Pub Date : 2023-06-01DOI: 10.1521/aeap.2023.35.3.201
Taylor Robbins, Leigh E Szucs, Lindsay Trujillo, Emily Young
In the U.S., HIV transmission rates have increased among male-male sexual contacts. Sex education reduces HIV-related risks; yet impacts for adolescent sexual minority males (ASMM) are less known. Data from a sample (n = 556) of ASMM (aged 13-18) in three U.S cities were used to examined associations between HIV education in school and sexual behaviors. Outcomes of interest included: sexually transmitted infection (STI), multiple sex partners, and condomless anal intercourse (CAI) with a male (all past 12 months). Adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) were calculated. Of 556 ASMM, 84% reported received HIV education. Among sexually active ASMM (n = 440) who received HIV education, fewer reported an STI (10% vs. 21%, aPR: 0.45, CI [0.26, 0.76]) and CAI (48% vs. 64%, aPR: 0.71, CI [0.58, 0.87]) than ASMM who did not receive HIV education. Protective effects of school HIV education on sexual behaviors are promising and suggest prevention education is vital to reducing HIV- and STI-related risks among ASMM.
在美国,男性-男性性接触中的 HIV 传播率有所上升。性教育可降低与 HIV 相关的风险;然而,性教育对青少年性少数群体男性(ASMM)的影响却鲜为人知。我们利用美国三个城市的性少数群体男性(13-18 岁)样本(n = 556)的数据,研究了学校中的 HIV 教育与性行为之间的关联。研究结果包括:性传播感染 (STI)、多个性伴侣和与男性无套肛交 (CAI)(均在过去 12 个月内)。计算了调整后的流行率 (aPR) 和 95% 的置信区间 (CI)。在 556 名 ASMM 中,84% 的人表示接受过 HIV 教育。在接受过 HIV 教育的性行为活跃的 ASMM(n = 440)中,报告性传播感染(10% 对 21%,aPR:0.45,CI [0.26,0.76])和 CAI(48% 对 64%,aPR:0.71,CI [0.58,0.87])的人数少于未接受过 HIV 教育的 ASMM。学校艾滋病教育对性行为的保护作用很有希望,这表明预防教育对降低艾滋病和性传播感染相关风险在 ASMM 中至关重要。
{"title":"AIDS or HIV Education and Sexual Behaviors Among Adolescent Sexual Minority Males: National HIV Behavioral Surveillance, 3 U.S. Cities, 2015.","authors":"Taylor Robbins, Leigh E Szucs, Lindsay Trujillo, Emily Young","doi":"10.1521/aeap.2023.35.3.201","DOIUrl":"10.1521/aeap.2023.35.3.201","url":null,"abstract":"<p><p>In the U.S., HIV transmission rates have increased among male-male sexual contacts. Sex education reduces HIV-related risks; yet impacts for adolescent sexual minority males (ASMM) are less known. Data from a sample (<i>n</i> = 556) of ASMM (aged 13-18) in three U.S cities were used to examined associations between HIV education in school and sexual behaviors. Outcomes of interest included: sexually transmitted infection (STI), multiple sex partners, and condomless anal intercourse (CAI) with a male (all past 12 months). Adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) were calculated. Of 556 ASMM, 84% reported received HIV education. Among sexually active ASMM (<i>n</i> = 440) who received HIV education, fewer reported an STI (10% vs. 21%, aPR: 0.45, CI [0.26, 0.76]) and CAI (48% vs. 64%, aPR: 0.71, CI [0.58, 0.87]) than ASMM who did not receive HIV education. Protective effects of school HIV education on sexual behaviors are promising and suggest prevention education is vital to reducing HIV- and STI-related risks among ASMM.</p>","PeriodicalId":47801,"journal":{"name":"Aids Education and Prevention","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9804442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1521/aeap.2023.35.3.225
Hong-Ha M Truong, Mary A Guzé, Kevin Kadede, Sayo Amboka, Beatrice Otieno, Hanningtone Odhiambo, Damaris Odeny, Marion Hewa, Maurice Opiyo, Fidel Opondo, Robin Fatch, David Ogolla, Lara E Miller, Dena Bushman, Colette Auerswald, Elizabeth A Bukusi, Craig R Cohen
Adolescents comprise approximately 15% of new HIV infections in Kenya. Impoverished living conditions in informal settlements place residents at high risk for HIV infection. We assessed factors associated with HIV infection among adolescents residing in urban informal settlements in Kisumu. We recruited 3,061 adolescent boys and girls aged 15-19. HIV prevalence was 2.5% overall, all newly identified cases were among girls and infection was positively associated with not completing a secondary education (p < .001). Girls who had ever been pregnant (p < .001) or out-of-school without completing a secondary education (p < .001) were more likely to be HIV-positive. Our findings of higher HIV prevalence among adolescent girls who had been pregnant or did not complete secondary school highlight the need to facilitate access to HIV testing, HIV pre-exposure prophylaxis, and sexual and reproductive health services as components of a comprehensive prevention strategy to decrease HIV infections in this priority population.
{"title":"HIV Infection Among Adolescents Residing in Urban Informal Settlements of Kenya.","authors":"Hong-Ha M Truong, Mary A Guzé, Kevin Kadede, Sayo Amboka, Beatrice Otieno, Hanningtone Odhiambo, Damaris Odeny, Marion Hewa, Maurice Opiyo, Fidel Opondo, Robin Fatch, David Ogolla, Lara E Miller, Dena Bushman, Colette Auerswald, Elizabeth A Bukusi, Craig R Cohen","doi":"10.1521/aeap.2023.35.3.225","DOIUrl":"10.1521/aeap.2023.35.3.225","url":null,"abstract":"<p><p>Adolescents comprise approximately 15% of new HIV infections in Kenya. Impoverished living conditions in informal settlements place residents at high risk for HIV infection. We assessed factors associated with HIV infection among adolescents residing in urban informal settlements in Kisumu. We recruited 3,061 adolescent boys and girls aged 15-19. HIV prevalence was 2.5% overall, all newly identified cases were among girls and infection was positively associated with not completing a secondary education (<i>p</i> < .001). Girls who had ever been pregnant (<i>p</i> < .001) or out-of-school without completing a secondary education (<i>p</i> < .001) were more likely to be HIV-positive. Our findings of higher HIV prevalence among adolescent girls who had been pregnant or did not complete secondary school highlight the need to facilitate access to HIV testing, HIV pre-exposure prophylaxis, and sexual and reproductive health services as components of a comprehensive prevention strategy to decrease HIV infections in this priority population.</p>","PeriodicalId":47801,"journal":{"name":"Aids Education and Prevention","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10624479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10181025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1521/aeap.2023.35.3.235
Moira C McNulty, Jared Kerman, Samantha A Devlin, Maria Pyra, Laura Rusie, Kate Curoe, Liz Thompson, Joseph A Mason, Eleanor E Friedman, A Ziggy Uvin, C Hendricks Brown, John Schneider, Rupa Patel
Monitoring pre-exposure prophylaxis (PrEP) metrics can guide service delivery yet does not occur routinely. We developed a survey to understand current practices for monitoring PrEP at PrEP-providing organizations in Illinois and Missouri. The survey was distributed from September through November 2020; 26 organizations participated. Most respondents indicated ongoing efforts to screen for PrEP eligibility (66.7%), link to care (87.5%), and retain clients in care (70.8%); 70.8% reported collecting data on PrEP initiation, 41.7% on retention in care, and 37.5% on missed visits. Barriers to monitoring PrEP metrics included lack of IT support (69.6%), manual processes (69.6%), and lack of staff resources (65.2%). Most respondents offered clients support for PrEP retention and adherence and wanted to expand interventions for PrEP persistence, yet fewer monitored corresponding metrics. To enhance PrEP implementation, organizations should improve monitoring and evaluation of PrEP metrics along the entire continuum and respond with appropriate services to support clients.
{"title":"PrEP Persistence Support and Monitoring in Areas of High HIV Burden in the Midwestern United States.","authors":"Moira C McNulty, Jared Kerman, Samantha A Devlin, Maria Pyra, Laura Rusie, Kate Curoe, Liz Thompson, Joseph A Mason, Eleanor E Friedman, A Ziggy Uvin, C Hendricks Brown, John Schneider, Rupa Patel","doi":"10.1521/aeap.2023.35.3.235","DOIUrl":"10.1521/aeap.2023.35.3.235","url":null,"abstract":"<p><p>Monitoring pre-exposure prophylaxis (PrEP) metrics can guide service delivery yet does not occur routinely. We developed a survey to understand current practices for monitoring PrEP at PrEP-providing organizations in Illinois and Missouri. The survey was distributed from September through November 2020; 26 organizations participated. Most respondents indicated ongoing efforts to screen for PrEP eligibility (66.7%), link to care (87.5%), and retain clients in care (70.8%); 70.8% reported collecting data on PrEP initiation, 41.7% on retention in care, and 37.5% on missed visits. Barriers to monitoring PrEP metrics included lack of IT support (69.6%), manual processes (69.6%), and lack of staff resources (65.2%). Most respondents offered clients support for PrEP retention and adherence and wanted to expand interventions for PrEP persistence, yet fewer monitored corresponding metrics. To enhance PrEP implementation, organizations should improve monitoring and evaluation of PrEP metrics along the entire continuum and respond with appropriate services to support clients.</p>","PeriodicalId":47801,"journal":{"name":"Aids Education and Prevention","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10328557/pdf/nihms-1911435.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10181021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1521/aeap.2023.35.2.101
Nicholas F Nogueira, Ana S Salazar, Lucila Hernandez, Jessica Orr, Paola Beato, Maria L Alcaide, Nilda Peragallo Montano, Rosina Cianelli, Natalia Villegas, Deborah L Jones, Victoria Orrego Dunleavy
This study addresses rural Guatemala's poor maternal health and HIV status by culturally adapting an evidence-based HIV intervention, SEPA (Self-Care, Education, Prevention, Self-Care), to extend the capacity of comadronas (Mayan birth attendants) as HIV prevention providers. This mixed-method study examined the acceptability, suitability, and feasibility of SEPA presented to traditional elder and a younger cohort of comadronas over three sessions. Outcome variables were reported as mean scores. Open-ended qualitative responses were categorized under central themes. Session 1, 2, and 3 acceptability (4.6/5, 4.6/5, 4.8/5), suitability (4.7/5, 4.6/5, 4.9/5), and feasibility (4.4/5, 4.7/5, 4.8/5) remained high across sessions. While comadronas reported that information was difficult, they reported high levels of understanding and comfort with SEPA content and they also found it to be culturally appropriate, increasing their confidence to discuss HIV with their community. The broader utilization of comadronas could create a pathway to enhance reproductive health among indigenous women.
{"title":"Acceptability, Suitability, and Feasibility of an Evidence-Based Intervention to Reduce HIV Risk Behaviors: Engaging Comadronas in HIV Prevention in Rural Guatemala.","authors":"Nicholas F Nogueira, Ana S Salazar, Lucila Hernandez, Jessica Orr, Paola Beato, Maria L Alcaide, Nilda Peragallo Montano, Rosina Cianelli, Natalia Villegas, Deborah L Jones, Victoria Orrego Dunleavy","doi":"10.1521/aeap.2023.35.2.101","DOIUrl":"https://doi.org/10.1521/aeap.2023.35.2.101","url":null,"abstract":"<p><p>This study addresses rural Guatemala's poor maternal health and HIV status by culturally adapting an evidence-based HIV intervention, SEPA (Self-Care, Education, Prevention, Self-Care), to extend the capacity of comadronas (Mayan birth attendants) as HIV prevention providers. This mixed-method study examined the acceptability, suitability, and feasibility of SEPA presented to traditional elder and a younger cohort of comadronas over three sessions. Outcome variables were reported as mean scores. Open-ended qualitative responses were categorized under central themes. Session 1, 2, and 3 acceptability (4.6/5, 4.6/5, 4.8/5), suitability (4.7/5, 4.6/5, 4.9/5), and feasibility (4.4/5, 4.7/5, 4.8/5) remained high across sessions. While comadronas reported that information was difficult, they reported high levels of understanding and comfort with SEPA content and they also found it to be culturally appropriate, increasing their confidence to discuss HIV with their community. The broader utilization of comadronas could create a pathway to enhance reproductive health among indigenous women.</p>","PeriodicalId":47801,"journal":{"name":"Aids Education and Prevention","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9898446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1521/aeap.2023.35.2.126
Sage J Kim, Anna Ahn, Elise Hu, Caryn E Peterson
While sources of stigma associated with HIV, incarceration, and aging have been explored separately, the concurrent effects of these multiple sources have been understudied. We conducted in-depth interviews with 48 older adults over 50 years of age with HIV infection who were returning from correctional settings concerning their experiences of stigma. Participants described HIV-related stigma substantially more often than incarceration-related stigma and a greater number of stigma experiences as time passed from release. Anticipated stigma experiences were frequently associated with HIV. Enacted stigma was often related to incarceration. Internalized stigma was associated with both HIV and incarceration. However, participants often described aging as a positive experience of gaining wisdom and control over their life. The findings indicated that multiple sources of stigma affect different dimensions of stigma. Postrelease interventions may benefit from addressing increasing experiences of stigma in the rapidly growing population of older adults living with HIV with a history of incarceration.
{"title":"Qualitative Analysis of Multiple Sources and Dimensions of Stigma Among Older Adults Living With HIV Infection Released From Corrections.","authors":"Sage J Kim, Anna Ahn, Elise Hu, Caryn E Peterson","doi":"10.1521/aeap.2023.35.2.126","DOIUrl":"https://doi.org/10.1521/aeap.2023.35.2.126","url":null,"abstract":"<p><p>While sources of stigma associated with HIV, incarceration, and aging have been explored separately, the concurrent effects of these multiple sources have been understudied. We conducted in-depth interviews with 48 older adults over 50 years of age with HIV infection who were returning from correctional settings concerning their experiences of stigma. Participants described HIV-related stigma substantially more often than incarceration-related stigma and a greater number of stigma experiences as time passed from release. Anticipated stigma experiences were frequently associated with HIV. Enacted stigma was often related to incarceration. Internalized stigma was associated with both HIV and incarceration. However, participants often described aging as a positive experience of gaining wisdom and control over their life. The findings indicated that multiple sources of stigma affect different dimensions of stigma. Postrelease interventions may benefit from addressing increasing experiences of stigma in the rapidly growing population of older adults living with HIV with a history of incarceration.</p>","PeriodicalId":47801,"journal":{"name":"Aids Education and Prevention","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9898447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1521/aeap.2023.35.2.114
Natalie M Brousseau, Redd Driver, Kay Simon, Ryan J Watson, Valerie A Earnshaw, Cristian J Chandler, Seth Kalichman, Lisa A Eaton
Despite documented efficacy in reducing HIV transmission, pre-exposure prophylaxis (PrEP) uptake among Black sexual minority men (BSMM) is limited. One understudied factor which may impede PrEP uptake is PrEP-related interactive toxicity beliefs (i.e., believing it is hazardous to use alcohol/drugs while taking PrEP). Data from N = 169 HIV negative BSMM over 4 months showed high rates of agreement with at least one alcohol (78%) or drug (84%) interactive toxicity belief. Univariate analyses showed increased alcohol or drug interactive toxicity beliefs predicted lower PrEP uptake. Multivariable regression suggested those with PrEP-related alcohol or drug interactive toxicity beliefs were more likely to report high PrEP stigma, more negative PrEP beliefs (e.g., concern that taking PrEP disrupts life), and were more likely to use alcohol/drugs (respectively) prior to/during sex. Findings warrant intervention work targeting interactive toxicity beliefs with tailored messaging to mitigate PrEP stigma and correct concerns around substance use and PrEP.
{"title":"PrEP-Related Interactive Toxicity Beliefs: Associations With Stigma, Substance Use, and PrEP Uptake.","authors":"Natalie M Brousseau, Redd Driver, Kay Simon, Ryan J Watson, Valerie A Earnshaw, Cristian J Chandler, Seth Kalichman, Lisa A Eaton","doi":"10.1521/aeap.2023.35.2.114","DOIUrl":"https://doi.org/10.1521/aeap.2023.35.2.114","url":null,"abstract":"<p><p>Despite documented efficacy in reducing HIV transmission, pre-exposure prophylaxis (PrEP) uptake among Black sexual minority men (BSMM) is limited. One understudied factor which may impede PrEP uptake is PrEP-related interactive toxicity beliefs (i.e., believing it is hazardous to use alcohol/drugs while taking PrEP). Data from <i>N</i> = 169 HIV negative BSMM over 4 months showed high rates of agreement with at least one alcohol (78%) or drug (84%) interactive toxicity belief. Univariate analyses showed increased alcohol or drug interactive toxicity beliefs predicted lower PrEP uptake. Multivariable regression suggested those with PrEP-related alcohol or drug interactive toxicity beliefs were more likely to report high PrEP stigma, more negative PrEP beliefs (e.g., concern that taking PrEP disrupts life), and were more likely to use alcohol/drugs (respectively) prior to/during sex. Findings warrant intervention work targeting interactive toxicity beliefs with tailored messaging to mitigate PrEP stigma and correct concerns around substance use and PrEP.</p>","PeriodicalId":47801,"journal":{"name":"Aids Education and Prevention","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9898450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1521/aeap.2023.35.2.141
Brian Perry, Nneka Molokwu, Kawango Agot, Duncan Ochieng Ngoje, Robert Strack, Amy Corneli
Young women in sub-Saharan Africa continue to be disproportionately at risk for HIV. Oral pre-exposure prophylaxis (PrEP) can reduce women's HIV risk when taken daily throughout their "seasons of risk". We used photovoice to describe community views on factors influencing interruptions in PrEP use among young cisgender women in Siaya County, Kenya. Through group discussions, young women taking PrEP and their social network members (female peers, male peers/partners, family, and community members) shared photographs and identified broad social-ecological causes of PrEP interruptions, including: (1) widespread misinformation about PrEP, (2) social pressures from religious communities, (3) health care staff recommendations to interrupt PrEP use, (4) partner rejection of PrEP, (5) changes in women's risk awareness, and (6) a personal desire to occasionally pause daily use. Collectively, participants identified strategies to address these challenges. These findings can inform future programs targeting the broader social-ecological influences on young women's persistent use of PrEP.
{"title":"Multilevel Factors Influencing Interruptions in PrEP Use Among Young Women in Siaya County, Kenya.","authors":"Brian Perry, Nneka Molokwu, Kawango Agot, Duncan Ochieng Ngoje, Robert Strack, Amy Corneli","doi":"10.1521/aeap.2023.35.2.141","DOIUrl":"https://doi.org/10.1521/aeap.2023.35.2.141","url":null,"abstract":"<p><p>Young women in sub-Saharan Africa continue to be disproportionately at risk for HIV. Oral pre-exposure prophylaxis (PrEP) can reduce women's HIV risk when taken daily throughout their \"seasons of risk\". We used photovoice to describe community views on factors influencing interruptions in PrEP use among young cisgender women in Siaya County, Kenya. Through group discussions, young women taking PrEP and their social network members (female peers, male peers/partners, family, and community members) shared photographs and identified broad social-ecological causes of PrEP interruptions, including: (1) widespread misinformation about PrEP, (2) social pressures from religious communities, (3) health care staff recommendations to interrupt PrEP use, (4) partner rejection of PrEP, (5) changes in women's risk awareness, and (6) a personal desire to occasionally pause daily use. Collectively, participants identified strategies to address these challenges. These findings can inform future programs targeting the broader social-ecological influences on young women's persistent use of PrEP.</p>","PeriodicalId":47801,"journal":{"name":"Aids Education and Prevention","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10461291/pdf/nihms-1923215.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10454027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1521/aeap.2023.35.2.158
Yvonne L van der Kooij, Chantal den Daas, Arjan E R Bos, Roy A Willems, Sarah E Stutterheim
Internalized HIV stigma is prevalent and research on internalized HIV stigma has increased during the past 10 years. The aim of this systematic review was to synthesize research on internalized HIV stigma and relationships with various health-related variables in order to better inform the development of interventions aimed at reducing internalized HIV stigma. We reviewed 176 studies with a quantitative design reporting correlates that were peer-reviewed, published in English before January 2021, drawn from PubMed, PSYCHINFO, Web of Science, EBSCO, and Scopus. Synthesis showed consistent associations between internalized stigma and negative psychological (e.g., depression, anxiety), social (e.g., lack of social support, discrimination, nondisclosure, and intersecting stigmas), and health (e.g., substance use, treatment nonadherence, negative clinical HIV outcomes) variables. We argue for a more socioecological approach to internalized stigma, with greater attention for intersectional stigmas, and more longitudinal research, if we are to effectively develop interventions that reduce internalized stigma.
在过去的10年里,HIV内在化的耻辱感普遍存在,对HIV内在化耻辱感的研究也有所增加。本系统综述的目的是综合研究内化的艾滋病毒耻辱及其与各种健康相关变量的关系,以便更好地为旨在减少内化艾滋病毒耻辱的干预措施的发展提供信息。我们回顾了176项经过同行评议的定量设计报告相关性的研究,这些研究在2021年1月之前以英文发表,来自PubMed、PSYCHINFO、Web of Science、EBSCO和Scopus。综合研究显示,内化的耻辱感与负面心理(如抑郁、焦虑)、社会(如缺乏社会支持、歧视、隐瞒和交叉耻辱感)和健康(如药物使用、治疗不依从性、HIV临床阴性结果)变量之间存在一致的关联。如果我们要有效地开发减少内化耻辱的干预措施,我们主张采用更社会生态学的方法来内化耻辱,更多地关注交叉耻辱,并进行更多的纵向研究。
{"title":"Correlates of Internalized HIV Stigma: A Comprehensive Systematic Review.","authors":"Yvonne L van der Kooij, Chantal den Daas, Arjan E R Bos, Roy A Willems, Sarah E Stutterheim","doi":"10.1521/aeap.2023.35.2.158","DOIUrl":"https://doi.org/10.1521/aeap.2023.35.2.158","url":null,"abstract":"<p><p>Internalized HIV stigma is prevalent and research on internalized HIV stigma has increased during the past 10 years. The aim of this systematic review was to synthesize research on internalized HIV stigma and relationships with various health-related variables in order to better inform the development of interventions aimed at reducing internalized HIV stigma. We reviewed 176 studies with a quantitative design reporting correlates that were peer-reviewed, published in English before January 2021, drawn from PubMed, PSYCHINFO, Web of Science, EBSCO, and Scopus. Synthesis showed consistent associations between internalized stigma and negative psychological (e.g., depression, anxiety), social (e.g., lack of social support, discrimination, nondisclosure, and intersecting stigmas), and health (e.g., substance use, treatment nonadherence, negative clinical HIV outcomes) variables. We argue for a more socioecological approach to internalized stigma, with greater attention for intersectional stigmas, and more longitudinal research, if we are to effectively develop interventions that reduce internalized stigma.</p>","PeriodicalId":47801,"journal":{"name":"Aids Education and Prevention","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9596940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1521/aeap.2023.35.2.173
Orrin D Ware, Ankur Srivastava, Rainier Masa, Stefani N Baca-Atlas, Gina Chowa
Residential substance use disorder treatment is designed to treat more severe substance use disorders. Considering the strong association between substance use and HIV, providing HIV prevention services during residential substance use disorder treatment is imperative. However, not all treatment facilities offer the same services, and differences in residential substance use disorder treatment facilities providing HIV prevention services might stem from facility-level characteristics. Using 3 years (2018-2020) of cross-sectional data from the National Survey of Substance Abuse Treatment Services, we examined which treatment facility characteristics were associated with having HIV prevention services. Using a logistic regression model with HIV prevention services as the outcome, we found that facilities that were accredited, engaged in community outreach, and offered assistance with housing and transportation were more likely to provide HIV prevention services. Furthermore, facilities in the Midwest and West were less likely to provide HIV prevention services than those in the South.
{"title":"HIV Prevention Services in Residential Substance Use Disorder Treatment Facilities in the United States.","authors":"Orrin D Ware, Ankur Srivastava, Rainier Masa, Stefani N Baca-Atlas, Gina Chowa","doi":"10.1521/aeap.2023.35.2.173","DOIUrl":"https://doi.org/10.1521/aeap.2023.35.2.173","url":null,"abstract":"<p><p>Residential substance use disorder treatment is designed to treat more severe substance use disorders. Considering the strong association between substance use and HIV, providing HIV prevention services during residential substance use disorder treatment is imperative. However, not all treatment facilities offer the same services, and differences in residential substance use disorder treatment facilities providing HIV prevention services might stem from facility-level characteristics. Using 3 years (2018-2020) of cross-sectional data from the National Survey of Substance Abuse Treatment Services, we examined which treatment facility characteristics were associated with having HIV prevention services. Using a logistic regression model with HIV prevention services as the outcome, we found that facilities that were accredited, engaged in community outreach, and offered assistance with housing and transportation were more likely to provide HIV prevention services. Furthermore, facilities in the Midwest and West were less likely to provide HIV prevention services than those in the South.</p>","PeriodicalId":47801,"journal":{"name":"Aids Education and Prevention","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9898445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-01DOI: 10.1521/aeap.2023.35.1.36
Nicole Crepaz, Yamir Salabarría-Peña, Mary M Mullins, Jayleen K L Gunn, Darrel H Higa
This systematic review synthesized published literature (January 2008-October 2021) about the association between social determinants of health (SDOH) and HIV testing among Hispanic/Latino gay, bisexual, and other men who have sex with men (HLMSM), a group disproportionally affected by HIV. Having higher education than a high school diploma, health insurance and access to health care services, and visiting a health care provider in the past 12 months were some of the determinants associated with HIV testing, while limited English proficiency was associated with reduced odds of HIV-testing among HLMSM. More research is needed to understand the relationship of SDOH (especially neighborhood) and HIV testing, how SDOH may affect HIV testing among different HLMSM groups, and how to increase self-testing and use of e-health in this priority population. Additionally, culturally and linguistically appropriate multilevel interventions and health services for HLMSM are urgently needed to diagnose HIV as early as possible after infection.
本系统性综述综合了已发表的文献(2008 年 1 月至 2021 年 10 月),内容涉及健康的社会决定因素(SDOH)与西班牙裔/拉丁裔男同性恋、双性恋及其他男男性行为者(HLMSM)中的 HIV 检测之间的关系,该群体受 HIV 的影响尤为严重。拥有高于高中文凭的教育程度、医疗保险和获得医疗保健服务的机会以及在过去 12 个月中看望过医疗保健提供者是与 HIV 检测相关的一些决定因素,而英语水平有限与 HLMSM 接受 HIV 检测的几率降低有关。需要进行更多的研究,以了解 SDOH(尤其是邻里关系)与 HIV 检测的关系、SDOH 如何影响不同 HLMSM 群体的 HIV 检测,以及如何在这一重点人群中增加自我检测和电子健康的使用。此外,迫切需要针对 HLMSM 的文化和语言适当的多层次干预措施和医疗服务,以便在感染后尽早诊断出艾滋病毒。
{"title":"Systematic Review of Social Determinants of Health Associated With HIV Testing Among Hispanic/Latino Gay, Bisexual, and Other Men Who Have Sex With Men in the United States.","authors":"Nicole Crepaz, Yamir Salabarría-Peña, Mary M Mullins, Jayleen K L Gunn, Darrel H Higa","doi":"10.1521/aeap.2023.35.1.36","DOIUrl":"10.1521/aeap.2023.35.1.36","url":null,"abstract":"<p><p>This systematic review synthesized published literature (January 2008-October 2021) about the association between social determinants of health (SDOH) and HIV testing among Hispanic/Latino gay, bisexual, and other men who have sex with men (HLMSM), a group disproportionally affected by HIV. Having higher education than a high school diploma, health insurance and access to health care services, and visiting a health care provider in the past 12 months were some of the determinants associated with HIV testing, while limited English proficiency was associated with reduced odds of HIV-testing among HLMSM. More research is needed to understand the relationship of SDOH (especially neighborhood) and HIV testing, how SDOH may affect HIV testing among different HLMSM groups, and how to increase self-testing and use of e-health in this priority population. Additionally, culturally and linguistically appropriate multilevel interventions and health services for HLMSM are urgently needed to diagnose HIV as early as possible after infection.</p>","PeriodicalId":47801,"journal":{"name":"Aids Education and Prevention","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9915884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10682974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}