A time for dogma, a time for the Bible, a time for condoms: building a catholic theology of prevention in the face of public health policies at Casa Fonte Colombo in Porto Alegre, Brazil

The Casa Fonte Colombo (CFC) is a religious organisation that assists people living with HIV/AIDS (PLWHA). The funding for its activities comes from public sources such as the Brazilian National STD/AIDS Program as well as the Catholic Church. Capuchin (Franciscan) priests run the CFC, and it has an extensive group of volunteers made up mostly of women. Between 2006 and 2009, we observed daily life at the Casa Fonte Colombo and interviewed priests, volunteers, employees, service providers, and clients. We also attended meetings, group sessions, and celebrations. Everyday actions carried out by the CFC reveal the efforts to resolve the tension between the position of the Catholic Church and the Brazilian state in the politics of AIDS. These efforts affirm that the Casa Fonte Colombo presents itself as a space where the position of the Catholic Church, as much as the politics of public health, are re-worked, giving way to a progressive act of Catholic prevention and assistance for AIDS, that we call “theology of prevention.

CATÓLICOS, FIDELIDADE CONJUGAL E AIDS: ENTRE A CRUZ DA DOUTRINA MORAL E AS ESPADAS DO COTIDIANO SEXUAL DOS ADEPTOS

Neste artigo discutimos a visão da Igreja Católica sobre sexualidade na interface com a epidemia do HIV/AIDS. Nossa reflexão está embasada em pesquisa etnográfica que envolveu dois meses de observação participante do cotidiano de católicos de um bairro popular da Região Metropolitana do Recife, além de contar com entrevistas a onze dos leigos engajados nos serviços religiosos da igreja do bairro e a oito sacerdotes que realizam seus trabalhos religiosos em outras localidades. Nelas abordamos diferentes temáticas relacionadas ao enfrentamento da epidemia da AIDS. Nesse contexto, conjugalidade e fidelidade se afiguram como importantes analisadores de como aqueles lidam com a epidemia, em uma variedade de re-descrições práticas e de re-interpretações conceptuais das assertivas do discurso moral religioso – ainda que, muitos impasses permaneçam em aberto em termos das prerrogativas da Igreja e seus possíveis rebatimentos na saúde sexual dos adepto

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

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

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

Integration of Social, Cultural, and Biomedical Strategies into an Existing Couple-Based Behavioral HIV/STI Prevention Intervention: Voices of Latino Male Couples

Introduction Successful HIV prevention and treatment requires evidence-based approaches that combine biomedical strategies with behavioral interventions that are socially and culturally appropriate for the population or community being prioritized. Although there has been a push for a combination approach, how best to integrate different strategies into existing behavioral HIV prevention interventions remains unclear. The need to develop effective combination approaches is of particular importance for men who have sex with men (MSM), who face a disproportionately high risk of HIV acquisition. Materials and Methods We collaborated with Latino male couples and providers to adapt Connect ‘n Unite, an evidence-based intervention for Black male couples, for Latino male couples. We conducted a series of three focus groups, each with two cohorts of couples, and one focus group with providers. A purposive stratified sample of 20 couples (N = 40, divided into two cohorts) and 10 providers provided insights into how to adapt and integrate social, cultural, and biomedical approaches in a couples-based HIV/AIDS behavioral intervention. Results The majority (N = 37) of the couple participants had no prior knowledge of the following new biomedical strategies: non-occupational post-exposure prophylaxis (nPEP); pre-exposure prophylaxis (PrEP); and HIV self-testing kits. After they were introduced to these biomedical interventions, all participants expressed a need for information and empowerment through knowledge and awareness of these interventions. In particular, participants suggested that we provide PrEP and HIV self-testing kits by the middle or end of the intervention. Providers suggested a need to address behavioral, social and structural issues, such as language barriers; and the promotion of client-centered approaches to increase access to, adaptation of, and adherence to biomedical strategies. Corroborating what couple participants suggested, providers agreed that biomedical strategies should be offered after providing information about these tools. Regarding culturally sensitive and responsive approaches, participants identified stigma and discrimination associated with HIV and sexual identity as barriers to care, language barriers and documentation status as further barriers to care, the couple-based approach as ideal to health promotion, and the need to include family topics in the intervention. Discussion We successfully adapted an evidence-based behavioral HIV prevention intervention for Latino male couples. The adapted intervention, called Conectando Latinos en Pareja, integrates social, cultural, behavioral and biomedical strategies to address the HIV epidemic among Latino MSM. The study highlights the promise regarding the feasibility of implementing a combination approach to HIV prevention in this populatio

They “Miss More Than Anything Their Normal Life Back Home”: Masculinity and Extramarital Sex Among Mexican Migrants in Atlanta

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72531/1/4102309.pd

Bisexual Latino Men and HIV and Sexually Transmitted Infections Risk: An Exploratory Analysis

Objectives. We sought to determine whether there were differences in sexual risk among behaviorally and self-identified bisexual men, men who reported having sex with both men and women without reporting a bisexual identity and men who self-identified as bisexual but reported only recent homosexual behavior over the past 6 months

Internalised stigma as durable social determinant of HIV care for transnational patients of Puerto Rican ancestry

Intersectional stigmas have been contributing barriers to linkage and retention in HIV care for Latinx communities. Our analysis examines whether reductions in HIV-related and other stigmas were associated (or not) with progression on the HIV continuum of care for Puerto Ricans living with HIV, patients of the U.S. Special Projects of National Significance (SPNS) initiative: ‘Culturally Appropriate Interventions of Outreach, Access and Retention among Latinx Populations from 2013 to 2018.’ We conducted multivariate regression modelling to test our primary hypotheses. Internalised (HIV and racial/ethnic) stigma scores and age at baseline were predictors of ART adherence at six months assessment. Internalised stigma (HIV and racial/ethnic), depression, and resiliency scores were predictors of the likelihood of detectable HIV viral load at six months assessment. Our study confirms the importance of understanding internalised stigma on its own terms, as a durable construct that has implications for HIV treatment disparities for Puerto Ricans living with HIV

Trends and disparities in treatment for co-occurring major depression and substance use disorders among us adolescents from 2011 to 2019.

Question: What was the prevalence of treatment use for co-occurring major depression and substance use disorders among adolescents in the US from 2011 to 2019, and were there any disparities? Findings: This survey study including 136 262 adolescents aged 12 to 17 years found persistent treatment gaps for co-occurring major depression and substance use disorders. Unmet treatment needs were significantly higher among Hispanic and Asian, Native Hawaiian, or Pacific Islander adolescents and uninsured adolescents. Meaning: The findings of this study suggest that continued efforts to improve service provision and coordination for adolescents with co-occurring depression and SUD are needed

A Critical Analysis of the Brazilian Response to HIV/AIDS: Lessons Learned for Controlling and Mitigating the Epidemic in Developing Countries

The Brazilian National AIDS Program is widely recognized as the leading example of an integrated HIV/AIDS prevention, care, and treatment program in a developing country. We critically analyze the Brazilian experience, distinguishing those elements that are unique to Brazil from the programmatic and policy decisions that can aid the development of similar programs in other low- and middle-income and developing countries. Among the critical issues that are discussed are human rights and solidarity, the interface of politics and public health, sexuality and culture, the integration of prevention and treatment, the transition from an epidemic rooted among men who have sex with men to one that increasingly affects women, and special prevention and treatment programs for injection drug users