Behavioral Risks and STI Outcomes in Men who have Sex with Men: Chicago, 2002-2010.

Behavioral Risks and STI Outcomes in Men who have Sex with Men: Chicago, 2002-2010

Associations of ethnic/racial discrimination with internalizing symptoms and externalizing behaviors among juvenile justice-involved youth of color

IntroductionYouth of color (e.g., Black/African American and Latinx/Hispanic) are overrepresented in the juvenile justice system and experience greater health disparities compared to non-Hispanic White youth. Ethnic/racial discrimination (ERD) is a risk marker for poor mental health and behavioral outcomes among youth of color, and traumatic stress and emotion dysregulation have been implicated in these pathways. Despite the relevance of these factors for justice-involved youth of color, understanding of their interrelations within this demographic is lacking.MethodsParticipants were 173 recently arrested adolescents (86% African American; 45% girls; ages 13-18) on probation in a large Midwest city in the United States. Participants completed surveys assessing ERD, traumatic stress, emotion dysregulation, internalizing symptoms, and externalizing behaviors. Using linear regression and path analysis, this study tested the cross-sectional links among two types of ERD (i.e., interpersonal experiences and perceptions of group experiences), traumatic stress symptoms, emotion dysregulation, and internalizing symptoms and externalizing behaviors.ResultsInterpersonal ERD (e.g., hearing racial insults) was associated with increased internalizing symptoms and externalizing behaviors; for internalizing symptoms, the relation was stronger for girls than boys. Gender differences were partially accounted for by traumatic stress symptoms and emotion dysregulation.ConclusionsThis study offers new insights into ERD experiences among juvenile justice-involved youth of color, gender differences in ethnic/racial discrimination experiences, and the potential value of gender-sensitive and culturally responsive programming in strengthening youths' ability to cope with ERD

An HIV intervention tailored for black young men who have sex with men in the House Ball Community

Black young men who have sex with men (BYMSM) are the group most disproportionately impacted by HIV in the USA and most in need of efficacious interventions to address community-level factors that increase their vulnerability to HIV. The House Ball Community (HBC) is a distinct social network within the larger BYMSM community that may be particularly vulnerable to social norms and stigma around HIV. This study tailored an evidence-based, community-level popular opinion leader (OL) intervention for use within the HBC. The intervention, called Promoting Ovahness through Safer Sex Education (POSSE), was then piloted to evaluate feasibility, acceptability, and preliminary efficacy. Recruiting OLs from the community and training them to deliver risk reduction messages were found to be feasible and highly acceptable. Community-level surveys (n = 406) were completed over five waves of data collection. Overall exposure to the intervention increased across waves. Statistically significant (p \u3c .05) declines were observed for multiple sexual partners, condomless anal intercourse with any male partners, and with male partners of unknown HIV status. HIV stigma declined as well, but the trend was not statistically significant

Predictors of readiness for oral rapid HIV testing by Chilean health care providers

This study identified the personal characteristics that affect Chilean health care providers' readiness to adopt HIV Oral Rapid Testing (ORT) in Chile as a new clinical evidence-based practice (EBP). Using a cross-sectional research design, the study sampled 150 nurses, midwives, and physicians employed at four clinics within the Pontifícia Universidad Católica de Chile Health Network in Santiago. Participants completed a self-administered survey asking about their demographic background, EBP attitudes and experience, personal beliefs related to HIV, the importance of HIV testing, and perceived self-comfort in performing a rapid HIV test. Of the participants, 90% believed that incorporating ORT would make a positive difference in their practice and said that they would be willing to adopt the technology for that reason. Nonetheless, the providers reported a mean "readiness to implement ORT" score of 15.1 out of a possible value of 20, suggesting only moderate self-perceived readiness to adopt the EBP. Education, beliefs about evidence-based practice, perceived comfort in performing ORT, and perceived importance of HIV testing explained 43.6% of the variance in readiness to adopt ORT. The findings of this first ORT pre-implementation study in Chile can help guide policy makers and HIV stakeholders to prepare for and increase primary health care providers' readiness to successfully adopt this evidence-based technology. Successful adoption of ORT could increase Chile's capacity to reach HIV-vulnerable Chileans for testing and referral to care if infected, thus helping the country to reduce further transmission of the virus and its medical complications

Isolated Hepatitis B Core Antibody Status Is Not Associated With Accelerated Liver Disease Progression in HIV/Hepatitis C Coinfection

BackgroundIsolated hepatitis B core antibody (anti-HBc) is a common serologic finding in HIV-infected persons, but the clinical significance is uncertain. We studied HIV/hepatitis C virus (HCV)-infected women over time to determine whether the trajectory of liver disease progression is affected by isolated anti-HBc serologic status.MethodsWe performed serial enhanced liver fibrosis (ELF) markers on HIV/HCV-coinfected women to assess liver disease progression trajectory over time comparing women with isolated anti-HBc to women with either negative HB serologies, anti-HBs alone, or anti-HBc and anti-HBs. ELF, a serum marker that combines direct markers of extracellular matrix remodeling and fibrosis, was performed on serum stored biannually. Women with at least 3 ELF determinations and persistent HCV RNA positivity were included.ResultsThree hundred forty-four women, including 132 with isolated anti-HBc and 212 with other serologic findings, were included. A median of 6 (interquartile range, 5-7) biannual ELF values was available for each woman, totaling 2119 visits. ELF increased over time from a median of 9.07 for women with isolated anti-HBc and 9.10 for those without isolated anti-HBc to 9.83 and 9.88, respectively, with no difference in degree of change or slope in the mixed-effects model including age, race, CD4 count, antiretroviral therapy, and drug and alcohol use. Factors independently associated with liver disease progression were older age, lower CD4, antiretroviral therapy nonuse, and Hispanic ethnicity.ConclusionIsolated anti-HBc serologic status was not associated with accelerated liver disease progression over a median of 9.5 years among HIV/HCV-coinfected women