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1.
PLoS One ; 15(7): e0234821, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32628674

RESUMEN

This mixed-methods study examined awareness of and willingness to use pre-exposure prophylaxis (PrEP) among sexually active Black and Latinx adolescents (13-17 years) residing in five cities in the United States with some of the highest burden of HIV. Data are from adolescents who participated in a cross-sectional survey (n = 208) and one-on-one interviews and focus groups (n = 26) conducted from September 2017-August 2019. Approximately 50% of the sample were recruited through community efforts, and the other half through a panel. Logistic regression with covariates including sexual orientation, relationship status, socioeconomic status, and race/ethnicity were used to assess factors associated with PrEP awareness and willingness. For the qualitative data, thematic analysis was used to develop a codebook of a-priori and inductive codes while analytic memos were written to identify key themes. PrEP awareness was reported by 38% of the sample and was associated with Black race (AOR = 0.49; 95% CI = 0.27, 0.90) and prior HIV testing (AOR = 3.89, 95% CI = 1.25, 12.08). PrEP willingness (defined as "definitely would use PrEP") was reported by 22% of the sample and was associated with higher age, more education, having had condomless sex in the past 6 months (AOR = 0.23; 95% CI = 0.10, 0.56), perceived likelihood of acquiring HIV (AOR = 3.59; 95% CI = 1.06, 12.21), and PrEP awareness (AOR = 0.41; 95% CI = 0.19, 0.89). Qualitative data showed that misconceptions about PrEP persist and PrEP stigma, fear of being punished, provider attitudes and recommendations, and empowerment were related to adolescents' willingness to use PrEP. Study findings reveal important strategies for improving PrEP delivery and scale-up to Black and Latinx adolescents. These strategies include using sociodemographic and health behavior data to target adolescents who may be more or less willing to use PrEP, improving provider communication about PrEP, and creating culturally and developmentally appropriate PrEP education materials that address common misconceptions held by adolescents.

2.
Curr HIV/AIDS Rep ; 17(4): 333-342, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32594365

RESUMEN

PURPOSE OF REVIEW: In recent years, researchers have been adopting and using ecological momentary assessment (EMA) methods via technology devices for real-time measurement of exposures and outcomes in HIV research. To assess and critically evaluate how EMA methods are currently being used in HIV research, we systematically reviewed recent published literature (October 2017-October 2019) and searched select conference databases for 2018 and 2019. RECENT FINDINGS: Our searches identified 8 published articles that used EMA via smartphone app, a handheld Personal Digital Assistant, and web-based survey programs for real-time measurement of HIV-related exposures and outcomes in behavioral research. Overall trends include use of EMA and technology devices to address substance use, HIV primary prevention (e.g., condom use and preexposure prophylaxis), and HIV treatment (medication adherence). This review supports the use of EMA methods in HIV research and recommends that researchers use EMA methods to measure psychosocial factors and social contexts and with Black and Latinx samples of gay and bisexual men, transgender women, and cisgendered women to reflect current HIV disparities in the U.S.A.

3.
PLoS One ; 15(6): e0234720, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32544212

RESUMEN

INTRODUCTION: Strategies to increase uptake of next-generation biomedical prevention technologies (e.g., long-acting injectable pre-exposure prophylaxis (PrEP)) can benefit from understanding associations between religion, faith, and spirituality (RFS) and current primary HIV prevention activities (e.g., condoms and oral PrEP) along with the mechanisms which underlie these associations. METHODS: We searched PubMed, Embase, Academic Search Premier, Web of Science, and Sociological Abstracts for empirical articles that investigated and quantified relationships between RFS and primary HIV prevention activities outlined by the United States (U.S.) Department of Health and Human Services: condom use, HIV and STI testing, number of sexual partners, injection drug use treatment, medical male circumcision, and PrEP. We included articles in English language published between 2000 and 2020. We coded and analyzed studies based on a conceptual model. We then developed summary tables to describe the relation between RFS variables and the HIV prevention activities and any underlying mechanisms. We used CiteNetExplorer to analyze citation patterns. RESULTS: We identified 2881 unique manuscripts and reviewed 29. The earliest eligible study was published in 2001, 41% were from Africa and 48% were from the U.S. RFS measures included attendance at religious services or interventions in religious settings; religious and/or spirituality scales, and measures that represent the influence of religion on behaviors. Twelve studies included multiple RFS measures. Twenty-one studies examined RFS in association with condom use, ten with HIV testing, nine with number of sexual partners, and one with PrEP. Fourteen (48%) documented a positive or protective association between all RFS factors examined and one or more HIV prevention activities. Among studies reporting a positive association, beliefs and values related to sexuality was the most frequently observed mechanism. Among studies reporting negative associations, behavioral norms, social influence, and beliefs and values related to sexuality were observed equally. Studies infrequently cited each other. CONCLUSION: More than half of the studies in this review reported a positive/protective association between RFS and HIV prevention activities, with condom use being the most frequently studied, and all having some protective association with HIV testing behaviors. Beliefs and values related to sexuality are possible mechanisms that could underpin RFS-related HIV prevention interventions. More studies are needed on PrEP and spirituality/subjective religiosity.


Asunto(s)
Infecciones por VIH/prevención & control , Religión , Fármacos Anti-VIH/uso terapéutico , Condones , Bases de Datos Factuales , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/psicología , Humanos , Profilaxis Pre-Exposición , Parejas Sexuales , Terapias Espirituales
4.
AIDS Care ; : 1-10, 2020 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-32408837

RESUMEN

Women with syndemic conditions, i.e., two or more co-occurring epidemics, are at elevated risk for HIV acquisition and are therefore prime candidates for pre-exposure prophylaxis (PrEP). However, PrEP uptake remains low among women, especially among Black and Hispanic women. This study examined associations of syndemic conditions with PrEP attitudes and HIV risk among women, and the moderating effect of race and ethnicity. In 2017, 271 non-Hispanic Black, non-Hispanic White, and Hispanic, PrEP-eligible women engaged in care at Planned Parenthood in the northeastern region of the U.S. completed an online survey. Participants reported syndemic conditions (i.e., intimate partner violence, depression, substance use), PrEP attitudes (e.g., PrEP interest), HIV sexual risk (e.g., multiple male sexual partners), and sociodemographics. Structural equation modeling was used to examine the effects of syndemic conditions on PrEP attitudes and HIV risk, and the moderating effect of race and ethnicity. Women with more syndemic conditions had a higher odds of reporting multiple male sexual partners. Syndemic conditions were positively associated with PrEP attitudes for Hispanic women than non-Hispanic Black and White women. Women with syndemic conditions, particularly Hispanic women, may be receptive to interventions promoting PrEP.

5.
Ethn Dis ; 30(2): 277-286, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32346273

RESUMEN

Objective: Black female youth have been disproportionately burdened by the HIV epidemic. Emerging literature suggests that individual and social-structural factors may uniquely increase HIV risk within this population during key developmental periods, namely adolescence (ages 10-17 years) and emerging adulthood (ages 18-25 years). Few studies, however, have compared drivers of risk within and between these key developmental periods. Therefore, we conducted a systematic review of recent literature to characterize and identify important gaps in our understanding of the individual, psychosocial, and social-structural determinants of HIV risk among Black adolescent girls and emerging adult women. Design: Using a replicable strategy, we searched electronic databases for articles and abstracts published between October 1, 2017 and September 30, 2019 in which the primary focus was on HIV prevention among Black adolescent girls and emerging adults in the United States. Results: In total, 21 studies met the inclusion criteria. Most of the studies on Black adolescent girls assessed family functioning, parental monitoring, and parent-adolescent communication as determinants of HIV-related behaviors. However, equivalent studies were lacking for Black emerging adult women. Moreover, few studies assessed neighborhood characteristics, social networks, or other community-level factors as determinants of HIV-related behaviors, which are known drivers of HIV disparities. Conclusions: Our findings highlighted several gaps in the literature, including failure to recognize the ethnic and cultural differences among Black women that may contribute to behavioral differences within this population and insufficient acknowledgment of the role of HIV protective factors (eg, resilience and community assets). Implications and future directions are discussed.

6.
J Relig Health ; 59(1): 431-451, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31828596

RESUMEN

Religion, a prominent factor among Black diasporic communities, influences their health outcomes. Given the increase in Black Caribbeans living in the United States, it is important to understand how religion's function among different ethnic groups of Black Americans. We systematically reviewed four databases and included articles of any study design if they (a) focused on the religious experiences of emerging adults (18-29 years) identifying as Black Caribbean in the United States, in light of medical, public health, or mental health outcomes, and (b) were published before November 30, 2018. Study results contribute to future studies' conceptualization and measurement of religion among Black Caribbean emerging adults.


Asunto(s)
Grupo de Ascendencia Continental Africana , Estado de Salud , Religión , Espiritualidad , Adulto , Afroamericanos , Región del Caribe/etnología , Emigración e Inmigración , Femenino , Humanos , Masculino , Salud Mental/etnología , Estados Unidos
7.
Sex Transm Infect ; 96(3): 189-196, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31506346

RESUMEN

BACKGROUND: This systematic review summarises evidence on the HIV testing barriers and intervention strategies among Caribbean populations and provides pertinent implications for future research endeavours designed to increase rates of HIV testing in the region. METHODS: We used a systematic approach to survey all literature published between January 2008 and November 2018 using four electronic databases (MEDLINE/PubMed, Embase, Web of Science and Global Health). Only peer-reviewed articles published in English that examined HIV testing uptake and interventions in the Caribbean with men, men who have sex with men, female sex workers, transgender women and incarcerated individuals were included. RESULTS: Twenty-one studies met the inclusion criteria. Lack of confidentiality, access to testing sites, stigma, discrimination, poverty and low HIV risk perception were identified as key barriers to HIV testing. These barriers often contributed to late HIV testing and were associated with delayed treatment initiation and decreased survival rate. Intervention strategies to address these barriers included offering rapid HIV testing at clinics and HIV testing outreach by trained providers and peers. CONCLUSION: HIV testing rates remain unacceptably low across the Caribbean for several reasons, including stigma and discrimination. Future HIV testing interventions should target places where at-risk populations congregate, train laypersons to conduct rapid tests and consider using oral fluid HIV self-testing, which allows individuals to test at home.

8.
J Int AIDS Soc ; 22(7): e25363, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31369211

RESUMEN

INTRODUCTION: Youth under the age of 25 are at high risk for HIV infection. While pre-exposure prophylaxis (PrEP) has the potential to curb new infections within this population, it is unclear how country-specific laws and policies that govern youth access to sexual and reproductive health (SRH) services impact access to PrEP. The purpose of this review was to analyse laws and policies concerning PrEP implementation and SRH services available to youth in countries with a high HIV incidence. To the best of our knowledge this is the first systematic assessment of country-level policies that impact the availability of PrEP to adolescent populations. METHODS: We conducted a review of national policies published on or before 12 June 2018 that could impact adolescents' access to PrEP, SRH services and ability to consent to medical intervention. Countries were included if: (1) there was a high incidence of HIV; (2) they had active PrEP trials or PrEP was available for distribution; (3) information regarding PrEP guidelines were publicly available. We also included a selected number of countries with lower adolescent HIV incidence. Internet and legal database searches were used to identify policies relevant to adolescent PrEP (e.g. age of consent to HIV testing). RESULTS AND DISCUSSION: Fifteen countries were selected for inclusion in this review. Countries varied considerably in their respective laws and policies governing adolescents' access to PrEP, HIV testing and SRH services. Six countries had specific polices around the provision of PrEP to youth under the age of 18. Five countries required people to be 18 years or older to access HIV testing, and six countries had specific laws addressing adolescent consent for- and access to- contraceptives. CONCLUSIONS: Adolescents' access to PrEP without parental consent remains limited or uncertain in many countries where this biomedical intervention is needed. Observational and qualitative studies are needed to determine if and how adolescent consent laws are followed in relation to adolescent PrEP provisions. Intensified efforts to amend laws that limit adolescent access to PrEP and restrict the establishment of national guidelines supporting adolescent PrEP are also needed to address the epidemic in this group.


Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Infecciones por VIH/prevención & control , Consentimiento Informado de Menores , Profilaxis Pre-Exposición/legislación & jurisprudencia , Servicios de Salud Reproductiva/legislación & jurisprudencia , Adolescente , Infecciones por VIH/tratamiento farmacológico , Humanos , Conducta Sexual
9.
AIDS Behav ; 23(9): 2498-2513, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31377893

RESUMEN

The purpose of this systematic review was twofold. First, we sought to summarize the literature on barriers and facilitators to successful healthcare transition for adolescents living with HIV from low- and middle-income countries (LMICs). Next, we assessed healthcare transition-related policies in countries from which we identified barriers and facilitators to determine the extent to which practice and policy meet to address the country-specific needs of adolescents living with HIV during healthcare transition. Ten studies met inclusion criteria. We identified four sub-themes of barriers to healthcare transition: emotional and psychological burden, effects of HIV disease, logistical and systemic impediments, and HIV stigma. We also identified five sub-themes of facilitators of healthcare transition: social support, skills development for adolescents and the adult treatment team, transition readiness, multidisciplinary teams, and transition coordination. Of the 12 countries from which we identified barriers and facilitators to healthcare transition among adolescents living with HIV, only five (Uganda, Kenya, Thailand, Brazil, and Cambodia) had healthcare transition-specific guidelines. Moreover, there was substantial variation across country-specific guidelines regarding the existence of protocols to monitor and enforce guidelines, and whether there were allocated funds to assist healthcare clinics with implementation. Our review has led to several recommendations to facilitate successful healthcare transition, including the development of surveillance systems to monitor and evaluate efforts to address adolescents' needs during healthcare transition, the development of guidelines specific to healthcare transition and based upon barrier and facilitators identified within target countries, and the incorporation of caregivers and training for the adult treatment team pre- and post-healthcare transition.


Asunto(s)
Prestación de Atención de Salud/organización & administración , Infecciones por VIH/tratamiento farmacológico , Política de Salud , Disparidades en Atención de Salud , Grupo de Atención al Paciente , Estigma Social , Apoyo Social , Transición a la Atención de Adultos , Adolescente , Adulto , Niño , Países en Desarrollo , Guías como Asunto , Infecciones por VIH/psicología , Accesibilidad a los Servicios de Salud , Humanos , Renta , Pobreza
10.
J Res Adolesc ; 29(2): 402-413, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31206880

RESUMEN

Decreasing the number of adolescents who have never had sexual intercourse is one way to address sexual health disparities. We used intersectionality to explore the joint effects of religiosity and racial identity on Black adolescent sexual initiation. Data originated from the National Survey of American Life-Adolescent (n = 1,170), a nationally representative study of Black adolescents. Latent profile analysis and survival analysis were used to evaluate study hypotheses. Results showed four distinct profiles of religiosity and racial identity. These profiles explained 19% of the variability in sexual initiation. Additional analyses revealed sociodemographic differences in profile membership. Findings contribute to understanding ethnic heterogeneity among Black adolescents and racial identity and religiosity as sociocultural factors that influence sexual initiation; and support reconceptualizing Black adolescent religiosity.

11.
J Acquir Immune Defic Syndr ; 81(4): 395-405, 2019 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-30973543

RESUMEN

BACKGROUND: US Centers for Disease Control and Prevention clinical guidelines for HIV pre-exposure prophylaxis (PrEP) are widely used to assess patients' PrEP eligibility. The guidelines include 2 versions of criteria-guidance summary criteria and recommended indications criteria-that diverge in a potentially critical way for heterosexually active women: Both require women's knowledge of their own risk behavior, but the recommended indications also require women's knowledge of their partners' HIV risk or recognition of a potentially asymptomatic sexually transmitted infection. This study examined women's PrEP eligibility according to these 2 different versions of criteria across risk and motivation categories. SETTING/METHODS: HIV-negative women (n = 679) recently engaged in care at Connecticut Planned Parenthood centers were surveyed online in 2017. The survey assessed PrEP eligibility by both versions of Centers for Disease Control and Prevention criteria, HIV risk indicators, PrEP motivation indicators, and sociodemographic characteristics. RESULTS: Participants were mostly non-Hispanic white (33.9%) or black (35.8%) and had low income (<$30,000/year; 58.3%). Overall, 82.3% were eligible for PrEP by guidance summary criteria vs. 1.5% by recommended indications criteria. Women disqualified by recommended indications criteria included those reporting condomless sex with HIV-positive or serostatus-unknown male partners (n = 27, 11.1% eligible); 1 or more recent sexually transmitted infection(s) (n = 53, 3.8% eligible); multiple sex partners (n = 168, 3.0% eligible); intended PrEP use (n = 211, 2.8% eligible); and high self-perceived risk (n = 5, 0.0% eligible). CONCLUSION: Current guidelines disqualify many women who could benefit from PrEP and may lead to discrepant assessments of eligibility. Guideline reform is needed to improve clarity and increase women's PrEP access and consequent HIV protection.


Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Infecciones por VIH/prevención & control , Motivación , Profilaxis Pre-Exposición/normas , Femenino , Guías como Asunto , Seropositividad para VIH , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Aceptación de la Atención de Salud , Factores de Riesgo , Asunción de Riesgos , Parejas Sexuales , Enfermedades de Transmisión Sexual/prevención & control , Encuestas y Cuestionarios , Estados Unidos
12.
AIDS Behav ; 23(7): 1737-1748, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30264207

RESUMEN

Pre-exposure prophylaxis (PrEP) is an effective biomedical HIV prevention method. PrEP uptake has been persistently low among US women, particularly Black women, who account for 61% of new HIV diagnoses among women. Further understanding of barriers to Black women accessing PrEP is needed. This 2017 cross-sectional survey study explored race-based differences in PrEP interest and intention among women and the indirect association between race and comfort discussing PrEP with a healthcare provider through medical mistrust. The sample consisted of 501 adult women (241 Black; 260 White) who were HIV-negative, PrEP-inexperienced, and heterosexually active. Black women reported greater PrEP interest and intention than White women. However, Black women expressed higher levels of medical mistrust, which, in turn, was associated with lower comfort discussing PrEP with a provider. Medical mistrust may operate as a unique barrier to PrEP access among Black women who are interested in and could benefit from PrEP.


Asunto(s)
Afroamericanos/psicología , Afroamericanos/estadística & datos numéricos , Grupo de Ascendencia Continental Europea/psicología , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Infecciones por VIH/prevención & control , Infecciones por VIH/psicología , Profilaxis Pre-Exposición , Confianza/psicología , Adulto , Estudios Transversales , Femenino , Personal de Salud , Humanos , Intención , Masculino , Persona de Mediana Edad , Profilaxis Pre-Exposición/métodos
13.
J Acquir Immune Defic Syndr ; 79(1): 46-53, 2018 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-29847480

RESUMEN

BACKGROUND: Pre-exposure prophylaxis (PrEP) uptake has lagged among US women. PrEP stigma is a recognized barrier to uptake among men who have sex with men but remains largely unexplored among women. This study examined the pervasiveness of PrEP stigma among US women and its implications for uptake. SETTING/METHODS: In a 2017 online survey of Planned Parenthood patients drawn from the 3 cities with the highest numbers of new HIV infections in Connecticut, 597 heterosexually active, HIV-negative, PrEP-inexperienced women reported background characteristics, 2 dimensions of anticipated PrEP stigma (PrEP-user stereotypes and PrEP disapproval by others), and 3 indicators of potential PrEP uptake (interest in learning more about PrEP, intention to use PrEP, and comfort discussing PrEP with a provider). RESULTS: Participants commonly perceived PrEP-user stereotypes, with many believing that others would regard them as promiscuous (37%), HIV-positive (32%), bad (14%), or gay (11%) if they used PrEP. Thirty percent would feel ashamed to disclose PrEP use. Many participants expected disapproval by family (36%), sex partners (34%), and friends (25%). In adjusted analyses, perception of PrEP-user stereotypes was uniquely associated with less comfort discussing PrEP with a provider. Expected PrEP disapproval by others was uniquely associated with less PrEP interest, less intention to use PrEP, and less comfort discussing PrEP with a provider. Exploratory moderation analyses suggested that intention to use PrEP was greatest when participants anticipated low levels of both PrEP-user stereotypes and PrEP disapproval by others. CONCLUSIONS: Findings highlight the need for positive messaging targeting potential PrEP users and their social networks to increase PrEP acceptance and uptake.


Asunto(s)
Infecciones por VIH/prevención & control , Infecciones por VIH/psicología , Federación Internacional para la Paternidad Responsable , Profilaxis Pre-Exposición , Estigma Social , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Sexo Seguro , Parejas Sexuales , Estereotipo , Adulto Joven
14.
J Relig Health ; 57(5): 1889-1904, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29564617

RESUMEN

This study determined the nature of the associations between religious socialization, religiosity, and adolescent sexual initiation. Data originated from the National Survey of American Life-Adolescent (n = 1170), a nationally representative study of black adolescents. Factor analysis, structural equation modeling, and logistic regression were used to evaluate hypotheses. Results indicated that as black adolescents received more messages about religious beliefs and practices, their religiosity was greater and, in turn, they were less likely to report sexual initiation; findings varied by ethnicity, gender, and age. Findings contribute to understanding religious socialization and its association with sexual initiation.


Asunto(s)
Afroamericanos/psicología , Grupo de Ascendencia Continental Africana/psicología , Religión , Conducta Sexual , Socialización , Adolescente , Región del Caribe , Femenino , Humanos , Masculino
15.
Am J Mens Health ; 12(4): 944-951, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29388489

RESUMEN

Neighborhoods are key socio-environmental contexts for marijuana use during emerging adulthood. This study examined the relationships between neighborhood context, traditional masculine norms (status, toughness, and anti-femininity), and marijuana use among 119 majority African American emerging adult men in a small urban community. Poisson regression models were used to determine the associations between neighborhood problems, social cohesion, and marijuana use. Moderator effects were examined to determine if masculinities modified these associations. Neighborhood problems and social cohesion were positively associated with marijuana use. Men who had a lower endorsement of some traditional masculine norms had greater marijuana use compared to men with a higher endorsement of these norms. These findings have implications for intervention strategies and policies.


Asunto(s)
Afroamericanos/estadística & datos numéricos , Uso de la Marihuana/epidemiología , Uso de la Marihuana/psicología , Características de la Residencia , Encuestas y Cuestionarios , Adolescente , Adulto , Factores de Edad , Connecticut/epidemiología , Humanos , Incidencia , Relaciones Interpersonales , Masculino , Fumar Marihuana/epidemiología , Fumar Marihuana/etnología , Fumar Marihuana/psicología , Uso de la Marihuana/etnología , Masculinidad , Distribución de Poisson , Psicología , Muestreo , Población Urbana , Adulto Joven
16.
J LGBT Youth ; 14(4): 380-392, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-30906498

RESUMEN

HIV disproportionately impacts young African American men who have sex with men (MSM). In this study, we sought to understand how previous relationship experiences and expectations for romantic relationships influence condom use among young African American MSM. Twenty African American MSM age 16 to 24 years completed a semi-structured interview and questionnaire on sexual experiences, romantic relationships, and sexual behavior. We identified three major themes characterizing romantic male-male relationships: (1) partner selection, (2) relationship ideals and expectations, and (3) relationship rules for condom use. Our findings indicate that young African American MSM rely on previous relationship experiences and desires for romantic relationships to determine condom use in subsequent relationships. Participants revealed that their previous relationship experiences and desires are often in conflict with their descriptions of their ideal romantic relationships, and subsequently influences their condom use. Our findings fill a gap in the literature describing male-male romantic relationships and condom use among young African American MSM.

17.
Prev Sci ; 17(5): 544-53, 2016 07.
Artículo en Inglés | MEDLINE | ID: mdl-27056632

RESUMEN

AMP! (Arts-based, Multiple component, Peer-education) is an HIV intervention developed for high school adolescents. AMP! uses interactive theater-based scenarios developed by trained college undergraduates to deliver messages addressing HIV/STI prevention strategies, healthy relationships, and stigma reduction towards people living with HIV/AIDS. We used a pre-test/post-test, control group study design to simultaneously assess intervention effect on ninth grade students in an urban county in California (N = 159) and a suburban county in North Carolina (N = 317). In each location, the control group received standard health education curricula delivered by teachers; the intervention group received AMP! in addition to standard health education curricula. Structural equation modeling was used to determine intervention effects. The post-test sample was 46 % male, 90 % self-identified as heterosexual, 32 % reported receiving free or reduced lunch, and 49 % White. Structural models indicated that participation in AMP! predicted higher scores on HIV knowledge (p = 0.05), HIV awareness (p = 0.01), and HIV attitudes (p = 0.05) at the post-test. Latent means comparison analyses revealed post-test scores were significantly higher than pre-test scores on HIV knowledge (p = 0.001), HIV awareness (p = 0.001), and HIV attitudes (p = 0.001). Further analyses indicated that scores rose for both groups, but the post-test scores of intervention participants were significantly higher than controls (HIV knowledge (p = 0.01), HIV awareness (p = 0.01), and HIV attitudes (p = 0.05)). Thus, AMP!'s theater-based approach shows promise for addressing multiple adolescent risk factors and attitudes concerning HIV in school settings.


Asunto(s)
Infecciones por VIH , Conocimientos, Actitudes y Práctica en Salud , Salud Reproductiva , Adolescente , California , Drama , Femenino , Humanos , Masculino , South Carolina
18.
Health Promot Pract ; 17(4): 537-47, 2016 07.
Artículo en Inglés | MEDLINE | ID: mdl-27095037

RESUMEN

Theater-based interventions are a viable prevention strategy for changing sexual health knowledge, attitudes, and behaviors related to HIV prevention. However, few studies have explored interventions in English-speaking, high-income countries such as the United States, Canada, or the United Kingdom. This article critically reviews the literature to identify key characteristics of theater-based HIV prevention strategies used for adolescents in school-settings in the United States, Canada, and the United Kingdom. Specifically, we identify the theatrical approach used in HIV prevention interventions, the behavioral theories that inform such interventions, and the study design and results of existing evaluation studies conducted in school settings. In the 10 articles reviewed, we found limited grounding in theory and the use of nonrigorous study design. To strengthen the evidence and practical application of theater-based HIV prevention interventions, we highlight three specific recommendations for practitioners and researchers: (1) define and operationalize the theater approach and techniques used, (2) ensure theater-based interventions are grounded in theory, and (3) conduct rigorous evaluation of theater-based interventions. These recommendations are key to strengthening future research on and implementation of theater-based interventions for HIV prevention.


Asunto(s)
Drama , Infecciones por VIH/prevención & control , Promoción de la Salud/métodos , Teoría Psicológica , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Adolescente , Humanos , Proyectos de Investigación , Estados Unidos
19.
J Med Internet Res ; 17(11): e248, 2015 Nov 02.
Artículo en Inglés | MEDLINE | ID: mdl-26525289

RESUMEN

BACKGROUND: Social media, including mobile technologies and social networking sites, are being used increasingly as part of human immunodeficiency virus (HIV) prevention and treatment efforts. As an important avenue for communication about HIV, social media use may continue to increase and become more widespread. OBJECTIVE: The objective of this paper is to present a comprehensive systematic review of the current published literature on the design, users, benefits, and limitations of using social media to communicate about HIV prevention and treatment. METHODS: This review paper used a systematic approach to survey all literature published before February 2014 using 7 electronic databases and a manual search. The inclusion criteria were (1) primary focus on communication/interaction about HIV/acquired immunodeficiency syndrome (AIDS), (2) discusses the use of social media to facilitate communication, (3) communication on the social media platform is between individuals or a group of individuals rather than the use of preset, automated responses from a platform, (4) published before February 19, 2014, and (5) all study designs. RESULTS: The search identified 35 original research studies. Thirty studies had low or unclear risk of at least one of the bias items in the methodological quality assessment. Among the 8 social media platform types described, short message service text messaging was most commonly used. Platforms served multiple purposes including disseminating health information, conducting health promotion, sharing experiences, providing social support, and promoting medication adherence. Social media users were diverse in geographic location and race/ethnicity; studies commonly reported users aged 18-40 years and users with lower income. Although most studies did not specify whether use was anonymous, studies reported the importance of anonymity in social media use to communicate about HIV largely due to the stigma associated with HIV. The ability to share and receive information about HIV was the most commonly reported benefit of social media use and the most common challenges were related to technology. Measures of frequency of use, satisfaction, and effects of use varied across studies. CONCLUSIONS: Using social media to bridge communication among a diverse range of users, in various geographic and social contexts, may be leveraged through pre-existing platforms and with attention to the roles of anonymity and confidentiality in communication about HIV prevention and treatment. More robust research is needed to determine the effects of social media use on various health and social outcomes related to HIV.


Asunto(s)
Infecciones por VIH/prevención & control , Comunicación en Salud/métodos , Promoción de la Salud/métodos , Medios de Comunicación Sociales/estadística & datos numéricos , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Red Social , Encuestas y Cuestionarios , Adulto Joven
20.
Prev Chronic Dis ; 12: E164, 2015 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-26425868

RESUMEN

INTRODUCTION: Cardiovascular disease is the leading cause of death in the United States, and mortality rates are higher among African Americans than among people of other races/ethnicities. We aimed to understand how African American adults and adolescents conceptualize cardiovascular health and perceive related barriers and facilitators. METHODS: This qualitative study was conducted as formative research for a larger study, Heart Healthy Lenoir, which aimed to reduce cardiovascular disease disparities among African Americans in eastern North Carolina, part of the widely-known "stroke belt" that runs through the southeastern United States. Using photovoice, a community-based participatory research method, we conducted eight 90-minute photovoice sessions with 6 adults and 9 adolescents in Lenoir County, North Carolina. Topics for each discussion were selected by participants and reflected themes related to cardiovascular health promotion. All sessions were transcribed and coded using a data-driven, inductive approach. RESULTS: Participants conceptualized cardiovascular health to have mental, spiritual, and social health dimensions. Given these broad domains, participants acknowledged many ecological barriers to cardiovascular health; however, they also emphasized the importance of personal responsibility. Facilitators for cardiovascular health included using social health (eg, family/community relationships) and spiritual health dimensions (eg, understanding one's body and purpose) to improve health behaviors. CONCLUSION: The perspectives of African American adults and adolescents elicited through this formative research provided a strong foundation for Heart Healthy Lenoir's ongoing engagement of community members in Lenoir County and development and implementation of its intervention to prevent cardiovascular disease.


Asunto(s)
Afroamericanos/psicología , Enfermedades Cardiovasculares/etnología , Enfermedades Cardiovasculares/psicología , Investigación Participativa Basada en la Comunidad/estadística & datos numéricos , Disparidades en el Estado de Salud , Adolescente , Conducta del Adolescente , Adulto , Afroamericanos/estadística & datos numéricos , Enfermedades Cardiovasculares/prevención & control , Relaciones Comunidad-Institución , Toma de Decisiones , Planificación Ambiental , Salud de la Familia , Femenino , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud/economía , Promoción de la Salud/métodos , Humanos , Masculino , Relaciones Metafisicas Mente-Cuerpo , North Carolina/epidemiología , Evaluación de Procesos y Resultados en Atención de Salud/normas , Percepción , Fotograbar , Prejuicio , Investigación Cualitativa , Espiritualidad , Estrés Psicológico
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