Ending the HIV epidemic using National HIV Behavioral Surveillance (NHBS): Recommendations based on DC model.

INTRODUCTION: Social network strategies have been used by health departments to identify undiagnosed cases of HIV. Heterosexual cycle (HET4) of National HIV Behavioral Surveillance (NHBS) is a social network strategy implemented in jurisdictions. The main objectives of this research are to 1) evaluate the utility of the NHBS HET cycle data for network analysis; 2) to apply statistical analysis in support of previous HIV research, as well as to develop new research results focused on demographic variables and prevention/intervention with respect to heterosexual HIV risk; and 3) to employ NHBS data to inform policy with respect to the EHE plan. METHOD: We used data from the 2016 NHBS HET4 (DC). A total of 747 surveys were collected. We used the free social-network analysis package, GEPHI, for all network visualization using adjacency matrix representation. We additionally conducted logistic regression analysis to examine the association of selected variables with HIV status in three models representing 1) demographic and economic effects, 2) behavioral effects, and 3) prevention-intervention effects. RESULTS: The results showed 3% were tested positive. Seed 1 initiated the largest networks with 426 nodes (15 positives); seed 4 with 273 nodes (6 positives). Seed 3 had 35 nodes (2 positives). All 23 HIV diagnoses were recruited from 4 zip-codes across DC. The risk of testing positive was higher among people high-school dropouts (Relative Risk (RR) (25.645); 95 CI% 5.699, 115.987), unemployed ((4.267); 1.295, 14.064), returning citizens ((14.319); 4.593, 44.645). We also found in the final model higher association of pre-exposure prophylaxis (PrEP) awareness among those tested negative ((4.783); 1.042, 21.944) and HIV intervention in the past 12 months with those tested positive ((17.887); 2.350,136.135). CONCLUSION: The network visualization was used to address the primary aim of the analysis-evaluate the success of the implementation of the NHBS as a social network strategy to find new diagnoses. NHBS remains one of the strongest behavioral supplements for DC's HIV planning activities. As part of the evaluation process our analysis helps to understand the impact of demographic, behavioral, and prevention efforts on peoples' HIV status. We strongly recommend other jurisdictions use network visualizations to evaluate the efficacy in reaching hidden populations.

Reflections on hateful responses to research on hate in the United States.

While researching hate and gaining media attention beginning in 2018, we incurred a good amount of hate toward us and our research in the form of online comments and direct correspondence. Rather than just pass the comments off as general hate, we collected the text and analyzed it in an attempt to better understand the beliefs, perceptions, and arguments of those that rejected our efforts toward gaining knowledge on geographical hate trends. We use content analysis to identify categories of anti-hate research argumentation based on the comments. A discussion is provided on the implications of our findings and insight from our experiences is given.

Physical Activity Barriers and Facilitators Among US Pacific Islanders and the Feasibility of Using Mobile Technologies for Intervention: A Focus Group Study With Tongan Americans.

BACKGROUND: Pacific Islanders experience an elevated risk of health conditions such as obesity and diabetes, which are related to a lack of physical activity (PA). However, little attention has been paid to understanding the determinants of PA and promoting PA among this racial/ethnic group in the United States. METHODS: We conducted focus group discussions with Tongan Americans, one of the major Pacific Islander groups in the United States, to gain a better understanding of their PA participation patterns, their barriers and facilitators, their attitudes toward PA, and their perceptions of how mobile technologies such as smartphones could help increase their PA levels. RESULTS: Results indicate that although the participants understand the various benefits of PA, they do not engage in much leisure-time PA for exercise purposes. A lack of time is cited as an important reason for insufficient PA participation. In addition, most participants report familiarity with smartphones, positive views of mobile technology, and interest in using smartphones to measure and promote PA. CONCLUSION: Multiple barriers were related with the low level of PA among Tongan Americans. Mobile technology is a promising way of enhancing PA among Tongan Americans and potentially other Pacific Islander subgroups. Culturally tailored strategies could significantly enhance the effectiveness of PA intervention.