ABSTRACT
INTRODUCTION: Black men in the Deep South have been disproportionally affected by high HIV and hepatitis C virus infection rates. Conventional clinic-based screening approaches have had limited success in reaching those with undiagnosed HIV or hepatitis C virus infection. The purpose of this study was to evaluate the acceptability, feasibility, and best practices of an integrated HIV and hepatitis C virus community-based health screening approach. METHODS: The study used a mixed methods approach: focus group discussion, individual interviews, and surveys that assessed perceptions, perspectives, and HIV and hepatitis C virus awareness among six communities across Alabama and Mississippi. Data were collected and analyzed in 2014-2017. RESULTS: Although HIV and hepatitis C virus knowledge was limited among community members surveyed, the results of this study suggest that (1) using an integrated, community-based HIV and hepatitis C virus testing approach is acceptable and feasible; (2) formation of a community advisory board is a key element of successful community mobilization; (3) education and training of community members on disease-specific topics and overcoming stigma are essential; and (4) focus on and inclusion of young community members will be critical for the sustainability of screening efforts. CONCLUSIONS: Including and engaging communities at risk for HIV and hepatitis C virus infection in prevention research is a promising strategy to overcome existing barriers of stigma and discrimination. Integration of HIV and hepatitis C virus testing in universal health screening efforts utilizing a Community Health Advisors model encourages unbiased communication with a focus on overall community health. Community health advisors are recognized as important agents in this effort. SUPPLEMENT INFORMATION: This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.
Subject(s)
Community Health Services/methods , Delivery of Health Care, Integrated/methods , HIV Infections/diagnosis , Hepatitis C/diagnosis , Mass Screening/methods , Adult , Black or African American , Alabama , Community Health Services/organization & administration , Community Participation , Culturally Competent Care/methods , Culturally Competent Care/organization & administration , Delivery of Health Care, Integrated/organization & administration , Feasibility Studies , Female , Focus Groups , HIV/isolation & purification , HIV Infections/virology , Health Knowledge, Attitudes, Practice , Health Status Disparities , Healthcare Disparities , Hepacivirus , Hepatitis C/virology , Humans , Male , Mass Screening/organization & administration , Middle Aged , Mississippi , Pilot Projects , Social Stigma , Young AdultABSTRACT
Practical high-temperature superconductors must be textured to minimize the reduction of the critical current density J(gb) at misoriented grain boundaries. Partial substitution of Ca for Y in YBa(2)Cu(3)O(7-delta) has shown significant improvement in J(gb) but the mechanisms are still not well understood. Here we report atomic-scale, structural and analytical electron microscopy combined with transport measurements on 7 degrees [001]-tilt Y(0.7)Ca(0.3)Ba(2)Cu(3)O(7-delta) and YBa(2)Cu(3)O(7-delta) grain boundaries, where the dislocation cores are well separated. We show that the enhanced carrier density, higher J(gb) and weaker superconductivity depression at the Ca-doped boundary result from a strong, non-monotonic Ca segregation and structural rearrangements on a scale of approximately 1 nm near the dislocation cores. We propose a model of the formation of Ca(2+) solute atmospheres in the strain and electric fields of the grain boundary and show that Ca doping expands the dislocation cores yet enhances J(gb) by improving the screening and local hole concentration.
