Racial/Ethnic Differences in Glycemic Control in Older Adults with Type 2 Diabetes: United States 2003-2014

The aim of this study was to determine whether racial differences in HbA1c persist in older adults (≥65 years) living with type 2 diabetes. Data from The National Health and Nutrition Examination Survey (NHANES) 2003-2014 were used to examine the association between HbA1c and older adults (≥65 years) over time. Compared to non-Hispanic Whites, Mexican Americans had the greatest difference in average HbA1c among minority groups, followed by those with unspecified/mixed ethnicities and non-Hispanic Blacks. In the adjusted linear model, racial minorities had a statistically significant relationship with HbA1c. There was no relationship between HbA1c and older age and insulin use. Trends in mean HbA1c over time increased for non-Hispanic Blacks and Mexican Americans and decreased for non-Hispanic Whites. The findings suggest that racial differences in HbA1c persist into older age and compared to non-Hispanic Whites, non-Hispanic Blacks and Mexican Americans are at an increased risk of morbidity, mortality, and disability due to high HbA1c. Furthermore, alternate measures of glycemic control may be needed to screen and manage T2DM in racial minorities

Condom Use Self-Efficacy Among Younger Rural Adolescents: The Influence of Parent-Teen Communication, and Knowledge of and Attitudes Toward Condoms

This study examines the role of condom use knowledge and attitudes, and parent-teen communication about sex and relationship quality on reports of condom use self-efficacy among rural, African American youth. Participants were 465 North Carolinian youth (10–14 years). Results indicated that greater condom use self-efficacy was predicted by greater knowledge of condom use (β = .206; p < .001), more favorable attitudes toward condom use (β = −.20; p < .0001) and parent-teen communication about sex (β = .13; p < .05), and actual parent-teen communication about sex and dating (β = .14; p < .05). There was low agreement between parents and youth on measures related to parent-teen communication about sex. Findings call for interventions targeting improvement of condom use knowledge among early adolescents, as well as parent-teen communication about sex. In addition, given the low parent-teen agreement regarding sexual communication, parent-teen sexual communication is an important point of intervention

“Family before Anyone Else”: A Qualitative Study on Family, Marginalization, and HIV among Hispanic or Latino/a/x Mexican Sexual Minority Males

This study explored the influence family relationships have on HIV-related factors among Hispanic or Latino/a/x Mexican sexual minority cisgender males in San Antonio, TX, US. A total of 15 young adults (7 people living with HIV; PLWH) ages 21–30 completed a semi-structured interview. Data were transcribed verbatim and analyzed using thematic analysis. The following themes emerged: (1) family support; (2) mother-son relationships; (3) father-son relationships; (4) sibling support; (5) family marginalization of sexual minorities; and (6) internalized homophobia. People who reported being HIV negative were more likely to have a prominent mother-son relationship, strong sense of family, supportive siblings, and family acceptance as a sexual minority. PLWH were more likely to report a weak sense of family, being raised in a maternal-led household, and less likely to have a relationship with their father and siblings. Marginalization among participants regardless of HIV status included exposure to religious rhetoric stigmatizing sexual minorities and fathers’ reinforcing Mexican traditional gender norms. In addition to encountering homophobia, PLWH were further marginalized by family members due to their HIV status. The findings suggest a need for greater attention to examining the impact of familial support of Hispanic or Latino/a/x Mexican sexual minority cisgender males as young adults with or at risk of HIV

Risky sexual behavior and substance use among adolescents: A meta-analysis

This study presents the results of a meta-analysis of the association between substance use and risky sexual behavior among adolescents. 87 studies fit the inclusion criteria, containing a total of 104 independent effect sizes that incorporated more than 120,000 participants. The overall effect size for the relationship between substance use and risky sexual behavior was in the small to moderate range (r = .22, CI = .18, .26). Further analyses indicated that the effect sizes did not substantially vary across the type of substance use, but did substantially vary across the type of risky sexual behavior being assessed. Specifically, mean effect sizes were smallest for studies examining unprotected sex (r = .15, CI = .10, .20), followed by studies examining number of sexual partners (r = .25, CI = .21, .30), those examining composite measures of risky sexual behavior (r = .38, CI = .27, .48), and those examining sex with an intravenous drug user (r = .53, CI = .45, .60). Furthermore, our results revealed that the relationship between drug use and risky sexual behavior is moderated by several variables, including sex, ethnicity, sexuality, age, sample type, and level of measurement. Implications and future directions are discussed

Crowdsourcing to Improve HIV and Sexual Health Outcomes: a Scoping Review.

PURPOSE OF REVIEW: This review synthesizes evidence on the use of crowdsourcing to improve HIV/sexual health outcomes. RECENT FINDINGS: We identified 15 studies, including four completed randomized controlled trials (RCTs), one planned RCT, nine completed observational studies, and one planned observational study. Three of the four RCTs suggested that crowdsourcing is an effective, low-cost approach for improving HIV testing and condom use among key populations. Results from the observational studies revealed diverse applications of crowdsourcing to inform policy, research, and intervention development related to HIV/sexual health services. Crowdsourcing can be an effective tool for informing the design and implementation of HIV/sexual health interventions, spurring innovation in sexual health research, and increasing community engagement in sexual health campaigns. More research is needed to examine the feasibility, acceptability, and effectiveness of crowdsourcing interventions, particularly in low- and middle-income countries

The Spoken Word Project: Using Poetry in Community Dialogue and Mobilization for HIV Prevention

Spoken word, a form of performance poetry, is a promising approach to HIV/AIDS awareness and prevention, as it has the potential to encourage dialogue among and within communities and address concerns regarding the social stigma present in rural communities. The purpose of this study is to describe the development and implementation of the Spoken Word Project (SWP), an HIV/AIDS pilot intervention in rural North Carolina designed to improve HIV-related attitudes and self-efficacy and decrease stigma through the use of performance poetry. Spoken word is a collaborative effort between residents of two rural counties in North Carolina and Project GRACE (Growing, Reaching, Advocating for Change and Empowerment), a community-based participatory research collaboration aimed at reducing health disparities in African American communities. The project included 15 adult and youth participants. Results indicated that spoken word has the ability to build upon local resources, generate community reflection, and engage a broad spectrum of performers and audiences. Our findings also showed that the effect of stigma and limited community conversations about HIV in rural communities can be abated through the use of spoken word

Social innovation in sexual health: a scoping review towards ending the HIV epidemic.

As donor financial support decreases, ending the HIV epidemic in Asia will require novel and sustainable approaches. Social innovation, a community-engaged process that links social change and health improvement, may be useful for helping to end the HIV epidemic in Asia. A scoping review to examine social innovation strategies in sexual health for the Asian region was conducted. The research identified focused on three types of social innovation: (1) microfinance; (2) social entrepreneurship; and (3) social enterprise. Microfinance provides financial opportunities (e.g. banking services, job opportunities) to spur local entrepreneurship and healthier behaviours. Social entrepreneurship uses business principles and tools (e.g. crowdsourcing, human-centred design) to improve health. Social enterprise is a business with a social mission. Further research is needed to measure the efficacy and cost-effectiveness of social innovation strategies in improving HIV services

SOCIO-ECOLOGICAL PREDICTORS OF INTERCOURSE FREQUENCY AND NUMBER OF SEXUAL PARTNERS AMONG MALE AND FEMALE AFRICAN AMERICAN ADOLESCENTS.

The current study examined 14 waves of data derived from a large, community-based study of the sexual behavior of impoverished youth between 12 and 17 years of age residing in the Deep South. We used multilevel linear modeling to identify ecological predictors of intercourse frequency and number of sexual partners among gender-specific subsamples. Results indicated that predictors of adolescent sexual behavior differed by both type of sexual behavior and gender. For males, age, maternal warmth, parental knowledge, curfew, self-worth, and sense of community predicted intercourse frequency, while age, parental knowledge, curfew, self-worth, friend support, and sense of community were significantly associated with having multiple sexual partners. Among females, age, curfew, and self-worth exerted significant effects on intercourse frequency, while age, parental knowledge, curfew, and self-worth exerted significant effects on having multiple sexual partners. Implications and future directions are discussed

Change in Age-Specific, Psychosocial Correlates of Risky Sexual Behaviors Among Youth: Longitudinal Findings From a Deep South, High-Risk Sample

The current study examined psychosocial predictors of change in intercourse frequency and number of sexual partners among youth within a socio-ecological framework and assessed whether these determinants vary by stage of adolescent development. Longitudinal data were derived from a large, community study of adolescent risky behavior among predominantly high-risk, African American youth. Significant predictors of intercourse frequency for early adolescents included age, gender, self-worth, and familial factors; for older youth, age, gender, self-worth, curfews, and sense of community exerted significant effects. Among early adolescents, age, gender, self-worth, familial factors, and sense of community predicted change in the number of sexual partners in the previous year, while age, gender, self-worth, parental knowledge, curfews, and sense of community were predictive of change in the number of sexual partners in the previous year among older youth. Study implications and future directions are discussed

Influence of sexual sensation-seeking on factors associated with risky sexual behaviour among African-American female adolescents

The identification of antecedents to sexual risk among youth is critical to the development and dissemination of multilevel interventions. Therefore, the aim of the present study was to examine the effect of sexual sensation-seeking on partner age, partner communication, and the sexual attitudes and behaviours of African-American female youth