleman, Jason D; Dauner, Kim Nichols; Richter, Donna L; Annang, Lucy; Sellers, Denethia B; Lindley, Lisa L

2011-09-01

This article aimed to examine changes in the HIV prevention capacity of HIV prevention program managers who completed the Institute for HIV Prevention Leadership ("Institute") between 2002 and 2004, and who worked in community-based organizations that primarily served African Americans. Participants completed a survey at three points in time, in which they rated the frequency with which they conducted activities related to HIV prevention practice. Participants also rated their confidence in performing activities. Repeated measures ANOVA was conducted to detect differences at three time points (baseline, immediate posttest, and 6 months posttest). A significant overall positive trend was found in the frequency and confidence of participants to perform specific HIV prevention practices and an overall positive trend in the frequency of processes that support HIV prevention practice. Investment in long-term, intensive, capacity-building programs like the Institute is critical to address the increasing incidence of HIV in many African American communities.

A Mid-South Perspective: African American Faith-based Organizations, HIV, and Stigma.

PubMed

Otey, Tamara D; Miller, Wendy Renee

2016-01-01

Shelby County, Tennessee has the fastest growing rate of HIV infection in the state, and the majority of new infections are in African Americans. In 2011, a Centers for Disease Control and Prevention report stated that Memphis (the largest city in Shelby County) ranked seventh highest in new HIV infections. Little research has addressed HIV-related themes in African American culture that could hinder HIV prevention measures. Our qualitative study engaged African American, faith-based leaders in areas with high rates of HIV in meaningful conversations regarding their attitudes toward HIV and those who are infected. Although faith-based leaders felt they had a role in HIV prevention, only 4% in our study had participated in HIV prevention activities, but they were open to HIV prevention programs. We found that faith-based leaders had limited knowledge of health disparities and ongoing stigma concerning HIV, which served as a major barrier to HIV prevention. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Project Eban: An HIV/STD Intervention for African American Couples

PubMed Central

2010-01-01

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

Risk and protection for HIV/AIDS in African-American, Hispanic, and White adolescents.

PubMed

Bartlett, Robin; Buck, Raymond; Shattell, Mona M

2008-07-01

African-Americans and Hispanics are disproportionately affected by HIV/AIDS in the United States. HIV infection is often acquired during adolescence, a time when risky sexual behaviors are at their peak. This study explored relationships among selected risk factors, protective factors, and risky sexual behaviors among African-American, Hispanic, and White adolescents, from a sample of adolescents from the National Longitudinal Study of Adolescent Health. African-Americans and Hispanics were more likely to have sexual intercourse without the use of birth control than were Whites. African-Americans were more likely to have sexual behavior with multiple sexual partners than either Hispanics or Whites were, and African-Americans had higher self-esteem than did Hispanics and Whites. In order to develop culturally sensitive, effective interventions to prevent HIV/AIDS in adolescents, racial differences in risk and protective factors must be examined.

Stigma Reduction Among African American Women with HIV: UNITY Health Study.

PubMed

Rao, Deepa; Kemp, Christopher G; Huh, David; Nevin, Paul E; Turan, Janet; Cohn, Susan E; Simoni, Jane M; Andrasik, Michele; Molina, Yamile; Mugavero, Michael J; French, Audrey L

2018-03-08

African American women encounter disproportionately high rates of HIVrelated morbidity and mortality which is partially mediated through stigma and its effect on HIV treatment adherence. To assess the effect of the UNITY peer support workshop on HIV-related stigma among African American women living with HIV, compared to a time and attention control group. African American women living with HIV were randomized to the UNITY workshop or a breast cancer education control group. Interventions took place in HIV clinics in Chicago, IL and Birmingham, AL. Participants self-reported HIV-related stigma and social support at baseline, post-workshop, and 4 follow-up visits over 12 months. 239 participants (UNITY n=124; breast cancer education n=115) were assessed over one year. Both arms experienced decreases in mean stigma scores over time. Our model estimated that allocation to UNITY was not associated with a significant difference in stigma points over time. Post-hoc analysis suggested that preceding increases in perceived social support are associated with decreased HIVrelated stigma in this population. Although UNITY did not significantly reduce HIV-related stigma in this population, our findings suggest that social support may be key to HIV-related stigma reduction.

Conspiracy beliefs about HIV/AIDS among HIV-positive African-American patients in rural Alabama.

PubMed

Zekeri, Andrew A; Habtemariam, Tsegaye; Tameru, Berhanu; Ngawa, David; Robnett, Vinaida

2009-04-01

This is apparently the first survey examining endorsement of HIV/ AIDS conspiracy beliefs and their relations to educational attainment among 205 HIV-positive African-American patients receiving care at an AIDS Outreach Organization in Alabama. 31% somewhat or strongly believed that, "AIDS is a form o genocide against African Americans," 29% strongly agreed that "AIDS was created by the government to control the black population," 56.1% agreed that the government is withholding a cure for AIDS, and 69.8% agreed that the government is withholding information about the disease from the public. 52% agreed that "HIV is a manmade virus," and 43.1% that "AIDS was produced in the governments laboratory." Respondents with high school or college education were less likely to endorse conspiracy liefs. Being open and sensitive to questions about conspiracy beliefs plus understanding the historical roots and social context from which such questions arise in African-American communities is needed to counter such beliefs.

Predictors of HIV/AIDS Programming in African American Churches: Implications for Prevention, Testing and Care

PubMed Central

Stewart, Jennifer M.; Hanlon, Alexandra; Brawner, Bridgette M.

2017-01-01

Using data from the National Congregational Study, we examined predictors of having a HIV/AIDS program in predominately African American churches across the United States. We conducted regression analyses of Wave II data (N = 1,506) isolating the sample to churches with a predominately African American membership. The dependent variable asked whether or not the congregation currently had any program focused on HIV or AIDS. Independent variables included several variables from the individual, organizational, and social levels. Our study revealed that region, clergy age, congregant disclosure of HIV-positive status, permitting cohabiting couples to be members, sponsorship or participation in programs targeted to physical health issues and having a designated person or committee to address health-focused programs significantly increased the likelihood of African American churches having a HIV/AIDS program. A paucity of nationally representative research focuses on the social, organizational and individual level predictors of having HIV/AIDS programs in African American churches. Determining the characteristics of churches with HIV/AIDS programming at multiple levels is a critical and necessary approach with significant implications for partnering with African American churches in HIV initiatives. PMID:27540035

Spirituality: a cultural strength for African American mothers with HIV.

PubMed

Polzer Casarez, Rebecca L; Miles, Margaret Shandor

2008-05-01

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.

What’s God got to do with it? Engaging African American faith-based institutions in HIV prevention

PubMed Central

Nunn, Amy; Cornwall, Alexandra; Thomas, Gladys; Waller, Pastor Alyn; Friend, Rafiyq; Broadnax, Pastor Jay; Flanigan, Timothy

2013-01-01

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 United State’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 program, we provide a roadmap for engaging African American faith communities in HIV prevention that include 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 for reducing racial disparities in HIV infection. PMID:23379422

A one-size-fits-all HIV prevention and education approach?: Analyzing and interpreting divergent HIV risk perceptions between African American and East African immigrant women in Washington, DC

PubMed Central

De Jesus, Maria; Taylor, Juanita; Maine, Cathleen; Nalls, Patricia

2015-01-01

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

HIV Risk Behaviors among African American Women with at-Risk Male Partners

PubMed Central

Paxton, Keisha C.; Williams, John K.; Bolden, Sherica; Guzman, Yesenia; Harawa, Nina T.

2014-01-01

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

Straight Talk: HIV Prevention for African-American Heterosexual Men--Theoretical Bases and Intervention Design

ERIC Educational Resources Information Center

Frye, Victoria; Bonner, Sebastian; Williams, Kim; Henny, Kirk; Bond, Keosha; Lucy, Debbie; Cupid, Malik; Smith, Stephen; Koblin, Beryl A.

2012-01-01

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…

Promoting African American women and sexual assertiveness in reducing HIV/AIDS: an analytical review of the research literature.

PubMed

Kennedy, Bernice Roberts; Jenkins, Chalice C

2011-01-01

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.

Effects of a Pilot Church-based Intervention to Reduce HIV Stigma and Promote HIV Testing among African Americans and Latinos

PubMed Central

Derose, Kathryn P.; Griffin, Beth Ann; Kanouse, David E.; Bogart, Laura M.; Williams, Malcolm V.; Haas, Ann C.; Flórez, Karen R.; Collins, Deborah Owens; Hawes-Dawson, Jennifer; Mata, Michael A.; Oden, Clyde W.; Stucky, Brian D.

2016-01-01

HIV-related stigma and mistrust contribute to HIV disparities. Addressing stigma with faith partners may be effective, but few church-based stigma reduction interventions have been tested. We implemented a pilot intervention with 3 Latino and 2 African American churches (4 in matched pairs) in high HIV prevalence areas of Los Angeles County to reduce HIV stigma and mistrust and increase HIV testing. The intervention included HIV education and peer leader workshops, pastor-delivered sermons on HIV with imagined contact scenarios, and HIV testing events. We surveyed congregants at baseline and 6 month follow-up (n=1235) and found statistically significant (p<.05) reductions in HIV stigma and mistrust in the Latino intervention churches but not in the African American intervention church nor overall across matched African American and Latino pairs. However, within matched pairs, intervention churches had much higher rates of HIV testing (p< .001). Stigma reduction and HIV testing may have synergistic effects in community settings. PMID:27000144

Effects of a Pilot Church-Based Intervention to Reduce HIV Stigma and Promote HIV Testing Among African Americans and Latinos.

PubMed

Derose, Kathryn P; Griffin, Beth Ann; Kanouse, David E; Bogart, Laura M; Williams, Malcolm V; Haas, Ann C; Flórez, Karen R; Collins, Deborah Owens; Hawes-Dawson, Jennifer; Mata, Michael A; Oden, Clyde W; Stucky, Brian D

2016-08-01

HIV-related stigma and mistrust contribute to HIV disparities. Addressing stigma with faith partners may be effective, but few church-based stigma reduction interventions have been tested. We implemented a pilot intervention with 3 Latino and 2 African American churches (4 in matched pairs) in high HIV prevalence areas of Los Angeles County to reduce HIV stigma and mistrust and increase HIV testing. The intervention included HIV education and peer leader workshops, pastor-delivered sermons on HIV with imagined contact scenarios, and HIV testing events. We surveyed congregants at baseline and 6 month follow-up (n = 1235) and found statistically significant (p < 0.05) reductions in HIV stigma and mistrust in the Latino intervention churches but not in the African American intervention church nor overall across matched African American and Latino pairs. However, within matched pairs, intervention churches had much higher rates of HIV testing (p < 0.001). Stigma reduction and HIV testing may have synergistic effects in community settings.

Religiosity and HIV risk behaviors in African-American students.

PubMed

Boyd-Starke, Kimberly; Hill, Oliver W; Fife, John; Whittington, Marcina

2011-04-01

The participants were 256 African-American students between the ages of 18 and 25, from two historically Black universities. The purpose of this study was to see how dimensions of religiosity and spirituality influenced the HIV risk behavior in African-American college students. Each participant completed the Expressions of Spirituality Inventory (ESI) and a survey of sexual attitudes, beliefs, and behaviors. The data were analyzed using a series of ANOVAs, t tests, and correlations. The results from the study confirmed that there was a relationship between religiosity/spirituality and one's tendency to engage in HIV risk behaviors in the population of African-American college students. Interestingly, this study was able to reveal that traditional indicators of religiosity, such as association and church attendance, were not predictors of any of the risky sexual behaviors or attitudes. The portions of religiosity with the greatest impact on these behaviors were the Experiential/Phenomenological, the Existential Well-being, and the Cognitive dimensions, with high scores on each indicative of less likelihood of engaging in risky sexual behaviors.

Attitudes, perceptions and behaviours towards HIV testing among African-American and East African immigrant women in Washington, DC: implications for targeted HIV testing promotion and communication strategies.

PubMed

De Jesus, Maria; Carrete, Claudia; Maine, Cathleen; Nalls, Patricia

2015-12-01

The objective of the study was to examine and compare the HIV testing attitudes, perceptions and behaviours between African-American and East African immigrant women in the Washington, DC metropolitan area. Adopting an inductive, qualitative methodological approach, we conducted a total of 40 in-depth, semistructured interviews between October 2012 and March 2013. Qualitative thematic analysis was used to analyse the data. Overall, African-American women held more favourable views towards 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-related or employment-related purposes. There were many barriers that impede women from seeking an HIV test including negative assumptions (eg, "Getting an HIV test implies that I am HIV positive"), negative emotions (eg, "Fear of being diagnosed with HIV and what this will mean for me") and potential negative reactions from partner or others (eg, "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. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Advice for prevention from HIV-positive African-American women: 'My story is not just a story'.

PubMed

Robillard, Alyssa; Padi, Akhila; Lewis, Kaleea; Julious, Carmen; Troutman, Jamie

2017-05-01

Large disparities in HIV incidence, prevalence and mortality exist for African-American women, especially in the southern region of the USA. Based on the culture-centric health promotion model, HIV-positive African American women can use their stories to support primary prevention. The purpose of this study was to document advice from HIV-positive African-American women (n = 25) to young African-American women, as described in their own cultural narratives collected through qualitative interviews. Content analysis of women's advice identified five common themes revolving broadly around: (1) advice for prevention, (2) support systems for prevention, (3) education, (4) empowerment/self-care and (5) potential barriers to prevention. Advice reflected recommendations based on personal experience and highlighted social determinants linked to HIV, such as stigma, access to education and healthcare, social support, and gender and power dynamics. Women also offered advice for coping with an HIV-positive diagnosis. Communication with parents, family and friends regarding education and social support emerged as an important interpersonal factor for participants, as were interactions with sexual/romantic partners. Stigma, at the community level, was consistently discussed as a hindrance to prevention. Narratives of HIV-positive women as community health agents of change can enhance the effectiveness of HIV prevention interventions for young US African-American women.

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

PubMed Central

De Jesus, Maria; Carrete, Claudia; Maine, Cathleen; Nalls, Patricia

2015-01-01

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

Knowing is not enough: a qualitative report on HIV testing among heterosexual African-American men

PubMed Central

Bond, Keosha T.; Frye, Victoria; Taylor, Raekiela; Williams, Kim; Bonner, Sebastian; Lucy, Debbie; Cupid, Malik; Weiss, Linda; Koblin, Beryl A.

2015-01-01

Despite having higher rates of HIV testing than all other racial groups, African-Americans continue to be disproportionately affected by the HIV epidemic in the United States. Knowing one’s status is the key step to maintaining behavioral changes that could stop the spread of the virus, yet little is known about the individual- and socio-structural-level barriers associated with HIV testing and communication among heterosexual African-American men. To address this and inform the development of an HIV prevention behavioral intervention for heterosexual African-American men, we conducted computerized, structured interviews with 61 men, focus group interviews with 25 men in 5 different groups, and in-depth qualitative interviews with 30 men living in high HIV prevalence neighborhoods in New York City. Results revealed that HIV testing was frequent among the participants. Even with high rates of testing, the men in the study had low levels of HIV knowledge; perceived little risk of HIV; and misused HIV testing as a prevention method. Factors affecting HIV testing, included stigma, relationship dynamics and communication, and societal influences, suggesting that fear, low perception of risk, and HIV stigma may be the biggest barriers to HIV testing. These results also suggest that interventions directed toward African-American heterosexual men must address the use of “testing as prevention” as well as correct misunderstandings of the window period and the meaning of HIV test results, and interventions should focus on communicating about HIV. PMID:25298014

Evaluating the Measurement Structure of the Abbreviated HIV Stigma Scale in a Sample of African Americans Living with HIV/AIDS

ERIC Educational Resources Information Center

Johnson, Eboneé T.; Yaghmaian, Rana A.; Best, Andrew; Chan, Fong; Burrell, Reginald, Jr.

2016-01-01

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…

Implementation of evidence-based HIV interventions for young adult African American women in church settings.

PubMed

Stewart, Jennifer M

2014-01-01

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. Mixed methods cross-sectional design. African American churches in Philadelphia, PA. 142 African American pastors, church leaders, and young adult women ages 18 to 25. Mixed methods convergent parallel design. 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. 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. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

African American Clergy Perspectives About the HIV Care Continuum: Results From a Qualitative Study in Jackson, Mississippi.

PubMed

Nunn, Amy; Parker, Sharon; McCoy, Katryna; Monger, Mauda; Bender, Melverta; Poceta, Joanna; Harvey, Julia; Thomas, Gladys; Johnson, Kendra; Ransome, Yusuf; Sutten Coats, Cassandra; Chan, Phil; Mena, Leandro

2018-01-01

Mississippi has some of the most pronounced racial disparities in HIV infection in the country; African Americans comprised 37% of the Mississippi population but represented 80% of new HIV cases in 2015. Improving outcomes along the HIV care continuum, including linking and retaining more individuals and enhancing adherence to medication, may reduce the disparities faced by African Americans in Mississippi. Little is understood about clergy's views about the HIV care continuum. We assessed knowledge of African American pastors and ministers in Jackson, Mississippi about HIV and the HIV care continuum. We also assessed their willingness to promote HIV screening and biomedical prevention technologies as well as efforts to enhance linkage and retention in care with their congregations. Four focus groups were conducted with 19 African American clergy. Clergy noted pervasive stigma associated with HIV and believed they had a moral imperative to promote HIV awareness and testing; they provided recommendations on how to normalize conversations related to HIV testing and treatment. Overall, clergy were willing to promote and help assist with linking and retaining HIV positive individuals in care but knew little about how HIV treatment can enhance prevention or new biomedical technologies such as pre-exposure prophylaxis (PrEP). Clergy underscored the importance of building coalitions to promote a collective local response to the epidemic. The results of this study highlight important public health opportunities to engage African American clergy in the HIV care continuum in order to reduce racial disparities in HIV infection.

The four Cs of HIV prevention with African Americans: crisis, condoms, culture, and community.

PubMed

Williams, John K; Wyatt, Gail E; Wingood, Gina

2010-11-01

HIV/AIDS continues to be a devastating epidemic with African American communities carrying the brunt of the impact. Despite extensive biobehavioral research, current strategies have not resulted in significantly decreasing HIV/AIDS cases among African Americans. The next generation of HIV prevention and risk reduction interventions must move beyond basic sex education and condom use and availability. Successful interventions targeting African Americans must optimize strategies that integrate socio-cultural factors and address institutional and historical barriers that hinder or support HIV risk reduction behaviors. Community-based participatory research to decrease the HIV/AIDS disparity by building community capacity and infrastructure and advocating for and distributing equitably, power and resources, must be promoted. Recommendations for paradigm shifts in using innovative theories and conceptual frameworks and for training researchers, clinicians, grant and journal reviewers, and community members are made so that culturally congruent interventions may be tested and implemented at the community level.

Sexual orientation a predictor of depressive symptoms among HIV-infected African American men: a descriptive correlational study.

PubMed

Coleman, Christopher Lance; Hummel, Dianne Bolster

2005-10-01

The purpose of this descriptive correlational study was to describe the occurrence of depressive symptoms among a sample of 98 HIV-infected African American men while controlling for HIV symptoms, sexual orientation, age, personal income, and educational level. A demographic questionnaire, the Beck Depression Inventory, and the HIV Sign and Symptom Checklist for Persons with HIV Disease were used to collect data. The results of a regression analysis indicated that being heterosexual and experiencing HIV symptoms were predictive of depressive symptoms in African American men. The study findings demonstrate the importance of assessing how sexual orientation within a cultural context affects the mental health of HIV-seropositive African American men.

College graduation reduces vulnerability to STIs/HIV among African-American young adult women.

PubMed

Painter, Julia E; Wingood, Gina M; DiClemente, Ralph J; Depadilla, Lara M; Simpson-Robinson, Lashun

2012-01-01

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. Copyright © 2012 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Predictors of HIV/AIDS Programming in African American Churches: Implications for HIV Prevention, Testing, and Care

ERIC Educational Resources Information Center

Stewart, Jennifer M.; Hanlon, Alexandra; Brawner, Bridgette M.

2017-01-01

Using data from the National Congregational Study, we examined predictors of having an HIV/AIDS program in predominately African American churches across the United States. We conducted regression analyses of Wave II data (N = 1,506) isolating the sample to churches with a predominately African American membership. The dependent variable asked…

African American Women: The Face of HIV/AIDS in Washington, DC

ERIC Educational Resources Information Center

Amutah, Ndidiamaka N.

2012-01-01

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…

Critical consciousness, racial and gender discrimination, and HIV disease markers in African American women with HIV.

PubMed

Kelso, Gwendolyn A; Cohen, Mardge H; Weber, Kathleen M; Dale, Sannisha K; Cruise, Ruth C; Brody, Leslie R

2014-07-01

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.

Critical Consciousness, Racial and Gender Discrimination, and HIV Disease Markers in African American Women with HIV

PubMed Central

Kelso, Gwendolyn A.; Cohen, Mardge H.; Weber, Kathleen M.; Dale, Sannisha K.; Cruise, Ruth C.; Brody, Leslie R.

2014-01-01

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

A One-Size-Fits-All HIV Prevention and Education Approach?: Interpreting Divergent HIV Risk Perceptions Between African American and East African Immigrant Women in Washington, DC Using the Proximate-Determinants Conceptual Framework.

PubMed

De Jesus, Maria; Taylor, Juanita; Maine, Cathleen; Nalls, Patricia

2016-02-01

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 United States. Forty in-depth, semistructured 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 semistructured interviews were preceded by the cognitive interviews and accompanying survey. Study protocol was reviewed and approved by the American University Institutional Review Board. 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. Although 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. 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 to resonate with these different audiences.

African-American and Hispanic perceptions of HIV vaccine clinical research: a qualitative study.

PubMed

Toledo, Lauren; McLellan-Lemal, Eleanor; Arreola, Sonya; Campbell, Chadwick; Sutton, Madeline

2014-01-01

To examine perceptions of phase-I human immunodeficiency virus (HIV) vaccine trial participation among African-Americans and Hispanics in San Francisco, California. Qualitative, semistructured interviews. San Francisco Department of Health. Thirty-six African-American and Hispanic men and women, 18 to 50 years of age, residing in the San Francisco Bay Area. Purposive sampling using advertisements, community-based organization rosters, and snowball referrals. Thematic analysis of transcripts identified salient themes and patterns. Participants viewed participation in HIV research as important; however, they held that HIV was not a health priority given limited awareness about HIV research or beliefs that only infected or high-risk persons were eligible for participation. Altruism and personal gain, trustworthy trial staff, convenient schedules and facilities, and involvement of trusted community groups in recruitment were perceived to motivate participants. Concerns about the social consequences of participating in HIV research and product-related side effects were seen as discouraging participation. Limitations include the possibility that participants in interview research have more favorable views of biomedical research than those who refuse to participate. Historically, African-Americans and Hispanics in the United States have had limited participation in HIV trials. Understanding their perceptions of HIV biomedical research, identifying facilitators and barriers to participation, addressing misinformation about HIV, distorted risk perceptions, HIV stigma, and providing accessible opportunities to participate are imperative to ensure health equity and generalizability of findings.

African-American patients' preferences for a health center campaign promoting HIV testing: an exploratory study and future directions.

PubMed

Arya, Monisha; Kallen, Michael A; Street, Richard L; Viswanath, Kasisomayajula; Giordano, Thomas P

2014-01-01

In 2006, the US Centers for Disease Control and Prevention recommended routine HIV testing in health care settings and called for HIV testing campaigns targeting African Americans. In a 2011 national survey, 63% of African Americans wanted information on HIV testing. In our study, 176 African Americans were surveyed to determine channels and spokespersons for an HIV testing campaign. Among 9 media channels, the top 3 ranked as "very likely" to convince them to get HIV tested were television, poster, and brochure. Among 10 spokespersons, the top 3 were doctor, nurse, and "real person like me." The media are a cost-effective strategy to promote HIV prevention. Posters and brochures are inexpensive and easy to reproduce for clinical settings. Television campaigns may be feasible in clinics with closed-circuit televisions. Research is needed on campaign messages. An effective health center HIV testing campaign may help mitigate the disproportionate toll HIV is having on African Americans. © The Author(s) 2014.

Source credibility and evidence format: examining the effectiveness of HIV/AIDS messages for young African Americans.

PubMed

Major, Lesa Hatley; Coleman, Renita

2012-01-01

Using experimental methodology, this study tests the effectiveness of HIV/AIDS prevention messages tailored specifically to college-aged African Americans. To test interaction effects, it intersects source role and evidence format. The authors used gain-framed and loss-framed information specific to young African Americans and HIV to test message effectiveness between statistical and emotional evidence formats, and for the first time, a statistical/emotional combination format. It tests which source--physician or minister--that young African Americans believe is more effective when delivering HIV/AIDS messages to young African Americans. By testing the interaction between source credibility and evidence format, this research expands knowledge on creating effective health messages in several major areas. Findings include a significant interaction between the role of physician and the combined statistical/emotional format. This message was rated as the most effective way to deliver HIV/AIDS prevention messages.

Behavioural Precursors and HIV Testing Behaviour among African American Women

ERIC Educational Resources Information Center

Uhrig, Jennifer D.; Davis, Kevin C.; Rupert, Doug; Fraze, Jami

2012-01-01

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…

Perceptions Towards Condom Use, Sexual Activity, and HIV Disclosure among HIV-Positive African American Men Who Have Sex with Men: Implications for Heterosexual Transmission

PubMed Central

Harawa, Nina T.; Ramamurthi, Hema Codathi; Bingham, Trista A.

2006-01-01

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

Factors affecting reproductive decisions of African American women living with HIV.

PubMed

Richter, Donna L; Sowell, Richard L; Pluto, Delores M

2002-01-01

This exploratory study used focus groups to examine attitudes and beliefs of HIV-infected African American women of child-bearing age about pregnancy and antiretroviral therapy. A convenience sample of thirty-three African American women of child-bearing age participated in five focus groups. Attitudes and beliefs about pregnancy decisions and the use of antiretroviral therapy during pregnancy were examined. Many of the women in this study living with HIV remained committed to having children and expressed confusion about their chances of transmitting the virus to their children. Health care providers must be aware of these concerns and convey clear and accurate information through the most readily accepted channels. Participants suggested that messages about these issues be conveyed by other women living with HIV who have faced these same decisions.

The Significance of Sexuality and Intimacy in the Lives of Older African Americans With HIV/AIDS.

PubMed

Nevedal, Andrea; Sankar, Andrea

2016-08-01

Aging and HIV/AIDS research focuses primarily on standardized clinical, social, and behavioral measures, leaving unanswered questions about how this chronic and stigmatizing condition affects life course expectations and the meaning of aging with the disease. Utilizing Gaylene Becker's (1997) life course disruption theory, we explored older African Americans' experiences of living with HIV/AIDS. A purposive sample (N = 43) of seropositive African Americans aged 50 and older was selected from a parent study. Thirteen participants completed one semi-structured in-depth interview on life course expectations and experiences of living with HIV/AIDS. Interview transcripts were analyzed using standard qualitative coding and thematic analysis. Responding to broad, open-ended questions about the impact of HIV on life course expectations, participants emphasized how HIV limited their ability to experience sexuality and intimacy. Two major themes emerged, damaged sexuality and constrained intimacy. Older African Americans' discussions of living with HIV focused on the importance of and the challenges to sexuality and intimacy. Researchers and clinicians should be attentive to significant and ongoing HIV-related challenges to sexuality and intimacy facing older African Americans living with HIV/AIDS. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

African American church-based HIV testing and linkage to care: assets, challenges and needs.

PubMed

Stewart, Jennifer M; Thompson, Keitra; Rogers, Christopher

2016-01-01

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.

Risky Sexual Behavior and Correlates of STD Prevalence Among African American HIV Serodiscordant Couples

PubMed Central

2014-01-01

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

Identity, Physical Space, and Stigma Among African American Men Living with HIV in Chicago and Seattle.

PubMed

Singleton, Judith L; Raunig, Manuela; Brunsteter, Halley; Desmond, Michelle; Rao, Deepa

2015-12-01

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.

Keeping the faith: African American faith leaders' perspectives and recommendations for reducing racial disparities in HIV/AIDS infection.

PubMed

Nunn, Amy; Cornwall, Alexandra; Chute, Nora; Sanders, Julia; Thomas, Gladys; James, George; Lally, Michelle; Trooskin, Stacey; Flanigan, Timothy

2012-01-01

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

Keeping the Faith: African American Faith Leaders’ Perspectives and Recommendations for Reducing Racial Disparities in HIV/AIDS Infection

PubMed Central

Nunn, Amy; Cornwall, Alexandra; Chute, Nora; Sanders, Julia; Thomas, Gladys; James, George; Lally, Michelle; Trooskin, Stacey; Flanigan, Timothy

2012-01-01

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

Life begins at 60: Identifying the social support needs of African American women aging with HIV.

PubMed

Warren-Jeanpiere, Lari; Dillaway, Heather; Hamilton, Pilar; Young, Mary; Goparaju, Lakshmi

2017-01-01

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.

Life begins at 60: Identifying the social support needs of African American women aging with HIV

PubMed Central

Warren-Jeanpiere, Lari; Dillaway, Heather; Hamilton, Pilar; Young, Mary; Goparaju, Lakshmi

2016-01-01

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

Our Children, Our Hope: Voices of African American Mothers Living with HIV and Rearing Uninfected Children.

PubMed

Muze, Ruth; Onsomu, Elijah O

2017-01-01

Parenting school-aged children while living with HIV has been associated with significant consequences for African American mothers. This article presents and discusses the results of a qualitative study that examined the parenting experiences of HIV-infected African American mothers rearing young children. A sample of 8 inner-city, African American mothers of uninfected preschool-aged children were interviewed individually. Interview guide questions explored day-to-day childcare activities from the mothers' perspective. Five themes emerged: role of mothering, doing it all, less time for self, fear, and hope. Findings can be used to guide the development of programs to support HIV-infected mothers rearing young children.

Enhancing Cultural and Contextual Intervention Strategies to Reduce HIV/AIDS Among African Americans

PubMed Central

2009-01-01

I describe 4 protective strategies that African Americans employ that may challenge current HIV prevention efforts: (1) an adaptive duality that protects identity, (2) personal control influenced by external factors, (3) long-established indirect communication patterns, and (4) a mistrust of “outsiders.” I propose the Sexual Health Model as a conceptual framework for HIV prevention interventions because it incorporates established adaptive coping strategies into new HIV-related protective skills. The Sexual Health Model promotes interconnectedness, sexual ownership, and body awareness, 3 concepts that represent the context of the African American historical and cultural experience and that enhance rather than contradict future prevention efforts. PMID:19762666

HIV-Associated Histories, Perceptions, and Practices Among Low-Income African American Women: Does Rural Residence Matter?

PubMed Central

Crosby, Richard A.; Yarber, William L.; DiClemente, Ralph J.; Wingood, Gina M.; Meyerson, Beth

2002-01-01

Objectives. This study compared HIV-associated sexual health history, risk perceptions, and sexual risk behaviors of low-income rural and nonrural African American women. Methods. A cross-sectional statewide survey of African American women (n = 571) attending federally funded Special Supplemental Nutrition Program for Women, Infants, and Children clinics was conducted. Results. Adjusted analyses indicated that rural women were more likely to report not being counseled about HIV during pregnancy (P = .001), that a sex partner had not been tested for HIV (P = .005), no preferred method of prevention because they did not worry about sexually transmitted diseases (P = .02), not using condoms (P = .009), and a belief that their partner was HIV negative, despite lack of testing (P = .04). Conclusions. This study provided initial evidence that low-income rural African American women are an important population for HIV prevention programs. PMID:11919067

Structural and sociocultural factors associated with cervical cancer screening among HIV-infected African American women in Alabama.

PubMed

Williams, Michelle; Moneyham, Linda; Kempf, Mirjam-Colette; Chamot, Eric; Scarinci, Isabel

2015-01-01

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.

Attitudes and beliefs regarding depression, HIV/AIDS and HIV risk-related sexual behaviors among clinically depressed African American adolescent females

PubMed Central

Brawner, Bridgette M.

2012-01-01

Individuals’ attitudes and beliefs toward behaviors are key indicators of behavioral performance. The purpose of this study was to elucidate attitudes and beliefs about depression, HIV/AIDS and HIV risk-related sexual behaviors among clinically depressed African American adolescent females and to develop an understanding of their context for HIV risk. For this descriptive qualitative inquiry, semi-structured interviews and surveys were employed (N = 24). The narratives reveal that behavioral sequelae of depression (i.e. loneliness) can produce risk for HIV. These findings may guide psychiatric nurse educators, scientists, and practitioners to modify HIV risk among clinically depressed African American adolescent females. PMID:23164403

Identity, Physical Space, and Stigma Among African American Men Living with HIV in Chicago and Seattle

PubMed Central

Singleton, Judith L.; Raunig, Manuela; Brunsteter, Halley; Desmond, Michelle; Rao, Deepa

2015-01-01

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

Relationship of African Americans' sociodemographic characteristics to belief in conspiracies about HIV/AIDS and birth control.

PubMed Central

Bogart, Laura M.; Thorburn, Sheryl

2006-01-01

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

Development of a Barbershop-Based HIV/STI Risk Reduction Intervention for Young Heterosexual African American Men.

PubMed

Jemmott, Loretta Sweet; Jemmott, John B; Lanier, Yzette; Thompson, Ciarra; Baker, Jillian Lucas

2016-08-12

Young, heterosexual African American men ages 18 to 24 years continue to be at high risk for HIV and other sexually transmitted infections. However, few interventions have been designed to meet the needs of this "forgotten" population. The article describes the systematic development of a theory-based, culturally-tailored, gender-specific, barbershop-based HIV risk reduction intervention for heterosexual African American men ages 18 to 24. The process included developing a community advisory board, selecting a guiding theoretical framework, incorporating community-based participatory research principles, and conducting formative research with African American males, barbers, and barbershop owners. The result was Shape Up: Barbers Building Better Brothers, a 2-day, HIV risk reduction intervention focused on increasing HIV knowledge and condom use and reducing the number of sexual partners. Intervention sessions were facilitated by barbers who used iPads to deliver the content. As a high-risk population, this intervention has great public health significance for the health of African American men and their sexual partners. © 2016 Society for Public Health Education.

An HIV self-care symptom management intervention for African American mothers.

PubMed

Miles, Margaret Shandor; Holditch-Davis, Diane; Eron, Joseph; Black, Beth Perry; Pedersen, Cort; Harris, Donna A

2003-01-01

Human immunodeficiency virus (HIV) infection has become a serious health problem for low-income African American women in their childbearing years. Interventions that help them cope with feelings about having HIV and increase their understanding of HIV as a chronic disease in which self-care practices, regular health visits, and medications can improve the quality of life can lead to better health outcomes. This study aimed to determine the efficacy of an HIV self-care symptom management intervention for emotional distress and perceptions of health among low-income African American mothers with HIV. Women caregivers of young children were randomly assigned to self-care symptom management intervention or usual care. The intervention, based on a conceptual model related to HIV in African American women, involved six home visits by registered nurses. A baseline pretest and two posttests were conducted with the mothers in both groups. Emotional distress was assessed as depressive symptoms, affective state, stigma, and worry about HIV. Health, self-reported by the mothers, included the number of infections and aspects of health-related quality of life (i.e., perception of health, physical function, energy, health distress, and role function). Regarding emotional distress, the mothers in the experimental group reported fewer feelings of stigma than the mothers in the control group. Outcome assessments of health indicated that the mothers in the experimental group reported higher physical function scores than the control mothers. Within group analysis over time showed a reduction in negative affective state (depression/dejection and tension/anxiety) and stigma as well as infections in the intervention group mothers, whereas a decline in physical and role function was found in the control group. The HIV symptom management intervention has potential as a case management or clinical intervention model for use by public health nurses visiting the home or by advanced practice

Receptivity of African American Adolescents to an HIV-Prevention Curriculum Enhanced by Text Messaging

PubMed Central

Cornelius, Judith B.; St Lawrence, Janet S.

2013-01-01

PURPOSE This study assessed African American adolescents’ receptivity to an HIV-prevention curriculum enhanced by text messaging. DESIGN AND METHODS Two focus groups were conducted with 14 African American adolescents regarding how an HIV-prevention curriculum could be enhanced for text messaging delivery. RESULTS The adolescents were receptive to the idea of text messaging HIV-prevention information but wanted to receive a maximum of three messages per day during the hours of 4:00–6:00 p.m. PRACTICE IMPLICATIONS By taking the findings of this study, nurses, other healthcare providers, and community-based organizations can adapt evidence-based interventions for text messaging delivery to individuals at high risk for HIV infection. PMID:19356206

African American race and HIV virological suppression: beyond disparities in clinic attendance.

PubMed

Howe, Chanelle J; Napravnik, Sonia; Cole, Stephen R; Kaufman, Jay S; Adimora, Adaora A; Elston, Beth; Eron, Joseph J; Mugavero, Michael J

2014-06-15

Racial disparities in clinic attendance may contribute to racial disparities in plasma human immunodeficiency virus type 1 : HIV-1) RNA levels among HIV-positive patients in care. Data from 946 African American and 535 Caucasian patients receiving HIV care at the University of North Carolina Center for AIDS Research HIV clinic between January 1, 1999, and August 1, 2012, were used to estimate the association between African American race and HIV virological suppression (i.e., undetectable HIV-1 RNA) when racial disparities in clinic attendance were lessened. Clinic attendance was measured as the proportion of scheduled clinic appointments attended (i.e., visit adherence) or the proportion of six 4-month intervals with at least 1 attended scheduled clinic appointment (i.e., visit constancy). In analyses accounting for patient characteristics, the risk ratio for achieving suppression when comparing African Americans with Caucasians was 0.91 (95% confidence interval: 0.85, 0.98). Lessening disparities in adherence or constancy lowered disparities in virological suppression by up to 44.4% and 11.1%, respectively. Interventions that lessen disparities in adherence may be more effective in eliminating disparities in suppression than interventions that lessen disparities in constancy. Given that gaps in care were limited to be no more than 2 years for both attendance measures, the impact of lessening disparities in adherence may be overstated. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Hip-hop to prevent substance use and HIV among African-American youth: a preliminary investigation.

PubMed

Turner-Musa, Jocelyn O; Rhodes, Warren A; Harper, P Thandi Hicks; Quinton, Sylvia L

2008-01-01

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.

Exploring the relationship of conspiracy beliefs about HIV/AIDS to sexual behaviors and attitudes among African-American adults.

PubMed Central

Bogart, Laura M.; Bird, Sheryl Thorburn

2003-01-01

Conspiracy beliefs about HIV/AIDS have been endorsed by significant percentages of African Americans in prior research. However, almost no research has investigated the relationship of such beliefs to behaviors and attitudes relevant to HIV risk. In the present exploratory study, 71 African-American adults (aged 18-45; 61% female) in the United States participated in a national, cross-sectional telephone survey examining the relationship of HIV/AIDS conspiracy beliefs to sexual attitudes and behaviors. Results indicated significant associations between endorsement of a general HIV/AIDS government conspiracy and negative beliefs regarding condoms and greater numbers of sexual partners. Endorsement of HIV/AIDS treatment conspiracies was related to positive attitudes about condoms and greater condom use intentions. Findings suggest that conspiracy beliefs have implications for HIV prevention in African-American communities. PMID:14651372

Knowledge about HIV in a Community Sample of Urban African Americans in the South.

PubMed

Klein, H; Sterk, C E; Elifson, K W

2016-10-01

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. 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. 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. 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.

Exploring Decision-Making of HIV-Infected Hispanics and African Americans Participating in Clinical Trials

PubMed Central

Rivera-Goba, Migdalia V.; Dominguez, Dinora C.; Stoll, Pamela; Grady, Christine; Ramos, Catalina; Mican, JoAnn M.

2011-01-01

Underrepresentation of HIV-infected Hispanics and African Americans in clinical trials seriously limits our understanding of the benefits and risks of treatment in these populations. This qualitative study examined factors that racial/ethnic minority patients consider when making decisions regarding research participation. Thirty-five HIV-infected Hispanic and African American patients enrolled in clinical research protocols at the National Institutes of Health were recruited to participate in focus groups and in-depth interviews. The sample of mostly men (n = 22), had a mean age of 45, nearly equal representation of race/ethnicity, and diagnosed 2 to 22 years ago. Baseline questionnaires included demographics and measures of social support and acculturation. Interviewers had similar racial/ethnic, cultural, and linguistic backgrounds as the participants. Four major themes around participants’ decisions to enroll in clinical trials emerged: Enhancers, Barriers, Beliefs, and Psychosocial Context. Results may help researchers develop strategies to facilitate inclusion of HIV-infected Hispanics and African Americans into clinical trials. PMID:21256054

Text-Messaging-Enhanced HIV Intervention for African American Adolescents: A Feasibility Study

PubMed Central

Cornelius, Judith B.; Dmochowski, Jacek; Boyer, Cherrie; St Lawrence, Janet; Lightfoot, Marguerita; Moore, Michael

2013-01-01

We examined the feasibility and acceptability of an HIV prevention intervention for African American adolescents delivered via mobile cell phones and looked at intervention-related changes in beliefs and sexual behaviors. We used a longitudinal one-group comparison design with data collected at three points. Forty adolescents, 13–18 years old, participated in the Becoming a Responsible Teen intervention followed by the delivery of daily multimedia messages for 3 months. The mobile-cell-phone enhanced intervention was feasible and acceptable to the participants. Greater HIV knowledge, improved attitudes toward condoms, and increased perceived HIV risk scores were observed with older adolescents (16–18 years old). Behavior trends showed a decrease in the number of times participants reported engaging in unprotected sexual intercourse over the previous 2 months. Mobile-cell-phone multimedia-text-messaging boosters tested in this study provided preliminary evidence of efficacy of the enhanced HIV prevention intervention for African American youth. PMID:23122907

The Significance of Sexuality and Intimacy in the Lives of Older African Americans With HIV/AIDS

PubMed Central

Nevedal, Andrea; Sankar, Andrea

2016-01-01

Purpose of the Study: Aging and HIV/AIDS research focuses primarily on standardized clinical, social, and behavioral measures, leaving unanswered questions about how this chronic and stigmatizing condition affects life course expectations and the meaning of aging with the disease. Utilizing Gaylene Becker’s (1997) life course disruption theory, we explored older African Americans’ experiences of living with HIV/AIDS. Design and Methods: A purposive sample (N = 43) of seropositive African Americans aged 50 and older was selected from a parent study. Thirteen participants completed one semi-structured in-depth interview on life course expectations and experiences of living with HIV/AIDS. Interview transcripts were analyzed using standard qualitative coding and thematic analysis. Results: Responding to broad, open-ended questions about the impact of HIV on life course expectations, participants emphasized how HIV limited their ability to experience sexuality and intimacy. Two major themes emerged, damaged sexuality and constrained intimacy. Implications: Older African Americans’ discussions of living with HIV focused on the importance of and the challenges to sexuality and intimacy. Researchers and clinicians should be attentive to significant and ongoing HIV-related challenges to sexuality and intimacy facing older African Americans living with HIV/AIDS. PMID:26035889

Applying Social Psychological Models to Predicting HIV-Related Sexual Risk Behaviors Among African Americans

PubMed Central

Cochran, Susan D.; Mays, Vickie M.

2011-01-01

Existing models of attitude-behavior relationships, including the Health Belief Model, the Theory of Reasoned Action, and the Self-Efficacy Theory, are increasingly being used by psychologists to predict human immunodeficiency virus (HIV)-related risk behaviors. The authors briefly highlight some of the difficulties that might arise in applying these models to predicting the risk behaviors of African Americans. These social psychological models tend to emphasize the importance of individualistic, direct control of behavioral choices and deemphasize factors, such as racism and poverty, particularly relevant to that segment of the African American population most at risk for HIV infection. Applications of these models without taking into account the unique issues associated with behavioral choices within the African American community may fail to capture the relevant determinants of risk behaviors. PMID:23529205

Aiming for more relevant HIV risk reduction: a black feminist perspective for enhancing HIV intervention for low-income African American women.

PubMed

Gentry, Quinn M; Elifson, Kirk; Sterk, Claire

2005-06-01

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.

National Institute of Mental Health Multisite Eban HIV/STD Prevention Intervention for African American HIV Serodiscordant Couples

PubMed Central

El-Bassel, Nabila; Jemmott, John B.; Landis, J. Richard; Pequegnat, Willo; Wingood, Gina M.; Wyatt, Gail E.; Bellamy, Scarlett L.

2014-01-01

Background Human immunodeficiency virus (HIV) has disproportionately affected African Americans. Couple-level interventions may be a promising intervention strategy. Methods To determine if a behavioral intervention can reduce HIV/sexually transmitted disease (STD) risk behaviors among African American HIV serodiscordant couples, a cluster randomized controlled trial (Eban) was conducted in Atlanta, Georgia; Los Angeles, California; New York, New York; and Philadelphia, Pennsylvania; with African American HIV serodiscordant heterosexual couples who were eligible if both partners were at least 18 years old and reported unprotected intercourse in the previous 90 days and awareness of each other's serostatus. One thousand seventy participants were enrolled (mean age, 43 years; 40% of male participants were HIV positive). Couples were randomized to 1 of 2 interventions: couple-focused Eban HIV/STD risk-reduction intervention or attention-matched individual-focused health promotion comparison. The primary outcomes were the proportion of condom-protected intercourse acts and cumulative incidence of STDs (chlamydia, gonorrhea, or trichomonas). Data were collected preintervention and postintervention, and at 6- and 12-month follow-ups. Results Data were analyzed for 535 randomized couples: 260 in the intervention group and 275 in the comparison group; 81.9% were retained at the 12-month follow-up. Generalized estimating equation analyses revealed that the proportion of condom-protected intercourse acts was larger among couples in the intervention group (0.77) than in the comparison group (0.47; risk ratio, 1.24; 95% confidence interval [CI], 1.09 to 1.41; P=.006) when adjusted for the baseline criterion measure. The adjusted percentage of couples using condoms consistently was higher in the intervention group (63%) than in the comparison group (48%; risk ratio, 1.45; 95% CI, 1.24 to 1.70; P<.001). The adjusted mean number of (log)unprotected intercourse acts was lower in

Problem posing and cultural tailoring: developing an HIV/AIDS health literacy toolkit with the African American community.

PubMed

Rikard, R V; Thompson, Maxine S; Head, Rachel; McNeil, Carlotta; White, Caressa

2012-09-01

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.

What African American Male Adolescents Are Telling Us about HIV Infection among Their Peers: Cultural Approaches for HIV Prevention

ERIC Educational Resources Information Center

Voisin, Dexter R.; Bird, Jason D. P.

2009-01-01

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…

HIV Risk Among Young African American Men Who Have Sex With Men: A Case–Control Study in Mississippi

PubMed Central

Dorell, Christina G.; Mena, Leandro A.; Thomas, Peter E.; Toledo, Carlos A.; Heffelfinger, James D.

2011-01-01

Objectives. We conducted a case–control study in the Jackson, Mississippi, area to identify factors associated with HIV infection among young African American men who have sex with men (MSM). Methods. During February to April 2008, we used surveillance records to identify young (16–25 years old) African American MSM diagnosed with HIV between 2006 and 2008 (case participants) and recruited young African American MSM who did not have HIV (controls). Logistic regression analysis was used to assess factors associated with HIV infection. Results. In a multivariable analysis of 25 case participants and 85 controls, having older male partners (adjusted odds ratio [OR] = 5.5; 95% confidence interval [CI] = 1.8, 17.3), engaging in unprotected anal intercourse with casual male partners (adjusted OR = 6.3; 95% CI = 1.8, 22.3), and being likely to give in to a partner who wanted to have unprotected sex (adjusted OR = 5.0; 95% CI = 1.2, 20.6) were associated with HIV infection. Conclusions. Given the high prevalence of risk behaviors among the young African American MSM in our study, HIV prevention efforts must begin before or during early adolescence and need to focus on improving negotiation and communication regarding sex. PMID:21088266

AIDS in Black and White: The Influence of Newspaper Coverage of HIV/AIDS on HIV/AIDS Testing Among African Americans and White Americans, 1993–2007

PubMed Central

STEVENS, ROBIN; HORNIK, ROBERT C.

2014-01-01

This study examined the impact of newspaper coverage of HIV/AIDS on HIV testing behavior in the US population. HIV testing data were taken from the CDC’s National Behavioral Risk Factor Surveillance System (BRFSS) from 1993 to 2007 (n=265,557). News stories from 24 daily newspapers and one wire service during the same time period were content analyzed. Distributed lagged regression models were employed to estimate how well HIV/AIDS newspaper coverage predicted later HIV testing behavior. Increases in HIV/AIDS newspaper coverage were associated with declines in population level HIV testing. Each additional 100 HIV/AIDS related newspaper stories published each month was associated with a 1.7% decline in HIV testing levels in the subsequent month. This effect differed by race, with African Americans exhibiting greater declines in HIV testing subsequent to increased news coverage than did Whites. These results suggest that mainstream newspaper coverage of HIV/AIDS may have a particularly deleterious effect on African Americans, one of the groups most impacted by the disease. The mechanisms driving the negative effect deserve further investigation to improve reporting on HIV/AIDS in the media. PMID:24597895

Till Death Do Us Part: Lived Experiences of HIV-Positive Married African American Women

ERIC Educational Resources Information Center

Edwards, Lorece V.; Irving, Shalon M.; Hawkins, Anita S.

2011-01-01

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…

Weighing the Consequences: Self-Disclosure of HIV-Positive Status among African American Injection Drug Users

ERIC Educational Resources Information Center

Valle, Maribel; Levy, Judith

2009-01-01

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…

Methodological Overview of an African American Couple-Based HIV/STD Prevention Trial

PubMed Central

2010-01-01

Objective To provide an overview of the NIMH Multisite HIV/STD Prevention Trial for African American Couples conducted in four urban areas: Atlanta, Los Angeles, New York, and Philadelphia. The rationale, study design methods, proposed data analyses, and study management are described. Design This is a two arm randomized Trial, implementing a modified randomized block design, to evaluate the efficacy of a couples based intervention designed for HIV serodiscordant African American couples. Methods The study phases consisted of formative work, pilot studies, and a randomized clinical trial. The sample is 535 HIV serodiscordant heterosexual African American couples. There are two theoretically derived behavioral interventions with eight group and individual sessions: the Eban HIV/STD Risk Reduction Intervention (treatment) versus the Eban Health Promotion Intervention (control). The treatment intervention was couples based and focused on HIV/STD risk reduction while the control was individual based and focused on health promotion. The two study conditions were structurally similar in length and types of activities. At baseline, participants completed an Audio Computer-assisted Self Interview (ACASI) interview as well as interviewer-administered questionnaire, and provided biological specimens to assess for STDs. Similar follow-up assessments were conducted immediately after the intervention, at 6 months, and at 12 months. Results The Trial results will be analyzed across the four sites by randomization assignment. Generalized estimating equations (GEE) and mixed effects modeling (MEM) are planned to test: (1) the effects of the intervention on STD incidence and condom use as well as on mediator variables of these outcomes, and (2) whether the effects of the intervention differ depending on key moderator variables (e.g., gender of the HIV-seropositive partners, length of relationship, psychological distress, sexual abuse history, and substance abuse history

Results from a secondary data analysis regarding satisfaction with health care among African American women living with HIV/AIDS.

PubMed

Baker, Jillian Lucas; Rodgers, Caryn R R; Davis, Zupenda M; Gracely, Edward; Bowleg, Lisa

2014-01-01

To analyze satisfaction with health care among African American women living with HIV/AIDS. Secondary analysis of baseline data of African American women who participated in Protect and Respect, a sexual risk reduction program for women living with HIV/AIDS SETTING: HIV Care Clinic in an urban city in the northeast United States. One hundred fifty-seven (157) African American women living with HIV/AIDS. Regression analyses were used to examine the relationships between demographic variables, self-reported health characteristics, communication with health care providers, and satisfaction with health care provider. A majority of women reported satisfaction with medical services (88%, n = 140). Communication with health care providers, detectable viral load, education, income, self-reported health status, and sexual orientation were significantly bivariately associated with satisfaction with healthcare (all ps < .05). In the multivariate models, no variables significantly predicted satisfaction with healthcare. Because satisfaction with health care can influence the quality of care received, health outcomes, and adherence to provider recommendations among patients living with HIV/AIDS, health care providers' ability to elicit satisfaction from their patients is just as important as the services they provide. This project is one of the first studies to find high rates of satisfaction with health care among African American women living with HIV/AIDS. Further examination of satisfaction with health care among African American women living HIV/AIDS may help in narrowing health care disparities and negative treatment outcomes. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Medical Mistrust among Social Network Members May Contribute to Antiretroviral Treatment Nonadherence in African Americans Living with HIV

PubMed Central

Bogart, Laura M.; Wagner, Glenn J.; Green, Harold D.; Mutchler, Matt G.; Klein, David J.; McDavitt, Bryce; Lawrence, Sean J.; Hilliard, Charles L.

2016-01-01

Rationale African Americans living with HIV are less likely to adhere to antiretroviral treatment (ART) compared to other racial/ethnic groups. Medical mistrust is thought to be a factor in this disparity. Objective We examined (1) whether exposure to HIV conspiracy beliefs, a specific type of HIV-related mistrust (about the origins and treatment of HIV) in social networks is associated with ART nonadherence among African Americans living with HIV; and (2) the characteristics of individuals who discuss HIV-related mistrust in the social networks of African Americans living with HIV. Methods At baseline and 6- and 12-months post-baseline, 175 African Americans living with HIV on ART completed egocentric social network assessments, from which we assessed the structure and composition of their personal networks (the social context immediately surrounding them). HIV-related mistrust was operationalized with an indicator of whether any social network member had expressed HIV conspiracy beliefs to the participant. Daily medication adherence was monitored electronically. Results At baseline, 63% of participants agreed with at least one conspiracy belief, and 55% reported hearing at least one social network member (“alter”) express conspiracy beliefs. In a multivariate linear repeated measures regression, expression of conspiracy beliefs by similar others in the network (in terms of age, gender, HIV status, sexual orientation, and race/ethnicity) was associated with ART nonadherence (i.e., percentage of prescribed doses taken). In a multivariate logistic regression, expression of conspiracy beliefs was more likely among social network members who were HIV-positive, who knew the participants’ serostatus, and with whom participants interacted frequently, and less likely among more well-connected social network members. Conclusion HIV-related mistrust in the network may be most influential when expressed by similar others who may be HIV-positive themselves. PMID

Hip-Hop to Prevent Substance Use and HIV among African-American Youth: A Preliminary Investigation

ERIC Educational Resources Information Center

Turner-Musa, Jocelyn O.; Rhodes, Warren A.; Harper, P. Thandi Hicks; Quinton, Sylvia L.

2008-01-01

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…

Conspiracy beliefs about HIV/AIDS and birth control among African Americans: implications for the prevention of HIV, other STIs, and unintended pregnancy.

PubMed

Bird, Sheryl Thorburn; Bogart, Laura M

2005-03-01

In this article, we examine the potential role that conspiracy beliefs regarding HIV/AIDS (e.g., "HIV is a manmade virus") and birth control (e.g., "The government is trying to limit the Black population by encouraging the use of condoms") play in the prevention of HIV, other STIs, and unintended pregnancies among African Americans in the United States. First, we review prior research indicating that substantial percentages of African Americans endorse conspiracy beliefs about HIV/AIDS and birth control. Next, we present a theoretical framework that suggests how conspiracy beliefs influence sexual behavior and attitudes. We then offer several recommendations for future research. Finally, we discuss the policy and programmatic implications of conspiracy beliefs for the prevention of HIV, other STIs, and unintended pregnancy.

Pastor and Lay Leader Perceptions of Barriers and Supports to HIV Ministry Maintenance in an African American Church

PubMed Central

2013-01-01

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

Pastor and lay leader perceptions of barriers and supports to HIV ministry maintenance in an African American church.

PubMed

Stewart, Jennifer M

2014-04-01

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.

Taking it one day at a time: African American women aging with HIV and co-morbidities.

PubMed

Warren-Jeanpiere, Lari; Dillaway, Heather; Hamilton, Pilar; Young, Mary; Goparaju, Lakshmi

2014-07-01

Self-managing HIV/AIDS presents challenges for anyone infected. These challenges may be further complicated for older HIV-infected African American women who acquired the disease at younger ages and now have co-morbidities. Little is known regarding how women's age identity, social responsibilities, co-morbidities, and romantic relationship status influence their HIV self-management. Five focus groups were conducted in Washington DC, with HIV-positive African American women aged 52-65. Topics included HIV and co-morbidity self-management, social support needs, medication adherence, and future plans for old age. A constant comparison approach was applied during data analysis. Co-morbidities, including diabetes and hypertension, were perceived to be more difficult to self-manage than HIV. This difficulty was not attributed to aging but to daily struggles such as lack of income and/or health insurance, an inflexible work schedule, and loneliness. Social responsibilities, including caring for family, positively impacted participants' ability to self-manage HIV by serving as motivation to stay healthy in order to continue to help family members. In contrast, inflexible work schedules negatively impacted women's ability to sustain medication adherence. Overall, this study demonstrates that HIV and co-morbidity self-management are inextricably linked. We can no longer afford to view engagement in HIV care as a single-disease issue and hope to attain optimal health and well-being in our HIV-affected populations. Optimal HIV self-management must be framed within a larger context that simultaneously addresses HIV and co-morbidities, while considering how social and cultural factors uniquely intersect to influence older African American women's self-management strategies.

Developing a Measure of Stigma by Association with African American Adolescents Whose Mothers Have HIV

ERIC Educational Resources Information Center

Mason, Sally; Berger, Barbara; Ferrans, Carol Estwing; Sultzman, Vickey; Fendrich, Michael

2010-01-01

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…

The role of public schools in HIV prevention: perspectives from African Americans in the rural South.

PubMed

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

2012-02-01

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.

Randomized Controlled Trials of Technology-Based HIV/STI and Drug Abuse Preventive Interventions for African American and Hispanic Youth: Systematic Review

PubMed Central

Mendoza Lua, Frania; Ovadje, Lauretta; Hong, Ethan; Castillo, Berenice; Salas-Wright, Christopher P

2017-01-01

Background HIV/sexually transmitted infections (STIs) and drug abuse remain significant public health concerns in the United States, and African American and Hispanic youth are disproportionately affected. Although technology-based interventions are efficacious in preventing and reducing HIV/STI and licit/illicit drug use behaviors, relatively little is known regarding the state of the science of these interventions among African American and Hispanic youth. Objective The aim of this review is to identify and examine randomized controlled trials (RCTs) of technology-based HIV/STI and/or drug abuse preventive interventions for African American and Hispanic youth. Methods We searched electronic databases (ie, PubMed, Proquest, PsycINFO, Ebscohost, Google Scholar) to identify studies between January 2006 and October 2016. RCTs of technology-based interventions targeting African American and Hispanic youth HIV/STI risk behaviors, including sexual risk, licit and illicit drug use, and HIV/STI testing were included. Results Our search revealed a total of three studies that used an RCT design and included samples comprised of >50% African American and/or Hispanic youth. The follow-up assessments ranged from two weeks to six months and the number of participants in each trial ranged from 72 to 141. The three interventions were theory-driven, interactive, and tailored. The long-term effects of the interventions were mixed, and outcomes included reductions in sex partners, licit drug use, and condomless anal sex acts. Conclusions Although technology-based interventions seem promising in the prevention of HIV/STI and drug abuse among African American and Hispanic youth, more research is needed. PMID:29237577

HIV/AIDS knowledge scores and perceptions of risk among African American students attending historically black colleges and universities.

PubMed

Sutton, Madeline Y; Hardnett, Felicia P; Wright, Pierre; Wahi, Sagina; Pathak, Sonal; Warren-Jeanpiere, Lari; Jones, Sandra

2011-01-01

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. African American undergraduate HBCU students completed online surveys assessing HIV/AIDS knowledge and behaviors, and we analyzed data to assess their knowledge and behaviors. 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). Educating students about effectively assessing sex partner risk will improve HIV knowledge and prevention efforts at HBCUs.

Promoting HIV Vaccine Research in African American Communities: Does the Theory of Reasoned Action Explain Potential Outcomes of Involvement?

PubMed Central

Frew, Paula M.; Archibald, Matthew; Martinez, Nina; del Rio, Carlos; Mulligan, Mark J.

2009-01-01

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

Promoting HIV Vaccine Research in African American Communities: Does the Theory of Reasoned Action Explain Potential Outcomes of Involvement?

PubMed

Frew, Paula M; Archibald, Matthew; Martinez, Nina; del Rio, Carlos; Mulligan, Mark J

2007-01-01

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.

Bridging barriers to clinic-based HIV testing with new technology: translating self-implemented testing for African American youth.

PubMed

Catania, J A; Dolcini, M M; Harper, G W; Dowhower, D P; Dolcini-Catania, L G; Towner, S L; Timmons, A; Motley, D N; Tyler, D H

2015-12-01

Numerous barriers to clinic-based HIV testing exist (e.g., stigmatization) for African American youth. These barriers may be addressed by new technology, specifically HIV self-implemented testing (SIT). We conducted a series of formative phase 3 translation studies (49 face-to-face interviews, 9 focus groups, 1 advisory panel review) among low-income African American youth (15-19 years) and providers of adolescent services in two US cities to identify potential translation difficulties of the OraQuick SIT. Based on content analysis, we found that providers and African American youth viewed SITs positively compared to clinic-based testing. Data suggest that SITs may reduce social stigma and privacy concerns and increase convenience and normalization of HIV testing. Challenges with SIT implementation include difficulties accessing confirmatory testing, coping with adverse outcomes, and instructional materials that may be inappropriate for low socioeconomic status (SES) persons. Study results underscore the need for translation studies to identify specific comprehension and implementation problems African American youth may have with oral SITs.

HIV risk behaviors among African American men in Los Angeles County who self-identify as heterosexual.

PubMed

Wohl, Amy Rock; Johnson, Denise F; Lu, Sharon; Jordan, Wilbert; Beall, Gildon; Currier, Judith; Simon, Paul A

2002-11-01

There are limited data on high-risk behaviors among heterosexual African American men with HIV infection. Risk behaviors were examined in a case-control study of HIV-infected (n = 90) and uninfected (n = 272) African American men who self-identified as heterosexual. Of men who self-identified as heterosexual, 31% (n = 28) of the infected men and 16% (n = 43) of the uninfected men reported having had anal sex with men. Among the heterosexual men reporting anal sex with men, 100% of the infected and 67% of the uninfected men reported inconsistent condom use during anal sex with men. Few of the infected (12%) and uninfected (2%) men reported oral sex with other men. Of the men who self-identified as heterosexual, 46% of those who were HIV-positive and 37% of those who were HIV-negative reported anal sex with women with infrequent condom use. An increasing risk for HIV was associated with decreasing age at first sexual experience (chi2, 9.3; p = .002). A history of injecting drugs (odds ratio [OR], 3.1; 95% confidence intervals [CIs], 1.8, 5.4) and amphetamine (OR, 4.3; 95% CIs, 1.1, 16.7) and methamphetamine (OR, 2.9; 95% CIs, 1.4, 6.3) use were associated with HIV. Innovative HIV prevention strategies are needed that move beyond the traditional gay versus straight model to effectively access hard-to-reach African American men who self-identify as heterosexual.

Association of discrimination-related trauma with sexual risk among HIV-positive African American men who have sex with men.

PubMed

Fields, Errol L; Bogart, Laura M; Galvan, Frank H; Wagner, Glenn J; Klein, David J; Schuster, Mark A

2013-05-01

We investigated whether 1 form of traumatic stress, discrimination-related trauma (e.g., physical assault because of race), was associated with unprotected anal intercourse, especially when compared with non-discrimination-related trauma, among African American men who have sex with men. A convenience sample of 131 HIV-positive African American men who have sex with men receiving antiretroviral treatment completed audio computer-assisted self-interviews that covered unprotected anal intercourse, interpersonal trauma, and whether trauma was because of discrimination on the basis of race/ethnicity, HIV serostatus, or sexual orientation. Sixty percent reported at least 1 interpersonal trauma; they attributed at least 1 trauma to being gay (47%), African American (17%), or HIV positive (9%). In a multivariate regression, experiencing discrimination-related trauma was significantly associated with unprotected anal intercourse (adjusted odds ratio [AOR] = 2.4; 95% confidence interval [CI] = 1.0, 5.7; P = .04), whereas experiencing non-discrimination-related trauma was not (AOR = 1.3; 95% CI = 0.6, 3.1; P = .53). HIV-positive African American men who have sex with men experience high levels of discrimination-related trauma, a stressor associated with greater risk taking. HIV prevention interventions should consider the potential damaging effects of discrimination in the context of trauma.

The Role of Public Schools in HIV Prevention: Perspectives from African Americans in the Rural South

ERIC Educational Resources Information Center

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

2012-01-01

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…

Views of Young, Rural African Americans of the Role of Community Social Institutions' in HIV Prevention

PubMed Central

Youmans, Selena; Lloyd, Stacy W.; Coker-Appiah, Dionne S.; Banks, Bahby; Blumenthal, Connie; Albritton, Tashuna; Ellison, Arlinda; Smith, Giselle Corbie; Adimora, Adaora A.

2010-01-01

Background We explored rural African American youths' perceptions about the role of community social institutions in addressing HIV. Methods We conducted four focus groups with African Americans aged 16 to 24 years in two rural counties in North Carolina. Groups were stratified by gender and risk status. We used a grounded theory approach to content analysis. Results Participants identified four social institutions as primary providers of HIV-related health promotion efforts: faith organizations, schools, politicians, and health agencies. They reported perceiving a lack of involvement in HIV prevention by faith-based organizations, constraints of abstinence-based sex education policies, politicians' lack of interest in addressing broader HIV determinants, and inadequacies in health agency services, and viewed all of these as being counter-productive to HIV prevention efforts. Conclusions youth have important insights about local social institutions that should be considered when designing HIV prevention interventions that partner with local organizations. PMID:20453373

HIV/AIDS Knowledge Scores and Perceptions of Risk Among African American Students Attending Historically Black Colleges and Universities

PubMed Central

Sutton, Madeline Y.; Hardnett, Felicia P.; Wright, Pierre; Wahi, Sagina; Pathak, Sonal; Warren-Jeanpiere, Lari; Jones, Sandra

2011-01-01

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

HIV-related sexual risk behavior among African American adolescent girls.

PubMed

Danielson, Carla Kmett; Walsh, Kate; McCauley, Jenna; Ruggiero, Kenneth J; Brown, Jennifer L; Sales, Jessica M; Rose, Eve; Wingood, Gina M; Diclemente, Ralph J

2014-05-01

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. 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. 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. 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.

High cancer-related mortality in an urban, predominantly African-American, HIV-infected population.

PubMed

Riedel, David J; Mwangi, Evelyn Ivy W; Fantry, Lori E; Alexander, Carla; Hossain, Mian B; Pauza, C David; Redfield, Robert R; Gilliam, Bruce L

2013-04-24

To determine mortality associated with a new cancer diagnosis in an urban, predominantly African-American, HIV-infected population. Retrospective cohort study. All HIV-infected patients diagnosed with cancer between 1 January 2000 and 30 June 2010 were reviewed. Mortality was examined using Kaplan-Meier estimates and Cox proportional hazards models. There were 470 cases of cancer among 447 patients. Patients were predominantly African-American (85%) and male (79%). Non-AIDS-defining cancers (NADCs, 69%) were more common than AIDS-defining cancers (ADCs, 31%). Cumulative cancer incidence increased significantly over the study period. The majority (55.9%) was taking antiretroviral therapy (ART) at cancer diagnosis or started afterward (26.9%); 17.2% never received ART. Stage 3 or 4 cancer was diagnosed in 67%. There were 226 deaths during 1096 person years of follow-up, yielding an overall mortality rate of 206 per 1000 person years. The cumulative mortality rate at 30 days, 1 year, and 2 years was 6.5, 32.2, and 41.4%, respectively. Mortality was similar between patients on ART whether they started before or after the cancer diagnosis but was higher in patients who never received ART. In patients with a known cause of death, 68% were related to progression of the underlying cancer. In a large cohort of urban, predominantly African-American patients with HIV and cancer, many patients presented with late-stage cancer. There was substantial 30-day and 2-year mortality, although ART had a significant mortality benefit. Deaths were most often caused by progression of cancer and not from another HIV-related or AIDS-related event.

Silent Endurance and Profound Loneliness: Socioemotional Suffering in African Americans Living With HIV in the Rural South

PubMed Central

Miles, Margaret Shandor; Isler, Malika Roman; Banks, Bahby B.; Sengupta, Sohini; Corbie-Smith, Giselle

2011-01-01

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

Risk Reduction for HIV-Positive African American and Latino Men with Histories of Childhood Sexual Abuse

PubMed Central

Wyatt, Gail E.; Rivkin, Inna; Ramamurthi, Hema Codathi; Li, Xiaomin; Liu, Honghu

2014-01-01

While the HIV epidemic has disproportionately affected African American and Latino men who have sex with men (MSM), few HIV prevention interventions have focused on African American and Latino men who have sex with both men and women (MSMW). Even fewer interventions target HIV-positive African American and Latino MSM and MSMW with histories of childhood sexual abuse (CSA), a population that may be vulnerable to high-risk sexual behaviors, having multiple sexual partners, and depression. The Men’s Health Project, a small randomized clinical trial, compared the effects of two 6-session interventions, the Sexual Health Intervention for Men (S-HIM), guided by social learning theory and aimed at decreasing high-risk sexual behaviors, number of sexual partners, and depressive symptoms, and a standard health promotion control (SHP).A community sample of 137 HIV-positive gay and non-gay identifying African American and Latino MSM and MSMW with histories of CSA was recruited. Results were based on an “intent to treat” analyses of baseline to post, 3 and 6 month follow-ups. The sample as a whole reported reductions in sexual risk behaviors and number of sexual partners from baseline to post-test, and from the 3 to 6 month follow-ups, although the decrease in sexual risk behavior from baseline to post-test was significant only for S-HIM participants. No significant differences between conditions were reported for depressive symptoms, but the total sample reported a significant decrease at 6 months. These findings highlight the importance of addressing sexual decision-making and psychological adjustment for ethnic men, while being sensitive to CSA histories and sexual minority status, and suggest the need to develop additional strategies to heighten HIV risk reduction over time. PMID:18506611

Why Take an HIV Test? Concerns, Benefits, and Strategies to Promote HIV Testing among Low-Income Heterosexual African American Young Adults

ERIC Educational Resources Information Center

Wallace, Scyatta A.; McLellan-Lemal, Eleanor; Harris, Muriel J.; Townsend, Tiffany G.; Miller, Kim S.

2011-01-01

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.…

HIV/AIDS stigma among a sample of primarily African-American and Latino men who have sex with men social media users.

PubMed

Garett, Renee; Smith, Justin; Chiu, Jason; Young, Sean D

2016-01-01

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.

Randomized Controlled Trials of Technology-Based HIV/STI and Drug Abuse Preventive Interventions for African American and Hispanic Youth: Systematic Review.

PubMed

Córdova, David; Mendoza Lua, Frania; Ovadje, Lauretta; Hong, Ethan; Castillo, Berenice; Salas-Wright, Christopher P

2017-12-13

HIV/sexually transmitted infections (STIs) and drug abuse remain significant public health concerns in the United States, and African American and Hispanic youth are disproportionately affected. Although technology-based interventions are efficacious in preventing and reducing HIV/STI and licit/illicit drug use behaviors, relatively little is known regarding the state of the science of these interventions among African American and Hispanic youth. The aim of this review is to identify and examine randomized controlled trials (RCTs) of technology-based HIV/STI and/or drug abuse preventive interventions for African American and Hispanic youth. We searched electronic databases (ie, PubMed, Proquest, PsycINFO, Ebscohost, Google Scholar) to identify studies between January 2006 and October 2016. RCTs of technology-based interventions targeting African American and Hispanic youth HIV/STI risk behaviors, including sexual risk, licit and illicit drug use, and HIV/STI testing were included. Our search revealed a total of three studies that used an RCT design and included samples comprised of >50% African American and/or Hispanic youth. The follow-up assessments ranged from two weeks to six months and the number of participants in each trial ranged from 72 to 141. The three interventions were theory-driven, interactive, and tailored. The long-term effects of the interventions were mixed, and outcomes included reductions in sex partners, licit drug use, and condomless anal sex acts. Although technology-based interventions seem promising in the prevention of HIV/STI and drug abuse among African American and Hispanic youth, more research is needed. ©David Córdova, Frania Mendoza Lua, Lauretta Ovadje, Ethan Hong, Berenice Castillo, Christopher P Salas-Wright. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 13.12.2017.

Social support, psychological vulnerability, and HIV risk among African American men who have sex with men

PubMed Central

Saleh, Lena D.; Chambers, Christopher S.; Operario, Don

2015-01-01

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

Family, cultural and gender role aspects in the context of HIV risk among African American women of unidentified HIV status: an exploratory qualitative study.

PubMed

Jarama, S L; Belgrave, F Z; Bradford, J; Young, M; Honnold, J A

2007-03-01

This was an exploratory, qualitative study of contextual cultural and social realities of the sexual interactions of a representative sample of African American women of unidentified HIV status. The study expanded our understanding of family and gender role variables by exploring influences of family of origin and idealistic perceptions of roles on sexual relationships. Data was collected on 51 African American women who were recruited through probability sampling. Between 39% and 70% of study participants reported at least one of the following HIV risk factors: low condom use, substance use during sex, partner's incarceration and history of abuse. Nonetheless, all women in our study perceived their chances of HIV infection to be almost non-existent, despite a fairly good knowledge of HIV/AIDS modes of transmission including that anyone could become HIV infected, knowing somebody with HIV/AIDS and acknowledgment, among some, of their partner's infidelity and risk behaviors. Our analysis revealed that parental communications about sexuality in relationships focused largely on trust (being mistrustful of men) and women's control of their sexual impulses. Trust was also emphasized (desired) by women in the discussions of gender roles. Women reported a strong reliance on God and made frequent references to the role of the church in HIV prevention. Our findings offer suggestions for HIV prevention for the general population of African American women. HIV-prevention messages that consider their views of relationships, gender roles, sexual abuse history and the role of the church are suggested.

Sexual Risk Behavior among African American College Women: Understanding Socio-Cultural Factors in the Context of HIV/AIDS

ERIC Educational Resources Information Center

Gibbons, Maya A.

2010-01-01

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…

Resilience in low-income African American women living and aging with HIV.

PubMed

Subramaniam, Sailaja; Camacho, Lizeth M; Carolan, Marsha T; López-Zerón, Gabriela

2017-01-01

Women are living with HIV into middle and older age and are likely to face multiple comorbidities and stressors as they age. This study focused on understanding how women who experience multiple forms of oppression and ongoing adversity are still able to adapt and stand strong. Using a theoretical framework of resilience and a feminist research ideology, interviews of eight middle-aged and older African American women living with HIV were analyzed. Despite experiences of HIV-related discrimination, trauma, and violence, these women demonstrated a remarkable ability to adapt and maintain support. Implications for research and practice are discussed.

HIV/AIDS and African American men: urban-rural differentials in sexual behavior, HIV knowledge, and attitude towards condoms use.

PubMed

Williams, Patrick Bassey; Sallar, Anthony M

2010-12-01

We assessed the differences and similarities in knowledge, attitude, beliefs, myths, and misconceptions; and the various high-risk behavioral factors that influence the rate of infectivity of human immunodeficiency virus (HIV)/AIDS among African American men in urban and rural communities of Mississippi. A cross-sectional sample survey was conducted on 466 African American men in 2 sites between 2005 and 2007. With the main outcome variables of knowledge, attitude/feelings, behavior/practices, and potentials for behavior change, we administered a 64-item, ethnically sensitive, gender-specific instrument to the subjects via a person-to-person interview. Of the 466 respondents (urban, 33%; rural, 67%), 70%, 14.4%, and 16.6%, respectively, were heterosexual, bisexual, and men who have sex with men (MSM). The number of the respondents' sexual partners in the previous 12 months were: 1 to 2 (54%), 3 to 4 (25.7%), and 5 or more (20.2%). Statistically significant differences were observed between the 2 populations on HIV knowledge (p < .001), HIV/sexually transmitted infection testing history (p < .001), sexual partners (p = .038), unprotected sexual intercourse with drug users (p < .001), unprotected casual sex (p < .001), intercourse in an open relationship or marriage (p < .001), and communication with potential sex partners regarding sexual limits prior to intercourse (p = .027). Although the level of HIV/AIDS knowledge and education were lower among urban than rural respondents, subjects' negative overall beliefs, attitude/feelings, behavior and potentials for behavioral change did not differ significantly among the African American men in the 2 communities.

African American College Students' Attitudes toward HIV/AIDS: Implications for Historically Black Colleges and Universities

ERIC Educational Resources Information Center

Taylor, Sandra E.; Jones, Tara

2007-01-01

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.…

Sources and Types of Social Support that Influence Engagement in HIV Care among Latinos and African Americans

PubMed Central

George, Sheba; Garth, Belinda; Wohl, Amy Rock; Galvan, Frank H.; Garland, Wendy; Myers, Hector F.

2011-01-01

The change in HIV from acute to chronic disease due to the introduction of HAART in the mid-1990s increased the importance of its successful management and imposed substantial lifestyle adjustments on HIV-positive persons and their support networks. Few studies have examined the sources and types of social support and the areas of care relevant for engagement in HIV treatment among HIV-positive Latinos and African Americans. This paper reports the results of twenty-four semi-structured in-depth interviews that were conducted with HIV-positive African American and Latino women and men who have sex with men. Formal networks were found to be more critical for engagement in HIV-specific medical care; specifically, study participants relied primarily on health care providers for support in accessing and maintaining illness-specific care. In contrast, informal networks (in the form of family and friends) were crucial for other general subsistence care, such as emotional, household-related, and financial support. PMID:20168014

National Institute of Mental Health Multisite Eban HIV/STD Prevention Intervention for African American HIV Serodiscordant Couples: a cluster randomized trial.

PubMed

El-Bassel, Nabila; Jemmott, John B; Landis, J Richard; Pequegnat, Willo; Wingood, Gina M; Wyatt, Gail E; Bellamy, Scarlett L

2010-09-27

Human immunodeficiency virus (HIV) has disproportionately affected African Americans. Couple-level interventions may be a promising intervention strategy. To determine if a behavioral intervention can reduce HIV/sexually transmitted disease (STD) risk behaviors among African American HIV serodiscordant couples, a cluster randomized controlled trial (Eban) was conducted in Atlanta, Georgia; Los Angeles, California; New York, New York; and Philadelphia, Pennsylvania; with African American HIV serodiscordant heterosexual couples who were eligible if both partners were at least 18 years old and reported unprotected intercourse in the previous 90 days and awareness of each other's serostatus. One thousand seventy participants were enrolled (mean age, 43 years; 40% of male participants were HIV positive). Couples were randomized to 1 of 2 interventions: couple-focused Eban HIV/STD risk-reduction intervention or attention-matched individual-focused health promotion comparison. The primary outcomes were the proportion of condom-protected intercourse acts and cumulative incidence of STDs (chlamydia, gonorrhea, or trichomonas). Data were collected preintervention and postintervention, and at 6- and 12-month follow-ups. Data were analyzed for 535 randomized couples: 260 in the intervention group and 275 in the comparison group; 81.9% were retained at the 12-month follow-up. Generalized estimating equation analyses revealed that the proportion of condom-protected intercourse acts was larger among couples in the intervention group (0.77) than in the comparison group (0.47; risk ratio, 1.24; 95% confidence interval [CI], 1.09 to 1.41; P = .006) when adjusted for the baseline criterion measure. The adjusted percentage of couples using condoms consistently was higher in the intervention group (63%) than in the comparison group (48%; risk ratio, 1.45; 95% CI, 1.24 to 1.70; P < .001). The adjusted mean number of (log)unprotected intercourse acts was lower in the intervention group

Project ORE: A Friendship-Based Intervention to Prevent HIV/STI in Urban African American Adolescent Females

ERIC Educational Resources Information Center

Dolcini, M. Margaret; Harper, Gary W.; Boyer, Cherrie B.; Pollack, Lance M.

2010-01-01

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…

"Out of All of this Mess, I Got a Blessing": Perceptions and Experiences of Reproduction and Motherhood in African American Women Living With HIV.

PubMed

Fletcher, Faith; Ingram, Lucy Annang; Kerr, Jelani; Buchberg, Meredith; Richter, Donna L; Sowell, Richard

2016-01-01

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. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

A Randomized Trial to Evaluate the Efficacy of a Web-Based HIV Behavioral Intervention for High-Risk African American Women.

PubMed

Billings, Douglas W; Leaf, Samantha L; Spencer, Joy; Crenshaw, Terrlynn; Brockington, Sheila; Dalal, Reeshad S

2015-07-01

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.

Correlates of HIV risk-taking behaviors among African-American college students: the effect of HIV knowledge, motivation, and behavioral skills.

PubMed Central

Bazargan, M.; Kelly, E. M.; Stein, J. A.; Husaini, B. A.; Bazargan, S. H.

2000-01-01

This study identifies theoretically based predictors of condom use in a sample of 253 sexually active African-American college students recruited from two historically African-American colleges. The Information-Motivation-Behavioral (IMB) skills model of AIDS-preventive behavior was employed to delineate the roles of HIV/AIDS knowledge, experiences with and attitudes toward condom use, peer influences, perceived vulnerability, monogamy, and behavioral skills. A predictive structural equation model revealed significant predictors of more condom use including: male gender, more sexual HIV knowledge, positive experiences and attitudes about condom use, nonmonogamy, and greater behavioral skills. Results imply that attention to behavioral skills for negotiating safer sex and training in the proper use of condoms are key elements in reducing high risk behaviors. Increasing the specific knowledge level of college students regarding the subtleties of sexual transmission of HIV is important and should be addressed. Heightening students' awareness of the limited protection of serial monogamy, and the need to address gender-specific training regarding required behavior change to reduce transmission of HIV should be an additional goal of college health professionals. PMID:10992684

The Role of the Black Church, the Barbershop/Beauty Salon, and Digital Communication to Support African American Persons Living with HIV/AIDS

ERIC Educational Resources Information Center

Pillay, Yegan

2011-01-01

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…

Risk and protective factors of posttraumatic stress disorder among African American women living with HIV.

PubMed

Andu, Eaden; Wagenaar, Brad H; Kemp, Chris G; Nevin, Paul E; Simoni, Jane M; Andrasik, Michele; Cohn, Susan E; French, Audrey L; Rao, Deepa

2018-04-26

We sought to examine risk and protective factors for Posttraumatic Stress Disorder (PTSD) among African American women living with HIV. This is a cross-sectional analysis of baseline data from a randomized trial of an HIV stigma reduction intervention. We examined data from two-hundred and thirty-nine African American women living with HIV. We examined whether age, marital status, level of education, internalized HIV-related stigma, and social support as potential protective and risk factors for PTSD symptoms using logistic regression. We analyzed bi-variate associations between each variable and PTSD symptoms, and constructed a multivariate logistic regression model adjusting for all variables. We found 67% reported clinically significant PTSD symptoms at baseline. Our results suggest that age, education, and internalized stigma were found to be associated with PTSD symptoms (p < 0.001), with older age and more education as protective factors and stigma as a risk factor for PTSD. Therefore, understanding this relationship may help improve assessment and treatment through evidence- based and trauma-informed strategies.

Prediction of HIV Sexual Risk Behaviors among Disadvantaged African American Adults using a Syndemic Conceptual Framework

PubMed Central

Nehl, Eric J.; Klein, Hugh; Sterk, Claire E.; Elifson, Kirk W.

2015-01-01

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

Stress processes in HIV-positive African American mothers: moderating effects of drug abuse history.

PubMed

Burns, Myron J; Feaster, Daniel J; Mitrani, Victoria B; Ow, Christina; Szapocznik, José

2008-01-01

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.

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.

PubMed

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

2015-01-01

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. © 2014 Society for Public Health Education.

Culturally Sensitive Approaches to Identification and Treatment of Depression among HIV Infected African American Adults: A Qualitative Study of Primary Care Providers' Perspectives.

PubMed

Le, Huynh-Nhu; Hipolito, Maria Mananita S; Lambert, Sharon; Terrell-Hamilton, Flora; Rai, Narayan; McLean, Charlee; Kapetanovic, Suad; Nwulia, Evaristus

2016-04-01

Major depressive disorder (MDD) is highly prevalent among HIV-infected (HIV+) individuals, and is associated with non-adherence to antiretroviral therapy (ART), and accelerated disease progression. MDD is underdiagnosed and undertreated among low-income African Americans, who are disproportionately impacted by the HIV epidemic. To improve detection and treatment of depression among African Americans living with HIV/AIDS, it is important to understand culturally and contextually relevant aspects of MDD and attitudes about mental health treatment. A focus group session was conducted with seven providers and staff at a primary care center that serves a largely African-American community heavily impacted by the HIV epidemic in Washington, DC. Data were analyzed using an inductive approach to distill prominent themes, perspectives, and experiences among participating providers. Five themes emerged to characterize the lived experiences of HIV+ African-American patients: (a) Changes in perceptions of HIV over time; (b) HIV is comorbid with mental illness, particularly depression and substance abuse; (c) Stigma is associated with both HIV and depression; (d) Existing mental health services vary and are insufficient and (e) Suggestions for optimal treatment for comorbid HIV and depression. This study reflects the views of providers from one clinic in this community. Substantial economic disadvantage, pervasive childhood adversity, limited education and limited resources jointly put members of this community at risk for acquisition of HIV and for development of depression and addictions. These contextual factors provide an important reminder that any patient-level depression identification or intervention in this community will have to be mindful of such circumstances.

Stress processes in HIV-positive African American mothers: Moderating effects of drug abuse history

PubMed Central

BURNS, MYRON J.; FEASTER, DANIEL J.; MITRANI, VICTORIA B.; OW, CHRISTINA; SZAPOCZNIK, JOSÉ

2008-01-01

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. PMID:18027126

Missed opportunities for HIV testing in health care settings among young African American men who have sex with men: implications for the HIV epidemic.

PubMed

Dorell, Christina G; Sutton, Madeline Y; Oster, Alexandra M; Hardnett, Felicia; Thomas, Peter E; Gaul, Zaneta J; Mena, Leandro A; Heffelfinger, James D

2011-11-01

Limited health care access and missed opportunities for HIV and other sexually transmitted infection (STI) education and testing in health care settings may contribute to risk of HIV infection. In 2008, we conducted a case-control study of African American men who have sex with men (MSM) in a southeastern city (Jackson, Mississippi) with an increase in numbers of newly reported HIV cases. Our aims were to evaluate associations between health care and HIV infection and to identify missed opportunities for HIV/STI testing. We queried 40 potential HIV-infected cases and 936 potential HIV-uninfected controls for participation in this study. Study enrollees included HIV-infected cases (n=30) and HIV-uninfected controls (n=95) who consented to participate and responded to a self-administered computerized survey about sexual risk behaviors and health care utilization. We used bivariate analysis and logistic regression to test for associations between potential risk factors and HIV infection. Cases were more likely than controls to lack health insurance (odds ratio [OR]=2.5; 95% confidence interval [CI]=1.1-5.7), lack a primary care provider (OR=6.3; CI=2.3-16.8), and to not have received advice about HIV or STI testing or prevention (OR=5.4; CI=1.3-21.5) or disclose their sexual identity (OR=7.0; CI=1.6-29.2) to a health care provider. In multivariate analysis, lacking a primary health care provider (adjusted odds ratio [AOR]=4.5; CI=1.4-14.7) and not disclosing sexual identity to a health care provider (AOR=8.6; CI=1.8-40.0) were independent risk factors for HIV infection among African American MSM. HIV prevention interventions for African American MSM should address access to primary health care providers for HIV/STI prevention and testing services and the need for increased discussions about sexual health, sexual identity, and sexual behaviors between providers and patients in an effort to reduce HIV incidence and HIV-related health disparities.

Preferences for Condomless Sex in Sexually Explicit Media Among Black/African American Men Who Have Sex with Men: Implications for HIV Prevention.

PubMed

Nelson, Kimberly M; Eaton, Lisa A; Gamarel, Kristi E

2017-05-01

Accumulating evidence suggests that viewing sexually explicit media (SEM; i.e., pornography) may be related to the sexual behaviors of men who have sex with men (MSM). Furthermore, stereotypical depictions of Black/African American MSM engaging in sexual risk behaviors in SEM may serve to normalize condomless sex, reinforce low peer norms around condom use, and facilitate HIV risk taking among Black/African American MSM. Despite this evidence, very little is known about the correlates of SEM consumption among Black/African American MSM, including HIV risk behaviors and their relation to preferences for viewing condomless sex in SEM. Participants were 653 HIV-seronegative Black-identified MSM ages 18-62 (M 33.58, SD 11.01) who completed a cross-sectional survey as a part of a HIV prevention trial in Atlanta, Georgia. Over three-quarters of the men (n = 514) reported a preference for condomless sex in SEM. In multivariate models, engaging in serodiscordant condomless sex was not significantly associated with preferences for condomless sex in SEM; however, men who self-identified as bisexual, engaged in transactional sex, and reported greater agreement with sexual risk cognitions (i.e., heat-of-the-moment thoughts about condom use) had significantly greater odds of reporting a preference for condomless sex in SEM. Study findings highlight the need for future research exploring the role of SEM in the sexual health of Black/African American MSM, including the extent to which SEM exposure alters norms and expectations about sexual behaviors among Black/African American MSM and how this might be addressed in HIV prevention programs.

Preferences for condomless sex in sexually explicit media among Black/African American men who have sex with men: Implications for HIV prevention

PubMed Central

Nelson, Kimberly M.; Eaton, Lisa A.; Gamarel, Kristi E.

2016-01-01

Accumulating evidence suggests that viewing sexually explicit media (SEM; i.e., pornography) may be related to the sexual behaviors of men who have sex with men (MSM). Furthermore, stereotypical depictions of Black/African American MSM engaging in sexual risk behaviors in SEM may serve to normalize condomless sex, reinforce low peer norms around condom use, and facilitate HIV risk-taking among Black/African American MSM. Despite this evidence, very little is known about the correlates of SEM consumption among Black/African American MSM, including HIV risk behaviors and their relation to preferences for viewing condomless sex in SEM. Participants were 653 HIV-seronegative Black-identified MSM ages 18 to 62 (M = 33.58, SD = 11.01) who completed a cross-sectional survey as a part of a HIV-prevention trial in Atlanta, Georgia. Over three-quarters of the men (n = 514) reported a preference for condomless sex in SEM. In multivariate models, engaging in serodiscordant condomless sex was not significantly associated with preferences for condomless sex in SEM; however, men who self-identified as bisexual, engaged in transactional sex, and reported greater agreement with sexual risk cognitions (i.e., heat of the moment thoughts about condom use) has significantly greater odds of reporting a preference for condomless sex in SEM. Study findings highlight the need for future research exploring the role of SEM in the sexual health of Black/African American MSM, including the extent to which SEM exposure alters norms and expectations about sexual behaviors among Black/African American MSM and how this might be addressed in HIV prevention programs. PMID:27987085

Teaching Modules to Build HIV/AIDS Knowledge and Safer Sex Skills among African-American College Students

ERIC Educational Resources Information Center

Kanekar, Amar; Sharma, Manoj

2011-01-01

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…

Mechanisms of Family Impact on African American Adolescents’ HIV-Related Behavior

PubMed Central

Kogan, Steven M.; Brody, Gene H.; Gibbons, Frederick X.; Chen, Yi-fu; Grange, Christina M.; Simons, Ronald L.; Gerrard, Meg; Cutrona, Carolyn E.

2010-01-01

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

A Pilot Trial Examining African American and White Responses to Algorithm-Guided Smoking Cessation Medication Selection in Persons Living with HIV.

PubMed

Valera, Pamela; McClernon, F Joseph; Burkholder, Greer; Mugavero, Michael J; Willig, James; O'Cleirigh, Conall; Cropsey, Karen L

2017-07-01

Algorithm-based treatments (AT) may be an effective clinical tool to aid HIV clinicians in prescribing pharmacotherapy to increase smoking cessation among people living with HIV (PLWH). Initial results from AT indicated significant increases in abstinence self-efficacy and medication utilization and declines in cigarettes smoked per day across time. Given historical racial disparities, it is unclear if both African Americans and White smokers would benefit equally from this type of intervention. Thus, the aim of this study was to examine racial differences in response to AT guided smoking cessation for African American and White smokers living with HIV. One hundred PLWH smokers (n = 100) were randomized to receive either AT guided smoking cessation or Treatment as Usual (TAU) which consisted of instructing participants to talk to a provider about smoking cessation assistance when ready to make a quit attempt. Participants were African American (75%) and White (25%) and majority men (71%) who had never been married (56%). African Americans smoked fewer cigarettes and were more likely to smoke mentholated cigarettes compared to White smokers at baseline. African Americans increased their use of other tobacco products (cigars/cigarillos) over time relative to White smokers. A significant interaction between race and quit goal was observed, with White smokers who reported complete abstinence as their goal having higher quit rates, while African Americans who reported a goal other than complete abstinence demonstrating higher quit rates. The increased use of cigars/cigarillos during quit attempts as well as having a goal other than complete abstinence should be considered when applying algorithm based interventions for PLWH African American smokers.

Project THANKS: Examining HIV/AIDS-Related Barriers and Facilitators to Care in African American Women: A Community Perspective.

PubMed

Amutah-Onukagha, Ndidiamaka; Mahadevan, Meena; Opara, Ijeoma; Rodriguez, Monica; Trusdell, Megan; Kelly, Jessica

2018-04-01

Project THANKS, (Turning HIV/AIDS into Knowledge for Sisters), is an evidence-based intervention that utilizes a community-based participatory and empowerment building approach for African American female substance abusers living with HIV and other chronic diseases. This qualitative study sought to gain insight from women living with HIV on how to improve Project THANKS. African American women living with substance abuse disorders, HIV, and other comorbidities were recruited from three community based health centers in New Jersey (N = 31). Ninety minute focus group sessions were implemented in each health center. The focus group sessions were designed to understand the perceived factors influencing the participants' ability to self-manage their health conditions and challenges they are currently facing regarding their diagnoses. The barriers and suggestions presented by participants included addressing stigmatization, managing mental health symptoms, improving physician-patient trust, accessing health education, educating community members, and proper nutrition. In addition, an engaged and trusting relationship with their healthcare provider and having positive sources of support were cited as motivators to adhering to their HIV treatment regimen. Participants living with HIV/AIDS also expressed more concern with difficulty treating their comorbidities than participants with only HIV/AIDS. Receiving input from African American women living with HIV related comorbidities was essential in improving the intervention to include a behavioral and primary health approach. Future programmatic interventions of Project THANKS will include a targeted focus on addressing mental health needs in women by offering meditation services and mental health referrals. In addition, Project THANKS will incorporate activities to improve communication with physicians, families, and media outlets to empower women to take an active role in their primary and social support needs.

The Impact of Perceived Group Support on the Effectiveness of an HIV Prevention Intervention for African American Women

ERIC Educational Resources Information Center

Belgrave, Faye Z.; Corneille, Maya; Hood, Kristina; Foster-Woodson, Julia; Fitzgerald, Angela

2010-01-01

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…

Attention HIV: older African American women define sexual risk.

PubMed

McCord, Laneshia R

2014-01-01

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.

Using computer technology for HIV prevention among African-Americans: development of a tailored information program for safer sex (TIPSS)

PubMed Central

Noar, Seth M.; Webb, Elizabeth M.; Van Stee, Stephanie K.; Redding, Colleen A.; Feist-Price, Sonja; Crosby, Richard; Troutman, Adewale

2011-01-01

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

Intervention Induced Changes on Parenting Practices, Youth Self-Pride and Sexual Norms to Reduce HIV-Related Behaviors Among Rural African American Youths

PubMed Central

Berkel, Cady; Chen, Yi-fu; Brody, Gene H.; Gibbons, Frederick X.; Gerrard, Meg

2017-01-01

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. PMID:21373904

Infected Lives: Lived Experiences of Young African American HIV-Positive Women.

PubMed

Peltzer, Jill N; Domian, Elaine W; Teel, Cynthia S

2016-02-01

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. © The Author(s) 2014.

Do People Know I'm Poz?: Factors Associated with Knowledge of Serostatus Among HIV-Positive African Americans' Social Network Members.

PubMed

Hoover, Matthew A; Green, Harold D; Bogart, Laura M; Wagner, Glenn J; Mutchler, Matt G; Galvan, Frank H; McDavitt, Bryce

2016-01-01

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.

Perinatal HIV testing among African American, Caucasian, Hmong and Latina women: exploring the role of health-care services, information sources and perceptions of HIV/AIDS.

PubMed

Lee King, Patricia A; Pate, David J

2014-02-01

Perinatal HIV transmission disproportionately affects African American, Latina and potentially Hmong women in the United States. Understanding racially and ethnically diverse women's perceptions of and experiences with perinatal health care, HIV testing and HIV/AIDS may inform effective health communications to reduce the risk of perinatal HIV transmission among disproportionate risk groups. We used a qualitative descriptive research design with content analysis of five focus groups of African American, Caucasian, Hmong and Latina women of reproductive age with low socioeconomic status distinguished by their race/ethnicity or HIV status. A purposive stratified sample of 37 women shared their health-care experiences, health information sources and perceptions of HIV testing and HIV/AIDS. Women's responses highlighted the importance of developing and leveraging trusted provider and community-based relationships and assessing a woman's beliefs and values in her sociocultural context, to ensure clear, consistent and relevant communications. Perinatal health communications that are culturally sensitive and based on an assessment of women's knowledge and understanding of perinatal health and HIV/AIDS may be an effective tool for health educators addressing racial and ethnic disparities in perinatal HIV transmission.

Individual interviews with African-American women regarding condom use: a pilot study.

PubMed

Hunter, Teressa Sanders

2010-07-01

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.

The experience of African American women living with HIV: creating a prevention film for teens.

PubMed

Norris, Anne E; DeMarco, Rosanna

2005-01-01

The personal and social costs of HIV are well documented. What remains unknown is the effect of public disclosure of HIV status on the individual who is doing the disclosing. This study describes the experience of four African American women living with HIV who participated in the development of an intergenerational education intervention for African American adolescent girls. These women suggested that they be filmed discussing the "dark side" of HIV in an effort to create an intergenerational education intervention that would alter the risk-taking behavior that they observed in young women in their community. After a rough cut of the film was completed, these women viewed the film and participated in a focus group during which they discussed what it was like to reveal and revisit their own painful experiences associated with becoming infected and then living with HIV. Findings from content analysis of transcribed dialogue included the following positive themes: (a) self-acceptance by telling one's own story and hearing the stories of the other women, (b) a sense of liberation by disclosing publicly one's image and message and letting go of others' judgments, (c) feeling supported by meeting other women who share the same experience, (d) value of using the film to impact or save young people from the pain one has experienced. A negative theme emerged related to personal pain in reliving the individual's history with HIV.

Addressing poverty and HIV using microenterprise: findings from qualitative research to reduce risk among unemployed or underemployed African American women.

PubMed

Prather, Cynthia; Marshall, Khiya; Courtenay-Quirk, Cari; Williams, Kim; Eke, Agatha; O'Leary, Ann; Stratford, Dale

2012-08-01

Microenterprise programs are widely used to improve health outcomes among women internationally. However, there is little information on applicability to American women living in poverty. We conducted formative research to identify activities that are viable and attractive, that may produce income to address some proportion of economic need and could be incorporated in the development of a micro-enterprise HIV-prevention intervention to reduce HIV/STD transmission among unemployed or underemployed African American women at risk for HIV. Focus groups were convened with young African American women and community leaders in two southern states. Interviews with women participating in the focus groups were also convened. Findings suggest an intervention should incorporate activities to increase self-esteem, enhance employability and job sustainability to decrease financial dependence. This research serves as the foundation for developing a novel approach to HIV prevention in the U.S. that may directly address poverty as a social determinant of health.

Bone Mineral Density and Vitamin D Levels in HIV Treatment-Naïve African American Individuals Randomized to Receive HIV Drug Regimens.

PubMed

Cook, Paul P; Stang, Alexandra Te; Walker, Lia R; Akula, Shaw M; Cook, Fiona J

2016-11-01

Treatment of human immunodeficiency virus (HIV)-infected patients with tenofovir disoproxil fumarate is associated with a decrease in bone mineral density (BMD). Treatment with efavirenz is associated with vitamin D deficiency. We compared the effects of efavirenz, emtricitabine, and tenofovir disoproxil fumarate (EFV/FTC/TDF) with the effects of raltegravir, darunavir, and ritonavir (RAL/DRV/r) on BMD and 25-hydroxyvitamin D (25[OH]D) levels in HIV-infected, antiretroviral treatment-naïve African American subjects. This was a pilot study at a single HIV clinic. Forty HIV treatment-naïve African American subjects were screened, 35 of whom were randomized to receive either EFV/FTC/TDF or RAL/DRV/r. All of the subjects received supplemental vitamin D 3 and calcium. CD4 counts, HIV RNA, parathyroid hormone, osteocalcin, N-telopeptide, and 25(OH)D levels were obtained at baseline and at 8, 24, 36, and 48 weeks. Dual-energy x-ray absorptiometry of the spine and hip was performed at baseline and at week 48. Of the 35 subjects enrolled, 10 patients receiving each regimen completed the study. Median baseline 25(OH)D levels were decreased and similar in both groups. All of the patients had plasma HIV RNA <50 copies per milliliter by week 24. By week 48, there was a sustained increase in 25(OH)D in the RAL/DRV/r group ( P = 0.0004) but not in the EFV/FTC/TDF group ( P = 0.78). There were reductions in BMD of the mean total hip ( P = 0.002) and the mean femoral neck ( P = 0.004) in the EFV/FTC/TDF group but not in the RAL/DRV/r group. Treatment of African American patients with HIV using EFV/FTC/TDF is associated with a reduction in BMD of the hip and sustained reductions of 25(OH)D not seen in the group that received RAL/DRV/r. This phenomenon may have long-term consequences on bone integrity in this population.

Complex lives: resiliency of African American Women with HIV/AIDS serving as informal kinship care providers.

PubMed

Stokes, Charu

2014-01-01

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.

Examining interest in secondary abstinence among young African American females at risk for HIV or STIs.

PubMed

Bradley, Erin L P; Sales, Jessica M; Murray, Colleen C; DiClemente, Ralph J

2012-12-01

Sexually active African American females are at increased risk for acquiring HIV or STIs. However, some reduce their risk by abstaining from sex for various periods of time following initiation, a practice known as secondary abstinence. Although this may be a valuable mechanism for reducing HIV or STI rates in this population, little is known about those interested in secondary abstinence. Baseline data were obtained from a sample of African American adolescent females, ages 14-20 years, prior to participation in an HIV-risk reduction intervention trial (N = 701). Differences in individual-level and interpersonal-level factors, as well as sociodemographic variables were examined between participants who reported strong interest in secondary abstinence and those who did not. 144 (20.5%) participants reported strong interest in secondary abstinence. Young women with strong interest in abstinence had higher odds of reporting a history of STIs and feeling negative emotions following sex because of their religious beliefs. They also had higher odds of believing their partner may be interested in abstaining and being less invested in their relationship with their main partner. Additionally, adolescents reported less interpersonal stress and more social support. African American females who are interested in practicing secondary abstinence and those who are not differ in their sexual health education needs. Findings from this study characterizing young women interested in secondary abstinence can help researchers provide more targeted health education by identifying those who may be more responsive to abstinence-promoting messages.

The Benefits of a Friendship-Based HIV/STI Prevention Intervention for African American Youth

ERIC Educational Resources Information Center

Harper, Gary W.; Dolcini, M. Margaret; Benhorin, Shira; Watson, Susan E.; Boyer, Cherrie B.

2014-01-01

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…

Religiosity and Risky Sexual Behaviors among an African American Church-based Population

PubMed Central

Hawes, Starlyn M.; Berkley-Patton, Jannette Y.

2014-01-01

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

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.

PubMed

Sutton, Madeline Y; Parks, Carolyn P

2013-06-01

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.

Comparative Effectiveness of a Faith-Based HIV Intervention for African American Women: Importance of Enhancing Religious Social Capital

PubMed Central

Robinson, LaShun R.; Braxton, Nikia D.; Er, Deja L.; Conner, Anita C.; Renfro, Tiffaney L.; Rubtsova, Anna A.; Hardin, James W.; DiClemente, Ralph J.

2013-01-01

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

Efficacy of the Young Women's CoOp: An HIV Risk-Reduction Intervention for Substance-Using African-American Female Adolescents in the South

ERIC Educational Resources Information Center

Wechsberg, Wendee M.; Browne, Felicia A.; Zule, William A.; Novak, Scott P.; Doherty, Irene A.; Kline, Tracy L.; Carry, Monique G.; Raiford, Jerris L.; Herbst, Jeffrey H.

2017-01-01

HIV/sexually transmitted infection (STI) risk-reduction interventions are needed to address the complex risk behaviors among African-American female adolescents in disadvantaged communities in North Carolina. In a two-group randomized trial, we reached 237 sexually active, substance-using African-American female adolescents, to test a…

Is there a legacy of the U.S. Public Health Syphilis Study at Tuskegee in HIV/AIDS-related beliefs among heterosexual African-Americans and Latinos?

PubMed

Mays, Vickie M; Coles, Courtney N; Cochran, Susan D

2012-01-01

Knowledge of the US Public Health Syphilis Study at Tuskegee is sometime cited as a principal reason for the relatively low participation rates seen among racial/ethnic minorities, particularly African Americans, in biomedical research. However, only a few studies have actually explored this possibility. We use data from a random digit dial telephone survey of 510 African-Americans and 253 Latinos, age 18 to 45 years, to investigate associations between knowledge of the USPHS Syphilis Study at Tuskegee and endorsement of HIV/AIDS conspiracy theories. All respondents were drawn from an area of low-income, predominantly race-segregated inner city households in Los Angeles. Results indicate that African Americans were significantly more likely than Latinos to endorse HIV/AIDS conspiracy theories. Further, African Americans were more aware of the USPHS Syphilis Study at Tuskegee (SST). Nevertheless, 72% of African Americans and 94% of Latinos reported that they have never heard of the Syphilis Study at Tuskegee. Further, while awareness of the Syphilis Study at Tuskegee was a significant predictor of endorsing HIV/AIDS conspiracy theories, results suggest that other factors may be more important in accounting for low biomedical and behavioral study participation rates.

Is there a legacy of the U.S. Public Health Syphilis Study at Tuskegee in HIV/AIDS-related beliefs among heterosexual African-Americans and Latinos?

PubMed Central

Mays, Vickie M.; Coles, Courtney N.; Cochran, Susan D.

2012-01-01

Knowledge of the US Public Health Syphilis Study at Tuskegee is sometime cited as a principal reason for the relatively low participation rates seen among racial/ethnic minorities, particularly African Americans, in biomedical research. However, only a few studies have actually explored this possibility. We use data from a random digit dial telephone survey of 510 African-Americans and 253 Latinos, age 18 to 45 years, to investigate associations between knowledge of the USPHS Syphilis Study at Tuskegee and endorsement of HIV/AIDS conspiracy theories. All respondents were drawn from an area of low-income, predominantly race-segregated inner city households in Los Angeles. Results indicate that African Americans were significantly more likely than Latinos to endorse HIV/AIDS conspiracy theories. Further, African Americans were more aware of the USPHS Syphilis Study at Tuskegee (SST). Nevertheless, 72% of African Americans and 94% of Latinos reported that they have never heard of the Syphilis Study at Tuskegee. Further, while awareness of the Syphilis Study at Tuskegee was a significant predictor of endorsing HIV/AIDS conspiracy theories, results suggest that other factors may be more important in accounting for low biomedical and behavioral study participation rates. PMID:23308036

African American adolescents and new media: associations with HIV/STI risk behavior and psychosocial variables.

PubMed

Whiteley, Laura B; Brown, Larry K; Swenson, Rebecca R; Romer, Daniel; DiClemente, Ralph J P; Salazar, Laura E; Vanable, Peter A; Carey, Michael P; Valois, Robert F

2011-01-01

Cell phones and online media are used frequently but we know little about their use among African American adolescents. This study examines the frequency of such use and its relationship to psychosocial variables and STI/HIV risk behavior. 1,518 African American, aged 13-18 years, from 2 Northeast US cities (Providence, RI; Syracuse, NY) and 2 Southeast US cities (Columbia, SC; Macon, GA), were assessed from 2008-2009. Participants were assessed on frequency of cell phone and Internet use, psychological constructs (ie, depression, life satisfaction, impulsivity) and HIV/STI risk behaviors (ie, history of intercourse, sexual sensation seeking attitudes, peer sexual risks norms) with reliable scales and measures using an audio computer-assisted self-interview. Over 90% of African American adolescents used cell phones every day or most days and 60% used social networking sites every day or most days (96% used Myspace). Greater frequency of cell phone use was associated with sexual sensation seeking (P = .000), riskier peer sexual norms (P = .000), and impulsivity (P = .016). Greater frequency of Internet use was associated with a history of oral/vaginal/anal sex (OR = 1.03, CI = 1.0-1.05) and sexual sensation seeking (P = .000). These findings suggest that riskier youth are online and using cell phones frequently. The Internet and cell phones may be useful platforms for targeted health promotion and prevention efforts with AA adolescents.

Capturing the Social Location of African American Mothers Living with HIV: An Inquiry into How Social Determinants of Health Are Framed

PubMed Central

Caiola, Courtney; Barroso, Julie; Docherty, Sharron L.

2017-01-01

Background The disparate health outcomes of African-American mothers living with HIV are considerable. Multidimensional approaches are needed to address the complex social and economic conditions of their lives, collectively known as the social determinants of health. Objectives The purpose of this paper is to explore the social determinants of health for African-American mothers living with HIV by examining how mothers describe their social location at the intersection of gender-, race-, and class inequality; HIV-related stigma; and motherhood. How they frame the impact of their social location on their health experiences is explored. Methods This exploratory study included in-depth, semistructured interviews with 18 African-American mothers living with HIV at three time points. We used an intersectional framework and frame analysis to explore the meaning of these constructs for participants. Results Findings from 48 interviews include a description of the intersecting social determinants functioning as systems of inequality and the heterogeneous social locations. Three frames of social location were used to organize and explain the how African-American mothers living with HIV may understand their social determinants of health: (a) an emancipatory frame, marked by attempts to transcend the negative social connotations associated with HIV and socially constructed identities of race, gender, and class; (b) a maternal frame, marked by a desire to maintain a positive maternal identity and maternal-child relations; and (c) an internalized frame, marked by an emphasis on the deleterious and stigmatizing effects of HIV, racial-, gender-, and class inequality. Discussion The findings offer knowledge about the heterogeneity in how demographically similar individuals frame their social location as well as how the intersections of social determinants influence participant’s health experiences. Potential health implications and interventions are suggested for the three

YOUR Blessed Health: A Faith-Based CBPR Approach to Addressing HIV/AIDS among African Americans

ERIC Educational Resources Information Center

Griffith, Derek M.; Pichon, Latrice C.; Campbell, Bettina; Allen, Julie Ober

2010-01-01

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.…

Attitudes toward antiretroviral therapy among African American women.

PubMed

Richter, Donna L; Sowell, Richard L; Pluto, Delores M

2002-01-01

To examine attitudes and beliefs of African American women of childbearing age, living with HIV, about pregnancy and antiretroviral therapy. Focus groups were conducted using an exploratory design with a convenience sample of HIV-infected women in 2 southeastern cities. Thirty-three African American women of childbearing age participated in 5 focus groups. Attitudes and beliefs about antiretroviral therapy were related to the women's willingness to comply with treatment. The challenge for health care providers is to counter women's willingness to "play the odds" of having a noninfected baby without taking antiretrovirals.

Transportation-related barriers to care among African American women living with HIV/AIDS: “What you getting out of the cab for?”

PubMed Central

Evans, Shenell D.; Williams, Bryman E.

2015-01-01

Transportation-related problems have been consistently reported as barriers to accessing and remaining in HIV medical care, particularly among African American women living in under-resourced areas. With emphasis on the Southern region of the United States, this commentary presents a brief overview of the HIV/AIDS epidemic among African Americans, barriers to remaining in HIV care, and pilot data from a study conducted among African American women living in Mississippi. A small focus group study was conducted to examine the relative influence of transportation-related barriers on attendance and motivation to attend HIV medical care appointments. Eight African American women (mean age of 43.50, SD = 10.82) who were engaged in medical care participated in one focus group session. Time since diagnosis ranged from 6 to 17 years. Participants reported transportation-related barriers that were generally consistent with previous research, including lack of personal transportation, limited financial resources to pay family and friends for transportation or gasoline, and inconveniences associated with sharing van services with other patients. Participants appeared to have learned how to successfully navigate these barriers in order to remain in care. Interestingly, participants reported significant fear of disclosure related to use of transportation services provided by insurance providers and community organizations. Specifically, many of the women indicated that family, friends, and neighbors questioned them about where they were going and why they used taxis. These types of encounters might influence whether individuals utilize available transportation services. Participants provided several recommendations for improving the transportation system. Additional research is warranted to obtain a more representative sampling of opinions among African American women living in under-resourced areas. PMID:26523160

African American Adolescents and New Media: Associations with HIV/STI risk behavior and psychosocial variables

PubMed Central

Whiteley, Laura B.; Brown, Larry K.; Swenson, Rebecca R.; Romer, Daniel; DiClemente, Ralph J.P.; Salazar, Laura F.; Vanable, Peter A.; Carey, Michael P.; Valois, Robert F.

2012-01-01

Objectives Cell phones and online media are used frequently but we know little about their use among African American adolescents. This study examines the frequency of such use and its relationship to psychosocial variables and STI/HIV risk behavior. Setting/Participants 1,518 African American, 13 to 18 years of age, from 2 Northeast U.S. cities (Providence, RI; Syracuse, NY) and 2 Southeast U.S. cities (Columbia, SC; Macon, GA) were assessed from 2008–2009. Design Participants were assessed on frequency of cell phone and Internet use, psychological constructs (depression, life satisfaction, impulsivity) and HIV/STI risk behaviors (history of intercourse, sexual sensation seeking attitudes, peer sexual risks norms) with reliable scales and measures using an audio computer-assisted self-interview. Results Over 90% of African American adolescents used cell phones everyday or most days and 60% used social networking sites everyday or most days (96% used Myspace). Greater requency of cell phone use was associated with sexual sensation seeking (p=.000), riskier peer sexual norms (p=.000), and impulsivity (p=.016). Greater frequency of Internet use was associated with a history of oral/vaginal/anal sex (OR= 1.03, CI=1.0–1.05) and sexual sensation seeking (p=.000). Conclusion These findings suggest that riskier youth are online and using cell phones frequently. The Internet and cell phones maybe useful platforms for targeted health promotion and prevention efforts with AA adolescents. PMID:21749027

HIV risk among low-income African American mothers of elementary school children.

PubMed

Cummings, G L; Battle, R; Barker, J; Krasnovsky, F

1997-01-01

Data from 119 African American low-income mothers of school aged children in Oakland, California show that 38% engaged in behavior that might place them at risk of exposure to the human immunodeficiency virus (HIV). Risk behaviors that were investigated included having multiple partners and having a partner with an incarceration history. Of women studied, 23% were at risk because of multiple partners, while 15% were at risk as a result of having had an incarcerated partner. Women who were < or = 35 years of age were three times more likely to report having had an incarcerated partner compared to women > or = 36 years of age (22% vs. 6%) mean 2 = 5.59, P < or = .01). Single women were also more likely to report having had a partner who had been incarcerated, 21% compared to 9% of married women (mean 2 = 3.73, P < or = .05). Although no significant relationships were found with respect to condom use, a larger proportion of women with an incarcerated partner reported never using condoms (71%) compared to women without an incarcerated partner (63%); whereas, fewer women with multiple partners reported never using condoms (56%) compared to women without multiple partners (67%). Findings suggest that low-income African American women outside of traditional high-risk groups (i.e., generally studied in high-risk settings such as drug treatment centers, sexually transmitted disease [STD] clinics, hospitals or from the sex industry) may be at risk and should be targeted in HIV risk prevention programs. These women may not consider themselves to be at risk and are not generally targeted in HIV risk prevention programs because they are mothers, housewives, and working women.

Young African American Male-Male Relationships: Experiences, Expectations, and Condom Use

ERIC Educational Resources Information Center

Taggart, Tamara; Ellen, Jonathan; Arrington-Sanders, Renata

2017-01-01

HIV disproportionately impacts young African American men who have sex with men (MSM). In this study, we sought to understand how previous relationship experiences and expectations for romantic relationships influence condom use among young African American MSM. Twenty African American MSM aged 16 to 24 years completed a semi-structured interview…

Religious Involvement, Coping, Social Support, and Psychological Distress in HIV-Seropositive African American Mothers

PubMed Central

Prado, Guillermo; Feaster, Daniel J.; Schwartz, Seth J.; Pratt, Indira Abraham; Smith, Lila; Szapocznik, Jose

2005-01-01

This study used a cross-sectional design to examine the role of religious involvement within a stress-process framework. Participants were 252 urban, low-income HIV-seropositive African American mothers. The relationships among religious involvement, stress, coping responses, social support, and psychological distress were examined using structural equation modeling. The number of stressors reported by the mother was related to greater religious involvement, which in turn was negatively related to psychological distress. Furthermore, the results suggest that social support, active coping, and avoidant coping responses mediated the relationship between religious involvement and psychological distress. According to the present results, interventions to attenuate psychological distress in HIV-seropositive African American mothers might focus on increasing social support, promoting active coping, and decreasing avoidant coping. The present findings suggest that this may be accomplished, in part, by promoting involvement in religious institutions and practices. However, in light of the cross-sectional design used in the present study, and given that religion may have both positive and negative consequences further research is needed to determine the extent to which promoting religiosity may increase or alleviate distress. PMID:15475672

Motivations for Sex among Low-Income African American Young Women

ERIC Educational Resources Information Center

Deardorff, Julianna; Suleiman, Ahna Ballonoff; Dal Santo, Teresa S.; Flythe, Michelle; Gurdin, J. Barry; Eyre, Stephen L.

2013-01-01

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),…

Intervention Induced Changes on Parenting Practices, Youth Self-Pride and Sexual Norms to Reduce HIV-Related Behaviors among Rural African American Youths

ERIC Educational Resources Information Center

Murry, Velma McBride; Berkel, Cady; Chen, Yi-fu; Brody, Gene H.; Gibbons, Frederick X.; Gerrard, Meg

2011-01-01

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…

HIV information and behavioral skills moderate the effects of relationship type and substance use on HIV risk behaviors among African American youth.

PubMed

Mustanski, Brian; Byck, Gayle R; Newcomb, Michael E; Henry, David; Bolland, John; Dick, Danielle

2013-06-01

The HIV/AIDS epidemic is disproportionately impacting young African Americans. Efforts to understand and address risk factors for unprotected sex in this population are critical in improving prevention efforts. Situational risk factors, such as relationship type and substance use before sex, are in need of further study. This study explored how established cognitive predictors of risky sexual behavior moderated the association between situational factors and unprotected sex among low-income, African American adolescents. The largest main effect on the number of unprotected sex acts was classifying the relationship as serious (event rate ratio=10.18); other significant main effects were alcohol use before sex, participant age, behavioral skills, and level of motivation. HIV information moderated the effect of partner age difference, motivation moderated the effects of partner age difference and drug use before sex, and behavioral skills moderated the effects of alcohol and drug use before sex. This novel, partnership-level approach provides insight into the complex interactions of situational and cognitive factors in sexual risk taking.

Barriers and Facilitators for Clinical Care Engagement Among HIV-Positive African American and Latino Men Who Have Sex with Men.

PubMed

Carey, James W; Carnes, Neal; Schoua-Glusberg, Alisú; Kenward, Katherine; Gelaude, Deborah; Denson, Damian; Gall, Elizabeth; Randall, Laura A; Frew, Paula M

2018-05-01

Achieving optimal health among people living with HIV (PLWH) requires linkage to clinical care upon diagnosis, followed by ongoing engagement in HIV clinical care. A disproportionate number of black/African American and Hispanic/Latino men who have sex with men (MSM) living with HIV do not, however, achieve ongoing care. We conducted semistructured interviews in 2014 with 84 urban black/African American and Hispanic/Latino MSM living with HIV to understand their barriers and facilitators to engagement. We classified men as care-engaged or not at the time of the interview, and conducted content analysis of the interview transcripts to identify barriers and facilitators to engagement. Respondent mean age was 42.4 years (range, 20-59). Over half (59.5%, n = 50) were black/African American. Slightly more than a third (38.1%, n = 32) reported not being continuously care-engaged since diagnosis, and 17.9% (n = 15) delayed entry, although they have subsequently entered and remained in care. Sustained engagement began with overcoming denial after diagnosis and having treatment plans, as well as having conveniently located care facilities. Engagement also was facilitated by services tailored to meet multiple patient needs, effective patient-provider communication, and providers who show empathy and respect for their patients. Respondents were less likely to be care-engaged when these factors were absent. It can be difficult for racial and ethnic minority MSM living with HIV to begin and sustain care engagement. To optimize care engagement, our findings underscore the value of (1) convenient multipurpose HIV care facilities that meet patient needs; (2) excellent provider-patient communication that reinforces respect, trust, and HIV treatment literacy; and (3) assisting PLWH to create personalized treatment plans and overcome possible challenges such as diagnosis denial.

Self-Esteem Enhancing Reasons for Having Sex and the Sexual Behaviors of African American Adolescents

ERIC Educational Resources Information Center

Robinson, Melissa L.; Holmbeck, Grayson N.; Paikoff, Roberta

2007-01-01

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…

Factors related to risky sexual behaviors and effective STI/HIV and pregnancy intervention programs for African American adolescents.

PubMed

Lee, Young Me; Cintron, Adanisse; Kocher, Surinder

2014-01-01

The purpose of this integrative literature review study was to investigate factors related to risky sexual behaviors among African American adolescents, to evaluate which of the factors are common across successful and effective STI/HIV and pregnancy intervention programs, and finally, to propose suggestions for future intervention programs for African American adolescents in West Englewood, Chicago. An integrative literature review was conducted. Using CINAHL, PubMed, and ProQuest database, the following terms were searched: African American, Black, adolescents, teenagers, sexual behavior, cultural factors, pregnancy, STIs/HIV/AIDS, and intervention programs. A total of 18 articles were reviewed, findings indicated there were five major contributing factors related to risky sexual behaviors: substance use, gender roles, peer influences, parental involvement, and level of knowledge and information on sex and STIs. Six successful STI/HIV and pregnancy programs that incorporated those factors to effectively reduce risky sexual behaviors were identified. After analyzing six national intervention programs proven to be effective, the findings suggest that future prevention programs should be designed with more emphasis on avoidance or limited substance use, increased parental involvement, integration of cultural teaching components such as storytelling and history as suggested from the Aban Aya Youth Project. This study also concluded that future prevention programs should consider the length of programs be longer than 1 year, as it has been shown to be more effective than shorter programs. © 2014 Wiley Periodicals, Inc.

The effects of a mass media HIV-risk reduction strategy on HIV-related stigma and knowledge among African American adolescents.

PubMed

Kerr, Jelani C; 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

2015-03-01

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.

The Effects of a Mass Media HIV-Risk Reduction Strategy on HIV-Related Stigma and Knowledge Among African American Adolescents

PubMed Central

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

2015-01-01

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

Feasibility of delivering evidence-based HIV/STI prevention programming to a community sample of African American teen girls via the internet.

PubMed

Danielson, Carla Kmett; McCauley, Jenna L; Jones, Andrea M; Borkman, April L; Miller, Stephanie; Ruggiero, Kenneth J

2013-10-01

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.

Foster care history and HIV infection among drug-using African American female sex workers.

PubMed

Surratt, Hilary L; Kurtz, Steven P

2012-05-01

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.

Sexual protective strategies and condom use in middle-age African American women: A qualitative study

PubMed Central

Smith, Tanyka K.

2015-01-01

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

Acquired immunodeficiency syndrome in older African Americans.

PubMed Central

Funnyé, Allen S.; Akhtar, Abbasi J.; Biamby, Gisele

2002-01-01

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. PMID:11991333

A synthesis of the theory of silencing the self and the social ecological model: understanding gender, race, and depression in African American women living with HIV infection.

PubMed

Lanier, Latrona; DeMarco, Rosanna

2015-03-01

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.

Theoretical Implications of Gender, Power, and Sexual Scripts for HIV Prevention Programs Aimed at Young, Substance-Using African-American Women.

PubMed

Hill, Mandy; Granado, Misha; Stotts, Angela

2017-12-01

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.

Gender differences in use of prayer as a self-care strategy for managing symptoms in African Americans living with HIV/AIDS.

PubMed

Coleman, Christopher Lance; Holzemer, William L; Eller, Lucille Sanzero; Corless, Inge; Reynolds, Nancy; Nokes, Kathleen M; Kemppainen, Jeanne K; Dole, Pam; Kirksey, Kenn; Seficik, Liz; Nicholas, Patrice; Hamilton, Mary Jane

2006-01-01

The objective of this study was to explore the association of gender to use of prayer as a self-care strategy for managing the HIV-related symptoms of fatigue, nausea, depression, and anxiety among African American men and women who are HIV-seropositive. To accomplish this, data were determined using convenience sampling from a sample of 448 African American men and women from the United States who were participants in a national study on self-care symptom management of HIV/AIDS. Chi-square analyses were used to examine the potential relationships between gender and the use of prayer for managing the four symptoms. The mean age of the sample was 42.69 +/- 7.93 years (range, 20-66). Results showed the following gender differences in the use of prayer as a self-care strategy: fatigue-men 46% (n = 62), women 54% (n = 74); nausea-men 52% (n = 33), women 48% (n = 30); depression-men 55% (n = 90), women 45% (n = 73); and anxiety-men 77% (n = 83), women 87% (n = 73). Chi-square analyses determined that significant differences exist between African American men and women in the frequency of the use of prayer for managing HIV-related fatigue (chi(2) = 14.81, 1 df, p = .000), nausea (chi(2) = 4.10, 1 df, p =.043), and depression (chi(2) = 5.21, 1 df, p = .022). There was no gender difference in the use of prayer to manage anxiety. Prayer was reported as a self-care strategy by over 50% of the respondents for three of the four symptoms and was rated highly efficacious. The authors conclude that the African American men and women differed in their selection of prayer as a self-care strategy for managing HIV-related depression, fatigue, and nausea. A higher proportion of women than men used prayer to manage fatigue, and more men than women reported using prayer to manage nausea and depression.

Using a Social Network Strategy to Distribute HIV Self-Test Kits to African American and Latino MSM.

PubMed

Lightfoot, Marguerita A; Campbell, Chadwick K; Moss, Nicholas; Treves-Kagan, Sarah; Agnew, Emily; Kang Dufour, Mi-Suk; Scott, Hyman; Sa'id, Aria M; Lippman, Sheri A

2018-05-04

Men who have sex with men (MSM) continue to be disproportionately impacted globally by the HIV epidemic. Studies suggest that HIV Self-testing (HIVST) is highly acceptable among MSM. Social network strategies to increase testing are effective in reaching MSM, particularly MSM of color, who may not otherwise test. We tested a social-network based strategy to distribute HIVST kits to African American and Latino MSM. This study was conducted in Alameda County, California a large, urban/suburban county with an HIV epidemic mirroring the national HIV epidemic. From January 2016 to March 2017, 30 AAMSM, LMSM, and Transgender women were trained as peer recruiters and asked to distribute five self-test kits to MSM social network members and support those who test positive in linking to care. Testers completed an online survey following their test. We compared peer-distributed HIVST testing outcomes to outcomes from Alameda County's targeted, community-based HIV testing programs using chi-squared tests. Peers distributed HIVST to 143 social and sexual network members, of whom 110 completed the online survey. Compared to MSM who utilized the County's sponsored testing programs, individuals reached through the peer-based self-testing strategy were significantly more likely to have never tested for HIV (3.51% vs. 0.41%, p<0.01) and to report a positive test result (6.14% vs 1.49%, p<0.01). Findings suggest that a network-based strategy for self-test distribution is a promising intervention to increase testing uptake and reduce undiagnosed infections among African American and Latino MSM.

Rationale, Design and Methods of the Ecological Study of Sexual Behaviors and HIV/STI among African American Men Who Have Sex with Men in the Southeastern United States (The MARI Study)

PubMed Central

Hickson, DeMarc A.; Truong, Nhan L.; Smith-Bankhead, Neena; Sturdevant, Nikendrick; Duncan, Dustin T.; Schnorr, Jordan; Gipson, June A.; Mena, Leandro A.

2015-01-01

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

Project GRACE: a staged approach to development of a community-academic partnership to address HIV in rural African American communities.

PubMed

Corbie-Smith, Giselle; Adimora, Adaora A; Youmans, Selena; Muhammad, Melvin; Blumenthal, Connie; Ellison, Arlinda; Akers, Aletha; Council, Barbara; Thigpen, Yolanda; Wynn, Mysha; Lloyd, Stacey W

2011-03-01

The HIV epidemic is a health crisis in rural African American communities in the Southeast United States; however, to date little attention has been paid to community-academic collaborations to address HIV in these communities. Interventions that use a community-based participatory research (CBPR) approach to address individual, social, and physical environmental factors have great potential for improving community health. Project GRACE (Growing, Reaching, Advocating for Change and Empowerment) uses a CBPR approach to develop culturally sensitive, feasible, and sustainable interventions to prevent the spread of HIV in rural African American communities. This article describes a staged approach to community-academic partnership: initial mobilization, establishment of organizational structure, capacity building for action, and planning for action. Strategies for engaging rural community members at each stage are discussed; challenges faced and lessons learned are also described. Careful attention to partnership development has resulted in a collaborative approach that has mutually benefited both the academic and community partners.

HIV Information and Behavioral Skills Moderate the Effects of Relationship Type and Substance Use on HIV Risk Behaviors Among African American Youth

PubMed Central

Byck, Gayle R.; Newcomb, Michael E.; Henry, David; Bolland, John; Dick, Danielle

2013-01-01

Abstract The HIV/AIDS epidemic is disproportionately impacting young African Americans. Efforts to understand and address risk factors for unprotected sex in this population are critical in improving prevention efforts. Situational risk factors, such as relationship type and substance use before sex, are in need of further study. This study explored how established cognitive predictors of risky sexual behavior moderated the association between situational factors and unprotected sex among low-income, African American adolescents. The largest main effect on the number of unprotected sex acts was classifying the relationship as serious (event rate ratio=10.18); other significant main effects were alcohol use before sex, participant age, behavioral skills, and level of motivation. HIV information moderated the effect of partner age difference, motivation moderated the effects of partner age difference and drug use before sex, and behavioral skills moderated the effects of alcohol and drug use before sex. This novel, partnership-level approach provides insight into the complex interactions of situational and cognitive factors in sexual risk taking. PMID:23701198

Reducing HIV sexual risk among African American women who use drugs: hearing their voices.

PubMed

Jemmott, Loretta Sweet; Brown, Emma J

2003-01-01

A pilot study was conducted to understand women's realities, perspectives, and perceived needs regarding the interaction between substance use, types of sexual relationships, and the challenges and barriers they pose to practicing safer sex. An additional purpose was to examine this population's willingness to participate in the program and receptiveness to the components of proposed interventions. Data were collected in this descriptive, exploratory study by the use of one focus group. Twelve African American women between 20 and 55 years of age who had previous drug detoxification experience participated in a 3-hour focus group. All participants were sexually active as well as current users of illicit substances, and all but one had traded sex for money, drugs, or alcohol. The focus group interview was guided by a semistructured questionnaire. Participants were recruited by counselors in detoxification units. Each unit counselor was asked to randomly select a third of their residents, explain and read the purpose of the focus group, and get the residents' verbal consent to participate. The women discussed their sexual behaviors and drug use that increased their risk for acquiring HIV. They provided insight about the effects of different drugs on one's sexual behavior, motivation for sex, and reasons for unsafe sex and made recommendations for HIV prevention intervention. Participants agreed that safer sex and healthy living intervention would be most beneficial if placed within the context of a detoxification program. The juxtaposition of increased sexual risk behavior and the potential to acquire and transmit HIV infection suggests the urgency of intervening with African American women who are substance abusers.

Prevalence and correlates of knowledge of male partner HIV testing and serostatus among African-American women living in high poverty, high HIV prevalence communities (HPTN 064)

PubMed Central

Jennings, Larissa; Rompalo, Anne M.; Wang, Jing; Hughes, James; Adimora, Adaora A.; Hodder, Sally; Soto-Torres, Lydia E.; Frew, Paula M.; Haley, Danielle F.

2014-01-01

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 (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. PMID:25160901

The meaning and use of spirituality among African American women living with HIV/AIDS.

PubMed

Dalmida, Safiya George; Holstad, Marcia McDonnell; DiIorio, Colleen; Laderman, Gary

2012-10-01

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.

The Meaning and Use of Spirituality Among African American Women Living With HIV/AIDS

PubMed Central

Dalmida, Safiya George; Holstad, Marcia McDonnell; DiIorio, Colleen; Laderman, Gary

2014-01-01

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

To Test or Not to Test: Barriers and Solutions to Testing African American College Students for HIV at a Historically Black College/University.

PubMed

Hall, Naomi M; Peterson, Jennifer; Johnson, Malynnda

2014-01-01

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.

Mediation Analysis of the Efficacy of the Eban HIV/STD Risk-Reduction Intervention for African American HIV Serodiscordant Couples.

PubMed

El-Bassel, Nabila; Jemmott, John B; Bellamy, Scarlett L; Pequegnat, Willo; Wingood, Gina M; Wyatt, Gail E; Landis, J Richard; Remien, Robert H

2016-06-01

Targeting couples is a promising behavioral HIV risk-reduction strategy, but the mechanisms underlying the effects of such interventions are unknown. We report secondary analyses testing whether Social-Cognitive-Theory variables mediated the Eban HIV-risk-reduction intervention's effects on condom-use outcomes. In a multisite randomized controlled trial conducted in four US cities, 535 African American HIV-serodiscordant couples were randomized to the Eban HIV risk-reduction intervention or attention-matched control intervention. Outcomes were proportion condom-protected sex, consistent condom use, and frequency of unprotected sex measured pre-, immediately post-, and 6 and 12 months post-intervention. Potential mediators included Social-Cognitive-Theory variables: outcome expectancies and self-efficacy. Mediation analyses using the product-of-coefficients approach in a generalized-estimating-equations framework revealed that condom-use outcome expectancy, partner-reaction outcome expectancy, intention, self-efficacy, and safer-sex communication improved post-intervention and mediated intervention-induced improvements in condom-use outcomes. These findings underscore the importance of targeting outcome expectancies, self-efficacy, and safer-sex communication in couples-level HIV risk-reduction interventions.

Efficacy of an HIV/STI sexual risk-reduction intervention for African American adolescent girls in juvenile detention centers: a randomized controlled trial.

PubMed

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

2014-01-01

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.

A sexual risk and stress reduction intervention designed for HIV-positive bisexual African American men with childhood sexual abuse histories.

PubMed

Williams, John K; Glover, Dorie A; Wyatt, Gail E; Kisler, Kimberly; Liu, Honghu; Zhang, Muyu

2013-08-01

HIV transmission risk is high among men who have sex with men and women (MSMW), and it is further heightened by a history of childhood sexual abuse (CSA) and current traumatic stress or depression. Yet, traumatic stress is rarely addressed in HIV interventions. We tested a stress-focused sexual risk reduction intervention for African American MSMW with CSA histories. This randomized controlled trial compared a stress-focused sexual risk reduction intervention with a general health promotion intervention. Sexual risk behaviors, psychological symptoms, stress biomarkers (urinary cortisol and catecholamines), and neopterin (an indicator of HIV progression) were assessed at baseline and at 3- and 6-month follow-ups. Both interventions decreased and sustained reductions in sexual risk and psychological symptoms. The stress-focused intervention was more efficacious than the general health promotion intervention in decreasing unprotected anal insertive sex and reducing depression symptoms. Despite randomization, baseline group differences in CSA severity, psychological symptoms, and biomarkers were found and linked to subsequent intervention outcomes. Although interventions designed specifically for HIV-positive African American MSMW can lead to improvements in health outcomes, future research is needed to examine factors that influence intervention effects.

Mortality among blacks or African Americans with HIV infection--United States, 2008-2012.

PubMed

Siddiqi, Azfar-e-Alam; Hu, Xiaohong; Hall, H Irene

2015-02-06

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.

Evaluation of an HIV prevention intervention for African Americans and Hispanics: findings from the VOICES/VOCES Community-based Organization Behavioral Outcomes Project.

PubMed

Fisher, Holly H; Patel-Larson, A; Green, K; Shapatava, E; Uhl, G; Kalayil, E J; Moore, A; Williams, W; Chen, B

2011-11-01

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.

Vitamin D deficiency in HIV-infected postmenopausal Hispanic and African-American women

PubMed Central

Stein, E. M.; McMahon, D. J.; Shu, A.; Zhang, C. A.; Ferris, D. C.; Colon, I.; Dobkin, J. F.; Hammer, S. M.; Shane, E.

2011-01-01

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

Association of Internalized and Social Network Level HIV Stigma With High-Risk Condomless Sex Among HIV-Positive African American Men.

PubMed

Wagner, Glenn J; Bogart, Laura M; Klein, David J; Green, Harold D; Mutchler, Matt G; McDavitt, Bryce; Hilliard, Charles

2016-08-01

We examined whether internalized HIV stigma and perceived HIV stigma from social network members (alters), including the most popular and most similar alter, predicted condomless intercourse with negative or unknown HIV status partners among 125 African American HIV-positive men. In a prospective, observational study, participants were administered surveys at baseline and months 6 and 12, with measures including sexual behavior, internalized HIV stigma, and an egocentric social network assessment that included several measures of perceived HIV stigma among alters. In longitudinal multivariable models comparing the relative predictive value of internalized stigma versus various measures of alter stigma, significant predictors of having had condomless intercourse included greater internalized HIV stigma (in all models), the perception that a popular (well-connected) alter or alter most like the participant agrees with an HIV stigma belief, and the interaction of network density with having any alter that agrees with a stigma belief. The interaction indicated that the protective effect of greater density (connectedness between alters) in terms of reduced risk behavior dissipated in the presence of perceived alter stigma. These findings call for interventions that help people living with HIV to cope with their diagnosis and reduce stigma, and inform the targets of social network-based and peer-driven HIV prevention interventions.

Association of Internalized and Social Network Level HIV Stigma With High-Risk Condomless Sex Among HIV-Positive African American Men

PubMed Central

Bogart, Laura M.; Klein, David J.; Green, Harold D.; Mutchler, Matt G.; McDavitt, Bryce; Hilliard, Charles

2016-01-01

We examined whether internalized HIV stigma and perceived HIV stigma from social network members (alters), including the most popular and most similar alter, predicted condomless intercourse with negative or unknown HIV status partners among 125 African American HIV-positive men. In a prospective, observational study, participants were administered surveys at baseline and months 6 and 12, with measures including sexual behavior, internalized HIV stigma, and an egocentric social network assessment that included several measures of perceived HIV stigma among alters. In longitudinal multivariable models comparing the relative predictive value of internalized stigma versus various measures of alter stigma, significant predictors of having had condomless intercourse included greater internalized HIV stigma (in all models), the perception that a popular (well-connected) alter or alter most like the participant agrees with an HIV stigma belief, and the interaction of network density with having any alter that agrees with a stigma belief. The interaction indicated that the protective effect of greater density (connectedness between alters) in terms of reduced risk behavior dissipated in the presence of perceived alter stigma. These findings call for interventions that help people living with HIV to cope with their diagnosis and reduce stigma, and inform the targets of social network-based and peer-driven HIV prevention interventions. PMID:26718361

Image versus Health: The Role of Perceptions of Masculinity on Sexual Risk Behaviors among HIV-Positive African American Men who have Sex with Men and Women

PubMed Central

Kisler, Kimberly A.; Williams, John K.

2013-01-01

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

Fine-mapping classical HLA variation associated with durable host control of HIV-1 infection in African Americans.

PubMed

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

2012-10-01

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.

"Straight Talk" for African-American heterosexual men: results of a single-arm behavioral intervention trial.

PubMed

Frye, Victoria; Henny, Kirk; Bonner, Sebastian; Williams, Kim; Bond, Keosha T; Hoover, Donald R; Lucy, Debbie; Greene, Emily; Koblin, Beryl A

2013-01-01

In the United States, heterosexual transmission is the second leading cause of HIV/AIDS, and two-thirds of all heterosexually acquired cases diagnosed between 2005 and 2008 occurred among African-Americans. Few HIV prevention interventions have been designed specifically for African-American heterosexual men not seeking clinical treatment. Here we report results of a single-arm intervention trial of a theory-based HIV prevention intervention designed to increase condom use, reduce concurrent partnering and increase HIV testing among heterosexually active African-American men living in high HIV prevalence areas of New York City. We tested our hypothesis using McNemar discordant pairs exact test for binary variables and paired t-tests for continuous variables. We observed statistically significant declines in mean number of total and new female partners, unprotected sex partners, and partner concurrency in both primary and nonprimary sex partnerships between baseline and 3 months postintervention.

Perinatal AIDS: Permanency Planning for the African-American Community.

ERIC Educational Resources Information Center

Taylor-Brown, Susan; And Others

1992-01-01

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)

Gender Ideologies, Socioeconomic Opportunities, and HIV/STI-related Vulnerability among Female, African-American Adolescents

PubMed Central

Andrinopoulos, Katherine; Chung, Shang-en; Glass, Barbara; Ellen, Jonathan

2008-01-01

The importance of gender within HIV/STI prevention has become widely recognized. However, gender ideologies associated with vulnerability to HIV/STI are often examined and addressed without sufficient attention to the larger socioeconomic context within which they arise and evolve. We conducted a cross-sectional survey with 155 female, African-American adolescents recruited from two health clinics in Baltimore, Maryland. Multivariate logistic regression was utilized to assess the relationships between HIV/STI vulnerability resulting from male partner concurrency, adherence to traditional female gender norms, using a measure of hyperfemininity, and perceived socioeconomic opportunity structures. The likelihood of reported partner concurrency increased significantly among participants reporting higher levels of hyperfemininity (OR = 2.08; 95%CI = 1.01–4.30). Hyperfeminine thinking and behavior was significantly lower in the context of higher perceived socioeconomic opportunity structures (OR = 0.87; 95%CI = 0.79–0.95). Interventions seeking to promote gender equity and reduce HIV/STI may be more effective when the socioeconomic context of gender ideologies is assessed and addressed. Programs and policies to increase educational and professional opportunity structures, particularly among marginalized communities, should be actively integrated into HIV/STI prevention planning. PMID:18553223

Gender ideologies, socioeconomic opportunities, and HIV/STI-related vulnerability among female, African-American adolescents.

PubMed

Kerrigan, Deanna; Andrinopoulos, Katherine; Chung, Shang-en; Glass, Barbara; Ellen, Jonathan

2008-09-01

The importance of gender within HIV/STI prevention has become widely recognized. However, gender ideologies associated with vulnerability to HIV/STI are often examined and addressed without sufficient attention to the larger socioeconomic context within which they arise and evolve. We conducted a cross-sectional survey with 155 female, African-American adolescents recruited from two health clinics in Baltimore, Maryland. Multivariate logistic regression was utilized to assess the relationships between HIV/STI vulnerability resulting from male partner concurrency, adherence to traditional female gender norms, using a measure of hyperfemininity, and perceived socioeconomic opportunity structures. The likelihood of reported partner concurrency increased significantly among participants reporting higher levels of hyperfemininity (OR = 2.08; 95%CI = 1.01-4.30). Hyperfeminine thinking and behavior was significantly lower in the context of higher perceived socioeconomic opportunity structures (OR = 0.87; 95%CI = 0.79-0.95). Interventions seeking to promote gender equity and reduce HIV/STI may be more effective when the socioeconomic context of gender ideologies is assessed and addressed. Programs and policies to increase educational and professional opportunity structures, particularly among marginalized communities, should be actively integrated into HIV/STI prevention planning.

Efficacy of an HIV/STI Sexual Risk-Reduction Intervention for African American Adolescent Girls in Juvenile Detention Centers: A Randomized Controlled Trial

PubMed Central

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

2014-01-01

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

Psychosocial Differences Between Whites and African Americans Living With HIV/AIDS in Rural Areas of 13 U.S. States

ERIC Educational Resources Information Center

Davantes Heckman, Bernadette

2006-01-01

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…

Sexuality, Sexual Practices, and HIV Risk among Incarcerated African-American Women in North Carolina

PubMed Central

Farel, Claire E.; Parker, Sharon D.; Muessig, Kathryn E.; Grodensky, Catherine A.; Jones, Chaunetta; Golin, Carol E.; Fogel, Catherine I.; Wohl, David A.

2013-01-01

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

An exploratory study of sexual assertiveness and characteristics of African American women in negotiating condom use at an HBCU.

PubMed

Jenkins, Chalice C; Kennedy, Bernice Roberts

2013-01-01

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.

Evaluation of an HIV risk reduction intervention among African-American homosexual and bisexual men.

PubMed

Peterson, J L; Coates, T J; Catania, J; Hauck, W W; Acree, M; Daigle, D; Hillard, B; Middleton, L; Hearst, N

1996-03-01

To provide the first data which evaluates an HIV risk reduction intervention designed to reduce HIV high-risk sexual behavior in African-American homosexual and bisexual men. Participants (n = 318) were recruited from bars, bathhouses, and erotic bookstores, and through homosexual African-American organizations, street out-reach, media advertisements, and personal referrals of individuals aware of the study. Participants were randomized into a single or triple session experimental group or a wait-list control group. Both experimental interventions included AIDS risk education, cognitive-behavioral self-management training, assertion training, and attempts to develop self-identity and social support. Data collection involved assessments of self-reported changes in sexual behavior at 12- and 18-month follow-up. Participants in the triple session intervention greatly reduced their frequency of unprotected anal intercourse (from 46 to 20%) at the 12-month follow-up evaluation and (from 45% to 20%) at the 18-month follow-up evaluation. However, levels of risky behavior for the control group remained constant (from 26 to 23% and from 24 to 18%) at 12- and 18-month follow-up evaluations, respectively. In addition, levels of risky behavior for the single session intervention decreased only slightly (from 47 to 38% and from 50 to 38%) at the 12- and 18-month follow-up evaluations, respectively. Results were interpreted to demonstrate the superiority of a triple session over a single session intervention in reducing risky sexual behavior in this cohort.

Sexual risk among African American girls: psychopathology and mother-daughter relationships.

PubMed

Donenberg, Geri R; Emerson, Erin; Mackesy-Amiti, Mary Ellen

2011-04-01

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 African American girls have higher rates of sexually transmitted infections than do girls of all other racial groups. A sample of 12- to 16-year-old African American girls (N = 266, mean age = 14.46 years) and their female caregivers (73% biological mothers) completed computerized assessments of girls' mental health symptoms, maternal monitoring and permissiveness, and mother-daughter communication and attachment. Girls indicated their sexual risk behaviors (vaginal/anal sex, consistent condom use, number of partners). African American girls who reported clinically significant externalizing problems, more permissive parenting, less open mother-daughter sexual communication, and more frequent mother-daughter communication were more likely to report having had vaginal and/or anal sex. Sexually active girls with greater maternal attachment were less likely to report inconsistent condom use. Findings revealed important risk and protective factors for African American girls in psychiatric care. HIV-prevention programs may be strengthened by improving mother-daughter relationships and communication and by reducing girls' mental health problems. (c) 2011 APA, all rights reserved.

Longitudinal relationships between antiretroviral treatment adherence and discrimination due to HIV-serostatus, race, and sexual orientation among African-American men with HIV.

PubMed

Bogart, Laura M; Wagner, Glenn J; Galvan, Frank H; Klein, David J

2010-10-01

African-Americans show worse HIV disease outcomes compared to Whites. Health disparities may be aggravated by discrimination, which is associated with worse health and maladaptive health behaviors. We examined longitudinal effects of discrimination on antiretroviral treatment adherence among 152 HIV-positive Black men who have sex with men. We measured adherence and discrimination due to HIV-serostatus, race/ethnicity, and sexual orientation at baseline and monthly for 6 months. Hierarchical repeated-measures models tested longitudinal effects of each discrimination type on adherence. Over 6 months, participants took 60% of prescribed medications on average; substantial percentages experienced discrimination (HIV-serostatus, 38%; race/ethnicity, 40%; and sexual orientation, 33%). Greater discrimination due to all three characteristics was significantly bivariately associated with lower adherence (all p's < 0.05). In the multivariate model, only racial discrimination was significant (p < 0.05). Efforts to improve HIV treatment adherence should consider the context of multiple stigmas, especially racism.

Motivations for sex among low-income African American young women.

PubMed

Deardorff, Julianna; Suleiman, Ahna Ballonoff; Dal Santo, Teresa S; Flythe, Michelle; Gurdin, J Barry; Eyre, Stephen L

2013-12-01

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), similarity assessment (n = 25), and focus groups (four groups), to elicit self-described motivations for sex among low-income African American young women (19-22 years). Analyses revealed six clusters: Love/Feelings, For Fun, Curiosity, Pressured, For Money, and For Material Things. Focus groups explored how African American women interpreted the clusters in light of condom use expectations. Participants expressed the importance of using condoms in risky situations, yet endorsed condom use during casual sexual encounters less than half the time. This study highlights the need for more effective intervention strategies to increase condom use expectations among low-income African American women, particularly in casual relationships where perceived risk is already high.

Exploring Why Young African American Women Do Not Change Condom-Use Behavior Following Participation in an STI/HIV Prevention Intervention

ERIC Educational Resources Information Center

Sales, J. M.; DiClemente, R. J.; Davis, T. P.; Sullivan, S.

2012-01-01

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…

Sexual risk and HIV prevention behaviours among African-American and Latino MSM social networking users.

PubMed

Young, Sean D; Szekeres, Greg; Coates, Thomas

2013-08-01

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.

The Efficacy of Behavioral Interventions in Reducing HIV Risk Behaviors and Incident Sexually Transmitted Diseases in Heterosexual African Americans

PubMed Central

Darbes, Lynae; Crepaz, Nicole; Lyles, Cynthia; Kennedy, Gail; Rutherford, George

2009-01-01

Objective To conduct a meta-analytic review of HIV interventions for heterosexual African Americans to determine the overall efficacy in reducing HIV-risk sex behaviors and incident sexually transmitted diseases (STD) and identify intervention characteristics associated with efficacy. Methods Comprehensive searches included electronic databases from 1988 to 2005, handsearches of journals, reference lists of articles, and contacts with researchers. Thirty-eight randomized controlled trials met the selection criteria. Random-effects models were used to aggregate data. Results Interventions significantly reduced unprotected sex (OR = 0.75, 95% CI = 0.67, 0.84, 35 trials, N = 14,682) and marginally significantly decreased incident STD (OR = 0.88, 95% CI = 0.72, 1.07, 10 trials, n = 10,944). Intervention characteristics associated with efficacy include: (1) culturally tailored, (2) aiming to influence social norms in promoting safe sex behaviour, (3) utilizing peer education, (4) providing skills training on correct use of condoms and communication skills needed for negotiating safer sex, and (5) multiple sessions and opportunities to practice learned skills. Conclusion Interventions targeting heterosexual African Americans are efficacious in reducing HIV-risk sex behaviors. Efficacious intervention components identified in this review should be incorporated into the development of future interventions and further evaluated for effectiveness. PMID:18525264

Capacity building among african american faith leaders to promote HIV prevention and vaccine research.

PubMed

Alio, Amina P; Lewis, Cindi A; Bunce, Catherine A; Wakefield, Steven; Thomas, Weldon G; Sanders, Edwin; Keefer, Michael C

2014-01-01

In light of the increasing rates of HIV infection in African Americans, it is essential that black faith leaders become more proactive in the fight against the epidemic. The study aim was to engage faith leaders in a sustainable partnership to increase community participation in preventive HIV vaccine clinical research while improving their access to and utilization of HIV/AIDS prevention services. Leadership Development Seminars were adapted for faith leaders in Rochester, NY, with topics ranging from the importance of preventive HIV vaccine research to social issues surrounding HIV/AIDs within a theological framework. Seminars were taught by field-specific experts from the black community and included the development of action plans to institute HIV preventive ministries. To assess the outcome of the Seminars, baseline and post-training surveys were administered and analyzed through paired sample t Tests and informal interviews. 19 faith leaders completed the intervention. In general, the majority of clergy felt that their understanding of HIV vaccine research and its goals had increased postintervention. A critical outcome was the subsequent formation of the Rochester Faith Collaborative by participating clergy seeking to sustain the collaborative and address the implementation of community action plans. Providing scientific HIV/AIDS knowledge within the context of clergy members' belief structure was an effective method for engaging black Church leaders in Rochester, NY. Collaborative efforts with various local institutions and community-based organizations were essential in building trust with the faith leaders, thereby building bridges for better understanding of HIV/AIDS prevention efforts, including HIV vaccine research.

Traditional Healing, Biomedicine and the Treatment of HIV/AIDS: Contrasting South African and Native American Experiences

PubMed Central

Flint, Adrian

2015-01-01

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

Traditional healing, biomedicine and the treatment of HIV/AIDS: contrasting south african and native American experiences.

PubMed

Flint, Adrian

2015-04-20

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.

Intervention Mapping as a Participatory Approach to Developing an HIV prevention Intervention in Rural African American Communities

PubMed Central

Corbie-Smith, Giselle; Akers, Aletha; Blumenthal, Connie; Council, Barbara; Wynn, Mysha; Muhammad, Melvin; Stith, Doris

2011-01-01

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 multilevel HIV interventions that have been developed, tailored or tested in rural communities for African Americans. We describe how Project GRACE integrated Intervention Mapping (IM) methodology with community based participatory research (CBPR) principles to develop a multi-level, multi-generational HIV prevention intervention. IM was carried out in a series of steps from review of relevant data through producing program components. Through the IM process, all collaborators agreed that we needed a family-based intervention involving youth and their caregivers. We found that the structured approach of IM can be adapted to incorporate the principles of CBPR. PMID:20528128

A Qualitative Study on Health Numeracy and Patient-Provider Communication of Laboratory Numbers in Older African Americans with HIV.

PubMed

Gakumo, C Ann; Raper, Jim L; Cerice, Diana K; Stand-Gravois, Michael J; Mugavero, Michael J

Health numeracy plays a vital role in the successful management of HIV because much HIV-related health information is expressed in quantitative terms. The purpose of our study was to explore what older African Americans with HIV (N = 20) understood about their HIV laboratory numbers and to examine communication of the numbers between patients and providers during clinic visits. The following four themes emerged: (a) HIV laboratory numbers are important to understand health status; (b) the numbers can often be confusing; (c) mutual communication between patient and provider is essential to understand the numbers; and (d) when communicating numbers, use less detail. Implications for future interventions to address health numeracy deficits in this population are discussed. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Predictors of Consistent Condom Use Among Young African American Women

PubMed Central

DiClemente, Ralph J.; Salazar, Laura F.; Wingood, Gina M.; McDermott-Sales, Jessica; Young, April M.; Rose, Eve

2012-01-01

The purpose of this study was to determine the predictive value of selected factors to the consistent use of condoms among high-risk young African American women. A clinic-based, prospective, study of 242 young, African-American women (ages 15–21) was conducted. In multivariate analysis, consistent condom use was predicted by having greater perceptions of condom negotiation self-efficacy, lower fear of negotiating condom use, and having communicated with sex partners (during the recall period) about condom use. Relational variables were predictive of consistent condom use among young African American women. STD/HIV preventive interventions should target these factors, perhaps in dyad-level interventions. PMID:21796442

Predictors of consistent condom use among young African American women.

PubMed

Crosby, Richard A; DiClemente, Ralph J; Salazar, Laura F; Wingood, Gina M; McDermott-Sales, Jessica; Young, April M; Rose, Eve

2013-03-01

The purpose of this study was to determine the predictive value of selected factors to the consistent use of condoms among high-risk young African American women. A clinic-based, prospective, study of 242 young, African-American women (ages 15-21) was conducted. In multivariate analysis, consistent condom use was predicted by having greater perceptions of condom negotiation self-efficacy, lower fear of negotiating condom use, and having communicated with sex partners (during the recall period) about condom use. Relational variables were predictive of consistent condom use among young African American women. STD/HIV preventive interventions should target these factors, perhaps in dyad-level interventions.

Exploring why young African American women do not change condom-use behavior following participation in an STI/HIV prevention intervention

PubMed Central

Sales, J. M.; DiClemente, R. J.; Davis, T. P.; Sullivan, S.

2012-01-01

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 post-participation in an HIV prevention intervention. Semi-structured interviews were conducted with 50 young African American women (18–23 years; approximately half were mothers) after participating in a demonstrated effective HIV prevention intervention; 24 did not increase condom use post-intervention. Interviews were thematically coded for barriers to condom-use post-intervention. Although nearly all young women reported partner-associated challenges to using condoms, there were relational differences observed among those who changed their condom use versus those who did not. Many ‘non-changers’ were engaged in non-stable ‘on and off’ relationships, with high rates of infidelity, often with the father of their child, in which they were fearful of requesting condom use. ‘Non-changers’ also reported more substance use, feeling incapable of change and not thinking about condom use. Thus, future HIV prevention efforts may benefit from incorporating strategies on how young mothers can maintain a non-sexual relationship with their child’s father, as well as elaborating on the intersection of substance use and risky sexual decision-making. PMID:22641793

Health-protective effects of attachment among African American girls in psychiatric care.

PubMed

Emerson, Erin; Donenberg, Geri R; Wilson, Helen W

2012-02-01

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.

Adapting a Comprehensive Approach to African American Women's Sexual Risk Taking.

ERIC Educational Resources Information Center

Wyatt, Gail E.; Tucker, M. Belinda; Romero, Gloria J.; Carmona, Jennifer Vargas; Newcomb, Michael D.; Wayment, Heidi A.; Loeb, Tamra Burns; Solis, Beatriz M.; Mitchell-Kernan, Claudia

1997-01-01

Examined factors predicting the context of HIV-related sexual behaviors in African American women. Surveys investigated demographics; sexual history, behavior, attitudes, risk, and communication; drug use; contraception; and risk reduction efforts since Magic Johnson's HIV disclosure. Demographics, sexual communication, and past sexual experiences…

Target organ damage in African American hypertension: role of APOL1.

PubMed

Freedman, Barry I; Murea, Mariana

2012-02-01

Apolipoprotein L1 (APOL1) gene association studies and results of the African American Study of Kidney Disease and Hypertension are disproving the longstanding concept that mild to moderate essential hypertension contributes substantially to end-stage renal disease susceptibility in African Americans. APOL1 coding variants underlie a spectrum of kidney diseases, including that attributed to hypertension (labeled arteriolar or hypertensive nephrosclerosis), focal segmental glomerulosclerosis, and HIV-associated nephropathy. APOL1 nephropathy risk variants persist because of protection afforded from the parasite that causes African sleeping sickness. This breakthrough will lead to novel treatments for hypertensive African Americans with low-level proteinuria, for whom effective therapies are lacking. Furthermore, APOL1 nephropathy risk variants contribute to racially variable allograft survival rates after kidney transplantation and assist in detecting nondiabetic forms of nephropathy in African Americans with diabetes. Discovery of APOL1-associated nephropathy was a major success of the genetics revolution, demonstrating that secondary hypertension is typically present in nondiabetic African Americans with nephropathy.

Evaluation of an evidence-based intervention implemented with African-American women to prevent substance abuse, strengthen relationship skills and reduce risk for HIV/AIDS.

PubMed

Collins, David A; Shamblen, Stephen R; Strader, Ted N; Arnold, Brooke B

2017-08-01

African-American females in the U.S. are disproportionately affected by HIV/AIDS, and a large majority of new infections in this population are attributed to heterosexual contact. Risk factors include substance abuse, lack of knowledge about male partners' possible HIV infection risk, incarceration, disruptions of social networks, and intimate partner violence. This study assessed the effects of a comprehensive, evidence-based prevention intervention, Creating Lasting Family Connections (CLFC) that was implemented with sensitivity to African-American females, using a quasi-experimental design. The CLFC program was implemented with 175 women and their results were compared to a convenience sample of 44 women who were similar on background characteristics. Results showed significant (p < .05, two-tailed) increases in the proportion of individuals getting HIV tested and getting the results from these tests, a larger decrease in intimate partner abuse within the past three months, and larger increases in three relationship skills (emotional expression, interpersonal skills, and relationship satisfaction) relative to the comparison group.

Social network predictors of disclosure of MSM behavior and HIV-positive serostatus among African American MSM in Baltimore, Maryland

PubMed Central

Latkin, Carl; Yang, Cui; Tobin, Karin; Roebuck, Geoffrey; Spikes, Pilgrim; Patterson, Jocelyn

2012-01-01

This study examined correlates of disclosure of MSM behavior and seropositive HIV status to social network members among 187 African American MSM in Baltimore, MD. 49.7% of participants were HIV-positive, 64% of their social network members (excluding male sex partners) were aware of their MSM behavior, and 71.3% were aware of their HIV-positive status. Disclosure of MSM behavior to network members was more frequent among participants who were younger, had a higher level of education, and were HIV-positive. Attributes of the social network members associated with MSM disclosure included the network member being HIV-positive, providing emotional support, socializing with the participant, and not being a female sex partner. Participants who were younger were more likely to disclose their positive HIV status. Attributes of social network members associated with disclosure of positive serostatus included the network member being older, HIV-positive, providing emotional support, loaning money, and not being a male sex partner. PMID:21811844

An extended model of reasoned action to understand the influence of individual- and network-level factors on African Americans' participation in HIV vaccine research.

PubMed

Frew, Paula M; Archibald, Matthew; Diallo, Dazon Dixon; Hou, Su-I; Horton, Takeia; Chan, Kayshin; Mulligan, Mark J; del Rio, Carlos

2010-06-01

In the United States, the number and proportion of HIV/AIDS cases among black/African Americans continue to highlight the need for new biomedical prevention interventions, including an HIV vaccine, microbicide, or new antiretroviral (ARV) prevention strategies such as pre-exposure prophylaxis (PrEP) to complement existing condom usage, harm reduction methods, and behavioral change strategies to stem the HIV epidemic. Although black/African Americans are disproportionately impacted by HIV/AIDS, their participation in HIV clinical research continues to have unique challenges. We theorize that interaction among multilevel factors creates ideal alignment for minority participation in HIV clinical studies. Thus, we initially set out to test an extended model of reasoned action with 362 participants to understand the interplay of sociopsychological and network-level considerations influencing minority participation in HIV prevention research efforts. In this study, we linked the intrapersonal dimensions of attitudes, beliefs, and normative concerns to community-level components, appraisal of involvement with the clinical research organization, an entity which operates within a networked structure of community partner agencies, and identification with coalition advocacy aims. Various participatory outcomes were explored including involvement in future HIV vaccine community functions, participation in community promotion of HIV vaccine research, and community mobilization. Three-stage least squares estimates indicated similar findings across three models. Significant effects demonstrate the importance of positive attitudes toward HIV vaccine research, favorable health research beliefs, perceived social support for participation, HIV/AIDS issue engagement, and perceived relevance of the clinical research site's mission and values. Identification of these nuanced pathway effects provides implications for tailored community program development.

"You Still Got to See Where She's Coming From": Using Photovoice to Understand African American Female Adolescents' Perspectives on Sexual Risk

ERIC Educational Resources Information Center

Sidibe, Turquoise; Turner, Kea; Sparks, Alicia; Woods-Jaeger, Briana; Lightfoot, Alexandra

2018-01-01

African Americans have the highest rate of new HIV infection in the United States. This photovoice study explored the perspectives and experiences of African American female youth and sought to understand how adolescent development impacts HIV risk. This study used the photovoice methodology with seven African American or Biracial female youth, in…

African-American Fathers' Perspectives on Facilitators and Barriers to Father-Son Sexual Health Communication.

PubMed

Randolph, Schenita D; Coakley, Tanya; Shears, Jeffrey; Thorpe, Roland J

2017-06-01

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. © 2017 Wiley Periodicals, Inc.

African-American Fathers’ Perspectives on Facilitators and Barriers to Father-Son Sexual Health Communication

PubMed Central

Randolph, Schenita D.; Coakley, Tanya; Shears, Jeffrey; Thorpe, Roland J.

2017-01-01

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. PMID:28220553

Evaluation of a Socio-Cultural Intervention to Reduce Unprotected Sex for HIV Among African American/Black Women

PubMed Central

Boekeloo, B; Geiger, T; Wang, M; Ishman, N; Quinton, S; Allen, G; Ali, B; Snow, D

2015-01-01

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

Careful Conversations and Careful Sex: HIV Posttesting Experiences Among African American Men in Rural Florida.

PubMed

Aholou, Tiffiany M; Sutton, Madeline Y; Brown, Emma E J

2017-01-01

In the United States, black/African American (black) men bear the greatest burden of human immunodeficiency virus (HIV), accounting for 42% of new HIV infections in 2012 despite being 6% of the population. In Florida, heterosexual HIV transmission has increased among black men. Few studies have examined HIV testing experiences for black heterosexual men (BHM) in the rural South. This study describes the post-HIV-testing trial experiences of BHM in rural Florida. We conducted 12 focus groups (4-7 participants per group) in 3 rural Florida counties with BHM who participated in a larger randomized HIV testing trial. Interviews were professionally transcribed and data were analyzed using NVivo 10. The qualitative analysis was informed by the strengths perspective (ie, emphasis on abilities rather than risks) and used a thematic analytical approach. Sixty-seven men participated (median age 41.5 years); 39 (58%) earned a monthly income of less than $500, 38 (57%) attained education through high school or higher, 37 (55%) were unmarried, and 40 (60%) reported practicing monogamy; all who tested for HIV were negative for HIV. We identified 3 main themes based on self-reported actions: (1) risk reduction (eg, more consistent condom use, fewer sex partners), (2) sexual health communications with sex partners (eg, negotiating HIV testing with sex partners, getting to know partners better), and (3) health communications with peers and family (eg, disclosing test results, encouraging others to get tested). Among BHM, being in this HIV testing study facilitated increased protective behaviors and communications for HIV prevention. Interventions for BHM in rural areas warrant incorporating these strategies to encourage routine HIV testing. © 2016 National Rural Health Association.

African American Males. A Critical Link in the African American Family.

ERIC Educational Resources Information Center

Jones, Dionne J., Ed.

African Americans are experiencing extreme stress in the United States, and African-American males appear to suffer the most. The chapters in this volume examine some of the issues confronting African-American men today. They include: (1) "Introduction" (Dionne J. Jones); (2) "Reaffirming Young African American Males: Mentoring and…

Opening up their doors: perspectives on the involvement of the African American faith community in HIV prevention in four communities.

PubMed

Wooster, Joanna; Eshel, Ariela; Moore, Andrea; Mishra, Meenoo; Toledo, Carlos; Uhl, Gary; Aguero, Linda Wright-De

2011-09-01

In 1998, the U.S. government launched the Minority AIDS Initiative (MAI) to address growing ethnic and racial disparities in HIV/AIDS cases. The CDC performed an evaluation of its MAI-funded programs, including an assessment of community stakeholders' perspective on the involvement of the faith community in HIV prevention. Individual interviews (N = 113) were conducted annually over 3 years in four communities. The majority of participants described a change in faith community's attitudes toward HIV and a rise in HIV-related activities conducted by faith-based organizations. Participants attributed changes to faith-based funding, acknowledgment by African American community leadership that HIV is a serious health issue, and faith leaders' desire to become more educated on HIV/AIDS. Participants reported conservative faith doctrine and stigma as barriers to faith community involvement. The findings suggest that although barriers remain, there is an increased willingness to address HIV/AIDS, and the faith community serves as a vital resource in HIV prevention.

The Health Intervention Project: HIV risk reduction among African American women drug users.

PubMed Central

Sterk, Claire E.

2002-01-01

OBJECTIVE: This article describes the Health Intervention Project, an intervention for African American women in Atlanta, Georgia, who are crack cocaine users. METHODS:A formative phase involved ethnographic mapping of the physical and social infrastructure of the study communities and in-depth interviews with women crack cocaine users. Key findings that were incorporated into the intervention program included the exchange of sex for money or drugs, the women's experience with trauma and abuse, the role of men and male partners, the women's roles as mothers and members of extended families, their identity as African Americans, and their desire to reduce their risk for HIV/AIDS related to their drug use and sexual behavior. Individualized intervention sessions were designed to meet the women's needs. The motivation intervention emphasized self-motivation for behavioral change with the assistance of the interventionist, who facilitated the women's goal identification, action plan, and problem-solving skills. The negotiation intervention focused on improving technical and assertive communication skills. An action plan was developed, and the women worked on negotiation skills, self-control regarding sexual and drug-use encounters, assertiveness in sexual and drug-use interactions, and conflict resolution. CONCLUSION: Effective prevention and intervention programs must be framed within an appropriate racial, ethnic, and cultural context. Future research is needed to better understand risk in its social context, including the impact of community factors. PMID:12435832

The Health Intervention Project: HIV risk reduction among African American women drug users.

PubMed

Sterk, Claire E

2002-01-01

This article describes the Health Intervention Project, an intervention for African American women in Atlanta, Georgia, who are crack cocaine users. A formative phase involved ethnographic mapping of the physical and social infrastructure of the study communities and in-depth interviews with women crack cocaine users. Key findings that were incorporated into the intervention program included the exchange of sex for money or drugs, the women's experience with trauma and abuse, the role of men and male partners, the women's roles as mothers and members of extended families, their identity as African Americans, and their desire to reduce their risk for HIV/AIDS related to their drug use and sexual behavior. Individualized intervention sessions were designed to meet the women's needs. The motivation intervention emphasized self-motivation for behavioral change with the assistance of the interventionist, who facilitated the women's goal identification, action plan, and problem-solving skills. The negotiation intervention focused on improving technical and assertive communication skills. An action plan was developed, and the women worked on negotiation skills, self-control regarding sexual and drug-use encounters, assertiveness in sexual and drug-use interactions, and conflict resolution. Effective prevention and intervention programs must be framed within an appropriate racial, ethnic, and cultural context. Future research is needed to better understand risk in its social context, including the impact of community factors.

Stress biomarkers as outcomes for HIV+ prevention: participation, feasibility and findings among HIV+ Latina and African American mothers.

PubMed

Glover, Dorie A; Garcia-Aracena, Elena F; Lester, Patricia; Rice, Eric; Rothram-Borus, Mary Jane

2010-04-01

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.

Using novel methods to examine stress among HIV-positive African American men who have sex with men and women.

PubMed

Glover, Dorie A; Williams, John K; Kisler, Kimberly A

2013-06-01

Biomarker composites (BCs) that objectively quantify psychosocial stress independent of self report could help to identify those at greatest risk for negative health outcomes and elucidate mechanisms of stress-related processes. Here, BCs are examined in the context of existing disease progression among HIV-positive African American men who have sex with men and women (MSMW) with high stress histories, including childhood sexual abuse. Participants (N = 99) collected 12-h overnight and morning urine samples for assay of cortisol and catecholamines (primary BC) and neopterin (an indicator of HIV disease progression). Data on cumulative psychosocial trauma history (severity, types, frequency, age at first incident), posttraumatic stress disorder (PTSD) symptoms, sexual risk behaviors, and a secondary BC consisting of routine health indicators (heart rate, blood pressure, body mass index, waist-to-hip ratio) were also collected. Lifetime trauma exposure was highly pervasive and significantly greater among those meeting a standard cutoff for PTSD caseness (24 %). After controlling for HIV factors (neopterin levels and years with disease), PTSD was a significant (p < .05) predictor of the primary, but not secondary BC. Those with PTSD also had significantly more sexual partners, sex without a condom, and exchange sex for money or drugs than those without PTSD. Specific trauma characteristics predicted PTSD severity and caseness independently and uniquely in regression models (p's < .05-.001). A primary BC appears sensitive to cumulative trauma burden and PTSD in HIV-positive African American MSMW, providing support for the use of BCs to quantify psychosocial stress and inform novel methods for examining mechanisms of stress influenced health behaviors and disease outcomes in at-risk populations.

Evaluation of an HIV/STD Sexual Risk-Reduction Intervention for Pregnant African American Adolescents Attending a Prenatal Clinic in an Urban Public Hospital: Preliminary Evidence of Efficacy

PubMed Central

Diclemente, R.J.; Wingood, G. M.; Rose, E.; Sales, J. M.; Crosby, R.A.

2009-01-01

Study Objective To evaluate an intervention to reduce HIV/STD-associated behaviors and enhance psychosocial mediators for pregnant African-American adolescents. Design A randomized controlled trial. Participants completed baseline and follow-up assessments. Setting An urban public hospital in the Southeastern U.S. Participants Pregnant African-American adolescents (N=170), 14-20 years of age, attending a prenatal clinic. Intervention Intervention participants received two 4-hour group sessions enhancing self-concept and self-worth, HIV/STD prevention skills, and safer sex practices. Participants in the comparison condition received a 2-hour session on healthy nutrition. Main Outcome Measures Consistent condom use. Results Intervention participants reported greater condom use at last intercourse (AOR = 3.9, P = .05) and consistent condom use (AOR = 7.9, P = .05), higher sexual communication frequency, enhanced ethnic pride, higher self-efficacy to refuse risky sex, and were less likely to fear abandonment as a result of negotiating safer sex. Conclusion Interventions for pregnant African-American adolescents can enhance condom use and psychosocial mediators. PMID:19643646

Sexual Decision Making in the Absence of Choice: The African American Female Dating Experience

PubMed Central

Andrasik, Michele P.; Nguyen, Hong V.; George, William H.; Kajumulo, Kelly F.

2016-01-01

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

Social Environment and Sexual Risk-Taking among Gay and Transgender African American Youth

PubMed Central

Stevens, Robin; Bernadini, Stephen; Jemmott, John B.

2014-01-01

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

The Committed Intimate Partnerships of Incarcerated African-American Men: Implications for Sexual HIV Transmission Risk and Prevention Opportunities.

PubMed

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

2017-10-01

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

Unity in Diversity: Results of a Randomized Clinical Culturally Tailored Pilot HIV Prevention Intervention Trial in Baltimore, Maryland, for African American Men Who Have Sex with Men

ERIC Educational Resources Information Center

Tobin, Karin; Kuramoto, Satoko J.; German, Danielle; Fields, Errol; Spikes, Pilgrim S.; Patterson, Jocelyn; Latkin, Carl

2013-01-01

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,…

Partnership-Level Analysis of African American Women's Risky Sexual Behavior in Main and Non-Main Partnerships.

PubMed

Broaddus, Michelle; Owczarzak, Jill; Pacella, Maria; Pinkerton, Steven; Wright, Cassandra

2016-12-01

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.

Employing a teen advisory board to adapt an evidence-based HIV/STD intervention for incarcerated African-American adolescent women.

PubMed

Latham, Teaniese P; Sales, Jessica M; Renfro, Tiffaney L; Boyce, Lorin S; Rose, Eve; Murray, Colleen C; Wingood, Gina M; DiClemente, Ralph J

2012-10-01

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.

Added benefits: Reduced depressive symptom levels among African-American female adolescents participating in an HIV prevention intervention

PubMed Central

Brown, Jennifer L.; Sales, Jessica M.; Swartzendruber, Andrea L.; Eriksen, Michael D.; DiClemente, Ralph J.; Rose, Eve S.

2014-01-01

Background Adolescents experience elevated depressive symptoms which health promotion interventions may reduce. Purpose This study investigated whether HIV prevention trial participation decreased depressive symptoms among African-American female adolescents. Methods Adolescents (N=701; M age = 17.6) first received a group-delivered HIV prevention intervention and then either 12 sexual health (intervention condition) or 12 general health (comparison condition) phone counseling contacts over 24 months. ACASI assessments were conducted at baseline, and at 6-, 12-, 18-, and 24-months post-baseline. Linear generalized estimating equations were used to detect percent relative change in depressive symptoms. Results Participants reported a 2.7% decrease in depressive symptoms (p = 0.001) at each assessment. Intervention participants endorsed an additional 3.6% decrease in depressive symptoms (p = 0.058). Conclusions Trial participation was associated with reduced depressive symptomatology, particularly among those receiving personalized sexual health counseling. HIV prevention interventions may benefit from incorporating additional content to address adolescents’ mental health needs. PMID:24366521

Taking Boys out of the Hood: Exile as a Parenting Strategy for African American Male Youth

ERIC Educational Resources Information Center

Richardson, Joseph B., Jr.; Van Brakle, Mischelle; St. Vil, Christopher

2014-01-01

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…

Text messaging for sexual communication and safety among African American young adults.

PubMed

Broaddus, Michelle R; Dickson-Gomez, Julia

2013-10-01

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, semistructured 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 found to be used in face-to-face communication.

Staying strong: gender ideologies among African-American adolescents and the implications for HIV/STI prevention.

PubMed

Kerrigan, Deanna; Andrinopoulos, Katherine; Johnson, Raina; Parham, Patrice; Thomas, Tracey; Ellen, Jonathan M

2007-05-01

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.

Urban African-American Men Speak Out on Sexual Partner Concurrency

PubMed Central

Carey, Michael P.; Senn, Theresa E.; Seward, Derek X.; Vanable, Peter A.

2008-01-01

Sexual partner concurrency, which fuels the spread of HIV, has been hypothesized as a cause of higher rates of HIV among low-income, urban African-Americans. Despite this hypothesis, little is known about the phenomenology of partner concurrency. To address this gap in the literature, we recruited 20 urban African-American men from a public STD clinic to elicit their ideas about partner concurrency. Five themes emerged during focus group discussions. First, there was a general consensus that it is normative to have more than one sexual partner. Second, men agreed it is acceptable for men to have concurrent partners, but disagreed about whether it was acceptable for women. Third, although men provided many reasons for concurrent partnerships, the most common reasons were that (a) multiple partners fulfill different needs, and (b) it is in a man’s nature to have multiple partners. Fourth, men described some (but not all) of the negative consequences of having concurrent partners. Finally, men articulated spoken and unspoken rules that govern concurrent partnerships. These findings increase knowledge about urban, African-American men’s attitudes toward concurrent partnerships, and can help to improve the efficacy of sexual risk-reduction interventions for this group of underserved men and their partners. PMID:18483847

Evaluation of a Faith-Based Culturally Relevant Program for African American Substance Users at Risk for HIV in the Southern United States

ERIC Educational Resources Information Center

MacMaster, Samuel A.; Jones, Jenny L.; Rasch, Randolph F. R.; Crawford, Sharon L.; Thompson, Stephanie; Sanders, Edwin C., II

2007-01-01

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…

Using Social Cognitive Theory to Predict Safer Sex Behaviors in African American College Students

ERIC Educational Resources Information Center

Kanekar, Amar; Sharma, Manoj

2009-01-01

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…

The Protective Role of the Family and Social Support Network in a Sample of HIV-Positive African American Women: Results of a Pilot Study

PubMed Central

Robbins, Michael; Szapocznik, José; Tejeda, Manuel; Samuels, Deanne; Ironson, Gail; Antoni, Michael

2005-01-01

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

Experiences of racial discrimination and relation to sexual risk for HIV among a sample of urban black and African American men.

PubMed

Reed, E; Santana, M C; Bowleg, L; Welles, S L; Horsburgh, C R; Raj, A

2013-04-01

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.

Text Messaging for Sexual Communication and Safety Among African American Young Adults

PubMed Central

Broaddus, Michelle R.; Dickson-Gomez, Julia

2014-01-01

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

Achieving Broad Participation in Congregational Health Surveys at African American and Latino Churches

ERIC Educational Resources Information Center

Hawes-Dawson, Jennifer; Derose, Kathryn P.; Aunon, Frances M.; Dominguez, Blanca X.; Felton, Alexandria; Mata, Michael A.; Oden, Clyde W.; Paffen, Sandra

2017-01-01

Congregation-based health program evaluations often rely on surveys, but little documentation is available regarding specific methods and challenges. Here we describe methods used to achieve acceptable response rates (73-79%) in a survey of HIV-related attitudes and behaviors in two African American and three Latino churches in high HIV-prevalence…

Assessment of HIV/AIDS prevention of rural African American Baptist leaders: implications for effective partnerships for capacity building in American communities.

PubMed

Foster, Pamela Payne; Cooper, Krista; Parton, Jason M; Meeks, John O

2011-04-01

This exploratory study sought to elicit information from rural Baptist leaders about their interest in HIV prevention activities within their congregation and other influencers in their human deficiency virus (HIV) prevention activities based on their geographical residence (urban vs rural). This study utilized both qualitative (in-depth interviews, N = 8) and quantitative (written survey, N = 56) methodologies (mixed method) in order to obtain pertinent information. A ministerial liaison was hired to assist in recruitment of participants within a statewide Baptist conference. Written surveys were distributed at a statewide meeting. The majority of participants (N = 50) in this study (89.3%) were receptive to conducting HIV/AIDS prevention activities within their congregations. The study also revealed rural/urban differences, including: interest in HIV/AIDS prevention, direct experiences with infected persons, or whether churches have a health-related ministry. Positive influencers of HIV/AIDS prevention in rural church leaders included either the participant or their spouse being in a health-related occupation, migratory patterns from larger metropolitan areas in other areas of the country to the rural south, and whether the church has a health-related ministry. Findings from this study are significant for a variety of reasons, including use of faith-based models for HIV/ AIDS capacity building and use of potential influencers on HIV/AIDS prevention in African Americans in the rural Deep South, where the epidemic is growing fastest. Future implications of this study might include expansion of faith-based models to include other denominations and health care providers as well of use of positive influencers to develop future HIV/AIDS intervention strategies.

Structural Ecosystems Therapy for HIV+ African-American women and drug abuse relapse.

PubMed

Feaster, Daniel J; Burns, Myron J; Brincks, Ahnalee M; Prado, Guillermo; Mitrani, Victoria B; Mauer, Megaly H; Szapocznik, Jose

2010-06-01

This report examines the effect of Structural Ecosystems Therapy (SET) for (n=143) HIV+ African-American women on rate of relapse to substance use relative to both a person-centered approach (PCA) to therapy and a community control (CC) group. A prior report has shown SET to decrease psychological distress and family hassles relative to these 2 comparison groups. In new analyses, SET and CC had a significant protective effect against relapse as compared with PCA. There is evidence that SET's protective effect on relapse was related to reductions in family hassles, whereas there was not a direct impact of change in psychological distress on rates of relapse. Lower retention in PCA, perhaps caused by the lack of a directive component to PCA, may have put these women at greater risk for relapse. Whereas SET did not specifically address substance abuse, SET indirectly protected at-risk women from relapse through reductions in family hassles.

Obesity and African Americans

MedlinePlus

... Data > Minority Population Profiles > Black/African American > Obesity Obesity and African Americans African American women have the ... youthonline . [Accessed 08/18/2017] HEALTH IMPACT OF OBESITY People who are overweight are more likely to ...

HIV/AIDS among African Americans

MedlinePlus

... Determination of Need Requests Pre-Exposure Prophylaxis (PrEP) Post-Exposure Prophylaxis (PEP) HIV Treatment as Prevention Condoms HIV in the Workplace HIV Testing Laboratory Tests Home Tests Testing in Nonclinical Settings CLIA Certificate ...

Assessment of HIV-related stigma in a US faith-based HIV education and testing intervention.

PubMed

Berkley-Patton, Jannette Y; Moore, Erin; Berman, Marcie; Simon, Stephen D; Thompson, Carole Bowe; Schleicher, Thomas; Hawes, Starlyn M

2013-11-13

The African American church is a highly influential institution with the potential to greatly increase the reach of HIV prevention interventions and address HIV-related stigma in US African American communities. However, there are few studies on HIV-related stigma and African American church populations. This study explored HIV-related stigma among church and community members participating in an HIV education and testing intervention pilot study in African American churches, named Taking It to the Pews. Four African American churches located in Kansas City, MO and KS, were randomized to either intervention or comparison groups. Churches assigned to the intervention group received religiously tailored HIV education, testing and compassion messages/activities (e.g. sermons, brochures/church bulletins, testimonials) via the Taking It to the Pews HIV Tool Kit. Comparison churches received non-religiously tailored HIV information. HIV-related stigma was assessed with 543 church members and with community members served through church outreach services (e.g. food/clothing pantries, social services) in the four churches. Participants completed surveys at baseline, 6 months and 12 months to assess their HIV-related stigma beliefs, exposure to intervention components and satisfaction with the study. At baseline, HIV-related stigma beliefs were similar across experimental groups and were quite low. Mean HIV-related stigma scores were not significantly different between experimental groups at 6 months (p=0.92) or at 12 months (p=0.70). However, mean HIV-related stigma scores within both groups showed decreasing trends at six months, which approached significance. Analysis of previously studied HIV-related stigma factors (e.g. age, gender, income, HIV knowledge, religiosity) did not yield changes in the null findings. Intervention group participants were highly exposed to several intervention components (sermons, HIV resource tables, posters, brochures/church bulletins

Assessment of HIV-related stigma in a US faith-based HIV education and testing intervention

PubMed Central

Berkley-Patton, Jannette Y; Moore, Erin; Berman, Marcie; Simon, Stephen D; Thompson, Carole Bowe; Schleicher, Thomas; Hawes, Starlyn M

2013-01-01

Introduction The African American church is a highly influential institution with the potential to greatly increase the reach of HIV prevention interventions and address HIV-related stigma in US African American communities. However, there are few studies on HIV-related stigma and African American church populations. This study explored HIV-related stigma among church and community members participating in an HIV education and testing intervention pilot study in African American churches, named Taking It to the Pews. Methods Four African American churches located in Kansas City, MO and KS, were randomized to either intervention or comparison groups. Churches assigned to the intervention group received religiously tailored HIV education, testing and compassion messages/activities (e.g., sermons, brochures/church bulletins, testimonials) via the Taking It to the Pews HIV Tool Kit. Comparison churches received non-religiously tailored HIV information. HIV-related stigma was assessed with 543 church members and with community members served through church outreach services (e.g., food/clothing pantries, social services) in the four churches. Participants completed surveys at baseline, 6 months and 12 months to assess their HIV-related stigma beliefs, exposure to intervention components and satisfaction with the study. Results At baseline, HIV-related stigma beliefs were similar across experimental groups and were quite low. Mean HIV-related stigma scores were not significantly different between experimental groups at 6 months (p=0.92) or at 12 months (p=0.70). However, mean HIV-related stigma scores within both groups showed decreasing trends at six months, which approached significance. Analysis of previously studied HIV-related stigma factors (e.g., age, gender, income, HIV knowledge, religiosity) did not yield changes in the null findings. Intervention group participants were highly exposed to several intervention components (sermons, HIV resource tables, posters

Exploring Self-Efficacy and Locus of Control as Risk Factors in Sexual Decision Making for African American Women

ERIC Educational Resources Information Center

Pimpleton, Asher M.

2012-01-01

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…

Beyond the Ball: Implications for HIV risk and prevention among the constructed families of African American Men who have Sex with Men

PubMed Central

Dickson-Gomez, Julia; Owczarzak, Jill; Lawrence, Janet St.; Sitzler, Cheryl; Quinn, Katherine; Pearson, Broderick; Kelly, Jeffrey A.; Amirkhanian, Yuri A.

2014-01-01

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

Effects of fear of abuse and possible STI acquisition on the sexual behavior of young African American women.

PubMed

Raiford, Jerris L; Diclemente, Ralph J; Wingood, Gina M

2009-06-01

We examined the interactive effects of fear of abuse and knowledge of sexually transmitted infections (STIs) on sexual risk behaviors in a sample of young African American women. We recruited 715 young African American women aged 15 to 21 years from a variety of health clinics and assessed them for fear of abuse because of negotiating condom use, knowledge of STIs, and several sexual risk behaviors. Overall, 75% of young African American women reported inconsistent condom use in the past 60 days. Surprisingly, under relatively higher levels of fear, young women with high STI knowledge were more likely than were those with low STI knowledge to exhibit inconsistent condom use in the past 60 days (89% vs 80%; chi(2) = 4.32; P < or = .04) and during the last sexual intercourse with a main sexual partner (76% vs 70%; chi(2) = 8.06; P < or = .01). Most HIV prevention interventions focus on increasing knowledge about the transmission of STIs. However, other contextual factors such as fear of abuse because of negotiating condom use may heighten the risk of HIV infection. Our findings highlight the need for combining dating violence prevention activities with STI and HIV prevention programs targeting young African American women.

A question of trust: user-centered design requirements for an informatics intervention to promote the sexual health of African-American youth.

PubMed

Veinot, Tiffany C; Campbell, Terrance R; Kruger, Daniel J; Grodzinski, Alison

2013-01-01

We investigated the user requirements of African-American youth (aged 14-24 years) to inform the design of a culturally appropriate, network-based informatics intervention for the prevention of HIV and other sexually transmitted infections (STI). We conducted 10 focus groups with 75 African-American youth from a city with high HIV/STI prevalence. Data analyses involved coding using qualitative content analysis procedures and memo writing. Unexpectedly, the majority of participants' design recommendations concerned trust. Youth expressed distrust towards people and groups, which was amplified within the context of information technology-mediated interactions about HIV/STI. Participants expressed distrust in the reliability of condoms and the accuracy of HIV tests. They questioned the benevolence of many institutions, and some rejected authoritative HIV/STI information. Therefore, reputational information, including rumor, influenced HIV/STI-related decision making. Participants' design requirements also focused on trust-related concerns. Accordingly, we developed a novel trust-centered design framework to guide intervention design. Current approaches to online trust for health informatics do not consider group-level trusting patterns. Yet, trust was the central intervention-relevant issue among African-American youth, suggesting an important focus for culturally informed design. Our design framework incorporates: intervention objectives (eg, network embeddedness, participation); functional specifications (eg, decision support, collective action, credible question and answer services); and interaction design (eg, member control, offline network linkages, optional anonymity). Trust is a critical focus for HIV/STI informatics interventions for young African Americans. Our design framework offers practical, culturally relevant, and systematic guidance to designers to reach this underserved group better.

African American adolescents meeting sex partners online: closing the digital research divide in STI/HIV prevention.

PubMed

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

2012-02-01

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.

On the Efficacy and Mediation of a One-on-One HIV Risk-Reduction Intervention for African American Men Who Have Sex with Men: A Randomized Controlled Trial.

PubMed

Jemmott, John B; Jemmott, Loretta Sweet; O'Leary, Ann; Icard, Larry D; Rutledge, Scott E; Stevens, Robin; Hsu, Janet; Stephens, Alisa J

2015-07-01

We examined the efficacy and mediation of Being Responsible for Ourselves (BRO), an HIV/STI risk-reduction intervention for African American men who have sex with men (MSM), the population with the highest HIV-diagnosis rate in the US. We randomized African American MSM to one of two interventions: BRO HIV/STI risk-reduction, targeting condom use; or attention-matched control, targeting physical activity and healthy diet. The interventions were based on social cognitive theory, the reasoned-action approach, and qualitative research. Men reporting anal intercourse with other men in the past 90 days were eligible and completed pre-intervention, immediately post-intervention, and 6 and 12 months post-intervention surveys. Of 595 participants, 503 (85 %) completed the 12-month follow-up. Generalized-estimating-equations analysis indicated that, compared with the attention-matched control intervention, the BRO intervention did not increase consistent condom use averaged over the 6- and 12-month follow-ups, which was the primary outcome. Although BRO did not affect the proportion of condom-protected intercourse acts, unprotected sexual intercourse, multiple partners, or insertive anal intercourse, it did reduce receptive anal intercourse compared with the control, a behavior linked to incident HIV infection. Mediation analysis using the product-of-coefficients approach revealed that although BRO increased seven of nine theoretical constructs it was designed to affect, it increased only one of three theoretical constructs that predicted consistent condom use: condom-use impulse-control self-efficacy. Thus, BRO indirectly increased consistent condom use through condom-use impulse-control self-efficacy. In conclusion, although BRO increased several theoretical constructs, most of those constructs did not predict consistent condom use; hence, the intervention did not increase it. Theoretical constructs that interventions should target to increase African American MSM

Social and psychological context for HIV risk in non-gay-identified African American men who have sex with men.

PubMed

Operario, Don; Smith, Carla Dillard; Kegeles, Susan

2008-08-01

This study used qualitative methods to explore the social and psychological context of sexual behavior and HIV risk among African American non-gay-identified men who have sex with men. Analysis of men's narratives on their sexual behaviors revealed four social and psychological factors contributing to risk for HIV infection: (a) a tendency to compartmentalize and personally disengage from same-sex behavior, (b) traditional gender roles that reinforce men's adherence to masculine images and ambivalent attitudes toward women, (c) cultural norms that favor secrecy and privacy about any personal matters, and (d) spontaneous and unplanned sexual episodes with other men. Findings indicate that innovative HIV prevention and risk reduction strategies are necessary to reach this group and question the legitimacy of conventional sexual orientation categories for these men. Interventions must address social contextual determinants of risk, reinforce men's public identifications as straight/heterosexual, and maintain men's need for privacy about same-sex behaviors.

Religiosity and Sexual Risk Behaviors Among African American Cocaine Users in the Rural South

PubMed Central

Montgomery, Brooke E.E.; Stewart, Katharine E.; Yeary, Karen H.K.; Cornell, Carol E.; Pulley, LeaVonne; Corwyn, Robert; Ounpraseuth, Songthip T.

2014-01-01

Purpose Racial and geographic disparities in human immunodeficency virus (HIV) are dramatic and drug use is a significant contributor to HIV risk. Within the rural South, African Americans who use drugs are at extremely high risk. Due to the importance of religion within African American and rural Southern communities, it can be a key element of culturally-targeted health promotion with these populations. Studies have examined religion’s relationship with sexual risk in adolescent populations, but few have examined specific religious behaviors and sexual risk behaviors among drug-using African American adults. This study examined the relationship between well-defined dimensions of religion and specific sexual behaviors among African Americans who use cocaine living in the rural southern United States. Methods Baseline data from a sexual risk reduction intervention for African Americans who use cocaine living in rural Arkansas (N = 205) were used to conduct bivariate and multivariate analyses examining the association between multiple sexual risk behaviors and key dimensions of religion including religious preference, private and public religious participation, religious coping, and God-based, congregation-based, and church leader-based religious support. Findings After adjusting individualized network estimator weights based on the recruitment strategy, different dimensions of religion had inverse relationships with sexual risk behavior, including church leadership support with number of unprotected vaginal/anal sexual encounter and positive religious coping with number of sexual partners and with total number of vaginal/anal sexual encounters. Conclusion Results suggest that specific dimensions of religion may have protective effects on certain types of sexual behavior, which may have important research implications. PMID:24575972

The Process of Adaptation of a Community-Level, Evidence-Based Intervention for HIV-Positive African American Men Who Have Sex with Men in Two Cities

ERIC Educational Resources Information Center

Robinson, Beatrice E.; Galbraith, Jennifer S.; Lund, Sharon M.; Hamilton, Autumn R.; Shankle, Michael D.

2012-01-01

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…

Sexual Risk among African American Girls: Psychopathology and Mother-Daughter Relationships

ERIC Educational Resources Information Center

Donenberg, Geri R.; Emerson, Erin; Mackesy-Amiti, Mary Ellen

2011-01-01

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…

The Mediating Role of Partner Communication Frequency on Condom Use Among African-American Adolescent Females Participating in an HIV Prevention Intervention

PubMed Central

Sales, Jessica M.; Lang, Delia L.; DiClemente, Ralph J.; Latham, Teaniese P; Wingood, Gina M.; Hardin, James W.; Rose, Eve S.

2011-01-01

Objective Although effective HIV prevention interventions have been developed for adolescents, few interventions have explored whether components of the intervention are responsible for the observed changes in behaviors post-intervention. This study examined the mediating role of partner communication frequency on African-American adolescent females’ condom use post-participation in a demonstrated efficacious HIV risk-reduction intervention. Main Outcome Measures Percent condom use in the past 60 days and consistent condom use in the past 6o days across the 12-month follow-up period. Design As part of a randomized controlled trial of African-American adolescent females (N=715), 15-21 years, seeking sexual health services, completed a computerized interview at baseline (prior to intervention) and again 6- and 12-month follow-up post-intervention participation. The interview assessed adolescents’ sexual behavior and partner communication skills, among other variables, at each time point. Using generalized estimating equation (GEE) techniques, both logistic and linear regression models were employed to test mediation over the 12-month follow-up period. Additional tests were conducted to assess the significance of the mediated models. Results Mediation analyses observed that partner communication frequency was a significant partial mediator of both proportion condom-protected sex acts (p =.001) and consistent condom use (p = .001). Conclusion Partner communication frequency, an integral component of this HIV intervention, significantly increased as a function of participating in the intervention partially explaining the change in condom use observed 12-months post-intervention. Understanding what intervention components are associated with behavior change is important for future intervention development. PMID:21843001

The differences between medical trust and mistrust and their respective influences on medication beliefs and ART adherence among African-Americans living with HIV.

PubMed

Pellowski, Jennifer A; Price, Devon M; Allen, Aerielle M; Eaton, Lisa A; Kalichman, Seth C

2017-09-01

The purpose of this study was to examine the relationships between medical mistrust and trust and to determine if these measures differentially predict antiretroviral therapy (ART) medication adherence for African-American adults living with HIV. A total of 458 HIV positive African-Americans completed a cross-sectional survey. Self-reported ART adherence was collected using the visual-analog scale. The Beliefs About Medicines Questionnaire was used to assess medication necessity and concern beliefs. All measures of medical mistrust and trust were significantly negatively correlated, ranging from r = -.339 to -.504. Race-based medical mistrust significantly predicted medication necessity and concern beliefs, whereas general medical mistrust only significantly predicted medication concerns. Both measures of trust significantly predicted medication necessity beliefs and medication concerns. Higher levels of race-based medical mistrust predicted lower medication adherence, whereas, neither trust in own physician nor trust in health care provider significantly predicted medication adherence. However, trust in own physician significantly predicted medication necessity beliefs, which predicted medication adherence. Trust and mistrust are not simply opposites of one another. These findings provide evidence for the complexity of understanding the relationship between health care trust, mistrust and patient-related health beliefs and behaviours.

"Jimmy Cap Before You Tap": Developing Condom Use Messages for African American Women.

PubMed

Hood, Kristina B; Shook, Natalie J; Belgrave, Faye Z

This study examined which characteristics of persuasive communications are most effective in changing African American women's condom use attitudes. Focus groups were convened with 40 African American women (M age  = 25.54, SD = 4.67) to assess their opinions on current effective strategies used to promote condom use among their peers. Participants discussed effective characteristics of messaging campaigns (i.e., source, message type, channel) and how these could be used in future prevention messages. Findings revealed that making messages that are fun, catchy, and informative, delivered frequently through social media, TV, or radio by a peer or celebrity would be perceived as most effective in changing young African American women's attitudes. Other themes that emerged were that condom use is more strongly associated with pregnancy prevention than HIV prevention and that sexual partners were perceived to have negative condom use attitudes. Recommendations centered on increasing exposure of HIV prevention messages by placing messages on the Internet and including a funny phrase or jingle in the message so that it is easy to remember and could potentially serve as a conversation starter for discussing safe sex with partners.

Loneliness and Substance Use: The Influence of Gender among HIV+ Black/African American Adults 50+

PubMed Central

Mannes, Zachary L.; Burrell, Larry E.; Bryant, Vaughn E.; Dunne, Eugene M.; Hearn, Lauren E.; Whitehead, Nicole Ennis

2016-01-01

Estimates suggest 30% of adults report the highest levels of loneliness. Though men are more likely than women to use illicit substances and engage in heavy drinking, the prevalence of substance use in women is growing and their escalation towards dependence occurs more rapidly. Loneliness and substance use have greater relevance within the HIV+ population, with higher rates of substance misuse than the general population. However, the association between loneliness and substance use within HIV+ individuals remains understudied. The purpose of the present study was to test the hypothesis that there would be an association between loneliness and substance moderated by gender in HIV+ older adults. A cross sectional study was conducted between October 2013 and January 2014. Study participants included 96 HIV-positive Black/African American men and women recruited through the University of Florida Center for HIV/AIDS Research, Education and Service (UF CARES) in Jacksonville, Florida. Participants completed an interviewer-administered assessment examining mental and behavioral health. Pearson correlations examined associations between loneliness and substance use. Binary logistic regression analyses stratified by gender examined the association between loneliness and substance use while controlling for covariates. Among women, loneliness was associated with illicit drug use, AOR=3.37, 95% CI: 1.23 – 9.21, p =. 018 and heavy drinking, AOR=2.47, 95% CI: 1.07 – 5.71, p =. 033. No significant associations were found between loneliness and illicit drug use, and heavy drinking in men. Substance use among women in this population may be linked to loneliness. Interventions should be gender specific. Further research into this association is necessary as it will likely have important clinical implications for this population. PMID:26654243

A mixed methods study of health and social disparities among substance-using African American/Black men who have sex with men.

PubMed

Buttram, Mance E; Kurtz, Steven P

2015-03-01

African American/Black men who have sex with men (MSM) in the U.S. experience health and social disparities at greater rates than MSM of other races/ethnicities, including HIV infection and substance use. This mixed methods paper presents: 1) a quantitative examination of health and social disparities among a sample of substance-using African American/Black MSM (N=108), compared to Caucasian/White MSM (N=250), and 2) in-depth qualitative data from a subsample of African American/Black MSM (N=21) in order to contextualize the quantitative data. Findings indicate that compared to Caucasian/White MSM, African American/Black MSM experienced a wide range of health and social disparities including: substance use and dependence; buying, trading or selling sex; educational attainment; employment; homelessness; identifying as gay; HIV status; arrest history; social support; and satisfaction with one's living situation. Qualitative data suggests that structural interventions that address homophobia and the social environment would be likely to mitigate many of the health and social disparities experienced by African American/Black MSM.

Discrepancies between HIV prevention communication attitudes and actual conversations about HIV testing within social and sexual networks of African American men who have sex with men.

PubMed

Tobin, Karin Elizabeth; Yang, Cui; Sun, Christina; Spikes, Pilgrim; Latkin, Carl Asher

2014-04-01

Promoting communication among African American men who have sex with men (AA MSM) and their social networks about HIV testing is an avenue for altering HIV prevention social norms. This study examined the attitudes of AA MSM on talking with peers about HIV testing and characteristics of their network members with whom they have these conversations. Data came from a cross-sectional survey of 226 AA MSM who were 18 years or older and self-reported sex with another male in the prior 90 days. Participants completed an inventory to characterize network members with whom they had conversations about HIV testing and HIV status. Most of the sample reported that it was important/very important to talk to male friends about HIV (85%) and that they were comfortable/very comfortable talking with their friends about sexual behaviors (84%). However, a small proportion of the social network had been talked to by the participant about HIV testing (14%). Among sexual networks, 58% had been talked to about their HIV status, and this was positively associated with main and casual partner type compared with partners with whom money or drugs were exchanged. Findings suggest that positive attitudes about communication may be necessary but not sufficient for actual conversations to occur. Designing interventions that increase communication with social networks is warranted.

A question of trust: user-centered design requirements for an informatics intervention to promote the sexual health of African-American youth

PubMed Central

Veinot, Tiffany C; Campbell, Terrance R; Kruger, Daniel J; Grodzinski, Alison

2013-01-01

Objective We investigated the user requirements of African-American youth (aged 14–24 years) to inform the design of a culturally appropriate, network-based informatics intervention for the prevention of HIV and other sexually transmitted infections (STI). Materials and Methods We conducted 10 focus groups with 75 African-American youth from a city with high HIV/STI prevalence. Data analyses involved coding using qualitative content analysis procedures and memo writing. Results Unexpectedly, the majority of participants’ design recommendations concerned trust. Youth expressed distrust towards people and groups, which was amplified within the context of information technology-mediated interactions about HIV/STI. Participants expressed distrust in the reliability of condoms and the accuracy of HIV tests. They questioned the benevolence of many institutions, and some rejected authoritative HIV/STI information. Therefore, reputational information, including rumor, influenced HIV/STI-related decision making. Participants’ design requirements also focused on trust-related concerns. Accordingly, we developed a novel trust-centered design framework to guide intervention design. Discussion Current approaches to online trust for health informatics do not consider group-level trusting patterns. Yet, trust was the central intervention-relevant issue among African-American youth, suggesting an important focus for culturally informed design. Our design framework incorporates: intervention objectives (eg, network embeddedness, participation); functional specifications (eg, decision support, collective action, credible question and answer services); and interaction design (eg, member control, offline network linkages, optional anonymity). Conclusions Trust is a critical focus for HIV/STI informatics interventions for young African Americans. Our design framework offers practical, culturally relevant, and systematic guidance to designers to reach this underserved group

African-Americans and Alzheimer's

MedlinePlus

... Share Plus on Google Plus African-Americans and Alzheimer's alz.org | IHaveAlz Introduction 10 Warning Signs Brain ... African-Americans are at a higher risk for Alzheimer's disease. Many Americans dismiss the warning signs of ...

Mental Health and African Americans

MedlinePlus

... than Non-Hispanic whites. The death rate from suicide for African American men was more than four ... for African American women, in 2014. However, the suicide rate for African Americans is 70% lower than ...

Breaking the Silence: The Black Church Addresses HIV.

ERIC Educational Resources Information Center

Swartz, Aimee

2002-01-01

AIDS is the leading cause of death among African Americans age 25-44 years. About half of all new U.S. HIV cases are African Americans, though African Americans make up only 13 percent of the population. Most U.S. children living with HIV are African American. There exists a strong pattern of resistance and denial of the disease in the African…

Theory-Based Analysis of Interest in an HIV Vaccine for Reasons Indicative of Risk Compensation Among African American Women.

PubMed

Painter, Julia E; Temple, Brandie S; Woods, Laura A; Cwiak, Carrie; Haddad, Lisa B; Mulligan, Mark J; DiClemente, Ralph J

2018-06-01

Licensure of an HIV vaccine could reduce or eliminate HIV among vulnerable populations. However, vaccine effectiveness could be undermined by risk compensation (RC), defined by an increase in risky behavior due to a belief that the vaccine will confer protection. Interest in an HIV vaccine for reasons indicative of RC may serve as an indicator of actual RC in a postlicensure era. This study assessed factors associated with interest in an HIV vaccine for reasons indicative of RC among African American women aged 18 to 55 years, recruited from a hospital-based family planning clinic in Atlanta, Georgia ( N = 321). Data were collected using audio-computer-assisted surveys. Survey items were guided by risk homeostasis theory and social cognitive theory. Multivariable logistic regression was used to assess determinants of interest in an HIV vaccine for reasons indicative of RC. Thirty-eight percent of the sample expressed interest in an HIV vaccine for at least one reason indicative of RC. In the final model, interest in an HIV vaccine for reasons indicative of RC was positively associated with higher impulsivity, perceived benefits of sexual risk behaviors, and perceived benefits of HIV vaccination; it was negatively associated with having at least some college education, positive future orientation, and self-efficacy for sex refusal. Results suggest that demographic, personality, and theory-based psychosocial factors are salient to wanting an HIV vaccine for reasons indicative of RC, and underscore the need for risk-reduction counseling alongside vaccination during the eventual rollout of an HIV vaccine.

Do People Know I’m Poz?: Factors Associated with Knowledge of Serostatus among HIV-positive African Americans’ Social Network Members

PubMed Central

Hoover, Matthew A.; Green, Harold D.; Bogart, Laura M.; Wagner, Glenn J.; Mutchler, Matt G.; Galvan, Frank H.; McDavitt, Bryce

2015-01-01

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. PMID:25903505

African American Suicide

MedlinePlus

African American Suicide Fact Sheet Based on 2012 Data (2014) Overview • In 2012, 2,357 African Americans completed suicide in the U.S. Of these, 1,908 (80. ... rate of 9.23 per 100,000). The suicide rate for females was 1.99 per 100, ...

Gender Moderates the Association of Depressive Symptoms to Sexual Risk Behavior Among HIV-Positive African-American Outpatients.

PubMed

Babowitch, Jacklyn D; Vanable, Peter A; Carey, Michael P

2018-05-01

Previous research has reported an association between depressive symptoms and sexual risk behavior. The purpose of this study was to explore whether gender moderates this association in a sample of HIV-positive African-Americans. Participants (N = 93) self-reported depressive symptoms (Center for Epidemiological Studies-Depression Scale; CES-D), and sexual risk behavior for the past 4 months. Analyses revealed that the depressive symptoms-by-gender interaction was associated with condomless sex and substance use proximal to sex. When analyses were stratified by gender, depressive symptoms were associated with condomless sex and frequency of substance use only for women. We conclude that depressive symptoms may be a more powerful sexual risk factor among women relative to men.

Psychological Misdiagnosis of African Americans.

ERIC Educational Resources Information Center

Garretson, Deborah J.

1993-01-01

Reviews historical and current problems with making accurate psychological diagnoses of African Americans. Suggests that misdiagnosis is strongly related to pathologization of African-American culture itself. Explores diagnostic process, stereotypes of African-American psychopathology, cultural differences in values and life stressors, and…

A GROUNDED THEORY STUDY OF THE PROCESS USED TO NEGOTIATE CONDOM USE AMONG AFRICAN-AMERICAN WOMEN: REVIEW OF THE LITERATURE.

PubMed

Hunter, Teressa Sanders; Tilley, Donna Scott

2015-01-01

This review of the literature identifies themes, variable, goals, and gaps in the literature related to HIV and AIDS among African American women. Black Feminist Epistemology and symbolic interactionism are used as a theoretical perspective and philosophical framework to examine experiences and social behaviors of African-American women and to guide and framework to explain the findings from the literature. This theoretical perspective/philosophical framework can also be used in understanding processes used by African-American women in behavioral, social, and intimate interactions.

HIV-related sexual decisions made by African-American adolescents living in different family structures: study from an ecodevelopmental perspective.

PubMed

Li, Ya-Huei; Cuccaro, Paula; Chen, Hua; Abughosh, Susan; Mehta, Paras D; Essien, Ekere J

2018-01-01

The purpose of this study was to explore the association between the dynamics of family structure and sexual behaviors of African-American adolescents using the ecodevelopmental theory. This study stratified data from 1,617 African-American adolescents of the Add Health Wave I respondents with an identified family composition. It examined the associations between family structure, parenting function, and adolescents' sexual decision-making: age of first sexual intercourse, sexual initiation before age 16, and using a condom during the first and last sexual intercourse. Emotional connection between parents and children (feeling more love from the father: β=0.17, P =0.0312; feeling more love from the mother: β=0.3314, P =0.0420) and mothers' less permissive attitude toward adolescents' sexual experience in their teens (β=0.33, P =0.0466) are positively associated with late age of sexual initiation of adolescents living in two-parent households. School-level factors (β=0.07, P =0.0008) and the adolescents' characteristics (being older: 0.42, P =0.0002; heterosexuality: β=2.28, P =0.0091) are the factors most positively related to the age of sexual initiation for those living with a single parent. Immediate social determinants, other than family factors (such as land use of immediate area [rural]: β=9.84, P <0.0001; the condition of living unit: β=1.55, P =0.0011; and safety of neighborhood: β=4.46, P =0.004), are related to late age of sexual initiation among those living with other relatives/alone. A higher tendency of condom use consistency was present in adolescents living with two parents compared to those living in other family structures. Less parent/child connection and parent/family influence were found in African-American adolescents living with other relatives or alone, suggesting that living with two residential parents plays an essential role in their late sexual initiation and could account for an important element to combat high HIV incidence of

Differential effects of the classroom on African American and non-African American's mathematics achievement.

PubMed

Schenke, Katerina; Nguyen, Tutrang; Watts, Tyler W; Sarama, Julie H; Clements, Douglas H

2017-08-01

We examined whether African American students differentially responded to dimensions of the observed classroom-learning environment compared with non-African American students. Further, we examined whether these dimensions of the classroom mediated treatment effects of a preschool mathematics intervention targeted at students from low-income families. Three observed dimensions of the classroom (teacher expectations and developmental appropriateness; teacher confidence and enthusiasm; and support for mathematical discourse) were evaluated in a sample of 1,238 preschool students in 101 classrooms. Using multigroup multilevel mediation where African American students were compared to non-African American students, we found that teachers in the intervention condition had higher ratings on the observed dimensions of the classroom compared with teachers in the control condition. Further, ratings on teacher expectations and developmental appropriateness had larger associations with the achievement of African American students than for non-African Americans. Findings suggest that students within the same classroom may react differently to that learning environment and that classroom learning environments could be structured in ways that are beneficial for students who need the most support.

Successfully Educating Our African-American Students

ERIC Educational Resources Information Center

Moncree-Moffett, Kareem

2013-01-01

The purpose of this empirical study was to explore the lived experiences of African American retired female teachers who have prior experience with educating urban African American students in public schools. Also explored are the experiences of active African American female teachers of urban African American students and comparisons are…

Romantic Relationship Dynamics of Urban African American Adolescents: Patterns of Monogamy, Commitment, and Trust

PubMed Central

Towner, Senna L.; Dolcini, M. Margaret; Harper, Gary W.

2013-01-01

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 focused on the differences in these dynamics between and within gender. The way that such dynamics interplay in romantic relationships has the potential to influence STI/HIV acquisition risk. In-depth interviews were conducted with 28 African American adolescents aged 14 to 21 living in San Francisco. Our results discuss data related to monogamous behaviors, expectations, and values; trust and respect in romantic relationships; commitment to romantic relationships; and outcomes of mismatched relationship expectations. Incorporating gender-specific romantic relationships dynamics can enhance the effectiveness of prevention programs. PMID:26691404

Romantic Relationship Dynamics of Urban African American Adolescents: Patterns of Monogamy, Commitment, and Trust.

PubMed

Towner, Senna L; Dolcini, M Margaret; Harper, Gary W

2015-05-01

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 focused on the differences in these dynamics between and within gender. The way that such dynamics interplay in romantic relationships has the potential to influence STI/HIV acquisition risk. In-depth interviews were conducted with 28 African American adolescents aged 14 to 21 living in San Francisco. Our results discuss data related to monogamous behaviors, expectations, and values; trust and respect in romantic relationships; commitment to romantic relationships; and outcomes of mismatched relationship expectations. Incorporating gender-specific romantic relationships dynamics can enhance the effectiveness of prevention programs.

Associations Between a Dopamine D4 Receptor Gene, Alcohol Use, and Sexual Behaviors among Female Adolescent African Americans

PubMed Central

Sales, Jessica M.; Smearman, Erica; Brown, Jennifer L.; Brody, Gene H.; Philibert, Robert A.; Rose, Eve; DiClemente, Ralph J.

2016-01-01

Adolescent African-American females are disproportionately impacted by HIV, thus there is a clear need to understand factors associated with increased HIV-risk behaviors among this vulnerable population. We sought to explore the association between a dopamine D4 receptor gene (DRD4), a genetic marker associated with natural variations in rewarding behaviors, and self-reported alcohol-use and sexual risk-behaviors, while controlling for other known correlates of risk-taking such as impulsivity, sensation seeking, and peer norms among a group of high-risk African American female adolescents to evaluate whether this biological factor enhances our understanding of patterns of risk in this vulnerable group. PMID:27087792

Teaching African-American Children.

ERIC Educational Resources Information Center

Horton, Harold

1994-01-01

Examines the historical blighting of African-American slaves' minds, which stripped them of their African culture. Examines the effect on African-American children, as well as other children of color. Offers suggestions for coping with the problems of modern schools in terms of respecting and teaching these children that the system is the problem,…

African American Women’s Preparation for Childbirth From the Perspective of African American Health-Care Providers

PubMed Central

Abbyad, Christine; Robertson, Trina Reed

2011-01-01

Preparation for birthing has focused primarily on Caucasian women. No studies have explored African American women’s birth preparation. From the perceptions of 12 African American maternity health-care providers, this study elicited perceptions of the ways in which pregnant African American women prepare for childbirth. Focus group participants answered seven semistructured questions. Four themes emerged: connecting with nurturers, traversing an unresponsive system, the need to be strong, and childbirth classes not a priority. Recommendations for nurses and childbirth educators include: (a) self-awareness of attitudes toward African Americans, (b) empowering of clients for birthing, (c) recognition of the role that pregnant women’s mothers play, (d) tailoring of childbirth classes for African American women, and (e) research on how racism influences pregnant African American women’s preparation for birthing. PMID:22211059

Gout in African Americans.

PubMed

Krishnan, Eswar

2014-09-01

African Americans have a substantially higher prevalence of risk factors for gout than Caucasians. The aim of the present study was to compare the risk for incident gout among African Americans and Caucasians. Incidence rates of physician-diagnosed gout among 11,559 Caucasian men and 931 African American men aged 35 to 57 years and at high cardiovascular risk, observed for 7 years as a part of the Multiple Risk Factor Intervention Trial, were analyzed. Cox regression models were used to account for potential confounding by age, body mass index, diuretic use, hypertension and diabetes status, aspirin and alcohol consumption, and kidney disease. At baseline, after accounting for risk factors, African Americans had a 14% lower prevalence of hyperuricemia than Caucasians. Incidence of gout increased with increasing prevalence of risk factors in both Caucasians and African Americans. Ethnic disparities in incidence rates were most apparent among those without other risk factors for gout. In separate Cox regression models, after accounting for risk factors, African American ethnicity was associated with a hazard ratio of 0.78 (95% confidence interval [CI], 0.66-0.93) for physician-diagnosed gout and 0.88 (95% CI, 0.85-0.90) for incident hyperuricemia. Significant interactions were observed; the association was the strongest (hazard ratio 0.47; 0.37-0.60). These associations were unaffected by addition of serum urate as a covariate or by using alternate case definitions for gout. After accounting for the higher prevalence of risk factors, African American ethnicity is associated with a significantly lower risk for gout and hyperuricemia compared with Caucasian ethnicity. Copyright © 2014 Elsevier Inc. All rights reserved.

Borderline Personality Disorder Symptom Severity and Sexually Transmitted Infection and HIV Risk in African American Incarcerated Men.

PubMed

Scheidell, Joy D; Lejuez, Carl W; Golin, Carol E; Hobbs, Marcia M; Wohl, David A; Adimora, Adaora A; Khan, Maria R

2016-05-01

Sexually transmitted infections (STI)/HIV rates are disproportionately high among men involved in the criminal justice system. Mental health disorders, including personality disorders, are also elevated among inmates. Borderline personality disorder (BPD) may be an important risk factor for STI/HIV, yet remains relatively understudied, particularly among inmates. We used baseline data from Project DISRUPT, a cohort study of African American men being released from prison in North Carolina who were in heterosexual relationships at prison entry (n=189), to assess their STI/HIV risk in the 6 months before incarceration and BPD symptoms focused on emotional lability and relationship dysfunction. We created a continuous BPD symptom severity score and a dichotomous BPD indicator split at the top quartile of the score (BPD-TQ) to examine associations between BPD and STI/HIV outcomes using logistic regression. We also examined associations between individual symptoms and outcomes. After adjustment for sociodemographics and antisocial personality disorder, BPD-TQ was associated with sexual risk behaviors including multiple partnerships (adjusted odds ratio, 2.58; 95% confidence interval, 1.24-5.36) and sex with nonmonogamous partners (adjusted odds ratio, 2.54; 95% confidence interval, 1.17-5.51). Prevalence of previous STI (47.5% vs. 29.6%) and prevalent chlamydial infection (6.9% vs. 3.1%) seemed higher in those in BPD-TQ, although the associations were not statistically significant. Associations were similar to those with the continuous score. Borderline personality disorder symptoms most associated with STI/HIV risk were abandonment worry, mood swings, and shifts in opinions. Borderline personality disorder is strongly associated with STI/HIV risk in this sample. Researchers should further evaluate the relationship between STI/HIV and BPD, in addition to mood disorders.

Narcolepsy in African Americans

PubMed Central

Kawai, Makoto; O'Hara, Ruth; Einen, Mali; Lin, Ling; Mignot, Emmanuel

2015-01-01

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

The Education of African-Americans.

ERIC Educational Resources Information Center

Willie, Charles V., Ed.; And Others

The 17 papers in this volume are products of a study group on the education of African Americans that was part of a national project, "The Assessment of the Status of African-Americans." The volume takes a comprehensive look at the education of African Americans, specifically early childhood through postsecondary education, and relevant…

Lung cancer disparities and African-Americans.

PubMed

Sin, Mo-Kyung

2017-07-01

African-Americans, as historically disadvantaged minorities, have more advanced stages of cancer when diagnosed, lower survival rates, and lower rates of accessing timely care than do Caucasians. Lung cancer incidence and mortality, in particular, are high among African-Americans. The U.S. Preventive Services Task Force recently released an evidence-based lung cancer screening technology called low-dose computerized tomography. High-risk African-Americans might benefit greatly from such screening but not many are aware of this technology. Public health nurses can play a key role in increasing awareness of the technology among African-American communities and encouraging qualified African-Americans to obtain screening. This study discusses issues with lung cancer and smoking among African-Americans, a recently released evidence-based lung cancer screening technology, and implications for public health nurses to enhance uptake of the new screening technology among high-risk African-Americans. © 2017 Wiley Periodicals, Inc.

Effectiveness of a mass media campaign in promoting HIV testing information seeking among African American women.

PubMed

Davis, Kevin C; Uhrig, Jennifer; Rupert, Douglas; Fraze, Jami; Goetz, Joshua; Slater, Michael

2011-10-01

"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.

None of Us Will Get Out of Here Alive: The Intersection of Perceived Risk for HIV, Risk Behaviors and Survival Expectations among African American Emerging Adults.

PubMed

Edwards, Lorece V; Lindong, Ian; Brown, Lawrence; Hawkins, Anita S; Dennis, Sabriya; Fajobi, Olaoluwa; Rowel, Randolph; Braithwaite, Ronald; Sydnor, Kim D

2017-01-01

The Human Immunodeficiency Virus (HIV) significantly affects minority emerging adults, among whom the rate of new diagnoses is high and health disparities are more pronounced. Importantly, emerging adults today have limited knowledge of the earlier toll of the virus when it was identified as a killer. Among this population, perceptions of risk for HIV are low and sexual risk taking behaviors are high. The Get SMART Project is a behavioral intervention aimed to provide re-purposed HIV, alcohol, and substance abuse prevention education and HIV testing to African American emerging adults ages 18-24. The project was guided by the Health Belief Model, Community Promise, and Training for Institutional Procedures. Findings revealed that HIV testing is low. Marijuana and alcohol are drugs of choice. Emerging adults do not see themselves at risk for HIV, although they engaged in high-risk behaviors. Additionally, survival expectations influence behavior risk.

Using Culturally Sensitive Media Messages to Reduce HIV-associated Sexual Behavior in High-risk African-American Adolescents: Results from a Randomized Trial

PubMed Central

Sznitman, Sharon; Vanable, Peter A.; Carey, Michael P.; Hennessy, Michael; Brown, Larry K.; Valois, Robert F.; Stanton, Bonita F.; Salazar, Laura F.; DiClemente, Ralph; Farber, Naomi; Romer, Daniel

2010-01-01

Purpose To test the long-term effects of a mass media intervention that used culturally and developmentally appropriate messages to enhance HIV-preventive beliefs and behavior of high-risk African-American adolescents. Methods Television and radio messages were delivered over three years in two cities (Syracuse, NY and Macon, GA) that were randomly selected within each of two regionally matched city pairs with the other cities (Providence, RI and Columbia, SC) serving as controls. African American adolescents ages 14 to 17 (N = 1710), recruited in the four cities over a 16-month period, completed audio computer-assisted self-interviews at recruitment and again at 3, 6, 12 and 18-months post-recruitment to assess the long-term effects of the media program. To identify the unique effects of the media intervention, youth who completed at least one follow-up and who did not test positive for any of three sexually transmitted infections at recruitment or at 6 and 12-month follow-up were retained for analysis (N=1346). Results The media intervention reached virtually all of the adolescents in the trial and produced a range of effects including improved normative condom-use negotiation expectancies and increased sex refusal self-efficacy. Most importantly, older adolescents (ages 16-17) exposed to the media program exhibited a less risky age trajectory of unprotected sex than those in the non-media cities. Conclusions Culturally tailored mass media messages delivered consistently over time have the potential to reach a large audience of high-risk adolescents, to support changes in HIV-preventive beliefs, and to reduce HIV-associated risk behaviors among older youth. PMID:21856515

Patterns of Mood and Personality Factors and Associations With STI/HIV-Related Drug and Sex Risk Among African American Male Inmates

PubMed Central

Scheidell, Joy D.; Lejuez, Carl W.; Golin, Carol E.; Adimora, Adaora A.; Wohl, David A.; Keen, Larry D.; Hammond, Michael; Judon-Monk, Selena; Khan, Maria R.

2018-01-01

Background Research on the association between antisocial personality disorder (ASPD) with comorbid mental disorders and sexually transmitted infection (STI)/HIV risk among inmates is scant despite the high prevalence of psychopathology and of STI/HIV in this population. Methods We used baseline data from Project DISRUPT, a cohort study conducted among incarcerated African American men (n= 207), to measure associations between ASPD and STI/HIV risk. We also conducted latent class analyses (LCAs) to identify subgroups defined by ASPD with comorbid stress, depression, and borderline personality disorder symptoms and measured associations between latent class membership and STI/HIV risk. Results Approximately 15% had ASPD and 39% reported depression. Controlling for sociodemographics, stress, and depression, ASPD was independently associated with illicit [AOR=3.23, 95% confidence interval (CI): 1.18–8.87] and injection drug use (AOR: 5.49, 95% CI: 1.23–24.42) but not with sexual risk. LCAs suggested that those at high risk of ASPD were likely to experience co-morbid mental disorders. ASPD comorbid with these disorders was linked to drug and sex risk. Conclusions STI/HIV prevention for inmates should incorporate diagnosis and treatment of ASPD and comorbid disorders, and interventions to address ASPD-related factors (e.g., impulsivity) that drive STI/HIV risk. PMID:28426364

Narcolepsy in African Americans.

PubMed

Kawai, Makoto; O'Hara, Ruth; Einen, Mali; Lin, Ling; Mignot, Emmanuel

2015-11-01

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. 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. 182 African-Americans, 839 Caucasians, 35 Asians, and 41 Latinos with narcolepsy. 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%). 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. © 2015 Associated Professional Sleep Societies, LLC.

When a relationship is imperative, will young women knowingly place their sexual health at risk? A sample of African American adolescent girls in the juvenile justice system.

PubMed

Raiford, Jerris L; Seth, Puja; Fasula, Amy M; DiClemente, Ralph J

2017-08-01

HIV and other sexually transmissible infections (HIV/STIs) are significant contributors to adolescent girls' morbidity in the US. Risks for HIV/STIs are increased among adolescent girls involved in the juvenile justice system, and African American adolescent girls comprise nearly 50% of adolescent girls in detention centres. Although HIV prevention programs focus on HIV/STI knowledge, increased knowledge may not be sufficient to reduce sexual risk. The present study examined the interactive effects of HIV/STI knowledge and the importance of being in a relationship (a relationship imperative) on sexual risk behaviours in a sample of detained African American adolescent girls. In all, 188 African American adolescent girls, 13-17 years of age, were recruited from a short-term detention facility in Atlanta, Georgia, and completed assessments on sexual risk behaviours, relationship characteristics, HIV/STI knowledge and several psychosocial risk factors. When girls endorsed a relationship imperative, higher HIV/STI knowledge was associated with low partner communication self-efficacy, inconsistent condom use and unprotected sex, when controlling for demographics and self-esteem. Young girls with high HIV/STI knowledge may have placed themselves at risk for HIV/STIs given the importance and value they place on being in a relationship. Contextual factors should be considered when developing interventions.

Assessment of a Culturally-Tailored Sexual Health Education Program for African American Youth.

PubMed

Zellner Lawrence, Tiffany; Henry Akintobi, Tabia; Miller, Assia; Archie-Booker, Elaine; Johnson, Tarita; Evans, Donoria

2016-12-24

African American youth are affected disproportionately by sexually transmitted infections (STIs), human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), and teenage pregnancy when compared to other racial groups. This paper evaluates the effectiveness of the To Help Young People Establish (2 HYPE) Abstinence Club, a behavioral intervention designed to promote delayed sexual activity among African American youth ages 12-18 in Atlanta, Georgia. The intervention included 20 h of curriculum and creative arts instruction. Pre- and post-intervention survey data collected from 2008-2010 were analyzed to determine the effectiveness of the intervention. Intervention ( n = 651) and comparison ( n = 112) groups were compared through analysis of variance and multivariate logistic regression models. There was a statistically significant increase in intervention youth who were thinking about being abstinent ( p = 0.0005). Those who had not been engaged in sexual activity were two times more likely to plan abstinence compared to participants that had been previously sexually active previously (odds ratio 2.41; 95% confidence interval 1.62, 3.60). Significant results hold implications for subsequent community-based participatory research and practice that broadens the understanding of the relevance of marriage, as just one among other life success milestones that may hold more importance to African American youth in positioning the value of delayed and responsible sexual activity towards effective STIs, HIV/AIDS, and teen pregnancy risk reduction interventions.

Partner influences and gender-related factors associated with noncondom use among young adult African American women.

PubMed

Wingood, G M; DiClemente, R J

1998-02-01

We examined the partner influences and gender-related correlates of noncondom use among African American women. The prevalence of noncondom use was 45.3%. Women whose sexual partners were noncondom users were four times more likely to believe that asking their partner to use a condom implied he was unfaithful, three times as likely to have a partner who resisted using condoms, three times more likely to receive AFDC, twice as likely to be sexually nonassertive, three times more likely to believe that it was not difficult to find an "eligible" African American man, and three times as likely to have had one sexual partner. HIV prevention tailored towards African American women should address these partner influences and gender-related factors.

Tales from the "hood:" placing reproductive health communication between African American fathers and children in context.

PubMed

Ohalete, Nnenna; Georges, Jane; Doswell, Willa

2010-01-01

To evaluate reproductive health communication between African American fathers and their children. In this qualitative ethnographic study, data were collected through tape-recorded individual interviews about the content and timing of reproductive health communication, the reproductive health values fathers intended to impart to their children, and their comfort level in doing so. A total sample of 19 African-American fathers participated. Data were coded according to the qualitative analytic principles established by Miles and Huberman (1994), and analyzed using manifest and latent content analysis approaches. Although 10 fathers reported feeling uncomfortable having these conversations, 18 reported having reproductive health communication with their children, and most encouraged their sons and daughters to delay sex until adulthood. These conversations were primarily driven by the fear of HIV/AIDS and the negative consequences of sex; however, some conversations were inappropriate for developmental age. African-American fathers may benefit from education to help them have age appropriate reproductive health communication with their children. Registered Nurses and Nurse Practitioners are well positioned to educate African American adolescents and their fathers on reproductive health. Future dyadic African American father-child studies are needed to explore more fully African-American children's perceptions of reproductive health communication and the effect on delaying sex.

Longitudinal Association of HIV Conspiracy Beliefs with Sexual Risk Among Black Males Living with HIV

PubMed Central

Galvan, Frank H.; Wagner, Glenn J.; Klein, David J.

2010-01-01

Research is needed to identify culturally relevant factors that may contribute to sexual risk among African Americans. We investigated HIV-specific medical mistrust as one such cultural factor, often exhibited as conspiracy beliefs about HIV (e.g., “AIDS was produced in a government laboratory”), which may be indicative of general suspicion of HIV treatment and prevention messages. Over a 6-month time-period, we measured endorsement of HIV conspiracy beliefs three times and frequency of condom use monthly among 181 HIV-positive African American males. A hierarchical multivariate repeated-measures logistic random effects model indicated that greater belief in HIV conspiracies was associated with a higher likelihood of reporting unprotected intercourse across all time-points. An average of 54% of participants who endorsed conspiracies reported unprotected intercourse, versus 39% who did not endorse conspiracies. Secondary prevention interventions may need to address medical mistrust as a contributor to sexual risk among African Americans living with HIV. PMID:20734227

African American Therapists Working with African American Families: An Exploration of the Strengths Perspective in Treatment

ERIC Educational Resources Information Center

Bell-Tolliver, Laverne; Burgess, Ruby; Brock, Linda J.

2009-01-01

With the exception of Hill's (1971, 1999) work, historically much of the literature on African American families has focused more on pathology than strengths. This study used interviews with 30 African American psychotherapists, self-identified as employing a strengths perspective with African American families, to investigate which strengths they…

Investigating Instructional Practices of an African American Male Mathematics Teacher with Underachieving African American Male Students

ERIC Educational Resources Information Center

Muhammad, Rhonda K.

2012-01-01

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…

"I got caught up in the game": generational influences on contraceptive decision making in African-American women.

PubMed

Harris, Allyssa L

2013-03-01

Reproductive health disparities are a significant issue for African-American adolescents. This study was designed to explore the cross-generational influences on adolescent sexuality in a cohort of daughters/granddaughters of U.S. born African-American women. Data were generated through interviews with triads of African-American women: grandmothers, and their daughters and granddaughters, to gain insight into the phenomena of early sexual debut, high rates of unintended pregnancies, HIV/AIDS, and other sexually transmitted infections from a cross-generational perspective. Six themes emerged from the data: southern influences; a worldview of relationships; communication-key to preparedness; seeking information from mom; "I got caught up in the game"; and contraceptive use and beliefs. In this sample, mothers' and grandmothers' culture, values, and beliefs significantly influenced the adolescents' sexual and reproductive decision making. Clinicians' knowledge of African-American culture, beliefs, and family values is key when providing guidance about contraception to these young women. ©2012 The Author(s) Journal compilation ©2012 American Association of Nurse Practitioners.

Predicting Non-African American Lesbian and Heterosexual Preadoptive Couples' Openness to Adopting an African American Child

ERIC Educational Resources Information Center

Goldberg, Abbie E.; Smith, JuliAnna Z.

2009-01-01

Despite increases in transracial adoption, African American children remain the least likely to be adopted. No research has examined the factors that predict prospective adopters' willingness to adopt an African American child. This study used multilevel modeling to examine predictors of willingness to adopt an African American child in a sample…

African American and Black Caribbean Feelings of Closeness to Africans

PubMed Central

Thornton, Michael C.; Taylor, Robert Joseph; Chatters, Linda M.; Forsythe-Brown, Ivy

2016-01-01

African American and Black Caribbean relations dominate research on interactions across black ethnic divides. Using National Survey of American Life data, we explore a different aspect of black interethnic attitudes: how close these groups feel toward Africans. African Americans and Black Caribbeans were largely similar in their feelings of closeness to Africans. For Black Caribbeans, younger and male respondents, those reporting higher levels of financial strain, living in the northeast and persons who immigrated to the United States at least 11 years ago, report feeling especially close to Africans. Being male was the only significant correlate among African Americans. The findings are discussed in relation to how race, ethnicity and national origin shape personal identities within the U.S. and their significance for intergroup perceptions. These broader issues warrant further consideration in light of assertions that race as a defining feature of American life and intergroup relations is obsolete. PMID:28943747

Mechanisms of Vowel Variation in African American English.

PubMed

Holt, Yolanda Feimster

2018-02-15

This research explored mechanisms of vowel variation in African American English by comparing 2 geographically distant groups of African American and White American English speakers for participation in the African American Shift and the Southern Vowel Shift. Thirty-two male (African American: n = 16, White American controls: n = 16) lifelong residents of cities in eastern and western North Carolina produced heed,hid,heyd,head,had,hod,hawed,whod,hood,hoed,hide,howed,hoyd, and heard 3 times each in random order. Formant frequency, duration, and acoustic analyses were completed for the vowels /i, ɪ, e, ɛ, æ, ɑ, ɔ, u, ʊ, o, aɪ, aʊ, oɪ, ɝ/ produced in the listed words. African American English speakers show vowel variation. In the west, the African American English speakers are participating in the Southern Vowel Shift and hod fronting of the African American Shift. In the east, neither the African American English speakers nor their White peers are participating in the Southern Vowel Shift. The African American English speakers show limited participation in the African American Shift. The results provide evidence of regional and socio-ethnic variation in African American English in North Carolina.

Cost-effectiveness of a brief video-based HIV intervention for African American and Latino sexually transmitted disease clinic clients.

PubMed

Sweat, M; O'Donnell, C; O'Donnell, L

2001-04-13

Decisions about the dissemination of HIV interventions need to be informed by evidence of their cost-effectiveness in reducing negative health outcomes. Having previously shown the effectiveness of a single-session video-based group intervention (VOICES/VOCES) in reducing incidence of sexually transmitted diseases (STD) among male African American and Latino clients attending an urban STD clinic, this study estimates its cost-effectiveness in terms of disease averted. Cost-effectiveness was calculated using data on effectiveness from a randomized clinical trial of the VOICES/VOCES intervention along with updated data on the costs of intervention from four replication sites. STD incidence and self-reported behavioral data were used to make estimates of reduction in HIV incidence among study participants. The average annual cost to provide the intervention to 10 000 STD clinic clients was estimated to be US$447 005, with a cost per client of US$43.30. This expenditure would result in an average of 27.69 HIV infections averted, with an average savings from averted medical costs of US$5 544 408. The number of quality adjusted life years saved averaged 387.61, with a cost per HIV infection averted of US$21 486. This brief behavioral intervention was found to be feasible and cost-saving when targeted to male STD clinic clients at high risk of contracting and transmitting infections, indicating that this strategy should be considered for inclusion in HIV prevention programming.

The specificity of maternal parenting behavior and child adjustment difficulties: a study of inner-city African American families.

PubMed

Jones, Deborah J; Forehand, Rex; Rakow, Aaron; Colletti, Christina J M; McKee, Laura; Zalot, Alecia

2008-04-01

The specificity of the association between 2 parenting behaviors (warmth and supervision) and 2 indicators, aggressive behavior and depressive symptoms, of major child outcomes (externalizing problems and internalizing problems) was examined among 196 inner-city African American mothers and their school age children. Given the growing number of African American families affected by HIV/AIDS and demonstrated compromises in parenting associated with maternal infection, the moderating role of maternal HIV/AIDS was also examined. Findings from longitudinal analyses supported the specificity of maternal warmth but not of maternal supervision. Maternal warmth was a stronger predictor of decreases in child aggressive behavior than of decreases in depressive symptoms. In addition, maternal warmth was a stronger predictor of decreases in aggressive behavior than was maternal supervision. Parenting specificity was not moderated by maternal HIV/AIDS. Clinical implications and future research directions are discussed. (c) 2008 APA, all rights reserved.

Understanding African American Males

ERIC Educational Resources Information Center

Bell, Edward Earl

2010-01-01

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…

Survival Disparity of African American Versus Non-African American Patients With ESRD Due to SLE.

PubMed

Nee, Robert; Martinez-Osorio, Jorge; Yuan, Christina M; Little, Dustin J; Watson, Maura A; Agodoa, Lawrence; Abbott, Kevin C

2015-10-01

A recent study showed an increased risk of death in African Americans compared with whites with end-stage renal disease (ESRD) due to lupus nephritis (LN). We assessed the impact of age stratification, socioeconomic factors, and kidney transplantation on the disparity in patient survival among African American versus non-African American patients with LN-caused ESRD, compared with other causes. Retrospective cohort study. Using the US Renal Data System database, we identified 12,352 patients with LN-caused ESRD among 1,132,202 patients who initiated maintenance dialysis therapy from January 1, 1995, through December 31, 2006, and were followed up until December 31, 2010. Baseline demographics and comorbid conditions, Hispanic ethnicity, socioeconomic factors (employment status, Medicare/Medicaid insurance, and area-level median household income based on zip code as obtained from the 2000 US census), and kidney transplantation as a time-dependent variable. All-cause mortality. Multivariable Cox and competing-risk regressions. Mean duration of follow-up in the LN-caused ESRD and other-cause ESRD cohorts were 6.24±4.20 (SD) and 4.06±3.61 years, respectively. 6,106 patients with LN-caused ESRD (49.43%) and 853,762 patients with other-cause ESRD (76.24%) died during the study period (P<0.001). Patients with LN-caused ESRD were significantly younger (mean age, 39.92 years) and more likely women (81.65%) and African American (48.13%) than those with other-cause ESRD. In the fully adjusted multivariable Cox regression model, African American (vs non-African American) patients with LN-caused ESRD had significantly increased risk of death at age 18 to 30 years (adjusted HR, 1.43; 95% CI, 1.24-1.65) and at age 31 to 40 years (adjusted HR, 1.17; 95% CI, 1.02-1.34). Among patients with other-cause ESRD, African Americans were at significantly increased risk at age 18 to 30 years (adjusted HR, 1.17; 95% CI, 1.11-1.22). We used zip code-based median household income as a

African-American adolescent females' predictors of having sex.

PubMed

Dancy, Barbara L; Crittenden, Kathleen S; Freels, Sally

2006-12-01

African-American adolescent females are at high risk for HIV infection, acquired primarily as a result of heterosexual intercourse. Multiple regression analyses was used to describe the correlates of the outcome variable, ever having had sex, for low-income African-American adolescent females in a cross-sectional study of 322 (N = 322) mother/daughter pairs. The results revealed that while the daughters' age was positively associated with the outcome variable, the daughters' perceptions of strictness of curfew and maternal monitoring, and the daughters'self-efficacy to refuse sex and their intention to refuse sex were negatively associated with the outcome variable. Mothers tended to report significantly more maternal monitoring and stricter curfews than what their daughters perceived them to be. The daughters'intention to refuse sex mediated the effects of age and self-efficacy to refuse sex on the outcome variable. These results suggest that health-care providers should promote clearer communication between mothers and daughters in order to reduce divergent perceptions and to help mothers facilitate their daughters' self-efficacy and their intention to refuse sex.

Lower liver-related death in African-American women with human immunodeficiency virus/hepatitis C virus coinfection, compared to Caucasian and Hispanic women.

PubMed

Sarkar, Monika; Bacchetti, Peter; French, Audrey L; Tien, Phyllis; Glesby, Marshall J; Nowicki, Marek; Plankey, Michael; Gange, Stephen; Sharp, Gerald; Minkoff, Howard; Peters, Marion G

2012-11-01

Among individuals with and without concurrent human immunodeficiency virus (HIV), racial/ethnic differences in the natural history of hepatitis C virus (HCV) have been described. African Americans have lower spontaneous HCV clearance than Caucasians, yet slower rates of liver fibrosis once chronically infected. It is not clear how these differences in the natural history of hepatitis C affect mortality, in either HIV-positive or -negative individuals. We conducted a cohort study of HIV/HCV coinfected women followed in the multicenter Women's Interagency HIV Study to determine the association of self-reported race/ethnicity with all-cause and liver-related mortality. Survival analyses were performed using Cox's proportional hazards models. The eligible cohort (n = 794) included 140 Caucasians, 159 Hispanics, and 495 African Americans. There were 438 deaths and 49 liver-related deaths during a median follow-up of 8.9 years and maximum follow-up of 16 years. African-American coinfected women had significantly lower liver-related mortality, compared to Caucasian (hazard ratio [HR], 0.41; 95% confidence interval [CI]: 0.19-0.88; P = 0.022) and Hispanic coinfected women (HR, 0.38; 95% CI: 0.19-0.76; P = 0.006). All-cause mortality was similar between racial/ethnic groups (HRs for all comparisons: 0.82-1.03; log-rank test: P = 0.8). African-American coinfected women were much less likely to die from liver disease, as compared to Caucasians and Hispanics, independent of other causes of death. Future studies are needed to investigate the reasons for this marked racial/ethnic discrepancy in liver-related mortality. Copyright © 2012 American Association for the Study of Liver Diseases.

African-American Sacred Music.

ERIC Educational Resources Information Center

Bailey, A. Peter

1991-01-01

The history of African-American sacred music is traced from the time of slavery to the present interest in gospel music. The religious music of African Americans is geared toward liberation themes. It is important that this music does not dilute its power through cross-over with other music forms. (SLD)

Correlates of sexually transmitted infection prevention knowledge among African American girls.

PubMed

Voisin, Dexter R; Tan, Kevin; Salazar, Laura F; Crosby, Richard; DiClemente, Ralph J

2012-08-01

To identify significant factors that distinguish African American girls who have high sexually transmitted infection (STI) prevention knowledge from those lacking such knowledge. We recruited a sample of 715 African American girls from three public health clinics in downtown Atlanta. Using audio computer-assisted self-interviewing (A-CASI) technology, we assessed for age, self-mastery, employment status, attendance at sex education classes, socioeconomic status, and STI prevention knowledge. Slightly more than one-third of the girls did not know that females are more susceptible to STI infections than males; and that having an STI increases the risk of contracting HIV. Almost half of the girls did not know if a man has an STI he will not have noticeable symptoms; and that most people who have AIDS look healthy. Logistic regression findings indicated that being older, having greater self-mastery, and being employed significantly predicted high STI knowledge. Health educators may especially target African American girls who are younger, unemployed, and experiencing low self-mastery for more tailored STI heath education. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Optimism and education buffer the effects of syndemic conditions on HIV status among African American men who have sex with men.

PubMed

O'Leary, Ann; Jemmott, John B; Stevens, Robin; Rutledge, Scott Edward; Icard, Larry D

2014-11-01

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.

Romantic Relationship Dynamics of Urban African American Adolescents: Patterns of Monogamy, Commitment, and Trust

ERIC Educational Resources Information Center

Towner, Senna L.; Dolcini, M. Margaret; Harper, Gary W.

2015-01-01

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…

16 Extraordinary African Americans.

ERIC Educational Resources Information Center

Lobb, Nancy

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…

Who Will Teach African American Youth?