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1.
Cephalalgia ; 44(1): 3331024231226186, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38215228

RESUMO

BACKGROUND: The trigeminal sensory neuropeptide calcitonin gene-related peptide (CGRP) is identified as an essential element in migraine pathogenesis. METHODS: In vitro and in vivo studies evaluated pharmacologic properties of the CGRP receptor antagonist atogepant. Radioligand binding using 125I-CGRP and cyclic adenosine monophosphate (cAMP) accumulation assays were conducted in human embryonic kidney 293 cells to assess affinity, functional potency and selectivity. Atogepant in vivo potency was assessed in the rat nitroglycerine model of facial allodynia and primate capsaicin-induced dermal vasodilation (CIDV) pharmacodynamic model. Cerebrospinal fluid/brain penetration and behavioral effects of chronic dosing and upon withdrawal were evaluated in rats. RESULTS: Atogepant exhibited high human CGRP receptor-binding affinity and potently inhibited human α-CGRP-stimulated cAMP responses. Atogepant exhibited significant affinity for the amylin1 receptor but lacked appreciable affinities for adrenomedullin, calcitonin and other known neurotransmitter receptor targets. Atogepant dose-dependently inhibited facial allodynia in the rat nitroglycerine model and produced significant CIDV inhibition in primates. Brain penetration and behavioral/physical signs during chronic dosing and abrupt withdrawal were minimal in rats. CONCLUSIONS: Atogepant is a competitive antagonist with high affinity, potency and selectivity for the human CGRP receptor. Atogepant demonstrated a potent, concentration-dependent exposure/efficacy relationship between atogepant plasma concentrations and inhibition of CGRP-dependent effects.


Assuntos
Peptídeo Relacionado com Gene de Calcitonina , Piperidinas , Piridinas , Pirróis , Receptores de Peptídeo Relacionado com o Gene de Calcitonina , Compostos de Espiro , Humanos , Ratos , Animais , Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Receptores de Peptídeo Relacionado com o Gene de Calcitonina/metabolismo , Antagonistas do Receptor do Peptídeo Relacionado ao Gene de Calcitonina/farmacologia , Antagonistas do Receptor do Peptídeo Relacionado ao Gene de Calcitonina/uso terapêutico , Hiperalgesia/tratamento farmacológico
2.
Am J Community Psychol ; 73(3-4): 526-540, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38353492

RESUMO

We used a convergent mixed methods research design to compare and contrast researchers' neighborhood environmental assessments collected using systematic social observations with adolescents' neighborhood environmental assessments collected by semi-structured interviews with US Mexican adolescents. Using qualitative methods, we found that adolescents sometimes observed the same neighborhood environmental features as researchers. They also sometimes observed different environmental features altogether; in both cases they sometimes layered on additional meaning making. Using mixed methods, we found that there was a high degree of overlap between researchers and adolescents in terms of agreement on the presence of neighborhood environmental features, including physical disorder, physical decay, street safety, and sociocultural symbols. Adolescents expanded upon these neighborhood environmental features with references to positive and negative affect and neighborhood environmental resources. This work highlights the shared and unique aspects of researcher versus adolescent observations and how both data sources are critical to understanding Latinx neighborhood environments.


Assuntos
Características da Vizinhança , Humanos , Adolescente , Feminino , Masculino , Hispânico ou Latino/psicologia , Características de Residência , Pesquisa Qualitativa , Meio Social , Pesquisadores/psicologia , Entrevistas como Assunto , Americanos Mexicanos/psicologia
3.
AIDS Behav ; 27(5): 1666-1673, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36318423

RESUMO

Communication about HIV and sexually transmitted infections (STI) is a cornerstone of risk reduction, yet there is a dearth of research that examines communication patterns among persons with dual risks for HIV/STI acquisition, such as women who sell sex and inject drugs (WSSID). We used logistic regression to identify factors associated with WSSID (N = 211) in Baltimore, Maryland always asking new clients about their HIV/STI status. Most WSSID were non-Hispanic White (73%) and 74% reported current homelessness. 50% of WSSID reported always asking new clients about their HIV/STI status. Experiencing depressive symptoms (adjusted odds ratio [aOR]: 0.53; 95% confidence interval [CI]: 0.29, 0.96) and having condomless sex with clients (aOR 0.31; 95% CI: 0.17, 0.57) were inversely associated with WSSID always asking new clients about their HIV/STI status. Recent entry into sex work (aOR 2.99; 95% CI: 1.30, 6.87) was positively associated with always asking new clients about their HIV/STI status. Enhancing HIV/STI communication in combination with engagement in other risk mitigation strategies may decrease disease incidence among WSSID.


Assuntos
Infecções por HIV , Infecções Sexualmente Transmissíveis , Feminino , Humanos , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/prevenção & controle , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Infecções por HIV/complicações , Comportamento Sexual , Fatores de Risco , Trabalho Sexual
4.
BMC Pregnancy Childbirth ; 23(1): 6, 2023 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-36600225

RESUMO

Africa has the highest rates of maternal deaths globally which have been linked to poorly functioning health care systems. The pandemic revealed already known weaknesses in the health systems in Africa, such as workforce shortages, lack of equipment and resources. The aim of this paper is to review the published literature on the impact of the COVID-19 pandemic on maternal and child health in Africa. The integrative review process delineated by Whittemore and Knafl (2005) was used to meet the study aims. The literature search of Ovid Medline, CINAHL, PubMed, WHO, Google and Google scholar, Africa journals online, MIDIRS was limited to publications between March 2020 and May 2022. All the studies went through the PRISMA stages, and 179 full text papers screened for eligibility, 36 papers met inclusion criteria. Of the studies, 6 were qualitative, 25 quantitative studies, and 5 mixed methods. Thematic analysis according to the methods of Braun and Clark (2006) were used to synthesize the data. From the search the six themes that emerged include: effects of lockdown measures, COVID concerns and psychological stress, reduced attendance at antenatal care, childhood vaccination, reduced facility-based births, and increase maternal and child mortality. A review of the literature revealed the following policy issues: The need for government to develop robust response mechanism to public health emergencies that negatively affect maternal and child health issues and devise health policies to mitigate negative effects of lockdown. In times of pandemic there is need to maintain special access for both antenatal care and child delivery services and limit a shift to use of untrained birth attendants to reduce maternal and neonatal deaths. These could be achieved by soliciting investments from various sectors to provide high-quality care that ensures sustainability to all layers of the population.


Assuntos
COVID-19 , Saúde da Criança , Recém-Nascido , Criança , Gravidez , Feminino , Humanos , Pandemias , COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , África/epidemiologia
5.
Monogr Soc Res Child Dev ; 88(3): 7-130, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37953661

RESUMO

Scientists have, for some time, recognized that development unfolds in numerous settings, including families, schools, neighborhoods, and organized and unorganized activity settings. Since the turn of the 20th century, the body of mainstream neighborhood effects scholarship draws heavily from the early 20th century Chicago School of Sociology frameworks and have been situating development in neighborhood contexts and working to identify the structures and processes via which neighborhoods matter for a range of developmental outcomes, especially achievement, behavioral and emotional problems, and sexual activity. From this body of work, two new areas of developmental scholarship are emerging. Both areas are promising for advancing an understanding of child development in context. First, cultural-developmental neighborhood researchers are advancing neighborhood effects research that explicitly recognizes the ways that racial, ethnic, cultural, and immigrant social positions matter for neighborhood environments and for youths' developmental demands, affordances, experiences, and competencies. This body of work substantially expands the range of developmental outcomes examined in neighborhood effects scholarship to recognize normative physical, emotional, cognitive, behavioral, social, and cultural competencies that have largely been overlooked in neighborhood effects scholarship that espoused a more color-blind developmental approach. Second, activity space neighborhood researchers are recognizing that residential neighborhoods have important implications for broader activity spaces-or the set of locations and settings to which youth are regularly exposed, including, for example, schools, work, organized activities, and hang-outs. They are using newer technologies and geographic frameworks to assess exposure to residential neighborhood and extra-neighborhood environments. These perspectives recognize that time (i.e., from microtime to mesotime) and place are critically bound and that exposures can be operationalized at numerous levels of the ecological system (i.e., from microsystems to macrosystems). These frameworks address important limitations of prior development in context scholarship by addressing selection and exposure. Addressing selection involves recognizing that families have some degree of choice when selecting into settings and variables that predict families' choices (e.g., income) also predict development. Considering exposure involves recognizing that different participants or residents experience different amounts of shared and nonshared exposures, resulting in both under-and over-estimation of contextual effects. Activity space scholars incorporate exposure to the residential neighborhood environments, but also to other locations and settings to which youth are regularly exposed, like schools, after-school settings, work, and hang-outs. Unfortunately, the cultural-development and activity space streams, which have both emerged from early 20th century work on neighborhood effects on development, have been advancing largely independently. Thus, the overarching aim of this monograph is to integrate scholarship on residential neighborhoods, cultural development, and activity spaces to advance a framework that can support a better understanding of development in context for diverse groups. In Chapters I and II we present the historical context of the three streams of theoretical, conceptual, and methodological research. We also advance a comprehensive cultural-developmental activity space framework for studying development in context among children, youth, and families that are ethnically, racially, and culturally heterogeneous. This framework actively recognized diversity in ethnic, racial, immigrant, and socioeconomic social positions. In Chapters III-V we advance specific features of the framework, focusing on: (1) the different levels of nested and nonnested ecological systems that can be captured and operationalized with activity space methods, (2) the different dimensions of time and exposures or experiences that can be captured and operationalized by activity space methods, and (3) the importance of settings structures and social processes for identifying underlying mechanisms of contextual effects on development. Structures are setting features related to the composition and spatial arrangement of people and institutions (e.g., socioeconomic disadvantage, ethnic/racial compositions). Social processes represent the collective social dynamics that take place in settings, like social interactions, group activities, experiences with local institutions, mechanisms of social control, or shared beliefs. In Chapter VI, we highlight a range of methodological and empirical exemplars from the United States that are informed by our comprehensive cultural-developmental activity space framework. These exemplars feature both quantitative and qualitative methods, including method mixing. These exemplars feature both quantitative and qualitative methods, including method mixing. The exemplars also highlight the application of the framework across four different samples from populations that vary in terms of race, ethnicity, gender, age, socioeconomic status (SES), geographic region, and urbanicity. They capture activity space characteristics and features in a variety of ways, in addition to incorporating family shared and nonshared activity space exposures. Finally, in Chapter VII we summarize the contributions of the framework for advancing a more comprehensive science of development in context, one that better realizes major developmental theories emphasizing persons, processes, contexts, and time. Additionally, we offer a place-based, culturally informed developmental research agenda to meet the needs of an increasingly diverse population.


Assuntos
Desenvolvimento Infantil , Etnicidade , Criança , Humanos , Adolescente , Estados Unidos , Projetos de Pesquisa
6.
J Ment Health Policy Econ ; 26(4): 137-147, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-38115753

RESUMO

BACKGROUND: Many individuals with serious mental illness (SMI) are capable of employment in regular jobs (i.e. jobs paying at least minimum wage, not set aside for persons with disabilities, and not obtained with assistance from mental health services), but they may need job accommodations to be successful. The extant literature focuses almost exclusively on accommodations for workers with SMI who are receiving employment support, so we know almost nothing about the nature or frequency of accommodations needed by workers who are independently employed. AIMS: Drawing on survey data from a sample of workers with diagnoses of SMI who are capable of regular, mainstream employment, we aim to: (i) describe the nature and frequency of job accommodations workers requested from their employer or initiated on their own; and (ii) identify individual- and work-related factors associated with the probabilities of requesting or initiating accommodations. METHODS: The analysis sample includes 731 workers with diagnoses of schizophrenia, bipolar disorder, or major depressive disorder, who were employed in regular jobs post-onset of SMI. Workers identified any job accommodations requested from their employer, or initiated on their own. Summary statistics describe the nature and frequency of accommodations in four categories: scheduling, workspace, supervision, job modification. Logistic regression models estimate the relationship between workers' health- and job-related characteristics and the probabilities of requesting or self-initiating accommodations. RESULTS: Whereas 84% of workers in our sample self-initiated accommodations, only 25% requested accommodations from their employer. The most frequent accommodations of either type involved flexibility in scheduling (63% self-initiated, 24% requested), or modifications to the workspace (58%, 19%). Factors significantly correlated with the probability of requesting accommodations include: supportive workplace culture, longer job tenure, more severe cognitive/social limitations. Factors significantly correlated with the probability of self-initiating accommodations include: younger age, more severe social limitations, greater job autonomy. DISCUSSION: This is the first study of job accommodations among a cohort of persons with SMI independently employed in regular jobs. We identify a type of accommodation, self-initiated by the worker, that has not been studied before. These self-initiated accommodations are far more prevalent than employer-provided accommodations in our sample. Key factors associated with the probabilities of requesting/initiating accommodations reflect need (e.g. compromised health) and feasibility of implementation in a particular job. Limitations of the study include the cross-sectional design which limits our ability to identify causal relationships. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: Providers who deliver vocational services for workers with SMI should be aware of the many ways these employees can accommodate their illness on their own, without the necessity of disclosing SMI to an employer. IMPLICATIONS FOR HEALTH POLICIES: Our results recommend workplace policies that support disclosure and employer-provided accommodations, as well as policies that create flexibility for employees to initiate their own accommodations. IMPLICATIONS FOR FURTHER RESEARCH: Given the prevalence of workers' self-initiated accommodations, it is imperative that research on job accommodations for workers with serious mental illness includes consideration of these types of accommodations.


Assuntos
Transtorno Depressivo Maior , Pessoas com Deficiência , Esquizofrenia , Humanos , Estudos Transversais , Local de Trabalho/psicologia , Ocupações
7.
J Res Adolesc ; 33(1): 202-215, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36052477

RESUMO

This study examined the developmental changes of familism values across adolescence among Latinx adolescents from an emerging immigrant community, and how changes in parental warmth were associated with changes in familism values. The sample included 547 Latinx adolescents. Multilevel model results indicated that familism values showed a linear decline from 6th to 10th grade. Between-person analyses showed that parental warmth was related to the higher initial levels of familism values but unrelated to changes in familism values. At the within-person level, on the occasions when adolescents report higher parental warmth, they also report higher familism values. This work highlights the importance of parental warmth for socializing developmental changes in Latinx adolescents' familism values in an emerging immigrant community context.


Assuntos
Comportamento do Adolescente , Emigrantes e Imigrantes , Humanos , Adolescente , Comportamento Social , Pais , Hispânico ou Latino
8.
Harm Reduct J ; 20(1): 69, 2023 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-37264367

RESUMO

BACKGROUND: The opioid overdose crisis in the USA has called for expanding access to evidence-based substance use treatment programs, yet many barriers limit the ability of people who inject drugs (PWID) to engage in these programs. Predominantly rural states have been disproportionately affected by the opioid overdose crisis while simultaneously facing diminished access to drug treatment services. The purpose of this study is to explore barriers and facilitators to engagement in drug treatment among PWID residing in a rural county in West Virginia. METHODS: From June to July 2018, in-depth interviews (n = 21) that explored drug treatment experiences among PWID were conducted in Cabell County, West Virginia. Participants were recruited from locations frequented by PWID such as local service providers and public parks. An iterative, modified constant comparison approach was used to code and synthesize interview data. RESULTS: Participants reported experiencing a variety of barriers to engaging in drug treatment, including low thresholds for dismissal, a lack of comprehensive support services, financial barriers, and inadequate management of withdrawal symptoms. However, participants also described several facilitators of treatment engagement and sustained recovery. These included the use of medications for opioid use disorder and supportive health care workers/program staff. CONCLUSIONS: Our findings suggest that a range of barriers exist that may limit the abilities of rural PWID to successfully access and remain engaged in drug treatment in West Virginia. Improving the public health of rural PWID populations will require expanding access to evidence-based drug treatment programs that are tailored to participants' individual needs.


Assuntos
Overdose de Drogas , Usuários de Drogas , Overdose de Opiáceos , Transtornos Relacionados ao Uso de Opioides , Abuso de Substâncias por Via Intravenosa , Humanos , Abuso de Substâncias por Via Intravenosa/complicações , Abuso de Substâncias por Via Intravenosa/tratamento farmacológico , West Virginia , Overdose de Opiáceos/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Overdose de Drogas/tratamento farmacológico
9.
Subst Use Misuse ; 58(1): 22-26, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36371695

RESUMO

Background: As overdose remains a major public health concern in the United States, it is important to understand the experiences people who inject drugs (PWID) have with overdose. Past experiences during such emergencies are an important determinant of future behavior, including help seeking, which can be lifesaving. Methods: We explored experiences with overdose, using data from 21 in-depth interviews collected from PWID in a rural county in West Virginia (Cabell County). We used an iterative, modified constant comparison approach to synthesize resulting interview data. Results: Participants reported pervasive experiences with overdose, including through their own personal overdose experiences, witnessing others overdose, and losing loved ones to overdose fatalities. Experiencing emotional distress when witnessing an overdose was common among our participants. Many participants reported regularly carrying naloxone and using it to reverse overdoses. Multiple participants described believing the myth that people grow immune to naloxone over time. Concerns about the presence of fentanyl in drugs were also common, with many participants attributing their own and others' overdoses to fentanyl. Conclusions: Our findings have important implications for naloxone access and education, as well as policies and practices to encourage help seeking during overdose events among rural PWID. Participant concerns about fentanyl in the drug supply highlight the need for access to drug checking technologies.


Assuntos
Overdose de Drogas , Usuários de Drogas , Angústia Psicológica , Abuso de Substâncias por Via Intravenosa , Humanos , Estados Unidos , Naloxona/uso terapêutico , Fentanila , West Virginia/epidemiologia , Analgésicos Opioides/uso terapêutico
10.
Qual Health Res ; 33(6): 481-495, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36916287

RESUMO

Persons with serious mental illness are often reluctant to disclose their disability to an employer because of the intense stigma associated with their illness. Yet, disclosure may be desirable to gain access to employer-provided job accommodations, or to achieve other goals. In this article, we aimed to (1) describe the contexts in which workers in regular employment disclose a mental illness to their employer and (2) describe employer responses to disclosure, as perceived by the workers themselves. Semi-structured interviews were conducted with 40 workers, who were currently or formerly employed in a mainstream, regular job, post-onset of mental illness. Workers were asked to describe the circumstances that led to disclosure, and to describe their employers' responses to disclosure. Conventional content analysis was applied to identify common themes in the transcribed interviews. Analyses revealed five mutually exclusive disclosure contexts: seeking job accommodations, seeking protection, seeking understanding, responding to an employer's symptom-based inquiries, or being exposed by a third party or event. Analyses also revealed a wider range of employer responses-positive, negative, and ambiguous-than has been suggested by studies in which employers described their reactions to worker disclosure. Some themes were more prevalent among current versus former workers. Overall, the disclosure process appeared to be more complex than has been described by extant frameworks to date, and the linkages between disclosure contexts and employer response themes suggested that many workers did not receive the responses they were seeking from their employers.


Assuntos
Pessoas com Deficiência , Transtornos Mentais , Humanos , Revelação , Local de Trabalho , Confidencialidade
11.
Am J Transplant ; 22(3): 705-716, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34726836

RESUMO

Intragraft events thought to be relevant to the development of tolerance are here subjected to a comprehensive mechanistic study during long-term spontaneous tolerance that occurs in C57BL/6 mice that receive life sustaining DBA/2 kidneys. These allografts rapidly develop periarterial Treg-rich organized lymphoid structures (TOLS) that form in response to class II but not to class I MHC disparity and form independently of lymphotoxin α and lymphotoxin ß receptor pathways. TOLS form in situ in the absence of lymph nodes, spleen, and thymus. Distinctive transcript patterns are maintained over time in TOLS including transcripts associated with Treg differentiation, T cell checkpoint signaling, and Th2 differentiation. Pathway transcripts related to inflammation are expressed in early stages of accepted grafts but diminish with time, while B cell transcripts increase. Intragraft transcript patterns at one week posttransplant distinguish those from kidneys destined to be rejected, that is, C57BL/6 allografts into DBA/2 recipients, from those that will be accepted. In contrast to inflammatory tertiary lymphoid organs (iTLOs) that form in response to chronic viral infection and transgenic Lta expression, TOLS lack high endothelial venules and germinal centers. TOLS represent a novel, pathogenetically important type of TLO that are in situ markers of regulatory tolerance.


Assuntos
Transplante de Rim , Tolerância ao Transplante , Animais , Rejeição de Enxerto/etiologia , Rejeição de Enxerto/patologia , Sobrevivência de Enxerto , Rim , Transplante de Rim/efeitos adversos , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos DBA
12.
Prev Med ; 163: 107189, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35964775

RESUMO

Drug criminalization creates significant barriers to prevention and treatment of substance use disorders and racial equity objectives, and removal of criminal penalties for drug possession is increasingly being endorsed by health and justice advocates. We present empirical data estimating the share of U.S. adults who support eliminating criminal penalties for possession of all illicit drugs, and examine factors associated with public support. Data from the Johns Hopkins COVID-19 Civic Life and Public Health Survey, a probability-based nationally representative sample of 1222 U.S. adults, was collected from November 11-30, 2020. Support for decriminalizing drug possession was assessed overall and by sociodemographic factors and attitudes towards politics and race. Correlates of support were examined using multivariable logistic regression. Thirty-five percent of adults supported eliminating criminal penalties for drug possession in the U.S. In adjusted regression models, respondents who were younger or identified as politically liberal were more likely to support decriminalization relative to other groups, and respondents who were Hispanic or identified strongly with their religious beliefs were less likely to support decriminalization. Among white respondents, greater racial resentment was strongly associated with reduced support for drug decriminalization. Support for drug decriminalization varies considerably by beliefs about politics and race, with racial resentment among white Americans potentially comprising a barrier to drug policy reform. Findings can inform communication and advocacy efforts to promote drug policy reform in the United States.


Assuntos
COVID-19 , Drogas Ilícitas , Adulto , Hispânico ou Latino , Humanos , Política Pública , Estados Unidos , População Branca
13.
AIDS Behav ; 26(8): 2632-2642, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35124757

RESUMO

Among women who exchange sex (WES), social cohesion is associated with multi-level HIV-risk reduction factors, and client condom coercion (CCC) is associated with increased HIV-risk. Sexual minority WES (SM-WES) face exacerbated HIV-risk, yet relevant research is scant. We examined the role of sexual orientation in the relationship between social cohesion and CCC among cisgender WES (n = 384) in Baltimore, Maryland using stratified logistic regression, controlling for potential confounders. Forty-five percent of WES experienced CCC. SM-WES reported significantly higher social cohesion than heterosexual WES. The relationship between social cohesion and CCC differed by sexual orientation. Among SM-WES, higher social cohesion was independently associated with decreased odds of experiencing CCC, controlling for food insecurity, crack use, police harassment, and method of finding clients. Among heterosexual WES, no significant association was found. Ongoing research and practice with WES should (1) collect sexual orientation data to allow for deeper understanding and tailored interventions, (2) leverage and nurture social cohesion and (3) tailor interventions to populations with attention to sexual orientation.


RESUMEN: Among women who exchange sex (WES), social cohesion is associated with multi-level HIV-risk reduction factors, and client condom coercion (CCC) is associated with increased HIV-riskEntre las mujeres que intercambian sexo (WES), la cohesión social atenúa el riesgo de VIH, y la coerción del uso del condón por parte de clientes (CCC) amplifica el riesgo de VIH. Las WES de minorías sexuales (SM-WES) experiencian un riesgo elevado de VIH, pero las investigaciónes relevantes son pocas. En este papel, examinamos la contribución de la orientación sexual en modificando la relación entre la cohesión social y la CCC entre WES cisgénero (n = 384) en Baltimore, Maryland, utilizando regresión logística estratificada, ajustando por posibles factores de confusión. Cuarenta y cinco por ciento de WES reportaron experiencias de CCC. SM-WES exhibieron cohesión social significativamente más alta que las WES heterosexuales. La relación entre la cohesión social y CCC fue moderada por la orientación sexual. Entre SM-WES, la cohesión social se asoció independientemente con menores probabilidades de reportar experiencias de CCC, ajustando por la inseguridad alimentaria, el uso de crack, el acoso policial y el método de encontrar a clientes. Entre las WES heterosexuales, la misma asociación no fue significativa. La investigación y la práctica con WES deben 1) recopilar datos de orientación sexual para permitir una comprensión más profunda e intervenciones personalizadas, 2) aprovechar y fomentar la cohesión social y 3) adaptar las intervenciones a estas poblaciones con atención a la orientación sexual.


Assuntos
Preservativos , Infecções por HIV , Baltimore/epidemiologia , Coerção , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Masculino , Comportamento Sexual , Coesão Social
14.
AIDS Behav ; 26(6): 1992-2002, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35362908

RESUMO

Despite growing availability, HIV pre-exposure prophylaxis (PrEP) uptake and adherence remains suboptimal among female sex workers (FSW) in the United States. Using cross-sectional data from a survey of 236 street-based cisgender FSW in Baltimore, Maryland, we examined interest in event-driven and long-acting PrEP formulations. Latent class analysis identified discrete patterns of interest in five novel PrEP agents. Multinomial latent class regression then examined factors associated with probabilistic class membership. A three-class solution emerged as the best-fit latent class model: Injectable Acceptors (~ 24% of sample), Universal Acceptors (~ 18%), and Non-Acceptors (~ 58%). Compared to Non-Acceptors, Universal Acceptors had significantly (p < 0.05) higher odds of reporting condomless vaginal sex with clients, client condom coercion, and client-perpetrated physical violence. Relative to Non-Acceptors, Injectable Acceptors were distinguished by significantly higher rates of condomless vaginal sex with clients and injection drug use. Expanding PrEP options for FSW could help overcome barriers to PrEP initiation and persistence.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , Profilaxia Pré-Exposição , Profissionais do Sexo , Fármacos Anti-HIV/uso terapêutico , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Análise de Classes Latentes , Masculino , Estados Unidos
15.
AIDS Behav ; 26(1): 47-56, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34076812

RESUMO

People who inject drugs (PWID) play a critical role in injection-naïve individuals transitioning to injection drug use. We investigated factors associated with future likelihood of initiating injection-naïve individuals using multivariable logistic regression among 418 PWID in rural Appalachia (Cabell County, West Virginia). Less than 10% reported they were likely to initiate someone in the future. Acquiring syringes from a syringe services program was associated with decreased odds of being likely to initiate someone in the future (adjusted odds ratio [aOR] 0.46, 95% CI 0.23, 0.95), while having previously initiated someone into injection drug use was associated with increased odds (aOR 8.65, 95% CI 4.07, 18.41). Among our sample of PWID in Appalachia, a small proportion reported that they would be likely to initiate an injection-naïve individual in the future. Efforts to reduce injection initiation assistance should focus on this subpopulation of PWID who indicate a willingness to engage in this behavior.


Assuntos
Usuários de Drogas , Infecções por HIV , Preparações Farmacêuticas , Abuso de Substâncias por Via Intravenosa , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Abuso de Substâncias por Via Intravenosa/epidemiologia , West Virginia/epidemiologia
16.
J Urban Health ; 99(4): 723-732, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35610474

RESUMO

Intervetions are urgently needed to reduce the trajectory of the US opioid overdose epidemic, yet implementation is often hampered by resistance or opposition from key community stakeholders. While businesses are economically and physically impacted by the opioid epidemic, they are rarely engaged in efforts to reduce its impact. The establishment of overdose prevention sites (OPS) is being discussed throughout many US jurisdictions with limited attention to the potential positive role of businesses in that process. We surveyed business owners and employees of businesses located in neighborhoods with concentrated drug markets. The study's primary aim was to examine their attitudes to locally-placed OPS. An iterative, two-phase sampling strategy was used to identify recruitment zones. In person (December 2019-March 2020) and telephone-based (April-July 2020) surveys were administered to distinct business owners and employees (N = 149). Sixty-five percent of participants supported OPS in their neighborhood and 47% had recently witnessed an overdose in or around their workplace. While 70% had heard of naloxone, and 38% reported having it on the premises. Correlates of supporting an OPS locally included living in the same neighborhood as work (adjusted odds ratio (aOR) 1.99, 95% confidence intervals (CI): 1.30-3.05); having a more positive attitude towards people who use drugs (aOR 1.33, 95% CI: 1.13-1.58); and having recently seen an overdose in/around the workplace (aOR 2.86, 95% CI: 1.11-7.32). Lack of support being an owner (aOR 0.35, 95% CI: 0.15-0.83). These data indicate the extent to which businesses are directly impacted by the opioid epidemic and the power of personal experience in shaping OPS support in advocacy efforts.


Assuntos
Overdose de Drogas , Epidemias , Transtornos Relacionados ao Uso de Opioides , Analgésicos Opioides , Baltimore/epidemiologia , Overdose de Drogas/epidemiologia , Humanos , Naloxona/uso terapêutico , Antagonistas de Entorpecentes/uso terapêutico , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Transtornos Relacionados ao Uso de Opioides/prevenção & controle
17.
J Res Adolesc ; 32(2): 470-486, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-34958152

RESUMO

To address injustices that privilege whiter neighborhoods, many advocate for residential integration. The developmental consequences of greater exposure to whiteness associated with integration, however, are unclear. Research examining BIPOC adolescent development within the context of intraindividual changes in neighborhood white concentration-the changes that take place if an adolescent moves to a whiter neighborhood or if their neighborhood becomes whiter-is needed. We examined trajectories of internalizing and externalizing symptoms in a longitudinal sample of U.S. Mexican adolescents (N = 749; 48.9% girls; 70.2% born in the United States). When adolescents experienced an uptick in neighborhood white concentration, they experienced a corresponding uptick in externalizing symptoms. We discuss the impacts of navigating whiter neighborhoods for U.S. Mexican adolescent well-being.


Assuntos
Racismo , Adolescente , Desenvolvimento do Adolescente , Saúde do Adolescente , Feminino , Humanos , Masculino , México , Características de Residência , Estados Unidos
18.
Harm Reduct J ; 19(1): 47, 2022 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-35590373

RESUMO

BACKGROUND: The coronavirus pandemic (COVID-19) exacerbated risks for adverse health consequences among people who inject drugs by reducing access to sterile injection equipment, HIV testing, and syringe services programs (SSPs). Several decades of research demonstrate the public health benefits of SSP implementation; however, existing evidence primarily reflects studies conducted in metropolitan areas and before the COVID-19 pandemic. OBJECTIVES: We aim to explore how the COVID-19 pandemic affected SSP operations in rural Kentucky counties. METHODS: In late 2020, we conducted eighteen in-depth, semi-structured interviews with persons (10 women, 8 men) involved in SSP implementation in rural Kentucky counties. The interview guide broadly explored the barriers and facilitators to SSP implementation in rural communities; participants were also asked to describe how COVID-19 affected SSP operations. RESULTS: Participants emphasized the need to continue providing SSP-related services throughout the pandemic. COVID-19 mitigation strategies (e.g., masking, social distancing, pre-packing sterile injection equipment) limited relationship building between staff and clients and, more broadly, the pandemic adversely affected overall program expansion, momentum building, and coalition building. However, participants offered multiple examples of innovative solutions to the myriad of obstacles the pandemic presented. CONCLUSION: The COVID-19 pandemic impacted SSP operations throughout rural Kentucky. Despite challenges, participants reported that providing SSP services remained paramount. Diverse adaptative strategies were employed to ensure continuation of essential SSP services, demonstrating the commitment and ingenuity of program staff. Given that SSPs are essential for preventing adverse injection drug use-associated health consequences, further resources should be invested in SSP operations to ensure service delivery is not negatively affected by co-occurring crises.


Assuntos
COVID-19 , Abuso de Substâncias por Via Intravenosa , Feminino , Humanos , Kentucky/epidemiologia , Masculino , Programas de Troca de Agulhas , Pandemias/prevenção & controle , População Rural , Abuso de Substâncias por Via Intravenosa/epidemiologia , Seringas
19.
Artigo em Inglês | MEDLINE | ID: mdl-36074584

RESUMO

OBJECTIVES: This study sought to describe latent transitions in developmentally and culturally salient interpersonal stressors from late childhood to late adolescence and examine whether different transition patterns predicted early adult mental health problems. METHOD: Data from four waves (Grades 5, 7, 10, 12) of a study of 749 U.S. Mexican-origin youth were used for a latent transition analysis (LTA) of family, peer, and community stressors; distal outcomes of externalizing and internalizing problems were measured 5 years after Grade 12. Latent class analysis (LCA) and LTA were conducted for investigating underlying subgroups of interpersonal stress at each wave and transitions between subtypes over waves. RESULTS: For the LCA, two latent classes emerged at all four waves, representing low and high interpersonal stress. The LTA model with two classes at all waves was conducted with good fit. Six prominent transition classes emerged and related to young adult internalizing and externalizing problems. Transition class related to young adult internalizing and externalizing problems, such that youth who consistently had exposure to interpersonal stress or who had transitions from low to high exposure had more internalizing and externalizing problems. CONCLUSIONS: Findings are discussed relative to the developmental salience of these transitions and opportunities to intervene during adolescence to mitigate later mental health problems. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

20.
J Early Adolesc ; 42(7): 914-936, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37409108

RESUMO

Among U.S. Mexican adolescents living in established immigrant communities, high familism values are positively associated with compliant, emotional, and dire prosocial behaviors via sociocognitive and cultural psychological mechanisms. Less is known about the behavioral mechanisms that may explain these associations, or about prosocial behaviors among U.S. Latinxs residing in emerging immigrant destinations. We examined the cross-sectional, intervening variable associations among familism values, family assistance behaviors, and culturally salient prosocial behaviors among 547 U.S. Latinx adolescents residing in an emerging immigrant destination (M age = 12.8 years; 55.4% girls). Familism values and family assistance behaviors promoted emotional and dire prosocial behaviors for boys and girls, and promoted compliant prosocial behaviors for boys only. Familism also had direct associations with all three prosocial behaviors for boys and girls. Family assistance behaviors may be a mechanism via which adolescents develop compliant, emotional, and dire prosocial behaviors.

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