33 research outputs found

    On the Efficacy and Mediation of a One-on-One HIV Risk-Reduction Intervention for African American Men Who Have Sex With Men: A Randomized Controlled Trial

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    We examined the efficacy and mediation of Being Responsible for Ourselves (BRO), an HIV/STI risk reduction intervention for African American men who have sex with men (MSM), the population with the highest HIV diagnosis rate in the US. We randomized African American MSM to one of two interventions: BRO HIV/STI risk reduction, targeting condom use; or attention-matched control, targeting physical activity and healthy diet. The interventions were based on social cognitive theory, the reasoned-action approach, and qualitative research. Men reporting anal intercourse with other men in the past 90 days were eligible and completed pre-intervention

    Syndemic factors associated with adult sexual HIV risk behaviors in a sample of Latino men who have sex with men in New York City

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    Objective: Syndemic theory has been proposed as a framework for understanding the role of multiple riskfactors driving the HIV epidemic among sexual and gender minority individuals. As yet, the frameworkhas been relatively absent in research on Latinos/as.Methods: We used logistic regression to assess relationships among cumulative syndemic conditions –including clinically significant depression, high-risk alcohol consumption, discrimination, and childhoodsexual abuse – engagement with multiple partners and condomless anal intercourse (CAI) in a sample of176 Latino men who have sex with men (MSM) in New York City.Results: In bivariate analyses, an increase in the number of syndemic factors experienced was associatedwith an increased likelihood of reporting multiple partners and CAI. In multivariable analyses, participantswith 2, 3, and 4 factors were significantly more likely to report multiple partners than those with 0(aOR = 4.66, 95% CI [1.29, 16.85); aOR = 7.28, 95% CI [1.94, 27.28] and aOR = 8.25, 95% CI [1.74, 39.24]respectively; p \u3c 0.05. Regarding CAI, only participants with 3 and 4 factors differed from those with 0aOR = 7.35, 95% CI [1.64, 32.83] and OR = 8.06, 95% CI [1.39, 46.73] respectively.Conclusions: Comprehensive approaches that address syndemic factors, and capitalize on resiliency, areneeded to address the sexual health needs of Latino MSM

    Syndemic factors associated with adult sexual HIV risk behaviors in a sample of Latino men who have sex with men in New York City

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    Objective: Syndemic theory has been proposed as a framework for understanding the role of multiple riskfactors driving the HIV epidemic among sexual and gender minority individuals. As yet, the frameworkhas been relatively absent in research on Latinos/as.Methods: We used logistic regression to assess relationships among cumulative syndemic conditions –including clinically significant depression, high-risk alcohol consumption, discrimination, and childhoodsexual abuse – engagement with multiple partners and condomless anal intercourse (CAI) in a sample of176 Latino men who have sex with men (MSM) in New York City.Results: In bivariate analyses, an increase in the number of syndemic factors experienced was associatedwith an increased likelihood of reporting multiple partners and CAI. In multivariable analyses, participantswith 2, 3, and 4 factors were significantly more likely to report multiple partners than those with 0(aOR = 4.66, 95% CI [1.29, 16.85); aOR = 7.28, 95% CI [1.94, 27.28] and aOR = 8.25, 95% CI [1.74, 39.24]respectively; p \u3c 0.05. Regarding CAI, only participants with 3 and 4 factors differed from those with 0aOR = 7.35, 95% CI [1.64, 32.83] and OR = 8.06, 95% CI [1.39, 46.73] respectively.Conclusions: Comprehensive approaches that address syndemic factors, and capitalize on resiliency, areneeded to address the sexual health needs of Latino MSM

    Syndemic conditions predict lower levels of physical activity among African American men who have sex with men: A prospective survey study.

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    African American men are disproportionately affected by, not only HIV/AIDS, but also chronic non-communicable diseases. Despite the known benefits of physical activity for reducing chronic non-communicable diseases, scant research has identified factors that may influence physical activity in this population. A growing literature centers on the syndemic theory, the notion that multiple adverse conditions interact synergistically, contributing to excess morbidity. This secondary data analysis examined two primary questions: whether syndemic conditions prospectively predicted physical activity, and whether, consistent with the syndemic theory, syndemic conditions interacted to predict physical activity. Participants were 595 African American men who have sex with men (MSM), a population underrepresented in health research, enrolled in a health-promotion intervention trial from 2008-2011. We used generalized-estimating-equations models to test the associations of syndemic conditions and resilience factors measured pre-intervention to self-reported physical activity 6 and 12 months post-intervention. As hypothesized, reporting more syndemic conditions pre-intervention predicted reporting less physical activity 6 and 12 months post-intervention, adjusting for the intervention. However, contrary to the syndemic theory, we did not find evidence for the interaction effects of syndemic conditions in predicting physical activity. Receiving high school education and having greater social network diversity predicted more physical activity whereas older age predicted less physical activity. To our knowledge, this is the first study to examine the syndemic theory in relation to physical activity. Although reporting a greater number of syndemic conditions was related to reduced physical activity, there was no evidence for synergy among syndemic conditions

    Physical Activity Intervention Effects on Waist-to-Hip Ratio in African American Men Living With HIV

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    People living with HIV on antiretroviral therapy have an increased risk of developing metabolic disturbances and central adiposity. Adequate engagement in physical activity (PA) could reduce the risk of chronic diseases associated with central adiposity. We conducted a secondary analysis of data from a randomized controlled trial of a PA intervention with 302 African American men aged 40 or older (53.9±7.2 years) living with HIV to assess whether the intervention reduced the waist-to-hip ratio (WHR). Generalized estimating equation analyses tested whether the PA intervention reduced WHR compared with the control group and whether age moderated its effect, adjusting for follow-up assessment time (3, 6, and 12 months postintervention) and baseline WHR and age. The analysis revealed that the intervention’s effect on WHR was not significant ( B = −0.008, p = .097). However, a significant interaction between age and the intervention ( B = 0.001, p = .046) indicated that the intervention’s effect in reducing WHR waned with increasing age. For instance, when dividing participants into three age subgroups, the intervention reduced WHR for men ages 40 to 50 ( B = −0.020, p = .013) and ages 50 and 60 ( B = −0.007, p = .315) but increased it among those older than 60 ( B = 0.013, p = .252). The intervention’s effects on WHR differed by participants’ age, suggesting that different PA strategies may be needed based on age to improve the metabolic profile and reduce chronic disease risk in African American men living with HIV

    Intervention Increases Physical Activity and Healthful Diet Among South African Adolescents Over 54 Months: A Randomized Controlled Trial

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    PurposeScant research has investigated whether health promotion interventions have sustained effects in increasing physical activity and healthful diet among adolescents in sub-Saharan Africa, which is experiencing an epidemiological transition from infectious diseases to noncommunicable diseases as leading causes of mortality. We examined whether an intervention increased adherence to 5-a-day diet and physical activity guidelines during a 54-month postintervention period among South African adolescents and whether its effects weakened at long-term (42 and 54 months postintervention) compared with short-term (3, 6, and 12 months postintervention) follow-up.MethodsWe randomized 18 randomly selected schools serving grade 6 learners (mean age = 12.6) in a township and a semirural area in Eastern Cape Province, South Africa, to one of the two 12-hour interventions: health promotion, targeting healthful diet and physical activity; attention-matched control, targeting sexual risk behaviors. We tested the intervention's effects on adherence to 5-a-day diet and physical activity guidelines using generalized estimating equations logistic regression models adjusting for baseline behavior and clustering within schools.ResultsHealth promotion intervention participants had higher odds of meeting 5-a-day diet and physical activity guidelines than control participants. The effect on 5-a-day diet did not weaken at long-term compared with short-term follow-up, but the effect on physical activity guidelines was weaker at long-term follow-up, mainly because of a reduced effect on muscle-strengthening physical activity. The intervention also increased health promotion attitude and intention and health knowledge and reduced binge drinking compared with the control group.ConclusionsA 12-hour intervention in grade 6 shows promise in increasing self-reported adherence to healthful diet and physical activity guidelines during a 4.5-year postintervention period among South African adolescents
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