Journal of healthcare, science and the humanities最新文献

We sought to determine the association between HIV-related medical mistrust (or belief in HIV conspiracy theories) and educational attainment among Blacks that are living with HIV. We analyzed data from the regional Survey on HIV in the Black Community in Alabama. HIV-related medical mistrust w or HIV Genocidal Conspiracy Theories were reported by majority of the patients. In multivariable analysis, controlling for income, education, and marital status, belief in conspiracy theories or HIV Genocidal Conspiracy Theories were significantly associated with higher education. The HIV-Related Medical Mistrust Scale item was independently associated with higher education. This finding speaks to the need for an improved understanding of the role of HIV related medical mistrust among African Americans to improve uptake of biomedical HIV prevention.

The US is witnessing rapid hospital closures in rural communities, with devastating consequences for community residents beyond decreased access to health care services. Hospital closures have been associated with outmigration of younger generations due to loss of employment opportunities and economic decline, and with creating uncertainty and a sense of powerlessness among residents. While great efforts have been undertaken to document the effects of hospital closures on health care access, particularly during the COVID-19 epidemic, limited attention has been given to the public health ethics associated with dismantling health care for populations in greatest need. Drawing on the narratives of community stakeholders and residents, several themes evolved around processes, structures, and spillover effects of hospital closures on their daily lives, including decision making processes of when and how to close hospitals. Concerns arose regarding lack of transparency and disregard for alternative health care services to meet the needs of rural communities. The researchers analyzed participants' stories using the six core values of the American Public Health Association's code of ethics to determine the extent to which the multilevel crisis emerging from rural hospital closures contradicts the public health ethical responsibility of ensuring access to health care in rural communities. Centering the voices of rural community stakeholders and residents is critical to inform and guide public health strategies and in turn address health care needs of rural communities.

Although Black men in the United States face high rates of hypertension, the nexus of health and religion remain understudied for this population. The present study analyzes religious variables, such as prayer, Bible reading, and religious meditation, to describe the frequency of these practices among hypertensive and non-hypertensive Black men. This study utilizes data from the Midlife in the United States (MIDUS) 3 - Milwaukee African American Sample series, with 135 Black men (51.1% stating that they had experienced hypertension in the past 12 months). Findings suggest that Black men with a diagnosis of hypertension were significantly more likely to report that they prayed and read religious literature more often than their non-hypertensive counterparts. The results of the present study demonstrate key religious practices that hypertensive Black men might use as a potential coping response to their health condition.

COVID-19 imploded the notion of educational equity, as school closures forced educational institutions to grapple with the equity of specific policies, subsequently reigniting a national and international discourse on systemic racism. Due to the uncertainty and debilitating impact of COVID-19 on schools, testing facilities, students, and the American economy, educational institutions temporarily suspended, staunch rules and institutional norms. Entry and exit exams that would otherwise serve as systemic barricades, historically precluding Black Americans from gaining entrance into the bastions of white privilege, became subject to white reprieves.

The purpose of this article is to discuss the hypocrisy of American ethics. This hypocrisy allows certain members of our society to breach their ethical duties and responsibilities without concern for the collective or regard for the oaths they pledge. This hypocrisy wields great power that continues to support the systemic discrimination that will be the downfall of this Country. By analyzing the January 6, 2021, raid on the Capital, we will examine how government officials and American citizens disregarded their oaths and committed unethical acts to overthrow the government. They used the American flag, that they pledge their lives in the name of Democracy, as a tool to incite violence and insurrection. Analysis of this incident clearly reflects that this selective application of ethical responsibility allows some government officials and members of society to commit violent acts against the government officials, institutions, and its citizenry, without the same criminal reprisal other Americans endure.

In Alabama, despite the high screening rates for cervical cancer in Blacks, they still have higher mortality rates compared to Whites. Our objective was to increase knowledge and awareness of cervical cancer with the intention to encourage more women to have Pap tests, Human Papillomavirus (HPV) tests and HPV vaccinations after a short-term educational-based intervention. Pre and post questionnaires were administered to collect data before and after a primary educational intervention in Macon County was taught by a team of experts in the subject area. Descriptive statistics were done using SAS software to generate frequency and chi-square tests. Out of the 100 participants: 9% had cervical cancer; 86% were Blacks; about 65% were over the age of 35 and earned less than $50,000/year; 62% lived in the Tuskegee community; 34% were students, staff or faculty of Tuskegee University; about 25% were either married or living with their partner; leaving about 75% of the women as single, divorced or widowed; and more than 80% were students between their first year of college and graduate school with only 40% working for pay. The short-term educational intervention increased participants' knowledge of: who knew what cervical cancer was; ever heard of HPV; and ever had an HPV-test by margins of 9%, 23% and 4% respectively. Participants who had ever heard of Pap test had the same knowledge of 97% before and after the intervention. There was a significant knowledge level increased: in understanding that cervical cancer was caused by 38% HPV infection; 39% of all HPV infections lead to cervical cancer; and cervical cancer has decreased in recent years by 50%. Significant differences were observed only among participants who had ever heard of Pap test before and after the educational intervention with p-values of 0.004 and 0.03 respectively, compared to participants who knew what cervical cancer was and who had ever heard of HPV test. Although some participants lacked knowledge in certain areas, this study showed an apparent increase in their knowledge and awareness following the educational intervention.

The two previous United States presidential administrations implemented efforts to combat HIV/AIDS, recently leading to a plan to end this epidemic by 2030. Although the plan outlines a biomedical framework of key areas to address, it does not prioritize the core systemic and social issues that have caused the disease to devastate Black communities. The Black AIDS Institute (BAI) responded directly to this gap with "We the People: A Black Strategy to End HIV." BAI connected with Black community members across the country and conducted key informant interviews, held town hall meetings, and hosted a community forum in the U.S. Conference on AIDS. Based on this extensive community-level input, BAI, along with a diverse group of social justice partners, finalized the plan's strategic direction and recommendations. The efforts culminated in the "We the People" framework's four key pillars directly informing all of BAI's policy work, to include radically reimagining housing, health care, and criminalization systems that perpetuate the HIV/AIDS crisis among Black Americans. "We the People" outlines a clear path to engage policymakers and ensure all communities can effectively access and utilize the treatment and prevention advances that have the potential to soon end this epidemic..

The burden of HIV infection disproportionately impacts Black people across the United States. New York City (NYC) has taken substantial steps to End the HIV Epidemic, boasting reductions in new HIV infections by 40% since 2015; however, racial inequities persist. In 2019, Black people living in NYC accounted for 24% of the population, yet represented 46.1% of new HIV diagnoses and 48.7% of HIV deaths. To address the high incidence of HIV in a predominately Black community in Central Brooklyn, Brookdale Hospital Medical Center (BHMC) developed a multi-faceted approach to increase routine opt-out HIV screening and linkage. In order to integrate HIV testing into routine clinical care, BHMC leadership updated screening policies; developed an Electronic Health Record (EHR) algorithm to trigger HIV screening in five BHMC ambulatory clinics; and modified the EHR to transmit positive HIV screening results to patient navigators dedicated to linking patients to HIV care. During the height of the COVID-19 pandemic, between March and April 2020, HIV screening across all five ambulatory sites decreased by 87.3%. After activation of the EHR algorithm in three ambulatory sites in June 2020, HIV screening increased 216.3% from the prior month. By the time the final EHR algorithm launched in August 2020, HIV testing had fully rebounded to pre-pandemic levels. Policies supporting routine opt-out HIV screening coupled with EHR-prompted screening can improve and sustain HIV testing in a Black community with a high incidence and prevalence of HIV.

Despite prior studies showing that a significant proportion of the general African-American population hold conspiracy beliefs about HIV/AIDS, limited research has investigated conspiracy beliefs among African Americans that are HIV-positive and the subgroups most likely to endorse such beliefs. I examined endorsement of HIV/AIDS conspiracy beliefs and their relationship to sociodemographic variables among 256 African Americans with HIV infection. Quantitative and qualitative methods were used in the study at an AIDS Outreach Organization clinic in Alabama that provides medical and social support services to HIV-positive persons. Patients reported agreement with statements capturing beliefs in HIV/AIDS conspiracies. Results indicated that about one-third subscribed to the notion that "AIDS is a form of genocide against Blacks" (29.7%) and some 27.7% of the respondents said that "AIDS was created by the government to control the black population." Regarding treatment-related conspiracy beliefs, over one-third (35.6%) somewhat or strongly agreed that "people who take the new medicines for HIV/AIDS are human guinea pigs for the government," while 29.9% somewhat or strongly endorsed the statement that "the medicine that doctors prescribe to treat HIV is poison." Results of multivariate analyses indicated that stronger HIV/AIDS conspiracy beliefs were significantly associated with educational attainment and age. A set of sociodemographic variables explained a small amount of the variance in conspiracy beliefs about HIV/AIDS (R² range=0.13-0.14). Qualitative results indicated that conspiracy beliefs are barrier to medication adherence among these patients living with HIV/AIDS. Focus group discussions suggested that conspiracy beliefs can be important barriers to quality of life and infection control among HIV-positive individuals. These findings suggested that addressing conspiracy beliefs should be a significant issue in HIV/AIDS treatment and prevention programs in the 21st Century.