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.

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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.

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Experiences of Anti-Homosexual Attitudes and Young Black Men Who Have Sex with Men in the South

PURPOSE:

In 2012, Jackson, Mississippi, had the third highest incidence rate of human immunodeficiency virus (HIV) among young Black men who have sex with men (MSM). The goal of this qualitative study (the initial phase of an HIV prevention clinical trial) was to explore how cultural norms regarding anti-homosexual attitudes interfere with the safe sex practices and relationship norms of young Black MSM in Mississippi.

METHODS:

Nine focus groups (N = 54) were conducted with young Black MSM aged 18-29. Participants were recruited through medical providers at local sexually transmitted infection clinics and through community organizers at local LGBT outreach programs. The data were analyzed through the use of grounded theory, multiple coders for consistency and intercoder reliability, and a qualitative data analysis software.

RESULTS:

Three major themes were identified during the analysis: (1) resiliency and condom use, (2) inconsistent condom use among closeted young Black MSM, and (3) intimate partner violence (IPV) among closeted young Black MSM. Black MSM in Mississippi continue to be highly stigmatized within their social networks (i.e., families, sexual partners, and community).

CONCLUSIONS:

The findings suggest that cultural and community norms regarding anti-homosexual attitudes may be a barrier to the practices of safe sex and a contributing factor to IPV among young Black MSM. There is a need for tailored interventions that address these cultural norms and establish social and community support for young Black MSM in Mississippi.

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By:  Geter A1, Ricks JM2, McGladrey M1, Crosby RA1, Mena LA3, Ottmar JM1.

• 1 Department of Health Behavior, University of Kentucky, Lexington, Kentucky.
• 2 Department of Behavioral Sciences and Health Education, Emory University, Atlanta, Georgia .
• 3 Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, Mississippi.
• LGBT Health. 2016 Feb 17.  

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US States with the Highest Rates of Gun Ownership

Via:  https://atlas.qz.com/charts/NJt0vesF

HIV-Related Stigma among Healthcare Providers in the Deep South

Stigma towards people living with HIV (PLWH) in healthcare settings is a barrier to optimal treatment. However, our understanding of attitudes towards PLWH from healthcare providers' perspective in the United States is limited and out-of-date. 

We assessed HIV-related stigma among healthcare staff in Alabama and Mississippi, using online questionnaires. Participants included 651 health workers (60 % White race; 83 % female). 

Multivariate regression suggests that several factors independently predict stigmatizing attitudes: Protestant compared to other religions, White race compared to other races, type of clinic (HIV/STI clinic), availability of post-exposure prophylaxis (yes: β = -0.107, p ≤ 0.05), and perceptions of policy enforcement (policies not enforced: β = 0.058, p = p ≤ 0.05). 

These findings may assist providers wishing to improve the quality care for PLWH. Enforcement of policies prohibiting discrimination may be a useful strategy for reducing HIV-related stigma among healthcare workers.

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By:   Stringer KL1, Turan B2, McCormick L3, Durojaiye M3, Nyblade L4, Kempf MC5,6, Lichtenstein B7, Turan JM3.

• 1Department of Sociology, College of Arts and Sciences, University of Alabama at Birmingham, HHB 460, 1720 2nd Ave South, Birmingham, AL, 35294-1152, USA. kristi.stringer.uab@gmail.com.
• 2Department of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, USA.
• 3Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
• 4RTI, International, Washington, DC, USA.
• 5Department of Family, Community and Health Systems, School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.
• 6Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
• 7Department of Criminal Justice, College of Arts and Sciences, University of Alabama, Tuscaloosa, AL, USA. 

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It Is Complicated: Sexual Partner Characteristic Profiles & Sexually Transmitted Infection Rates within a Predominantly African American Population in Mississippi

Mississippi has among the highest prevalence of sexually transmitted infections (STIs) in the United States. Understanding sexual networks can provide insight into risk factors for transmission and guide prevention interventions.

Participants included 1437 primarily African American (95%) adults presenting for care at an STI clinic in Jackson, Mississippi. Latent class analysis identified underlying population subgroups with unique patterns of response on a comprehensive set of 14 sexual partner variables, such as living with or having a child with a partner, partner dependence and trust, 1-time sexual encounters, multiple main partners, substance use, sexual concurrency, and incarceration. Classes were compared on participant age, sex, sexual orientation, public assistance, lifetime partners, relationship status, and self-reported past-year STI.

Three classes emerged. Class 1 (n = 746) participants were less dependent on partners and less likely to live with or have a child with a partner. Class 2 participants (n = 427) endorsed multiple STI risk factors, including partner incarceration, 6 or more lifetime partners, sexual concurrency, 1-time sexual encounters, and substance use at last sex. Class 3 participants (n = 226) were more likely to be in dependent, committed relationships with children. Class 2 had a higher proportion of self-report past-year STIs (36.7%) compared with classes 1 (26.6%) and 3 (26.1%).

Certain partner factors such as incarceration, substance use, and concurrency may contribute to increased STI risk. Partner factors may be useful proxies for STI risks and could be useful questions to include in screening questionnaires in clinical settings.

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By: Alexander J1, Rose J, Dierker L, Chan PA, MacCarthy S, Simmons D, Mena L, Nunn A.

• 1From the *Department of Psychology, Wesleyan University, Middletown, CT; †Division of Infectious Diseases, Alpert Medical School, Brown University, Providence, RI; ‡Program on Global Health and Human Rights, Institute for Global Health, University of Southern California, Los Angeles, CA; §Jackson State University, Jackson, MS; and ¶Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, MS.  

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