Predicting Covid-19 infection and death rates among E.U. minority populations in the absence of racially disaggregated data through the use of US data comparisons.

BACKGROUND: The E.U.'s lack of racially disaggregated data impedes the formulation of effective interventions, and crises such as Covid-19 may continue to impact minorities more severely. Our predictive model offers insight into the disparate ways in which Covid-19 has likely impacted E.U. minorities and allows for the inference of differences in Covid-19 infection and death rates between E.U. minority and non-minority populations. METHODS: Data covering Covid-19, social determinants of health and minority status were included from 1 March 2020 to 28 February 2021. A systematic comparison of US and E.U. states enabled the projection of Covid-19 infection and death rates for minorities and non-minorities in E.U. states. RESULTS: The model predicted Covid-19 infection rates with 95-100% accuracy for 23 out of 28 E.U. states. Projections for Covid-19 infection and mortality rates among E.U. minority groups illustrate parallel trends to US rates. CONCLUSIONS: Disparities in Covid-19 infection and death rates by minority status likely exist in patterns similar to those observed in US data. Policy Implications: Collecting data by race/ethnicity in the E.U. would help document health disparities and craft more targeted health interventions and mitigation strategies.

What We "Cannot Not Know in America": 400 Years of Inequality and Seven Sins.

The 400 Years of Inequality Project was created to call organizations to observe the 400th anniversary of the first Africans landing in Jamestown in 1619. The project focused on the broad ramifications of inequality. Used as a justification of chattel slavery, structures of inequality continue to condition the lives of many groups in the US. Over 110 organizations joined this observance and held 150 events. The highlight of the year was the homily given by Reverend William Barber II, co-chair of the Poor People's Campaign, who described the "seven sins" that link the concept of inequality to every aspect of national life, from politics to militia. These "seven sins" help us to analyze and address crises, such as the COVID pandemic.

It's Time for a Haircut: a Perspective on Barbershop Health Interventions Serving Black Men.

Black men in the USA experience disproportionate cardiovascular disease mortality compared to their white counterparts, in part due to an excess of uncontrolled hypertension. A promising intervention to address these disparities involves the direct pharmacologic management of hypertension by clinical pharmacists in Black male patrons of barbershops, as demonstrated in the Los Angeles Barbershop Blood Pressure Study (LABBPS). Despite the observed reduction in systolic blood pressure of > 20 mmHg after 1 year, the feasibility of scaling up such an intervention to a regional or national platform remains uncertain. Here we explore the success of LABBPS in the context of prior barbershop interventions and theorize the most important aspects driving the observed reductions. We further make a case for prioritizing preventive care in nontraditional settings in an effort to reduce health disparities.

'Other than that, I'm Good': Formerly Incarcerated Young Black Men's Self-Perceptions of Health Status.

Black men are incarcerated at higher rates than men from other racial groups, and there are significant health disparities disfavoring Black men overall. Reentry from incarceration is an important time period for health risks. However, health studies among recently released Black male youth populations are limited. This mixed methods study examined perceived health status and health care utilization among recently released Black men ages 18-25 years. Qualitative interviews (N=20) and quantitative surveys (N= 170) were conducted. Qualitative findings described several health concerns, including chronic conditions. Quantitative results indicated most survey respondents rated their health status as excellent or good despite reporting having a health concern within the past year. Health status ranking was examined by how men felt vs. an objective measure such as a medical report. In addition, men indicated having problems finding health care since their release. This study may be beneficial for addressing ways to promote health and health care utilization among formerly incarcerated young Black men.

The limits of collaboration: a qualitative study of community ethical review of environmental health research.

OBJECTIVES: We assessed the effectiveness of various systems of community participation in ethical review of environmental health research. METHODS: We used situation analysis methods and a global workspace theoretical framework to conduct comparative case studies of 3 research organizations at 1 medical center. RESULTS: We found a general institutional commitment to community review as well as personal commitment from some participants in the process. However, difficulty in communicating across divides of knowledge and privilege created serious gaps in implementation, leaving research vulnerable to validity threats (such as misinterpretation of findings) and communities vulnerable to harm. The methods used in each collaboration solved some, but not all, of the problems that hindered communication. CONCLUSIONS: Researchers, community spokespersons, and institutional review boards constitute organizational groups with strong internal ties and highly developed cultures. Few cross-linkages and little knowledge of each other cause significant distortion of information and other forms of miscommunication between groups. Our data suggest that organizations designed to protect human volunteers are in the best position to take the lead in implementing community review.

Are HIV/AIDS prevention interventions for heterosexually active men in the United States gender-specific?

Although gender-specific theories are often deployed in interventions to reduce women's HIV risks, the same is often not true for interventions among men. Theories of masculinity are not guiding most US research on the risky sexual behavior of heterosexual men or on what can be done to intervene. We first assess the extent to which evidence-based HIV-prevention interventions among heterosexually active men in the United States draw upon relevant theories of masculinity. Next, we introduce a useful framework within masculinity and gender studies that can be applied to HIV-prevention interventions with heterosexually active men. Finally, we make suggestions to improve the gender specificity of HIV-prevention interventions for heterosexually active men in the United States.

Exercise training improves cardiovascular and autonomic profiles in HIV.

OBJECTIVES: Human immunodeficiency virus (HIV) is associated with cardiovascular (CV) and autonomic dysfunction, however the effects of fitness on vascular and autonomic mechanisms in HIV disease are unknown. METHODS: We studied forty-eight subjects (40.4 +/- 4.2 years) in a cross-sectional design matched for age, gender, BMI, and fitness. Participants were assigned to 1 in 4 groups: 1) Healthy Unfit (HU), 2) Healthy Fit (HF), 3) HIV Positive Unfit (HPU), and 4) HIV Positive Fit (HPF). Fitness was assessed via open-circuit spirometry; arterial compliance and autonomic modulations were measured via applanation tonometry and power spectral analysis, respectively, and baroreflex sensitivity was obtained using the alpha index. RESULTS: Arterial compliance was augmented in HPF vs. HPU [7.4 +/- 1.9 mmHg x second vs. 4.4 +/- 1.7 mmHg x second (P = 0.006)]. Parasympathetic modulation was higher in HPF vs. HPU [2244.5 +/- 2997.6 msecond(2) vs. 489.1 +/- 552.9 msecond(2) (P < 0.05)]. Sympathetic modulation was lower in HPF vs. HU [4.7 +/- 5.0 mmHg(2) vs. 12.9 +/- 9.7 mmHg(2) (P < 0.05)]. Baroreflex sensitivity was higher in HPF vs. HPU [17.3 +/- 10.2 msecond/mmHg vs. 7.4 +/- 3.8 msecond/mmHg (P = 0.003)], and HPF vs. HU [17.3 +/- 10.2 msecond/mmHg vs. 6.2 +/- 3.0 msecond/mmHg (P = 0.004)]. CONCLUSIONS: Augmentations in arterial compliance and baroreflex sensitivity associated with fitness portent an improved CV and autonomic profile for HIV-positive individuals. Physical activity may be an adjuvant method to enhance the overall vascular health in HIV-compromised individuals.

Collective consciousness and its pathologies: understanding the failure of AIDS control and treatment in the United States.

We address themes of distributed cognition by extending recent formal developments in the theory of individual consciousness. While single minds appear biologically limited to one dynamic structure of linked cognitive submodules instantiating consciousness, organizations, by contrast, can support several, sometimes many, such constructs simultaneously, although these usually operate relatively slowly. System behavior remains, however, constrained not only by culture, but by a developmental path dependence generated by organizational history, in the context of market selection pressures. Such highly parallel multitasking--essentially an institutional collective consciousness--while capable of reducing inattentional blindness and the consequences of failures within individual workspaces, does not eliminate them, and introduces new characteristic malfunctions involving the distortion of information sent between workspaces and the possibility of pathological resilience--dysfunctional institutional lock-in. Consequently, organizations remain subject to canonical and idiosyncratic failures analogous to, but more complicated than, those afflicting individuals. Remediation is made difficult by the manner in which pathological externalities can write images of themselves onto both institutional function and corrective intervention. The perspective is applied to the failure of AIDS control and treatment in the United States.

Obvious and not-so-obvious strategies to disseminate research.

The findings of health disparities research will have to be disseminated to a broad public in order to influence health outcomes. Some strategies for dissemination are obvious, and these generally work for ideas that are within the mainstream of current paradigms. However, ideas that challenge existing theories and assumptions may require different, and not-so-obvious, strategies. This article discusses the use of movies and site visits as two novel strategies for research dissemination.

Heterosexually transmitted HIV infection among African Americans in North Carolina.

CONTEXT: Rates of heterosexually transmitted HIV infection among African Americans in the southeastern United States greatly exceed those for whites. OBJECTIVE: Determine risk factors for heterosexually transmitted HIV infection among African Americans. METHODS: Population-based case-control study of black men and women, aged 18-61 years, reported to the North Carolina state health department with a recent diagnosis of heterosexually transmitted HIV infection and age- and gender-matched controls randomly selected from the state driver's license file. A lower-risk stratum of respondents was created to identify transmission risks among people who denied high-risk behaviors. RESULTS: Most case subjects reported annual household income < $16,000, history of sexually transmitted diseases, and high-risk behaviors, including crack cocaine use and sex partners who injected drugs or used crack cocaine. However, 27% of case subjects (and 69% of control subjects) denied high-risk sexual partners or behavior. Risk factors for HIV infection in this subset of participants were less than high school education (adjusted odds ratio [OR] 5.0; 95% CI: 2.2, 11.1), recent concern about having enough food for themselves or their family (OR 3.7; 1.5, 8.9), and having a sexual partner who was not monogamous during the relationship with the respondent (OR 2.9; 1.3, 6.4). CONCLUSION: Although most heterosexually transmitted HIV infection among African Americans in the South is associated with established high-risk characteristics, poverty may be an underlying determinant of these behaviors and a contributor to infection risk even in people who do not have high-risk behaviors.

Remembering the lizard: reconstructing sexuality in the rooms of narcotics anonymous.

The crack epidemic was devastating to poor American communities in part because of the destruction wrought by the system of exchanging sex for drugs, which was a key feature of the crack-use culture. Sex-for-drugs exchanges were often conducted under unsafe circumstances and were linked to the spread of AIDS and other STDs, as well as unplanned pregnancies. The existence of this alternative system of sexual relationships threatened the economic viability of established commercial sex work and undermined the status and power of women. Narcotics Anonymous (NA) meetings helped men and women recover from crack addiction through a well-described 12-step process. Described as the rooms, these time- and space-specific encounters helped people become sober in the context of neighborhoods that were centers of the drug trade. Because of the key role of sex in the crack culture, transformation of sexual relationships was essential to establishing and maintaining sobriety. The manner in which the rooms of NA influence the sexuality and lifeworld of addicted people is explored using Barker's theory of ecological psychology.