The Influence of Religion and Spirituality on HIV Prevention Among Black and Latino Men Who Have Sex with Men, New York City

The influence of religion and spirituality (R/S) on HIV prevention has been understudied, especially for Black and/or Latino men who have sex with men (BLMSM), who bear a disproportionate burden of HIV, and who are part of racial/ethnic communities with high engagement in R/S. The specific aim of this study was to explore perspectives about R/S among BLMSM to inform HIV prevention strategies and reduce HIV-related health disparities. Data from 105 qualitative interviews with BLMSM were analyzed; 58 (55%) stated that R/S had no personal influence on HIV prevention. For those reporting any R/S influence, main themes were: (1) R/S positively influenced decision-making and self-respect, (2) perceived judgment and stigma by religious communities, (3) belief in a higher power, and (4) altruism. These findings can inform faith-based HIV prevention interventions for BLMSM

“We hide…”: Perceptions of HIV Risk Among Black and Latino MSM in New York City

Black and Latino men who have sex with men (BLMSM) are disproportionately infected with HIV; they comprised 66% of HIV diagnoses among men who have sex with men (MSM) in the United States in 2015. Risk factors for HIV infection among BLMSM include a high community prevalence of diagnosed and undiagnosed HIV/STDs, and dense sex partner networks. Perceptions of HIV risk among BLMSM were explored to inform HIV prevention efforts. During 2011–2012, semistructured interviews were conducted with BLMSM in New York City. Using computer-assisted thematic analyses (NVivo), transcribed interview responses to questions regarding HIV risk for main themes were examined. Interview data were available for 108 BLMSM: 86% Black, 13% Latino, 26% aged 18–24 years, 59% selfidentified as “gay,” and 33% self-identified as “bisexual.” The main emergent theme was stigma. Subthemes related to stigma included: (a) homophobia in the Black and Latino community, (b) fear of losing support from family and friends, and (c) lack of support leading to low self-esteem. Addressing the stigma felt by BLMSM may be an important strategy to facilitate improved HIV prevention efforts, HIV care and treatment, and to decrease HIV-related disparities

Predictors of willingness to participate in HIV vaccine trials among African Americans

African Americans in the United States (U.S.) are disproportionately affected by HIV. Developing an HIV vaccine is an important part of the HIV prevention and treatment toolkit and may help contribute to ending the HIV epidemic. To date, HIV vaccine trials have not engaged representative numbers of African Americans. We evaluated the willingness of African Americans to participate in HIV vaccine trials and identified correlates of willingness to participate (WTP) by surveying African Americans at low- and high-risk of HIV infection in a multi-site, cross-sectional study. We enrolled 1,452 participants; 59% heterosexual women; 21% heterosexual men; 20% men who have sex with men (MSM). Over half of participants (58%) expressed some level of WTP in HIV vaccine trials. Multivariable analyses revealed several variables were positively related to WTP: HIV risk behavior, knowing someone with HIV/AIDS, social support for trial participation, high perception of risk, perceived protection if in a trial, altruism, and greater tolerance for the ambiguous nature of trials (p\u3c0.01). Emphasis on contextual factors related to personal HIV experiences, including knowledge of someone with HIV, and community support for research, may provide effective strategies for engaging African Americans in future HIV vaccine trials

Acceptability of oral rapid HIV testing at dental clinics in communities with high HIV prevalence in South Florida.

Expanding HIV screening for populations at risk necessitates testing in nontraditional settings. We assessed HIV testing in dental clinics in South Florida, an urban area with the highest rates of HIV diagnoses in the United States in 2015.We explored patients' acceptance of oral HIV rapid tests administered by dental providers and identified reasons for accepting or declining HIV testing.During 2014 and 2015, dentists and hygienists at two federally qualified health center (FQHC) dental clinics who serve racial/ethnic minority patient populations in South Florida were trained to administer oral HIV rapid tests as a part of a routine dental visit. Patients presenting for dental services were offered a rapid HIV test and brief survey regarding their demographics, HIV testing history and behaviors.We enrolled 600 patients (median age = 43 years; IQR: 29-56 years), 45% non-Hispanic black and 35% Hispanic/Latino, 83% graduated high school, and 50% unemployed. Most (85%) accepted oral HIV rapid testing (none tested HIV-positive); 14% had never been tested for HIV. The most common reasons for testing were a desire to know HIV status (56%) and free testing (54%). Among 93 (15%) patients who declined testing, 58% were tested recently and 31% felt confident that they were HIV-negative; however, 74 (80%) who declined testing said they would feel comfortable discussing HIV prevention with their dentist. Additionally, 290 of 600 patients (48%) reported condomless vaginal or anal sex in the past 6 months. Further, among 119 patients who had condomless sex with an HIV-positive partner and/or one whose HIV status was unknown, 98 (82%) accepted the oral HIV test.Dental clinics may provide expanded opportunities for oral HIV rapid testing and conversations about HIV prevention in high HIV prevalence communities

Demographics of the Southern Counties with Historically Black Colleges and Universities (HBCUs), American Community Survey, United States, 2014 (n = 69 counties).

<p>Demographics of the Southern Counties with Historically Black Colleges and Universities (HBCUs), American Community Survey, United States, 2014 (n = 69 counties).</p

Estimated Rates of Blacks/African Americans Living with Diagnosed HIV Infections, 2013, and Locations of HBCUs, U.S.

<p>Estimated Rates of Blacks/African Americans Living with Diagnosed HIV Infections, 2013, and Locations of HBCUs, U.S.</p

Risk factors for non-adherence and loss to follow-up in a three-year clinical trial in Botswana.

BACKGROUND: Participant non-adherence and loss to follow-up can compromise the validity of clinical trial results. An assessment of these issues was made in a 3-year tuberculosis prevention trial among HIV-infected adults in Botswana. METHODS AND FINDINGS: Between 11/2004-07/2006, 1995 participants were enrolled at eight public health clinics. They returned monthly to receive bottles of medication and were expected to take daily tablets of isoniazid or placebo for three years. Non-adherence was defined as refusing tablet ingestion but agreeing to quarterly physical examinations. Loss to follow-up was defined as not having returned for appointments in ≥60 days. Between 10/2008-04/2009, survey interviews were conducted with 83 participants identified as lost to follow-up and 127 identified as non-adherent. As a comparison, 252 randomly selected adherent participants were also surveyed. Multivariate logistic regression analysis was used to identify associations with selected risk factors. Men had higher odds of being non-adherent (adjusted odds ratio (AOR), 2.24; 95% confidence interval [95%CI] 1.24-4.04) and lost to follow-up (AOR 3.08; 95%CI 1.50-6.33). Non-adherent participants had higher odds of reporting difficulties taking the regimen or not knowing if they had difficulties (AOR 3.40; 95%CI 1.75-6.60) and lower odds associated with each year of age (AOR 0.95; 95%CI 0.91-0.98), but other variables such as employment, distance from clinic, alcohol use, and understanding study requirements were not significantly different than controls. Among participants who were non-adherent or lost to follow-up, 40/210 (19.0%) reported that they stopped the medication because of work commitments and 33/210 (15.7%) said they thought they had completed the study. CONCLUSIONS: Men had higher odds of non-adherence and loss to follow-up than women. Potential interventions that might improve adherence in trial participants may include:targeting health education for men, reducing barriers, clarifying study expectations, educating employers about HIV/AIDS to help reduce stigma in the workplace, and encouraging employers to support employee health. TRIAL REGISTRATION: ClinicalTrials.gov NCT00164281

Demographic characteristics for patients receiving dental care at 2 federally qualified healthcare centers, South Florida, 2014–2015 (<i>N</i> = 600).

<p>Demographic characteristics for patients receiving dental care at 2 federally qualified healthcare centers, South Florida, 2014–2015 (<i>N</i> = 600).</p