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AIDS Behav ; 2020 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-31912274


We present findings from qualitative interviews (N = 67) with 36 staff and 31 participants of nine distinct individual and/or group level interventions to engage transgender women of color (TWOC) in HIV care in the U.S. We examine the commonalities amongst the intervention services (addressing unmet basic needs, facilitating engagement in HIV care, health system navigation, improving health literacy, emotional support), and the relationships formed during implementation of the interventions (between interventionists and participants, among participants in intervention groups, between participants and peers in the community). Interventionists, often TWOC themselves, who provided these services developed caring relationships, promoted personal empowerment, and became role models for participants and the community. Intervention groups engaged participants to reinforce the importance of health and HIV care and provided mutual support. Gender affirming services and caring relationships may be two key characteristics of interventions that address individual and structural-level barriers to engage TWOC in HIV care.

AIDS Behav ; 2019 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-31144131


Transgender women of color are disproportionately impacted by HIV, poor health outcomes, and transgender-related discrimination (TD). We tested the Model of Gender Affirmation (GA) to identify intervention-amenable targets to enhance viral suppression (VS) using data from 858 transgender women of color living with HIV (49% Latina, 42% Black; 36% virally suppressed) in a serial mediation model. Global fit statistics demonstrated good model fit; statistically significant (p ≤ 0.05) direct pathways were between TD and GA, GA and healthcare empowerment (HCE), and HCE and VS. Significant indirect pathways were from TD to VS via GA and HCE (p = 0.036) and GA to VS via HCE (p = 0.028). Gender affirmation and healthcare empowerment significantly and fully mediated the total effect of transgender-related discrimination on viral suppression. These data provide empirical evidence for the Model of Gender Affirmation. Interventions that boost gender affirmation and healthcare empowerment may improve viral suppression among transgender women of color living with HIV.

AIDS Behav ; 22(3): 774-790, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-27844296


The primary romantic relationship plays a fundamental role in health maintenance, but little is known about its role in HIV care engagement among young Black men who have sex with men (MSM) living with HIV. We examined how HIV care engagement outcomes (i.e., having a primary healthcare provider, receiving HIV treatment, taking antiretroviral medication, and medication adherence) vary by partnership status (single vs. concordant-positive vs. discordant) in a sample of young Black MSM living with HIV. Results showed mixed findings. Partnership status was significantly associated with HIV care engagement, even after adjusting for individual, social, and structural factors. While partnered men were consistently more likely than their single counterparts to have a regular healthcare provider, to receive recent treatment, and to have ever taken antiretroviral medication, they were less likely to report currently receiving antiretroviral therapy. Moreover, men with a discordant partner reported better adherence compared to men with a concordant or no partner. The association between partnership status and HIV care engagement outcomes was not consistent across the stages of the HIV Care Continuum, highlighting the complexity in how and why young Black men living with HIV engage in HIV healthcare. Given the social context of HIV disease management, more research is needed to explicate underlying mechanisms involved in HIV care and treatment that differ by relational factors for young Black MSM living with HIV.

Afro-Americanos/psicologia , Grupo com Ancestrais do Continente Africano/psicologia , Antirretrovirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , Homossexualidade Masculina , Adesão à Medicação , Parceiros Sexuais , Adulto , HIV , Infecções por HIV/etnologia , Infecções por HIV/psicologia , Soropositividade para HIV/epidemiologia , Pessoal de Saúde , Humanos , Masculino
J Homosex ; 60(7): 984-1010, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23808347


Limited research exists about gay men in the Caribbean region. A qualitative study was conducted to characterize gay men in Barbados, their HIV risk, and the impact of stigma on their lives. The 2 main groups of gay men ("bougies" and "ghetto") reflect social class and level of "outness" in broader society. Homophobia, stigma, and buggery (sodomy) laws increase their HIV vulnerability. The need for anti-discrimination legislation and tools for self-development were identified for gay men to realize their strengths, develop their self-worth, and protect themselves from HIV.

Infecções por HIV/etiologia , Homossexualidade Masculina/psicologia , Estereotipagem , Adulto , Barbados/epidemiologia , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Homofobia , Humanos , Legislação como Assunto , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
AIDS Behav ; 14(1): 218-24, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19160034


Methods of collecting behavioral surveillance data, including Web-based methods, have recently been explored in the United States. Questions have arisen as to what extent Internet recruitment methods yield samples of MSM comparable to those obtained using venue-based recruitment methods. We compare three recruitment methods among MSM with respect to demographic and risk behaviors, one sample was obtained using time location sampling at venues in San Francisco, one using a venue based like approach on the Internet and one using direct-marketing advertisements to recruit participants. The physical venue approach was most successful in completing interviews with approached men than both Internet approaches. Respondents recruited via the three methods reported slight differences in risk behavior. Direct marketing internet recruitment can obtain large samples of MSM in a short time.

Infecções por HIV/prevenção & controle , Comportamentos Relacionados com a Saúde , Internet/estatística & dados numéricos , Vigilância da População/métodos , Meio Social , Adolescente , Adulto , California/epidemiologia , Infecções por HIV/epidemiologia , Humanos , Masculino , Projetos Piloto , Fatores de Risco , Comportamento Sexual , Estados Unidos , Adulto Jovem