As Much As I Can - Utilizing Immersive Theatre to Reduce HIV-Related Stigma and Discrimination Toward Black Sexual Minority Men.

BACKGROUND: Despite advances in biomedical HIV prevention modalities such as pre-exposure prophylaxis to prevent the transmission of HIV, racial/ethnic and sexual/gender minority populations are disproportionately impacted by HIV epidemic. Alarming rates of HIV have persisted among Black gay and bisexual men, particularly in Southern states. METHODS: Utilizing data from the ViiV ACCELERATE! initiative, we explored the impact of As Much As I Can, an immersive theatre production, on HIV-related stigma behaviors. A self-administered post-performance survey was conducted with a cohort (n = 322) of randomly selected audience members. RESULTS: Overall, the results showed participants had a highly favorable experience, rating the performance with a mean score of 9.77/10. Respondents indicated they intended to change behaviors to promote HIV prevention education and to reduce stigma and discrimination including: (1) Say something if I hear stigmatizing language against people living with HIV (75.4%), (2) Say something if I hear anti-gay language (69.7%) and (3) Tell others about HIV prevention options (e.g., PrEP, PEP, condoms (64.1%). The findings show there is an association between HIV-related behavior intention and linkage to HIV care. Respondents who reported they were more likely to say something about HIV stigma were almost three times (O.R. 2.77; 95% C.I. 0.98-7.8) more likely to indicate they would follow up with a healthcare professional. CONCLUSIONS: This study suggests that immersive theatre is an effective method for communicating HIV prevention education and reducing HIV-related structural stigma and discrimination that increases HIV vulnerability for Black sexual minority men.

Intergenerational Influences on Faith-based Strategies Used in Response to Racial Discrimination Among Young African American Adults.

OBJECTIVE: In this report, we used a qualitative descriptive design to explore young African American adults' intergenerationally influenced strategies to experienced racial discrimination. METHODS: The study was guided by a qualitative descriptive design using criterion and snowball sampling, and semi-structured interview questions. We also explored, quantitatively, gender differences among the racial discrimination experiences encountered and the strategies used. FINDINGS: Forty-nine participants included in this report were an average age of 29.5 (SD = 10.1). Racial discrimination experiences included daily microaggressions such as insensitive comments, stereotyping, exclusion from work and school activities, perceived low expectations, inequities in employment, and police profiling. Intergenerationally influenced strategies used in response to these experiences included religious beliefs and practices, positive reframing, and modeling behaviors used by previous generations. These intergenerationally influenced strategies enabled participants to remain calm, to express goodwill toward others, and to be patient and hopeful for a better future. CONCLUSION: Since intergenerationally influenced strategies are likely potential sources of strength and resilience for young African Americans, knowledge of these strategies might be useful to health care practitioners seeking to improve the mental health care of this population.

Trends in cultural psychiatry in the United kingdom.

Cultural psychiatry in the United Kingdom exhibits unique characteristics closely related to its history as a colonial power, its relationship with Commonwealth countries and the changing socio-demographic characteristics of its diverse population throughout the centuries. It is not surprising, therefore, that the emergence of this discipline was centred around issues of race and religion. After a brief historical review of the development of cultural psychiatry and the mention of pioneering intellectual and academic figures, as well as the evolvement of the field in organizations such as the Royal College of Psychiatrists, this chapter examines the need of a critical cultural psychiatry, more than a narrative social science distanced from the realities of clinical practice. In such context, issues such as policies and experience with efforts to delivering race equality, and address inequities in a renewed public health approach seem to confer British cultural psychiatry with a defined socially active role aimed at the pragmatic management, understanding and improvement of diverse and alternative systems of care and care practices.

Incentives for nondiscriminatory wellness programs in group health plans. Final rule.

This document contains final regulations, consistent with the Affordable Care Act, regarding nondiscriminatory wellness programs in group health coverage. Specifically, these final regulations increase the maximum permissible reward under a health-contingent wellness program offered in connection with a group health plan (and any related health insurance coverage) from 20 percent to 30 percent of the cost of coverage. The final regulations further increase the maximum permissible reward to 50 percent for wellness programs designed to prevent or reduce tobacco use. These regulations also include other clarifications regarding the reasonable design of health-contingent wellness programs and the reasonable alternatives they must offer in order to avoid prohibited discrimination.