No Man Is an Island: Resiliency Among Older African American Men Living with HIV.

African American men face chronic illness earlier in life and earlier death due to higher severity of illness and poor control of chronic diseases than their white male counterparts. Preexposure and post-exposure prophylaxis PrEP and PREP have improved the odds of survival among those living with HIV. However, the anti-retroviral treatments, though effective, are only as effective as early prevention and detection and in cases where patients can adhere to treatment regimens. The mean age of participants (N = 11) was 56.44 (SD = 5.175, range = 47-63). The current study employs qualitative methodology to propose an ecosystems-driven intersectional model to identify resilience and the influence of personal, social, and societal forces shaping the lives of older African American men living with HIV. Findings determine stigma, community violence, and structural barriers to care as crucial stress areas. Participants discussed self-advocacy and family as constituent elements of resilience. Several implications for practice and research emerged. Practice must design and deploy assessment instruments to include exposure to racism and violence, including emotional and structural violence. Practice must include advocacy at the micro, meso, and macro levels. Assessment must also be self-reflexive. Organizational assessment should involve internal and structural reviews of barriers to meeting client preferences.

Grandparenting Among Maoris of New Zealand: Reflecting on Meanings.

Regardless of nation and culture, grandparents have been instrumental in the survival of families and communities as well as the preservation of cultures. This study explored the meaning and roles of grandparenting among Maori grandparents in New Zealand as a possible platform for advancing the conversation on the significance of grandparents in the lives of people across cultures. Participants interviewed included 17 Maori grandparents to great, great grandparents in Aotearoa New Zealand, living in intergenerational homes. A phenomenology approach was used to analyze the data. Five themes were extracted that elucidated the meaning of the roles of grandparenting from the perspective of Maori grandparents: Elders' responsibilities from a cultural perspective; support, resources, and assets; sociopolitical and economic challenges; current state of Elders' and role in family, and benefits and rewards. Implications and recommendations are discussed towards a more systemic and culturally responsive support of grandparents.

Constructing Taxonomies: Identifying Distinctive Class of HIV Support and Risk Networks among People Who Use Drugs (PWID) and Their Network Members in the HPTN 037 Randomized Controlled Trial.

Injection drug use is a significant mode of HIV transmission. Social networks are potential avenues for behavior change among high-risk populations. Increasing knowledge should include a classification or taxonomy system of networks' attributes, risks, and needs. The current study employed 232 networks comprising 232 indexes, with 464 network members enrolled in Philadelphia. LCA revealed a three-class solution, Low-Risk, Paraphernalia Risk, and High Sex/Moderate Paraphernalia Risk class, among participants. The analysis found receiving money or drugs for sex and employment status increased the odds of belonging to PR and PSR classes. Homelessness and incarceration increased the odds of belonging to the PR class when compared to the LR class. Our findings suggest that classes of risk among PWID comprise clusters of information concerning their members. These findings add depth to our understanding while extending our knowledge of the contextual environment that nurtures or exacerbates the problem.

Hidden or uninvited? A content analysis of elder LGBT of color literature in gerontology.

As longevity increases and marginalized communities achieve greater visibility in the United States, a content analysis of 64 articles in social work, health, medicine and nursing, and gerontology/psychology examined the extent to which the literature examines the needs and concerns of lesbian, gay, bisexual, and transgender (LGBT) seniors of color (SOC). We found recognition of the distinct cultural needs of sexual orientation and gender minorities. However the distinctive needs of LGBT SOC remains underexplored and poorly documented. Gerontologists, social workers, policymakers, and advocates must support research that values the experience and multiple vulnerabilities of LGBT seniors and questions the structures preventing inclusion and participation.

A comparative analysis of sexual risk characteristics of Black men who have sex with men or with men and women.

Many behavioral studies of Black men fail to differentiate between those who have sex exclusively with men (MSM) and those who have sex with both men and women (MSMW). Respondent-driven sampling was used to recruit a total of 1,154 Black MSM and MSMW in New York City and Philadelphia. In descriptive analyses, MSMW and MSM were compared on several demographic, health, and behavioral risk correlates using chi-square tests. Differences in prevalence of unprotected anal intercourse (UAI) between these two groups were examined in two multivariate logistic regressions. Age, country of birth, self-identified sexual orientation, experience of being forced to have sex, self-reported HIV status, exchange sex for money/food/ drug, and drug use in the past 3 months were significantly associated with either insertive or receptive UAI in the past 3 months. The strongest correlate of either insertive or receptive UAI among both groups of men was engaging in exchange sex. Differences between MSMW and MSM were found in the areas of forced sexual experiences, disclosure of same sex behavior, and history of being arrested or incarcerated. Findings from our study highlight the need for specific HIV prevention interventions targeting Black MSMW as distinguished from Black MSM.