Patterns of Sexual Experience among Urban Latino & African American 9th Grade Students

This analysis assessed patterns of sexual experience, the order in which behaviors were initiated, and associated factors, among Latino and African American ninth grade students (average age 15.2) who self-administered audio-computer-assisted surveys on netbooks in classes at 10 Los Angeles–area public high schools. 

Lifetime experiences with vaginal and oral sex were most common (19% and 16%, respectively); fewer reported anal sex (6%). Of the 23% reporting any sex, 91% fell into four categories: 36% reporting both oral and vaginal sex; 23% vaginal only; 18% all three; and 13% oral only. Most sexually experienced students (88%) initiated with vaginal or oral sex (46% vaginal, 33% oral, 9% both same day). 

No dominant pathway of sexual onset emerged for those reporting all three types of sex. We found no evidence that oral or anal sex substituted for or delayed vaginal sex. Males, those with a current partner, and those reporting multiple partners were more likely than others to report all three sexual behaviors versus vaginal only (odds ratios [ORs] 2.0, 1.5, 3.0; p = .02, .06, < .01, respectively). 

Although vaginal intercourse dominated their early sexual behavior, one-fifth of sexually experienced students reported anal intercourse, highlighting the need for specific prevention messages surrounding this higher-risk behavior.

Purchase full article at:   http://goo.gl/UM5lNq

   

By:  Robin A. Donatello^a*, Christine J. De Rosa^b, Bret D. Moulton^c,Emily Q. Chung^d, Rachel Viola^c, Louise Ann Rohrbach^c &Abdelmonem A. Afifi^e

^a Department of Mathematics and Statistics, California State University, Chico

^b Los Angeles County Department of Public Health, Division of HIV and STD Programs; Institute for Health Promotion and Disease Prevention, University of Southern California

^c Institute for Health Promotion and Disease Prevention, University of Southern California

^d Los Angeles County Department of Public Health, Division of HIV and STD Programs

^e Department of Biostatistics, Fielding School of Public Health, University of California at Los Angeles 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Examining Risk for Frequent Cocaine Use: Focus on an African American Treatment Population

BACKGROUND:

Cocaine use and its consequences are disproportionately higher and more severe among African Americans compared to other ethnic/racial groups.

OBJECTIVES:

The aims of this study were to examine a risk model specific for African American users and assess whether risk varies as a function of sex.

METHODS:

270 African American adults in a residential drug treatment facility completed measurements assessing first and past year crack/cocaine use frequency, childhood trauma, and stress reactivity. Multiple linear regression analysis was used to examine the unique effect of each predictor variable on past year crack/cocaine frequency. Sex was included as a moderator variable in the regression analysis.

RESULTS:

All predictor variables were positively correlated with past year crack/cocaine use. However, sex differences were also observed: females reported higher rates of childhood emotional abuse, childhood sexual abuse, and stress reactivity-as well as past year crack use and cocaine use-than males. Regression analyses were performed with sex, first year use, and stress reactivity emerging as the only significant predictors for frequency of crack and cocaine use among all study participants. Moreover, sex differences were observed in the influence of first year crack use frequency on past year crack use frequency, such that the effect was stronger for males than for females. Conclusion/Importance: This study offers a clearer understanding of the risk factors for crack and cocaine abuse specific to African Americans, as well as sex specific pathways to risk, providing useful implications for future prevention and treatment efforts.

Purchase full article at:   http://goo.gl/9P8A3e

By:  Zapolski TC1, Baldwin P1, Lejuez CW2.

• 1 Department of Psychology , Indiana University Purdue University-Indianapolis , Indianapolis , Indiana , USA.
• 2 Department of Psychology , University of Maryland , College Park , Maryland , USA. 
• Subst Use Misuse. 2016 Apr 21:1-10. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

The Role of Social Capital in African Americans' Attempts to Reduce and Quit Cocaine Use

BACKGROUND:

Research examining substance users' recovery has focused on individual-level outcomes while paying limited attention to the contexts within which individuals are embedded, and the social processes involved in recovery.

OBJECTIVES:

This paper examines factors underlying African American cocaine users' decisions to reduce or quit cocaine use and uses practice theory to understand how lifestyle changes and shifts in social networks facilitate access to the capital needed to change cocaine use patterns.

METHODS:

The study, an in-depth analysis of substance-use life history interviews carried out from 2010 to 2012, included 51 currently not-in-treatment African American cocaine users in the Arkansas Mississippi Delta region. A blended inductive and deductive approach to data analysis was used to examine the socio-cultural and economic processes shaping cocaine use and recovery.

RESULTS:

The majority of participants reported at least one lifetime attempt to reduce or quit cocaine use; motivations to reduce use or quit included desires to meet social role expectations, being tired of using, and incarceration. Abstinence-supporting networks, participation in conventional activities, and religious and spiritual practices afforded access to capital, facilitating cocaine use reduction and sobriety.

CONCLUSIONS:

Interventions designed to increase connection to and support from nondrug using family and friends with access to recovery capital (e.g., employment, faith community, and education) might be ideal methods to reduce substance use among minorities in low-income, resource-poor communities.

Purchase full article at:   http://goo.gl/tu8pcE

By:  Cheney AM¹, Booth BM², Borders TF³, Curran GM⁴.

¹ Center for Healthy Communities , University of California Riverside , Riverside , California , USA.

² Division of Health Services Research , University of Arkansas for Medical Sciences , Little Rock , Arkansas , USA.

³ Department of Health Management and Policy , University of Kentucky , Lexington , Kentucky , USA.

⁴ Department of Pharmacy Practice , University of Arkansas for Medical Sciences , Little Rock , Arkansas , USA.

Subst Use Misuse. 2016 Apr 20:1-11.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Neighborhood Context and Binge Drinking by Race and Ethnicity in New York City

BACKGROUND:

Neighborhood context is associated with binge drinking and has significant health, societal, and economic costs. Both binge drinking and neighborhood context vary by race and ethnicity. We examined the relations between neighborhood characteristics-neighborhood norms that are accepting of drunkenness, collective efficacy, and physical disorder-and binge drinking, with a focus on examining race and ethnic-specific relationships.

METHODS:

Respondent data were collected through 2005 random digit-dial-telephone survey for a representative sample of New York City residents; neighborhood data were based on the 2005 New York City Housing and Vacancy Survey. Participants were 1,415 past-year drinkers; Whites (n = 877), Blacks (n = 292), and Hispanics (n = 246). Generalized estimating equations were used to estimate population average models.

RESULTS:

For the overall sample, neighborhood norms that were more accepting of drunkenness were associated with greater binge drinking; collective efficacy and physical disorder were not significant. However, when examining this by race/ethnicity, greater collective efficacy and greater physical disorder were associated with less binge drinking for Whites only. Neighborhood norms that were more accepting of drunkenness were associated with binge drinking among Whites and, while not significant (perhaps due to power), the associations were similar for Hispanics and slightly lower for Blacks.

CONCLUSIONS:

Overall, results suggest that neighborhood characteristics and binge drinking are shaped, in part, by factors that vary across race/ethnicity. Thus, disaggregating data by race/ethnicity is important in understanding binge drinking behaviors.

Purchase full article at:   http://goo.gl/AeTW66

By:  Chauhan P1, Ahern J2, Galea S3, Keyes KM4.

• 1Department of Psychology, John Jay College of Criminal Justice, New York, New York.
• 2Department of Epidemiology , University of California, Berkeley, Berkeley, California.
• 3School of Public Health, Boston University, Boston, Massachusetts.
• 4Department of Epidemiology, Columbia University, New York, New York. 
• Alcohol Clin Exp Res. 2016 Apr;40(4):785-93. doi: 10.1111/acer.13011. Epub 2016 Mar 10.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Predictors of Disclosure of Maternal HIV Status by Caregivers to their Children in an Inner-City Community in the United States

Disclosure of HIV status to children is a challenge parents living with HIV face. To evaluate predictors of maternal HIV disclosure in a low-income clinic in the U.S. that serves an African American, Hispanic and immigrant population with high HIV prevalence, 172 caregivers with 608 children completed a standardized survey. 

Caregivers were 93% female, 84% biological mothers, and 34% foreign born. Sixty-two (36 %) caregivers had at least one disclosed child, 42 of whom also had other nondisclosed children. Of all children, 581 (96%) were uninfected and 181 (30 %) were disclosed. Caregiver's U.S. birth, child's age, and increased HIV-stigma perception by caregiver predicted disclosure. Children were more often disclosed if their caregiver was born in the U.S. or reported higher HIV-related stigma. 

These findings suggest that complex family context may complicate disclosure, particularly among immigrants.

Purchase full article at:   http://goo.gl/eh7v2d

By:  Abdulrahman R1, Stuard E2, Vachon ME2, Nicholas C2, Neugebauer R3, Hagmann SH2, Purswani MU2.

• 1Columbia University, Mailman School of Public Health, Environmental Health Department, New York, NY, USA. rozanabdul@gmail.com.
• 2Bronx-Lebanon Hospital Center, Department of Pediatrics, Bronx, NY, USA.
• 3Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, NY, USA. 
• AIDS Behav. 2016 Mar 24. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

HIV Infection Itself May Not Be Associated with Subclinical Coronary Artery Disease among African Americans without Cardiovascular Symptoms

BACKGROUND:

The key objectives of this study were to examine whether HIV infection itself is associated with subclinical coronary atherosclerosis and the potential contributions of cocaine use and antiretroviral therapies (ARTs) to subclinical coronary artery disease (CAD) in HIV-infected persons.

METHODS AND RESULTS:

Between June 2004 and February 2015, 1429 African American (AA) adults with/without HIV infection in Baltimore, Maryland, were enrolled in an observational study of the effects of HIV infection, exposure to ART, and cocaine use on subclinical CAD. The prevalence of subclinical coronary atherosclerosis was 30.0% in HIV-uninfected and 33.7% in HIV-infected (P=0.17). Stratified analyses revealed that compared to HIV-uninfected, HIV-infected ART naïve were at significantly lower risk for subclinical coronary atherosclerosis, whereas HIV-infected long-term ART users (≥36 months) were at significantly higher risk. Thus, an overall nonsignificant association between subclinical coronary atherosclerosis and HIV was found. Furthermore, compared to those who were ART naïve, long-term ART users (≥36 months) were at significantly higher risk for subclinical coronary atherosclerosis in chronic cocaine users, but not in those who never used cocaine. Cocaine use was independently associated with subclinical coronary atherosclerosis.

CONCLUSIONS:

Overall, HIV infection, per se, was not associated with subclinical coronary atherosclerosis in this population. Cocaine use was prevalent in both HIV-infected and -uninfected individuals and itself was associated with subclinical disease. In addition, cocaine significantly elevated the risk for ART-associated subclinical coronary atherosclerosis. Treating cocaine addiction must be a high priority for managing HIV disease and preventing HIV/ART-associated subclinical and clinical CAD in individuals with HIV infection.

Below:  Prevalences of subclinical CAD by HIV serostatus

Below:  Unadjusted prevalence estimates of subclinical CAD by the 2013 ACC/AHA cardiovascular risk profile quintile

Below:  Associations between HIV infection and presence of coronary stenosis by duration of ART use

Full article at:   http://goo.gl/iwwLdK

By:  Lai H1, Moore R2, Celentano DD3, Gerstenblith G2, Treisman G4, Keruly JC2, Kickler T5, Li J5, Chen S5, Lai S6, Fishman EK1.

• 1Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD.
• 2Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
• 3Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
• 4Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD.
• 5Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD.
• 6Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD slai@jhmi.edu. 
• J Am Heart Assoc. 2016 Mar 24;5(3). pii: e002529. doi: 10.1161/JAHA.115.002529.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Place Matters: Contextualizing the Roles of Religion & Race for Understanding Americans' Attitudes About Homosexuality

As laws and policies related to homosexuality have evolved, Americans' attitudes have also changed. Race and religion have been established as important indicators of feelings about homosexuality. However, researchers have given almost no attention to how county characteristics shape Americans' attitudes. 

Using Hierarchical Linear Modeling techniques, we examine how personal characteristics and the religious and racial context of a county shape feelings about homosexuality drawing on data from the American National Election Survey and information about where respondents reside. 

We find that African Americans initially appear less tolerant than other racial groups, until we account for the geographical distribution of attitudes across the nation. 

Additionally, once we consider religious involvement, strength of belief, and religious affiliation African Americans appear to have warmer feelings about homosexuality than whites. Drawing on the moral communities' hypothesis, we also find that the strength of religiosity amongst county residents heightens the influence of personal religious beliefs on disapproving attitudes. 

There is also a direct effect of the proportion conservative Protestant, whereby people of all faiths have cooler attitudes towards homosexual individuals when they reside in a county with a higher proportion of conservative Protestants. 

Finally, we do not find any evidence for an African American cultural influence on attitudes.

Purchase full article at:   http://goo.gl/dKyMoj

By:  Adamczyk A1, Boyd KA2, Hayes BE3.

• 1John Jay College of Criminal Justice and the Graduate Center, City University of New York, USA. Electronic address: AAdamczyk@jjay.cuny.edu.
• 2Department of Sociology, Philosophy, and Anthropology, The University of Exeter, UK.
• 3Department of Criminal Justice and Criminology, Sam Houston State University, USA. 
• Soc Sci Res. 2016 May;57:1-16. doi: 10.1016/j.ssresearch.2016.02.001. Epub 2016 Feb 8.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Persistent Racial Disparities in HIV Infection in the USA: HIV Prevalence Matters

OBJECTIVES:

Despite increased funding and efforts to prevent and control HIV infections in the black and Hispanic communities, racial disparities persist in the USA. We used a mathematical model to explain the phenomena.

METHODS:

A mathematical model was constructed to project HIV prevalence ratio (PR), incidence rate ratio (IRR), and HIV-specific mortality rate ratio (MRR) among blacks and Hispanics vs. whites in two scenarios: (1) an annual reduction in HIV incidence rate at the 2007-2010 level and (2) an annual reduction in HIV incidence rate at the 2007-2010 level among whites (4.2 %) and twice that of whites among blacks and Hispanics (8.4 %).

RESULTS:

In scenario no. 1, the PR, IRR, and MRR among blacks would decrease from 7.6 to 5.8, 7.9 to 5.9, and 11.3 to 5.3 and among Hispanics from 2.8 to 1.8, 3.1 to 1.9, and 2.3 to 1.0, respectively. In scenario no. 2, the PR, IRR, and MRR among blacks would decrease from 7.6 to 5.1, 7.9 to 2.5, and 11.3 to 4.7 and among Hispanics from 2.8 to 1.6, 3.1 to 0.8, and 2.3 to 0.9, respectively.

CONCLUSIONS:

Much of the persistent racial disparities in HIV infection in the USA, as measured by PR, IRR, and MRR, can be explained by higher HIV prevalence among blacks and Hispanics. The public health community should continue its efforts to reduce racial disparities, but also need to set realistic goals and measure progress with sensitive indicators.

Purchase full article at:   http://goo.gl/RO0369

By:  Xia Q1, Braunstein SL2, Wiewel EW2, Hadler JL3, Torian LV2.

• 1HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, 42-09 28th St, Queens, NY, 11101, USA. qxia@health.nyc.gov.
• 2HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, 42-09 28th St, Queens, NY, 11101, USA.
• 3Yale University School of Public Health, New Haven, CT, USA. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Identity, Physical Space & Stigma among African American Men Living with HIV in Chicago & Seattle

African American men have the highest rates of HIV in the USA, and research has shown that stigma, mistrust of health care, and other psychosocial factors interfere with optimal engagement in care with this population. 

In order to further understand reducing stigma and other psychosocial issues among African American men, we conducted qualitative interviews and focus groups with African American men in two metropolitan areas in the USA: Chicago and Seattle. We examined transcripts for relationships across variables of stigma, anonymity, self-identity, and space within the context of HIV. 

Our analysis pointed to similarities between experiences of stigma across the two cities and illustrated the relationships between space, isolation, and preferred anonymity related to living with HIV. The men in our study often preferred that their HIV-linked identities remain invisible and anonymous, associated with perceived and created isolation from physical community spaces. This article suggests that our health care and housing institutions may influence preferences for anonymity. 

We make recommendations in key areas to create safer spaces for African American men living with HIV and reduce feelings of stigma and isolation.

Purchase full article at:   http://goo.gl/wlYXTd

By:  Singleton JL1,2, Raunig M3, Brunsteter H3, Desmond M3, Rao D4.

• 1Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA.
• 2School of Urban Public Health, Hunter College, City University of New York (CUNY), New York, NY, USA.
• 3Department of Global Health, University of Washington, Box 359931, 325 9th Ave, Seattle, WA, 98104, USA.
• 4Department of Global Health, University of Washington, Box 359931, 325 9th Ave, Seattle, WA, 98104, USA. deeparao@uw.edu. 
• J Racial Ethn Health Disparities. 2015 Dec;2(4):548-55. doi: 10.1007/s40615-015-0103-1. Epub 2015 Apr 1.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Color It Real: A Program to Increase Condom Use and Reduce Substance Abuse and Perceived Stress

Few interventions have targeted perceived stress as a co-occurring construct central to substance use and subsequent HIV/AIDS risk reduction among African American urban young adults. 

The Color It Real Program was a seven session, weekly administered age-specific and culturally-tailored intervention designed to provide substance abuse and HIV education and reduce perceived stress among African Americans ages 18 to 24 in Atlanta, GA. Effectiveness was assessed through a quasi-experimental study design that consisted of intervention (n = 122) and comparison (n = 70) groups completing a pre- and post-intervention survey. 

A series of Analysis of Variance (ANOVA) tests were used to assess pre- to post-intervention changes between study groups. For intervention participants, perceived stress levels were significantly reduced by the end of the intervention (t(70) = 2.38, p = 0.020), condom use at last sexual encounter significantly increased (F = 4.43, p = 0.0360), intervention participants were significantly less likely to drink five or more alcoholic drinks in one sitting (F = 5.10, p = 0.0245), and to use clean needles when injecting the drug (F = 36.99, p = 0.0001). 

This study is among the first of its kind to incorporate stress management as an integral approach to HIV/SA prevention. The program has implications for the design of other community-based, holistic approaches to addressing substance use and risky behaviors for young adults.

Below:  Perceived Stress Scale Composite Score for Intervention and Comparison Group

Purchase full article at: 

By:  Tiffany Zellner,1,* Jennie Trotter,2 Shelia Lenoir,2 Kelvin Walston,2 L’dia Men-Na’a,2 Tabia Henry-Akintobi,1 and Assia Miller3

¹Department of Community Health and Preventive Medicine, Morehouse School of Medicine Prevention Research Center, 720 Westview Drive SW, Atlanta, GA 30310, USA; Email: ude.msm@ibotnikat

²Wholistic Stress Control Institute, Incorporated, 2545 Benjamin E Mays Drive, Atlanta, GA 30311, USA; Email: moc.1citsilohw@tj (J.T.); Email:moc.1citsilohw@lks (S.L.); Email: moc.liamtoh@notslawnivlek (K.W.); Email: moc.loa@aannemaidl (L.M.-N.)

³McKing Consulting Corporation, 2900 Chamblee Tucker Road, Building 10, Suite 100, Atlanta, GA 30341, USA; Email: ude.msm@rellima

^*Correspondence: Email: ude.msm@renllezt; Tel.: +1-404-756-8833; Fax: +1-404-752-1707

Int J Environ Res Public Health. 2016 Jan; 13(1): 51. Published online 2015 Dec 22. doi:  10.3390/ijerph13010051

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Comprehensive Assessment of Health Needs of Young Minority Males Attending a Family Planning Clinic

The objective of this study was to assess the overall health, including sexual and reproductive health (SRH) knowledge and needs, sexual behaviors, and testicular health practices among young minority males. 

Anonymous questionnaires were administered to 18- to 25-year-old males receiving services at health clinics in a large southwestern U.S. city. The survey was completed by 258 males with a mean age of 20.8 years. Most young males (67.1%) identified as African American, and 32.9% as Hispanic. 

Results suggest study participants lack SRH knowledge related to pregnancy and condom effectiveness, and engage in risky sexual behavior including not using birth control at their last sexual encounter. 

Although 21.6% of participants had a sexually transmitted infection (STI) in the past year, approximately 80% perceived their STI/HIV risk as very low or low. Respondents had low engagement and lack of knowledge of testicular health practices. The majority of respondents (71.1%) reported having been in a physical fight one or more times and 18.1% reported being victims of intimate partner violence. 

These data support a need for comprehensive health services for minority young males.

Purchase full article at:   http://goo.gl/UKHrSF

By:  Pastuszak AW1, Wenker EP2, Smith PB2, Abacan A2, Lamb DJ2, Lipshultz LI2, Buzi R2.

• 1Baylor College of Medicine, Houston, TX, USA pastusza@bcm.edu.
• 2Baylor College of Medicine, Houston, TX, USA. 
• Am J Mens Health. 2016 Feb 4. pii: 1557988316629627.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health