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1.
Am J Public Health ; 113(S2): S110-S114, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-37339413

RESUMEN

The Women-Centered Program for Women of Color, a culturally congruent sexual health intervention, was implemented in 2018 in Los Angeles County, California, according to the principles of community-based participatory research: enhancing community capacity, establishing sustainable programs, and translating research findings to community settings. Participants exhibited significantly increased knowledge of and interest in preexposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) over time, but no significant change in condom use was evident. Booster sessions are needed to maintain interest in PrEP and PEP given concerns about reproductive and sexual health. (Am J Public Health. 2023;113(S2):S110-S114. https://doi.org/10.2105/AJPH.2023.307296).


Asunto(s)
Infecciones por VIH , Profilaxis Pre-Exposición , Salud Sexual , Masculino , Humanos , Femenino , Homosexualidad Masculina , Infecciones por VIH/prevención & control , Los Angeles , Pigmentación de la Piel
2.
AIDS Care ; 32(5): 537-545, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-31269801

RESUMEN

Lack of condom use by married or cohabiting couples in populations with high rates of HIV infection has become a significant public health issue. This study investigated whether an HIV risk-reduction intervention (RRI) would increase condom use when delivered to serodiscordant couples as a unit. Of the 62 couples that were screened, 30 serodiscordant couples were enrolled in the study, and randomized 2:1 to an immediate intervention-waitlist control study. The 12-week intervention focused on communication, problem-solving, and negotiation skills. Participants were assessed at baseline, three and six months after the intervention. The main outcome measures were consistent condom use, HIV seroconversion and fidelity to the programme. The use of condoms increased for both the intervention and control groups after receiving a 12-week RRI. Group comparisons showed a significant difference at three months, with a significantly higher mean proportion of condom-protected sex acts (p = 0.0119) between the control and intervention groups, the later showing an increase in condom use. No seroconversion was detected, and the overall retention rate of participants was 83.33%. Counselling heterosexual couples as a unit prompted an increase in condom use, but sustained condom use remains a challenge.


Asunto(s)
Condones/estadística & datos numéricos , Infecciones por VIH/prevención & control , Conducta de Reducción del Riesgo , Sexo Seguro/estadística & datos numéricos , Adulto , Comunicación , Consejo , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/transmisión , Humanos , Masculino , Evaluación de Procesos y Resultados en Atención de Salud , Parejas Sexuales , Sudáfrica/epidemiología
4.
Metab Brain Dis ; 29(2): 281-99, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24729207

RESUMEN

Violence against women is a global public health problem. Exposure to intimate partner violence (IPV) during pregnancy has been associated with a number of adverse maternal and fetal outcomes, including delivery of a low birthweight (LBW) infant. However, there is a paucity of data from low-middle income countries (LMIC). We examined the association between antenatal IPV and subsequent LBW in a South African birth cohort. This study reports data from the Drakenstein Child Lung Health Study (DCLHS), a multidisciplinary birth cohort investigation of the influence of a number of antecedent risk factors on maternal and infant health outcomes over time. Pregnant women seeking antenatal care were recruited at two different primary care clinics in a low income, semi-rural area outside Cape Town, South Africa. Antenatal trauma exposure was assessed using the Childhood Trauma Questionnaire (CTQ) and an IPV assessment tool specifically designed for the purposes of this study. Potential confounding variables including maternal sociodemographics, pregnancy intention, partner support, biomedical and mental illness, substance use and psychosocial risk were also assessed. Bivariate and multiple regression analyses were performed to determine the association between IPV during pregnancy and delivery of an infant with LBW and/or low weight-for-age z (WAZ) scores. The final study sample comprised 263 mother-infant dyads. In multiple regression analyses, the model run was significant [r2 = 0.14 (adjusted r2 = 0.11, F(8, 212) = 4.16, p = 0.0001]. Exposure to physical IPV occurring during the past year was found to be significantly associated with LBW [t = -2.04, p = 0.0429] when controlling for study site (clinic), maternal height, ethnicity, socioeconomic status, substance use and childhood trauma. A significant association with decreased WAZ scores was not demonstrated. Exposure of pregnant women to IPV may impact newborn health. Further research is needed in this field to assess the relevant underlying mechanisms, to inform public health policies and to develop appropriate trauma IPV interventions for LMIC settings.


Asunto(s)
Maltrato a los Niños/tendencias , Recién Nacido de Bajo Peso/fisiología , Maltrato Conyugal/tendencias , Adolescente , Adulto , Maltrato a los Niños/economía , Maltrato a los Niños/psicología , Estudios de Cohortes , Femenino , Humanos , Recién Nacido de Bajo Peso/psicología , Recién Nacido , Masculino , Embarazo , Factores de Riesgo , Factores Socioeconómicos , Sudáfrica/epidemiología , Maltrato Conyugal/economía , Maltrato Conyugal/psicología , Encuestas y Cuestionarios , Adulto Joven
5.
Cult Health Sex ; 2014 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-24393013

RESUMEN

Adult men of different ethnic backgrounds who experienced childhood sexual abuse (CSA) may vary in their reports of the psychological and behavioural impact of CSA on their lives. Empirical studies rarely examine the impact of race/ethnicity or cultural context on the psychological and behavioural struggles of adult male CSA survivors. This study utilised qualitative content analysis to examine the reported CSA-related psychological and behavioural challenges of 150 US men, with equal numbers of Blacks, Latinos and non-Latino Whites. Interview data revealed some ethnic differences: Black men more frequently denied having present day adverse effects than other groups. However, Black men who did report negative consequences of CSA discussed difficulties with substance use and hyper-sexualised behaviour more often than other ethnicities. Latino men reported anger, anxiety, hyper-vigilance, flashbacks and communication problems more often than the other two groups. Black and Latino men also discussed guilt/shame issues and sexual identity concerns more often than Whites did. In contrast, White men more frequently discussed issues related to low self-esteem, loneliness and isolation. These findings suggest that ethnically diverse men may respond differently to CSA experiences and that considerations need to be taken into account when providing healthcare to men with CSA histories.

6.
Violence Vict ; 29(3): 451-63, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25069149

RESUMEN

OBJECTIVE: Little research exists identifying risk factors for posttraumatic stress symptoms (PTSS) among men with histories of childhood sexual abuse (CSA) who have been exposed to intimate partner violence (IPV). METHODS: One hundred and fifty African American, Latino and non-Latino White men with histories of CSA participated in this study. RESULTS: An ordinary least squares regression model with race/ethnicity, HIV serostatus, and CSA severity treated as cofounders and with IPV as the predictor was fitted to predict level of PTSS. Higher levels of IPV were significantly associated with higher PTSS, as were higher levels of chronic stress, and being African American. CONCLUSIONS: Mental health service providers should routinely screen for IPV in men who report histories of CSA and PTSS.


Asunto(s)
Adultos Sobrevivientes del Maltrato a los Niños/psicología , Parejas Sexuales , Trastornos por Estrés Postraumático/etnología , Violencia/etnología , Adulto , Humanos , Masculino , Persona de Mediana Edad , Factores Desencadenantes , Investigación Cualitativa , Índice de Severidad de la Enfermedad
7.
Womens Health Issues ; 34(3): 241-249, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38267337

RESUMEN

BACKGROUND: African American women are disproportionately at risk for HIV infection. To increase women's readiness to consider taking pre-exposure prophylaxis (PrEP), we conducted a pilot study of Women Prepping for PrEP Plus (WP3+). Adapted from an evidence-based HIV risk reduction intervention for African American couples who are HIV-serodiscordant, WP3+ is a group-based culturally congruent program designed for African American women without HIV. METHODS: Women were screened for eligibility; if eligible, they were invited to participate in the four-session WP3+ group. Participants completed surveys at baseline (n = 47) and post-implementation (n = 28); surveys assessed demographics, HIV and PrEP knowledge, depression and posttraumatic stress (PTS) symptoms, substance use, sexual risk behaviors, health care-related discrimination, and social support. In a process evaluation, a subset of women completed qualitative interviews at baseline (n = 35) and post-implementation (n = 18); the interviews were designed to converge with (e.g., on HIV and PrEP knowledge) and expand upon (e.g., unmeasured perceived impacts of WP3+) quantitative measures. To triangulate with the quantitative data, deductive qualitative analysis concentrated on women's knowledge and awareness of PrEP and HIV, their relationship dynamics and challenges, and their considerations (e.g., barriers, facilitators) related to taking PrEP; inductive analysis focused on women's experiences in the intervention. RESULTS: Participants in the WP3+ intervention reported: improved proportion of condom use in the past 90 days (p < .01) and in a typical week (p < .05); reduced PTS symptoms (p < .05); increased HIV knowledge (p < .0001) and awareness of PrEP (p < .001); and greater consideration of using PrEP (p < .001). In interviews, participants expressed not only increased knowledge but also appreciation for learning how to protect themselves against HIV, communicate with their partners, and take charge of their health, and they expressed greater receptiveness to using PrEP as a result of the knowledge and skills they gained. CONCLUSIONS: The WP3+ pilot study demonstrated preliminary efficacy and acceptability as an HIV-prevention program for African American women. A controlled trial is needed to confirm its efficacy for increasing PrEP use among African American women.


Asunto(s)
Fármacos Anti-VIH , Negro o Afroamericano , Infecciones por VIH , Conocimientos, Actitudes y Práctica en Salud , Profilaxis Pre-Exposición , Población Urbana , Humanos , Femenino , Proyectos Piloto , Negro o Afroamericano/psicología , Negro o Afroamericano/estadística & datos numéricos , Infecciones por VIH/prevención & control , Infecciones por VIH/etnología , Adulto , Fármacos Anti-VIH/uso terapéutico , Fármacos Anti-VIH/administración & dosificación , Aceptación de la Atención de Salud , Conducta Sexual , Apoyo Social , Persona de Mediana Edad , Asunción de Riesgos , Conducta de Reducción del Riesgo , Encuestas y Cuestionarios , Adulto Joven , Parejas Sexuales , Investigación Cualitativa
8.
PLoS One ; 19(5): e0298063, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38701040

RESUMEN

OBJECTIVE: To investigate the associations of Insulin-like growth factor-II (IGF2) gene, Insulin-like growth factor-II receptor (IGF2R) gene and Insulin-like growth factor-II binding protein 2 (IGF2BP2) gene polymorphisms with the susceptibility to gestational diabetes mellitus (GDM) in Chinese population. METHODS: A total of 1703 pregnant women (835 GDM and 868 Non-GDM) were recruited in this case-control study. All participants underwent prenatal 75 g oral glucose tolerance test (OGTT) examinations during 24-28 gestational weeks at the Maternal and Child Health Hospital of Hubei Province from January 15, 2018 to March 31, 2019. Genotyping of candidate SNPs (IGF2 rs680, IGF2R rs416572, IGF2BP2 rs4402960, rs1470579, rs1374910, rs11705701, rs6777038, rs16860234, rs7651090) was performed on Sequenom MassARRAY platform. Logistic regression analysis was conducted to investigate the associations between candidate SNPs and risk of GDM. In addition, multifactor dimensionality reduction (MDR) method was applied to explore the effects of gene-gene interactions on GDM risk. RESULTS: There were significant distribution differences between GDM group and non-GDM group in age, pre-pregnancy BMI, education level and family history of diabetes (P < 0.05). After adjusted for age, pre-pregnancy BMI, education level and family history of diabetes, there were no significant associations of the candidate SNPs polymorphisms and GDM risk (P > 0.05). Furthermore, there were no gene-gene interactions on the GDM risk among the candidate SNPs (P > 0.05). However, the fasting blood glucose (FBG) levels of rs6777038 CT carriers were significantly lower than TT carriers (4.69±0.69 vs. 5.03±1.57 mmol/L, P < 0.01), and the OGTT-2h levels of rs6777038 CC and CT genotype carriers were significantly lower than TT genotype carriers (8.10±1.91 and 8.08±1.87 vs. 8.99±2.90 mmol/L, P < 0.01). CONCLUSIONS: IGF2 rs680, IGF2R rs416572, IGF2BP2 rs4402960, rs1470579, rs11705701, rs6777038, rs16860234, rs7651090 polymorphisms were not significantly associated with GDM risk in Wuhan, China. Further lager multicenter researches are needed to confirm these results.


Asunto(s)
Diabetes Gestacional , Predisposición Genética a la Enfermedad , Factor II del Crecimiento Similar a la Insulina , Polimorfismo de Nucleótido Simple , Proteínas de Unión al ARN , Receptor IGF Tipo 2 , Adulto , Femenino , Humanos , Embarazo , Pueblo Asiatico/genética , Estudios de Casos y Controles , China/epidemiología , Diabetes Gestacional/genética , Genotipo , Prueba de Tolerancia a la Glucosa , Factor II del Crecimiento Similar a la Insulina/genética , Receptor IGF Tipo 2/genética , Proteínas de Unión al ARN/genética
9.
Am J Orthopsychiatry ; 2024 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-38546560

RESUMEN

Black and Latinx people are disproportionately impacted by HIV, COVID-19, and other syndemic health crises with similar underlying social determinants of health. Lessons learned from the HIV pandemic and COVID-19 response have been invoked to improve health equity at the systemic level in the face of other emergent health crises. However, few have examined the potential translation of strategies between syndemics at the individual level. The current mixed-methods study examined strategies used to manage HIV during the COVID-19 pandemic and the extent to which they were helpful in managing COVID-19 vulnerability among Black and Latinx people living with HIV. Participants (n = 30) were interviewed by telephone and completed demographic, mental health, alcohol and substance use, health literacy, and clinical measures in October and November 2020 in Los Angeles County. Rapid qualitative analysis, descriptive statistics, and mixed-methods merging were used to analyze the data. Qualitative results demonstrated that participants found HIV self-management strategies translated to aspects of the COVID-19 pandemic including hygiene and social distancing and coping with a health-related stressor. Although telemedicine provided continuity of HIV care for most participants, technology access and literacy posed a potential barrier, particularly to those facing other sociodemographic marginalization (i.e., low education, disability). Findings suggest providers can encourage leveraging individual HIV self-management strategies in response to other public health crises. However, these interventions must be culturally responsive and address intersecting social determinants of health. Future research should examine mechanisms that predict individual translation of HIV management strategies to other health concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

10.
Am J Public Health ; 103(8): 1476-84, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23763412

RESUMEN

OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.


Asunto(s)
Adultos Sobrevivientes del Maltrato a los Niños/psicología , Bisexualidad , Negro o Afroamericano/psicología , Infecciones por VIH/psicología , Infecciones por VIH/transmisión , Promoción de la Salud/métodos , Conducta de Reducción del Riesgo , Conducta Sexual , Trastornos por Estrés Postraumático/psicología , Análisis de Varianza , Biomarcadores/orina , Catecolaminas/orina , Distribución de Chi-Cuadrado , Humanos , Hidrocortisona/orina , Masculino , Persona de Mediana Edad , Neopterin/orina , Encuestas y Cuestionarios
11.
Fam Syst Health ; 41(2): 149-159, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-36521110

RESUMEN

INTRODUCTION: Substantial unmet need for mental health services (MHS) exists in the United States, with pronounced disparities among people of color. Research highlights the need to identify facilitators and barriers to MHS utilization among Black and Latinx individuals to better promote overall health. We tested an expanded model of MHS use based on Andersen's (1995) conceptual framework of health care utilization. Associations were examined between sociodemographic variables, trauma and adversity burden, living with HIV, and unmet need for MHS in a community sample of underresourced Black and Latinx individuals. Barriers to MHS utilization are described. METHODS: Five-hundred participants completed the UCLA Life Adversities Screener (LADS), sociodemographic measures, and items assessing need for and barriers to MHS. RESULTS: 228 (46%) participants reported a need for MHS; of these, 115 (51%) reported receiving MHS. A binomial logistic regression model estimated the relative contribution of the LADS on need for MHS. Severity of LADS, younger age, and living with HIV predicted unmet need for MHS. Barriers to MHS included financial and time constraints and health system-related issues. One-way analysis of variance (ANOVA) tests revealed differences in mental health symptoms by MHS need. DISCUSSION: The unmet need for MHS in this sample of Black and Latinx individuals highlights the importance of addressing the systemic roots of trauma and adversity burden, and eliminating structural barriers to treatment to reduce existing health and mental health inequities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Asunto(s)
Servicios de Salud Mental , Aceptación de la Atención de Salud , Adulto , Humanos , Hispánicos o Latinos , Infecciones por VIH , Salud Mental , Estados Unidos , Negro o Afroamericano
12.
Int J STD AIDS ; 33(5): 479-484, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-35315305

RESUMEN

Background: Although there are several ways to transmit HIV, condomless sex remains the primary mode in sub-Saharan Africa, including South Africa, with KwaZulu-Natal Province being one of the epicentres of HIV infection. This study explored the use of condoms in serodiscordant couples who were exposed to an HIV-risk reduction intervention that aimed to improve condom use and reduce the spread of HIV.Methods: A Total of 30 couples completed a paper-based questionnaire on their demographics and general health at baseline and 3 months, plus a semi-structured questionnaire with four domains. An analysis of HIV knowledge, condom use, condom use attitudes and protection perceptions about how other serodiscordant couples behave was conducted following a 12-week HIV risk reduction intervention. Participants were randomised 2:1 into intervention and control groups.Results: Condom use increased from 55% at baseline to 73.7% (p = .0047) at 3 months for the intervention group and condom use in the last 7 days increased from 53% to 86% (p = .0117). For the control group, condom use remained low at the 3 months follow up period (p = .625). HIV knowledge improved significantly from baseline to 3 months for the intervention group (p < .0001), as well as the control group (p = .0005). Negative HIV condom use attitude scores in both groups decreased significantly from baseline to 3 months; intervention group (p = .0059) and control group (p = .0007).Conclusion: HIV knowledge and condom use improved significantly, while negative condom use attitudes and HIV protection perceptions decreased significantly following exposure to a risk-reduction intervention, suggesting that HIV preventive interventions should focus on partnership interventions.


Asunto(s)
Condones , Infecciones por VIH , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Humanos , Conducta de Reducción del Riesgo , Conducta Sexual , Parejas Sexuales , Sudáfrica
13.
Arch Womens Ment Health ; 14(2): 135-43, 2011 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-21052749

RESUMEN

The study aims to determine if recent intimate partner violence (IPV) is a prenatal risk factor for postpartum depression (PPD) among pregnant Latinas seeking prenatal care. A prospective observational study followed Latinas from pregnancy through 13 months postpartum. Prenatal predictors of PPD included depression, recent IPV exposure, remote IPV exposure, non-IPV trauma history, poverty, low social support, acculturation, high parity, and low education. Postpartum depression was measured at 3, 7, and 13 months after birth with the Beck's Depression Inventory-Fast Screen. Strength of association was evaluated using bivariate and multivariable odds ratio analysis. Subjects were predominantly low income, monolingual Spanish, and foreign-born, with mean age of 27.7. Recent IPV, prenatal depression, non-IPV trauma, and low social support were associated with greater likelihood of PPD in bivariate analyses. Recent IPV and prenatal depression continued to show significant association with PPD in multivariate analyses, with greater odds of PPD associated with recent IPV than with prenatal depression (adjusted OR = 5.38, p < 0.0001 for recent IPV and adjusted OR = 3.48, p< 0.0001 for prenatal depression). Recent IPV exposure is a strong, independent prenatal predictor of PPD among Latinas. Screening and referral for both IPV and PPD during pregnancy may help reduce postpartum mental health morbidity among Latinas.


Asunto(s)
Depresión Posparto/etiología , Violencia Doméstica/psicología , Hispánicos o Latinos/psicología , Parejas Sexuales , Adolescente , Adulto , Depresión Posparto/etnología , Violencia Doméstica/ética , Femenino , Predicción , Humanos , Masculino , Estudios Prospectivos , Estados Unidos , Adulto Joven
14.
J Nerv Ment Dis ; 199(7): 471-7, 2011 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21716061

RESUMEN

A history of childhood sexual abuse (CSA) has been associated with adult depression, but data on abuse severity and disclosure are scant, particularly among low-income ethnic minorities. CSA often co-occurs with other adversities, which also increase the risk of depression. This study examined the peritrauma variable of abuse severity and the posttrauma variables of disclosure and self-blame as predictors of current depression symptoms in 94 low-income African-American and Latina women with histories of CSA. After controlling for nonsexual childhood adversity and adult burden (i.e., chronic stress), severe CSA overall was associated with higher depression scores, especially among Latinas who disclosed their abuse. Depression symptoms among African-American women were highest in those who disclosed and reported high levels of self-blame at the time of the incident. The link between depression and specific peri- and post-CSA factors in minority women may help guide future interventions.


Asunto(s)
Adultos Sobrevivientes del Maltrato a los Niños/psicología , Negro o Afroamericano/psicología , Trastorno Depresivo/etiología , Hispánicos o Latinos/psicología , Autorrevelación , Adolescente , Adulto , Trastorno Depresivo/psicología , Femenino , Humanos , Entrevistas como Asunto , Persona de Mediana Edad , Modelos Psicológicos , Escalas de Valoración Psiquiátrica , Factores de Riesgo , Índice de Severidad de la Enfermedad , Adulto Joven
15.
Matern Child Health J ; 15(7): 1046-54, 2011 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20652383

RESUMEN

This study examined the associations of prenatal psychosocial factors, including depressive symptoms, post-traumatic stress disorder symptoms, trauma exposure including intimate partner violence, perceived stress, and social support, with perceived postpartum health status. Low-income Latinas (N = 203) were recruited from two health plans within the first 12 weeks of their pregnancies and followed through 3 months after birth. Participants completed semi-structured interviews conducted in English or Spanish within the first 12 weeks of pregnancy, and again at 12 weeks postpartum. Perceived health status was measured by the SF-12. Participants with complete follow-up data (n= 193) were used in data analysis. Women were mostly foreign-born (75%) with low-incomes (59%) and reported postpartum health status in the average range (M = 102.5; SD = 12.2). Overall health status was positively associated with decreased levels of perceived stress (P < .0001), being foreign-born and having resided in the US <10 years (P = .003). Emotional well-being was positively linked with being foreign-born and having resided in the US <10 years (P = .002), increased levels of social support (P = .01), and decreased levels of perceived stress (P < .001). Exposure to non-specific IPV trauma (P = .01) and health problems experienced during pregnancy or delivery (P = .05) were negatively associated with physical health status. Prenatal psychosocial factors and length of residency in the US are differentially predictive of overall postpartum health status and emotional well-being, and have less impact on physical well-being after birth. Health professionals are encouraged to assess these factors in early pregnancy.


Asunto(s)
Estado de Salud , Hispánicos o Latinos , Periodo Posparto/etnología , Pobreza , Atención Prenatal , Apoyo Social , Estrés Psicológico/etnología , Heridas y Lesiones , Adulto , Femenino , Humanos , Entrevistas como Asunto , Estados Unidos , Adulto Joven
16.
J Trauma Dissociation ; 11(2): 152-73, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20373204

RESUMEN

OBJECTIVE: Adult posttraumatic stress symptoms and a biomarker index of current health risk in childhood sexual abuse (CSA) survivors were investigated in relation to CSA severity, disclosure, and other peri- and post-trauma factors. METHOD: A community sample of 94 African American and Latina female CSA survivors was assessed. RESULTS: Severe CSA predicted posttraumatic stress symptoms overall, avoidance/numbing symptoms, and greater biomarker risk and was not mediated by post-trauma variables. Moderate CSA severity was mediated by post-trauma disclosure, predicted reexperiencing symptoms, but was unrelated to biomarker risk. No overall ethnic differences were found. CONCLUSION: Results suggest targets for interventions to improve the well-being of minority women CSA survivors.


Asunto(s)
Adultos Sobrevivientes del Maltrato a los Niños/psicología , Biomarcadores/análisis , Negro o Afroamericano/psicología , Abuso Sexual Infantil/psicología , Hispánicos o Latinos/psicología , Autorrevelación , Trastornos por Estrés Postraumático/psicología , Adolescente , Adulto , Negro o Afroamericano/estadística & datos numéricos , Femenino , Conductas Relacionadas con la Salud , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Entrevistas como Asunto , Modelos Lineales , Los Angeles , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Factores de Riesgo , Encuestas y Cuestionarios , Índices de Gravedad del Trauma
17.
Am Psychol ; 75(8): 1146-1157, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33252951

RESUMEN

Couples-based behavioral HIV prevention interventions have demonstrated efficacy, but few are routinely available in community-based settings in the United States. The Eban intervention, designed for heterosexual African American serodiscordant couples and proven efficacious in a cluster randomized trial, was implemented in community-based HIV service organizations in two cities disproportionately affected by the HIV epidemic. This article reports primarily on the effectiveness results related to condom use and results related to retention challenges within a Hybrid Type 2 implementation/effectiveness trial. Ninety-one individuals enrolled at baseline; 39 completed the posttest, and 30 completed the 3-month follow-up. Although condom use did not monotonically increase from baseline to posttest and 3-month follow-up, it did increase from baseline (44%) to posttest (73%), and from baseline to 3-month follow-up with an overall positive slope of Time 0.13 to 0.14 (p < .001). There was a significant increase in the number of people who used condoms 100% of the time from baseline (36.3%) to posttest (56.4%; p = .04) but not from baseline to 3-month follow-up (46.7%; p = .2907). Challenges with resources as basic as housing, food, and transportation complicated participation (and therefore implementation) and may have impeded couples' maintenance of risk reduction strategies beyond the intervention. In light of couples' numerous observed vulnerabilities, we constructed a composite score of "critical vulnerability" and found that depression was persistently related to critical vulnerability and that retention was higher among those with less vulnerability. These findings highlight the important yet underaddressed role of patient-level factors in the process and outcomes of hybrid implementation/effectiveness research. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Asunto(s)
Negro o Afroamericano , Medicina Basada en la Evidencia , Composición Familiar , Infecciones por VIH/prevención & control , Infecciones por VIH/transmisión , Seronegatividad para VIH , Seropositividad para VIH , Sexo Seguro , Condones , Femenino , Humanos , Ciencia de la Implementación , Masculino , Persona de Mediana Edad , Conducta de Reducción del Riesgo , Estados Unidos
18.
Am J Orthopsychiatry ; 90(5): 614-622, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32584076

RESUMEN

That racial/ethnic discrimination has adverse physical and psychological consequences, including stress, anxiety, depression, and their attendant health effects, is well documented. However, the particular dimensions within the broad construct of discrimination and their role in mental health are less well understood. This study investigates the dimensions of discrimination and explores their relation to depression and posttraumatic stress (PTS) symptoms. Using the Brief Perceived Ethnic/Racial Discrimination Questionnaire-Community Version, discrimination experiences were assessed among a community sample of African American and Latinx participants (N = 500). Factor analyses revealed 4 dimensions: Social Rejection, Stereotyping, Direct Threats/Attacks, and Police Mistreatment. In multivariate analyses, full regression models were significantly related to PTS and depression symptoms. Among the individual predictors, Social Rejection and ethnicity (Latinx) uniquely contributed to PTS symptoms in men, whereas Stereotyping and Direct Threat/Attack were associated with PTS symptoms for women. In regards to depressive symptoms, income, ethnicity (Latinx), and Social Rejection were significant predictors for men, while Social Rejection had an independent contribution for women. Thus, social rejection emerged as a significant unique predictor in 3 of the four models, suggesting that social ostracism may be a particularly harmful aspect of discrimination. Implications of these findings include the use of proactive and intervention strategies that emphasize a sense of belonging and mitigate the effects of exclusion and rejection. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Asunto(s)
Negro o Afroamericano/psicología , Depresión/epidemiología , Hispánicos o Latinos/psicología , Racismo/psicología , Trastornos por Estrés Postraumático/epidemiología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Distancia Psicológica , Factores Sexuales , Aislamiento Social , Estereotipo , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Población Urbana
19.
Ethn Dis ; 30(2): 261-268, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32346271

RESUMEN

Objectives: African Americans face challenges in accessing services for sexually transmitted infections (STIs). From 2012-2016, the EBAN II intervention was funded by the NIH to test the effectiveness of implementing a culturally congruent, evidence-based HIV/AIDS prevention program in Los Angeles and Oakland, California. This study examined the impact of personal characteristics and experiences of discrimination on the likelihood of being tested for STIs. Methods: Participants (N=91) completed a baseline survey. Descriptive statistics were used to test for differences between those who did and did not obtain STI testing. Factors included HIV serostatus, sociodemographic variables, STI history, the presence of outside partners, and discrimination experiences. Multiple logistic regressions were conducted for men and women separately. Results: Participants with no recent experiences of discrimination were more than 3 (3.4) times more likely to obtain a baseline STI test than those who reported discrimination experiences. HIV-positive women with no recent experiences of discrimination were 11 times more likely than those with reports of recent discrimination to obtain STI tests. Conclusions: It is often women who are the gatekeepers for health seeking in families and the same may be for these couples. Experiences of discrimination may impede STI testing, and heighten several health risks, particularly among HIV-positive African American women in HIV-serodiscordant relationships. Addressing the impact of discrimination experiences may be important for STI prevention and treatment efforts in interventions promoting health care utilization.


Asunto(s)
Negro o Afroamericano , Barreras de Comunicación , Infecciones por VIH/diagnóstico , Enfermedades de Transmisión Sexual , Discriminación Social , Serodiagnóstico del SIDA , Adulto , Negro o Afroamericano/psicología , Negro o Afroamericano/estadística & datos numéricos , Femenino , Humanos , Los Angeles/epidemiología , Masculino , Aceptación de la Atención de Salud , Parejas Sexuales/psicología , Enfermedades de Transmisión Sexual/etnología , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de Transmisión Sexual/psicología , Discriminación Social/etnología , Discriminación Social/prevención & control , Discriminación Social/psicología
20.
Psychol Trauma ; 10(5): 491-498, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29154595

RESUMEN

OBJECTIVE: Somatic symptoms are often reported among victims of trauma, and place a significant burden on primary care health providers. We examined the relationship between lifetime histories of trauma and adversity, including aspects not previously studied (i.e., perceived discrimination), and somatic symptoms, as well as the mediating role of posttraumatic stress symptoms (PTSS) and depressive symptoms. METHOD: A multiethnic community sample of 500 male and female participants (230 African American and 270 Latino) completed measures of demographic characteristics, the University of California, Los Angeles Lifetime Adversities Screener (LADS), depressive symptoms, PTSS, and somatic symptoms. RESULTS: An ordinary least-squares regression analysis controlling for age, gender, and race/ethnicity indicated that higher levels of lifetime adversity and trauma were significantly associated with more severe somatic symptoms (b = 6.95, p < .0001). Formal mediation tests indicated that there was a significant indirect effect of LADS on somatic symptoms via PTSS and depressive symptoms, indirect effect = 2.64 (95% confidence interval [CI] [1.2, 4.1]) and 2.19 (95% CI [1.3, 3.3]), respectively. Even after PTSS and depressive symptoms were taken into account, the LADS remained significantly associated with somatic symptoms (b = 2.13, p < .05), suggesting partial mediation. CONCLUSION: Exposure to traumatic and adverse events (the LADS) was associated with somatic symptom severity. Furthermore, although PTSS and depressive symptoms partially accounted for the association between the LADS and somatic symptoms, the LADS remained significant, suggesting that both exposure to trauma and adversity and the resultant development of PTSS and depressive symptoms influence the development of somatic symptoms. (PsycINFO Database Record


Asunto(s)
Síntomas sin Explicación Médica , Adulto , Negro o Afroamericano/psicología , Depresión/diagnóstico , Depresión/etnología , Femenino , Hispánicos o Latinos/psicología , Humanos , Análisis de los Mínimos Cuadrados , Masculino , Pronóstico , Escalas de Valoración Psiquiátrica , Análisis de Regresión , Factores Socioeconómicos , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/etnología , Estrés Psicológico/diagnóstico , Estrés Psicológico/etnología
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