Associations Between Health Insurance Coverage with HIV Detection and Prevention Behaviors Among Individuals with Undiagnosed HIV or at Increased Risk for HIV Infection in the USA.

Background: Improving HIV detection and prevention remains a critical public health initiative that requires policy-based solutions. This study sought to compare HIV detection/prevention behaviors before and after healthcare reform in Massachusetts, USA, among heterosexually active persons - the group with the highest reported number of undiagnosed HIV cases. The current study sought to (1) characterize differences in insurance coverage and HIV detection/prevention behaviors between cycles 1 (2006) to 5 (2019); (2) evaluate socio-demographic disparities in insurance coverage accounting for cycle; and (3) evaluate associations between health insurance coverage and HIV detection/prevention behaviors accounting for cycle and socio-demographics.

The shame spiral of addiction: Negative self-conscious emotion and substance use.

Background: The bidirectional associations between negative self-conscious emotions such as shame and guilt and substance use are poorly understood. Longitudinal research is needed to examine the causes, consequences, and moderators of negative self-conscious emotions in people who use substances.

Methods: Using parallel process latent growth curve modeling, we assessed bidirectional associations between shame and guilt and substance use (i.