There is an urgent need for efficient behavioral interventions to increase rates of HIV viral suppression for populations with serious barriers to engagement along the HIV care continuum. We carried out an optimization trial to test the effects of five behavioral intervention components designed to address barriers to HIV care continuum engagement for African American/Black and Latino persons living with HIV (PLWH) with non-suppressed HIV viral load levels: motivational interviewing sessions (MI), focused support groups (SG), peer mentorship (PM), pre-adherence skill building (SB), and navigation with two levels, short (NS) and long (NL). The primary outcome was HIV viral suppression (VS) and absolute viral load (VL) and health-related quality of life were secondary outcomes.
View Article and Find Full Text PDFBackground: The persistence of racial/ethnic inequities in rates of engagement along the HIV care continuum signals the need for novel approaches. We developed six behavioral intervention components for use in an optimization trial, grounded in a model that integrates critical race theory, harm reduction, and self-determination theory, designed to address various barriers that African American/Black and Latino persons living with HIV (PLWH) experience to the HIV care continuum. The components were: health education, motivational interviewing sessions, pre-adherence skill building, peer mentorship, focused support groups, and navigation.
View Article and Find Full Text PDFBackground: Rates of participation in HIV care, medication uptake, and viral suppression are improving among persons living with HIV (PLWH) in the United States. Yet, disparities among African American/Black and Latino PLWH are persistent, signaling the need for new conceptual approaches. To address gaps in services and research (e.
View Article and Find Full Text PDFIntroduction: There is limited functional knowledge and utilization of pre-exposure prophylaxis (PrEP) among young adult Black cisgender women (YBW).
Methods: We conducted four focus groups with YBW using an intersectional framework to explore multiple levels of factors that impede YBW awareness, interest, and utilization of PrEP in conjunction with their sexual and reproductive healthcare needs.
Results: Influences at the cultural-environmental level included a lack of information and resources to access to PrEP and medical mistrust in the healthcare system.
Homelessness in the United States has been increasing at an exponential rate over the past three decades, and the US has not experienced the current level of homelessness since the Great Depression of the 1930's. With this rise in homelessness has come an increase in the number of rules, regulations, and strict and punitive policies within shelters. Given the historic levels of homelessness nationally and increased bureaucracy, this paper aims to expand on the current literature related to governance of homeless shelters to examine: 1) how families residing in the shelters are impacted by policies related to homelessness, and governance within shelters (i.
View Article and Find Full Text PDFPurpose: Gender affirmation lessens mental health disparities among transgender and gender nonbinary (TGNB) persons. However, the concept of what it means to be affirmed in one's gender has not been fully explored, nor has the impact of gender affirmation on other health indicators been determined. The purpose of this study was to explore the meaning of gender affirmation among a sample of TGNB persons.
View Article and Find Full Text PDFSubstance use problems are highly prevalent among persons living with (PLWH) in the United States and serve as serious barriers to engagement in HIV care. Yet, in contrast to studies of single substances, little is known about patterns of polysubstance use in this population. Moreover, other risk factors (e.
View Article and Find Full Text PDFBackground: Although periods of HIV antiretroviral therapy (ART) discontinuation have deleterious health effects, ART is not always sustained. Yet, little is known about factors that contribute to such ART non-persistence among long-term HIV survivors. The present study applied a convergent parallel mixed-methods design to explore the phenomena of stopping/starting and sustaining ART, focusing on low-socioeconomic status African American or Black and Latino persons living with HIV (PLWH) who face the greatest challenges.
View Article and Find Full Text PDFThe COVID-19 pandemic has great potential to disrupt the lives of persons living with HIV (PLWH). The present convergent parallel design mixed-methods study explored the early effects of COVID-19 on African American/Black or Latino (AABL) long-term survivors of HIV in a pandemic epicenter, New York City. A total of 96 AABL PLWH were recruited from a larger study of PLWH with non-suppressed HIV viral load.
View Article and Find Full Text PDFDespite high rates of Hepatitis C virus (HCV) infection among people who use drugs (PWUDs), access to the HCV care continuum combined with the receipt of medications for addiction treatment in primary care settings remains suboptimal. A qualitative study was conducted among adults admitted for inpatient detoxification for opioid use disorder (OUD) in New York City (n=23) to assess barriers and facilitators with HCV prevention, screening, treatment, interactions with primary care providers, and experiences with integrated care approaches. Study findings yielded six major themes related to HCV care.
View Article and Find Full Text PDFPrevious studies have found impaired affective decision-making, as measured by the Iowa Gambling Task (IGT), in various antisocial populations. This is the first study to compare the IGT in violent and nonviolent incarcerated American youth. The IGT was administered to 185 incarcerated adolescent male offenders charged with either nonviolent (38.
View Article and Find Full Text PDFBackground: Persons living with HIV (PLWH) are living longer, although racial/ethnic and socioeconomic status (SES) disparities persist. Yet, little is known about the experience of living with and managing HIV over decades. The present study took a qualitative approach and used the lens of symbolic violence, a type of internalized, non-physical violence manifested in the power differential between social groups.
View Article and Find Full Text PDFBackground: Ambulatory assessment of electrodermal activity (EDA) is an emerging technique for capturing individuals' autonomic responses to real-life events. There is currently little guidance available for processing and analyzing such data in an ambulatory setting.
Objective: This study aimed to describe and implement several methods for preprocessing and constructing features for use in modeling ambulatory EDA data, particularly for measuring stress.
We examined technology use patterns (e.g., mobile phone and computer ownership, text messaging, internet access) and preferences for adopting health information technologies to optimize office-based treatment for substance use disorders, HIV, and Hepatitis C virus (HCV) infection.
View Article and Find Full Text PDFIt is estimated that one in six Black and Latino adult persons living with HIV (PLWH) spend time in correctional institutions each year. Yet after release, PLWH of color evidence poor HIV health outcomes across the HIV care continuum. This study, guided by an ecological approach and Critical Race Theory, sought to understand the lived experiences of socioeconomically disadvantaged PLWH of color who received an HIV diagnosis and/or medical care while incarcerated, and the ways in which those experiences influenced engagement in medical care after release.
View Article and Find Full Text PDFRunaway and homeless youth (RHY) are dependent on the specialized settings that locate, engage, and serve them. Yet, little research has focused on the features of effective settings for RHY. The present qualitative study, grounded in the Youth Program Quality Assessment model, explored characteristics of higher quality organizations for RHY and gaps that remain from staff and RHY perspectives.
View Article and Find Full Text PDFBackground: Many adolescent mothers are parenting young children under highly stressful conditions as they are managing first-time parenthood, poverty, lack of housing, school and work, and challenging peer and familial relationships. Mobile health (mHealth) technology has the potential to intervene at various points in the emotion regulation process of adolescent mothers to provide them support for more adaptive emotional and behavioral regulation in the course of their daily life.
Objective: The goal of this study was to examine the acceptability, feasibility, use patterns, and mechanisms by which a mobile technology used as an adjunct to in-person, provider-delivered sessions fostered adolescent mothers' adaptive emotion regulation strategies under real-life conditions.
Background: Technology-based interventions offer a practical, low-cost, and scalable approach to optimize the treatment of substance use disorders (SUDs) and related comorbidities (HIV, hepatitis C infection). This study assessed technology use patterns (mobile phones, desktop computers, internet, social media) among adults enrolled in inpatient detoxification treatment.
Methods: A 49-item, quantitative and qualitative semi-structured survey assessed for demographic characteristics, technology use patterns (ie, mobile phone, text messaging [TM], smart phone applications, desktop computer, internet, and social media use), privacy concerns, and barriers to technology use.
To characterize the prevalence of tobacco, alcohol, and drug use and the acceptability of screening in university health centers. Five hundred and two consecutively recruited students presenting for primary care visits in February and August, 2015, in two health centers. Participants completed anonymous substance use questionnaires in the waiting area, and had the option of sharing results with their medical provider.
View Article and Find Full Text PDFThis study primarily tests whether incarceration negatively affects cognitive functioning; namely emotion regulation, cognitive control, and emotion recognition. As a secondary interest, we test protective effects of a Cognitive Behavioral Therapy/Mindfulness Training (CBT/MT) intervention. Dormitories containing 197 incarcerated males aged 16-18 were randomly assigned to either a CBT/MT program or an active control condition.
View Article and Find Full Text PDFRunaway and homeless youth (RHY) comprise a large population of young people who reside outside the control and protection of parents and guardians and who experience numerous traumas and risk factors, but few buffering resources. Specialized settings have developed to serve RHY, but little is known about their effects. The present cross-sectional qualitative descriptive study, grounded in the positive youth development approach and the Youth Program Quality Assessment model, addressed this gap in the literature.
View Article and Find Full Text PDFBackground: Annual HIV testing is recommended for populations at-risk for HIV in the United States, including heterosexuals geographically connected to urban high-risk areas (HRA) with elevated rates of HIV prevalence and poverty, who are primarily African American/Black or Hispanic. Yet this subpopulation of "individuals residing in HRA" (IR-HRA) evidence low rates of regular HIV testing. HIV stigma is a recognized primary barrier to testing, in part due to its interaction with other stigmatized social identities.
View Article and Find Full Text PDFOrganizations for runaway and homeless youth (RHY) provide essential services to highly vulnerable youth who have a wide variety of basic needs and complex psychosocial challenges. We present a mixed-methods case study of an RHY organization to identify the specific mechanisms and processes by the organization successfully promotes engagement and positive development of the youth they serve. We analyzed the qualitative and quantitative data separately and then integrated these two strands of data.
View Article and Find Full Text PDFBackground: An increasing number of mobile app interventions have been developed for problem drinking among college students; however, few studies have examined the integration of a mobile app with continuous physiological monitoring and alerting of affective states related to drinking behaviors.
Objective: The aim of this paper was to evaluate the acceptability and feasibility of Mind the Moment (MtM), a theoretically based intervention for female college students with problem drinking that combines brief, in-person counseling with ecological momentary intervention (EMI) on a mobile app integrated with a wearable sensorband.
Methods: We recruited 10 non-treatment seeking, female undergraduates from a university health clinic who scored a 3 or higher on the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) to participate in this pilot study.