An exploratory study of community violence and HIV care engagement among Black gay and bisexual men.

This study examined the relationship between exposure to community violence and HIV care engagement among 107 Black gay or bisexual men living with HIV in Chicago. Measures assessed the importance of demographic covariates (age, annual income, health insurance status, and years living with HIV), community violence exposures, mental health, social support, in explaining variations in missed doses of antiretroviral therapy (ART) medication and missed HIV care appointments. Results showed that participants who reported higher rates of exposure to community violence were two times more likely to have missed ART doses and HIV care appointments. Participants who reported depression scores were two times more likely to have greater non-ART adherence. Finally, older participants were more likely to report fewer missed ART doses. More research is needed to clarify the mechanisms between age or depression and ART adherence given community violence exposure. Health care providers should screen for depression when attempting to promote better ART adherence and keeping HIV care appointments for Black gay and bisexual men living with HIV. Younger Black gay and bisexual men living with HIV may be more vulnerable than older men for missed ART doses and may require additional screening and follow-up.

Economic Fragility of Older Adults: Factors Contributing to a Continuing Crisis.

With rapid population aging in the U.S. a greater number of older adults now experience economic insecurity, a situation disproportionately affecting older people of color. The COVID pandemic, rising inflation, and increasing economic inequality have reduced the purchasing power of both wages and fixed incomes. Compared with prior cohorts, the current cohort of adults at or nearing retirement age faces higher levels of secured and unsecured debt burden from mortgages, home equity loans, student loans, credit cards, and out-of-pocket medical costs. Long-standing disparities in opportunities and generational wealth have resulted in more outstanding debt for Black older adults than their white counterparts. This "financial fragility" may result in older people foregoing proper nutrition, doctor's visits, needed medications, or home or car repairs, while stress about finances may contribute to chronic health and mental health conditions. Along with programs to educate and advise older adults on their pressing financial concerns, practitioners who interact with older people in many settings should incorporate needed financial assessment and referrals into their work with this population. Professional and continuing education should ensure financial literacy and awareness of financial fragility for those working with older adults.