African American Emerging Adult Perspectives on Unintended Pregnancy and Meeting Their Needs With Mobile Technology: Mixed Methods Qualitative Study

Background: In the United States, a disproportionate number of unintended pregnancies occur among African Americans, particularly those in their later teenage years and early 20s. Mobile technology is becoming more ubiquitous as a method for health promotion; however, relatively little research has been done with this population to determine their perspectives about unintended pregnancy, the potential of successfully using mobile technology to prevent unintended pregnancy, and the content of such programs. Objective: The purpose of this study was to obtain the perspectives of African American emerging adults about unintended pregnancy and the use of mobile technology to reduce unintended pregnancy rates. Methods: Focus groups and interviews were conducted with 83 African Americans, aged 18-21 years. Data were analyzed using an open coding process. Emergent codes were then added as needed, and themes and subthemes were identified. Results: Participants cited the social environment and lack of education as primary reasons for disproportionate rates of unintended pregnancy. They noted that unintended pregnancy is an important issue and that they desire more sexual health information. They enthusiastically supported mobile technology as a means to communicate unintended pregnancy prevention programming and offered many suggestions for program content, look, and feel. Conclusions: Young and emerging adult African Americans want and need sexual health resources, and a mobile-based platform could be widely accepted and address needs to lower disproportionate rates of unintended pregnancy. An essential next step is to use these findings to inform the development of a mobile-based unintended pregnancy prevention and sexual health program prototype to determine feasibility

An examination of high-risk sexual behaviors among participants obtaining community-based HIV testing and related sexual health services provided at the community level

African American women continue to have the highest rates of HIV infection and are diagnosed with common STIs more frequently than women of other racial/ethnic groups. Since African American women are affected by HIV disproportionately, community based HIV testing has become more customary. Among African Americans these studies aim to prevent the spread of HIV by targeting women with the highest risk behaviors to identify women who are infected unknowingly. Women who test positive for HIV are linked to HIV care, leaving patients who test HIV negative at the greatest concern as linking them to additional services is more difficult to determine. This creates a public health concern that detecting other undiagnosed infections for African American women using these services may be missed. This dissertation incorporated three studies to evaluate the prevalence of high-risk behaviors of individuals utilizing community-based HIV testing services, 2) determine satisfaction of services associated with community-based rapid HIV testing, and 3) review the literature to investigate standard approaches used in community-based rapid HIV testing programs to link clients to services not provided during the rapid HIV testing visit

Veterans' Perspectives on Interventions to Improve Retention in HIV Care.

Poor retention in HIV medical care is associated with increased mortality among patients with HIV/AIDS. Developing new interventions to improve retention in HIV primary care is needed. The Department of Veteran Affairs (VA) is the largest single provider of HIV care in the US. We sought to understand what veterans would want in an intervention to improve retention in VA HIV care. We conducted 18 one-on-one interviews and 15 outpatient focus groups with 46 patients living with HIV infection from the Michael E. DeBakey VAMC (MEDVAMC). Analysis identified three focus areas for improving retention in care: developing an HIV friendly clinic environment, providing mental health and substance use treatment concurrent with HIV care and encouraging peer support from other Veterans with HIV

Gene–Toxicant Interactions in Gulf War Illness: Differential Effects of the PON1 Genotype

About 25–35% of United States veterans who fought in the 1990–1991 Gulf War report several moderate or severe chronic systemic symptoms, defined as Gulf War illness (GWI). Thirty years later, there is little consensus on the causes or biological underpinnings of GWI. The Gulf War Era Cohort and Biorepository (GWECB) was designed to investigate genetic and environmental associations with GWI and consists of 1343 veterans. We investigate candidate gene–toxicant interactions that may be associated with GWI based on prior associations found in human and animal model studies, focusing on SNPs in or near ACHE, BCHE, and PON1 genes to replicate results from prior studies. SOD1 was also considered as a candidate gene. CDC Severe GWI, the primary outcome, was observed in 26% of the 810 deployed veterans included in this study. The interaction between the candidate SNP rs662 and pyridostigmine bromide (PB) pills was found to be associated with CDC Severe GWI. Interactions between PB pill exposure and rs3917545, rs3917550, and rs2299255, all in high linkage disequilibrium in PON1, were also associated with respiratory symptoms. These SNPs could point toward biological pathways through which GWI may develop, which could lead to biomarkers to detect GWI or to better treatment options for veterans with GWI