Journal of healthcare, science and the humanities最新文献

HIV incidence has shifted racially and geographically in the United States and now represents higher proportions of African Americans living in the Rural South. Lower levels of HIV knowledge may be the culprit behind the increasing HIV rates observed in the Rural South. The purpose of this study was to investigate the individual and joint correlates of HIV knowledge in a sample of rural African Americans. Baseline data from a faith-based anti-stigma intervention (Project FAITHH, N= 210) was used to assess associations between sociodemographic characteristics, spirituality, stigma, and HIV knowledge scores. Associations were examined with recursive partitioning. Statistical significance was determined at P< 0.05 with a two-sided test. Recursive partitioning revealed five distinct groups based on the data. HIV knowledge scores were highest among participants who attended some college (P < 0.001) with lower levels of individual stigma (P < 0.001). HIV knowledge scores were lowest among less educated individuals (P < 0.001) who had lower levels of perceived community stigma (P = 0.002). Future interventions designed to improve HIV knowledge in rural African Americans should consider tailoring content to those who have the greatest deficits in HIV knowledge, which may be based on perceived community stigma and education levels.

The human immunodeficiency virus (HIV) attacks the body's immune system by destroying cells which fight disease and infection. If left untreated, it can lead to AIDS (acquired immunodeficiency syndrome) (1). African American women represent 13% of the total female population in the United States and account for 61% of new HIV diagnoses (2). There are various types of stigma associated with HIV (3). Enacted stigma refers to an individual's experiences of prejudice and discrimination because of their HIV status, whereas, internalized stigma refers to an individual's acceptance of negative attitudes of beliefs related to their HIV status (4 ). A positive status, can affect individuals on a daily basis as it relates to stigma. For example, guilt, shame, isolation, or perhaps low self-esteem. HIV does not discriminate. Individuals across all races, ethnicities, and socio-economic status have been diagnosed as HIV positive.

According to census and surveillance reports (2018), Black people in Illinois make up 15% of the state population (12,587,530) but comprise more than 46% of people living with HIV infections (35,841) and 51% of people newly diagnosed infections (1,361). Comparably, Blacks in Chicago make up 30% of the population (2,693,976) but comprise more than 51% of people living with HIV infection (18,719), as well as 54% newly diagnosed infections (724). (Dawson, Kates, 2021) (AIDSVU, 2020) This trend has been consistent for the past 15 years, whereas Blacks accounted for the highest proportion of people living with and newly diagnosed HIV infections. However, HIV funding to Black-Led HIV/AIDS Service Providers was not equitably distributed as compared to White-Led Service Providers. As there was no justification or accountability for these grossly inequitable funding allotments, Black-Led HIV/AIDS Service Providers unified to form the BLACK LEADERSHIP ADVOCACY COALITION FOR HEALTH EQUITY (BLACHE). This case study will relay how BLACHE brought awareness to the public, legislators, and others. Moreover, how this organization moved the needle for funding by increasing the allotment from zero dollars ($0) in 2019 to $15M in the 2021 Illinois State budget through the African American HIV/AIDS Response Act (AAHARA).

A collaborative HIV health promotion program was implemented in Durham, North Carolina to aid in mitigating the deleterious impact of HIV in the African American community. This equity-centered program produced engagement and action at the community, organizational and individual socio-ecological levels. A variety of organizations successfully collaborated in this effort. This cooperative act details the collective power of community members, Black faith-based organizations, a local health department and two community-based non-profit organizations to actualize solutions regarding the HIV epidemic. Health equity and social justice were promoted as a result of this successful initiative.

In 2006, the Centers for Disease Control (CDC) recommended routine HIV screening for all patients aged 13-64 years old who access healthcare for services. To date, 40% of people in the United States have never had an HIV test, and less than 30 % of people in the United States most at risk for acquiring HIV were tested in the past year. Description of Services: Baptist Hospital of Southeast Texas (BHSET) through support from Texas Department of State Health Services (TXDSHS) implemented Routine HIV screening in their ED in October 2011, and with additional support from Gilead Sciences, Inc. FOCUS program in 2016. Patients18 and older, are tested for HIV/HCV and linked to medical care within BHSET, and external community partners. Opt-out routine screening tests those who may not perceive themselves to be at risk and identifies those previously diagnosed for re-engagement in care. CDC reported 15% of those who do not know their status account for 38% of new transmissions, and 23% of those who knew their status, but were not engaged in care accounted for 43% of new transmissions.

Results: BHSET performed 160,000 tests, identified (0.3 % seropositivity) (0.1%) of new diagnosis (.05%) of acute cases, and (95%) linked to care. October 2016 HCV testing has performed 52% testing on patients outside the birth cohort, with a positivity rate of tested 43%.During COVID-19, HIV tests numbered 11,960 (0.1% seropositivity) with (.02%) new diagnosis, (98%) linked to care. HCV tests 9, 487, identified (6% HCV Ab seropositivity), (38% RNA positivity) linked (40%) to care.

Conclusion: BHSET has utilized its policy-driven opt-out HIV routine screening practices, protocols, and processes to improve Jefferson County's HIV prevalence from being ranked 4th in the state with cases of people who are living in 2010 to 14th in 2018.

The Black community is currently battling two pandemics, one is HIV, and the other is COVID-19. Similarly, as with HIV, COVID-19 has shone a spotlight on our healthcare system's structural failings and revealed the disproportionate impact on the Black community, particularly Black women. Black women accounted for the largest proportion of new HIV diagnoses (58 %) among all women in 2018 and represented about one-quarter of new HIV diagnoses among all Black Americans. Additionally, Black women's exposure to an abundance of misinformation about the COVID-19 infection resulted in an increased risk of complications and death from the COVID-19 virus compared to other racial and ethnic groups. Factors that increase HIV transmission risks for Black women include living in poverty, intimate partner violence, and stigma associated with HIV. Moreover, environmental, physical, cultural, financial, social, and psychological barriers are identified as unique challenges for this population's cohort. After being diagnosed with HIV, Black often were unable to access quality HIV care. Access and retention in care are tantamount to the overall well-being of women who are HIV positive. Frequently healthcare providers may attempt to engage and retain patients using only clinical measures. Our non-clinical intervention, The Evolution of Dignity, supports medical outcomes by creating a process that empowers women to motivate themselves toward improved health outcomes while ensuring their engagement and retention in care. Thus, by implementing our comprehensive intervention, all of the necessary elements contributing and promoting improved service utilization and medical adherence are integrated.

Low literacy levels in Black women with HIV (WWH) have been shown to amplify pre-existing health disparities and sequelae of non-adherence to health-related guidance. Wisdom Matters is a community-based participatory research program with an aim of improving health literacy in populations of Black WWH and assessing the existing knowledge, attitudes, and beliefs surrounding HIV care delivery and psychosocial barriers in these populations. Our research was conducted in Boston, MA, where 17 Black WWH were recruited to complete a 6-week curriculum designed to provide a thorough and cohesive path to empowerment, both individually and collectively, pertaining to living with HIV. Data collection was augmented through pre- and posttest data as well as qualitative data collected via focus groups. Content and narrative analyses of these qualitative data demonstrate individual and group improvement in the areas of nutrition, medication adherence, stress management, and disclosure of HIV status after participation in the Wisdom Matters program. The study demonstrates the feasibility and acceptability of health literacy interventions based within community settings and addresses gaps in literacy that healthcare workers can prioritize in the education of their patients.

This literature review describes the historical impact of HIV and AIDS among Black populations in United States (US), as well as the misalignment between root causes of HIV-related inequities and HIV prevention efforts. Specifically, we describe how distal factors (including structural racism) contribute to the disproportionate rates of HIV infection within Black communities. Further, we highlight consequences of focusing primarily on proximal determinants of acquiring HIV. Finally, we share some brief conclusions and recommendations to help move towards eliminating HIV and AIDS inequities among Black populations.