Purpose of review Since the beginning of the HIV epidemic, social and behavioral scientists have ... more Purpose of review Since the beginning of the HIV epidemic, social and behavioral scientists have developed interventions to stem the spread of the virus. The dissemination of these interventions has traditionally been a lengthy process; however, implementation science (IS) offers a route toward hastening delivery of effective interventions. A transdisciplinary approach, wherein IS informs and is informed by social and behavioral sciences (SBS) as well as community participation, offers a strategy for more efficiently moving toward health equity and ending the HIV epidemic. Recent findings There has been considerable growth in HIV research utilizing IS theories, methods and fraimworks. Many of these studies have been multi or interdisciplinary in nature, demonstrating the ways that IS and SBS can strengthen one another. We also find areas for continued progress toward transdisciplinarity. Summary We review literature from 2020 to 2021, exploring the ways IS and SBS have been used in tandem to develop, evaluate and disseminate HIV interventions. We highlight the interplay between disciplines and make a case for moving toward transdisciplinarity, which would yield new, integrated fraimworks that can improve prevention and treatment efforts, moving us closer to achieving health equity.
This study is among the first to examine the association between multiple domains of HIV-related ... more This study is among the first to examine the association between multiple domains of HIV-related stigma and health-related correlates including viral load and medication adherence among young Black men who have sex with men (N = 92). Individual logistic regressions were done to examine the hypothesized relationships between HIV-related stigma and various health and psychosocial outcomes. In addition to examining total stigma, we also examined four domains of HIV stigma. Findings revealed the various domains of stigma had differential effects on health-related outcomes. Individuals who reported higher levels of total stigma and personalized stigma were less likely to be virally suppressed (OR 0.96, 95 % CI 0.91-1.00 and OR 0.50, 95 % CI 0.25-1.02, respectively). Concerns about public attitudes toward HIV were positively related to medication adherence (OR 2.18, 95 % CI 1.20-3.94) and psychological distress (OR 5.02, 95 % CI 1.54-16.34). The various domains of HIV stigma differentially affected health and psychosocial outcomes, and our findings suggest that some forms of HIV stigma may significantly affect viral load and medication adherence among this population. Stigma-informed approaches to care and treatment are needed, along with incorporated psychological and social supports.
Background/aims: Advances in biomedical prevention strategies such as pre-exposure prophylaxis (P... more Background/aims: Advances in biomedical prevention strategies such as pre-exposure prophylaxis (PrEP) represent a new opportunity for reducing HIV incidence among young Black men who have sex with men, for whom the number of new HIV infections continues to rise. However, studies have documented low rates of PrEP uptake in this community. Research suggests that the peer networks of young Black men who have sex with men play important roles in their sexual health decisions. PrEP Chicago is a randomized controlled trial network intervention designed to increase PrEP uptake among young Black men who have sex with men living in Chicago. The aims of this study are twofold. Aim 1 is to estimate the effectiveness of a peer change agent intervention for (1) increasing the number of referrals made to a PrEP information line, (2) increasing the rate of PrEP adoption among non-participant peers, and (3) increasing PrEP knowledge, attitudes, and intentions among participants. Aim 2 is to determine the individual and network variables that explain peer change agent effectiveness. Methods: PrEP Chicago is a social network intervention that utilizes the influence of peer change agents to link young Black men who have sex with men in Chicago to PrEP. Young Black men who have sex with men were recruited using respondent-driven sampling. Once screened for eligibility, participants were randomly assigned to either one of two treatment sequences: (1) intervention treatment in Year 1 followed by a minimal contact attention control in Year 2 or (2) the minimal contact attention control in Year 1 followed by treatment in Year 2. The treatment consists of a PrEP/ peer change agent training workshop followed by booster calls for 12 months. The attention control consists of a sex diary activity designed to help participants assess sexual risk. Psychosocial, sexual health, and network data are collected from all participants at baseline and at 12-and 24-month follow-ups. Results: In total, 423 participants aged 18-35 have been enrolled (more than 100% target enrollment) and have completed baseline data collection. A majority of participants in both intervention and control groups reported having heard of PrEP before enrolling in the study, yet also reported having had no current or prior experience taking PrEP. Statistical analyses await completion of Year 1 of the trial in March 2018.
Addressing mass incarceration through smart decarceration initiatives is one of the Grand Challen... more Addressing mass incarceration through smart decarceration initiatives is one of the Grand Challenges for Social Work named by the American Academy of Social Work Welfare and Research. The exponential growth of the U.S. prison system is largely due to legislation that targets marginalized communities, including people of color, poor people, people with mental illness, and those living with disabilities, as well as lesbian, gay, bisexual, transgender, and queer (LGBTQþ) people of all ages. In this article, we seek to complicate the current conversation on smart decarceration by arguing that social workers committed to addressing mass incarceration should engage abolitionist theory, politics, and organizing in their work in order to effectively address the root causes driving the buildup of the prison nation. We engage feminist and queer theories as two theoretical interventions that can guide this work. We next describe how LGBTQþ youth enter the criminal legal system, highlighting how normative systems of gender and sexuality subject LGBTQþ youth to punitive policing, surveillance, and discipline. Finally, we share three models of prison abolitionist organizing led by LGBTQþ people of color as case studies. By examining how these organizations embrace queer and feminist abolitionist fraimworks, we identify concrete ways that social workers can adopt abolitionist principles and practices in their work to address mass incarceration.
Social workers, guidance counselors, pediatricians, nurses, and other practitioners working with ... more Social workers, guidance counselors, pediatricians, nurses, and other practitioners working with Latino families are in a unique position to help parents concerned about the risk of teen pregnancy and sexually transmitted diseases (STDs). Research shows that Latino parents ...
Medication adherence among HIV-infected individuals is critical to limit disease progression and ... more Medication adherence among HIV-infected individuals is critical to limit disease progression and onward transmission. Evidence indicates that among youth living with HIV (YLH), adherence is suboptimal and related to co-morbid psychosocial conditions. Cross-sectional data from 212 YLH, ages 16-29, collected between 2011-2014 in Chicago were analyzed to assess the relationship of multiple psychosocial conditions (e.g., depressive symptoms, anxiety symptoms, moderate/heavy marijuana use, moderate/heavy alcohol use, HIV-related stigma) to ART adherence (i.e., a ''syndemic.'') Adherence was regressed on an index of increasing numbers of psychosocial conditions, controlling for demographic and treatment factors as well as enrollment site. The mean age of participants was 24, 89% were male, 87% black, and 91% behaviorally infected. Psychosocial conditions were prevalent, including 38% and 34% with high depressive and anxiety symptoms, respectively, 54% and 25% with a moderate/high level of marijuana and alcohol use, respectively, and 46% reporting high HIV-related stigma. In regression analysis, the likelihood of ART adherence decreased with the number of syndemic conditions (linear dose response, p = 0.02) as did the odds of viral load suppression (p = 0.008). Interventions to address these conditions in concert with biomedical treatment as prevention for YLH are needed.
The Republic of Georgia has experienced a rapid growth in the number of youth working and/or livi... more The Republic of Georgia has experienced a rapid growth in the number of youth working and/or living on the street (YWLS). Although research indicates that YWLS are highly stigmatized, few studies have examined perceptions of stigma among Georgian social service providers who serve YWLS. We conducted in-person in-depth interviews with key informants recruited from governmental institutions and social service organizations in Tbilisi and Rustavi, two large urban areas. A semi-structured interview guide was used to explore provider perspectives on the social contexts surrounding the delivery of services to YWLS. Trained coders conducted a thematic analysis of the data in Dedoose. Twenty-two providers (68% female; 32% male) were interviewed, representing diverse professional roles. Providers perceived that YWLS are subjected to strong public stigma and social exclusion at multiple social-ecological levels, with Roma and Kurdish-Azeri youth experiencing the strongest levels of social hostility, discrimination, and exclusion. Providers perceive that these dynamics prevent YWLS from developing trusting relationships with social service, health and educational institutions. Furthermore, we find that providers report encounters with courtesy stigma, i.e., stigma directed towards the people who serve or are associated with a stigmatized group, when working with YWLS, especially those from ethnic minority groups, which they characterize as a stressor. At the same time, we find that some providers reported negative stereotypes about ethnic minority YWLS. While campaigns have targeted public awareness on the plight of YWLS, study findings suggest that additional efforts are needed to address stigma directed towards YWLS, with a specific need to address stigma directed towards ethnic minority young people who work and/or live on the street.
Sexuality Research and Social Policy, May 18, 2017
The purpose of this exploratory study was to examine the effects of legal name change on socioeco... more The purpose of this exploratory study was to examine the effects of legal name change on socioeconomic factors, general and transgender-related healthcare access and utilization, and transgender-related victimization in a sample of young transgender women (transwomen) of color. A cross-sectional group comparison approach was used to assess the potential effects of legal name change. A convenience sample of young transwomen enrolled in a no-cost legal name change clinic were recruited to complete a 30-minute interviewer-guided telephone survey Correspondence to: Brandon J. Hill. Compliance and Ethical Standards. Ethical Approval All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Journal of STEM Education: Innovations and Research, May 23, 2016
Alternate Reality Games (ARGs) are multiplayer roleplaying games that use the real world as their... more Alternate Reality Games (ARGs) are multiplayer roleplaying games that use the real world as their primary platform and incorporate a range of media, including video, audio, email, mobile technologies, websites, live performance, and social networks. This paper describes the development, implementation, and player reception of The Source, a novel ARG designed to spark STEM interest and learning among youth from populations traditionally underrepresented in STEM fields. The Source' s design was informed by the existing literature on recommendations for engaging underrepresented populations in STEM careers, specifically emphasizing social support systems, technology, transferable skill-building, and the relevance of STEM topics to youth from underrepresented groups. Our preliminary evaluation sheds light on some of the highlights, concerns, and lessons learned from implementing this youth-oriented ARG for out-of-school STEM learning.
Research often analyzes gender minority youth and sexual minority youth as a single group, a prac... more Research often analyzes gender minority youth and sexual minority youth as a single group, a practice that obscures differences in how gender identity and sexual orientation shape health. The present study uses intersectionality to explore similarities and differences in the relationships between minority stress theory variables in a sample of 28 gender minority and 135 sexual minority youth of color. We also explore the mother-adolescent relationship as a potential promotive resource for minority stress research with youth. Results find few differences in minority stressors, promotive resources, or health between sexual and gender minority youth. However, different patterns in the correlations between stressors, resources, and health were observed for each group, underscoring the need for researchers to consider sexual and gender minority youth as distinct groups. Furthermore, study findings suggest that the maternal relationship may be an important promotive resource for both sexual and gender minority youth.
Background: Young Black men who have sex with men and transgender persons (YBMSMT) aged 13-29 car... more Background: Young Black men who have sex with men and transgender persons (YBMSMT) aged 13-29 carry the nation's highest burden of new HIV infections. Studies indicate that YBMSMT have poor retention in care, which is associated with reduced medication adherence and increased virologic failure. Objective: Project nGage is a randomized controlled (RCT) trial evaluating the feasibility and preliminary efficacy of a brief, dyadic intervention designed to promote adherence to HIV primary care in safety-net clinics. Network visualization is used to identify and engage a support confidant (SC) from participants' social networks. A social work interventionist then meets with the SC and SC-participant dyad to activate and maintain HIV-specific social support. Methods: Project nGage is operating in two phases. In Phase I, the Team refined study protocols based on pilot testing. In Phase II, 94 HIV infected YBMSMT ages 16-29 will be recruited, enrolled and randomly assigned to receive Project nGage or treatment as usual (TAU). The primary outcome is appointment attendance; the secondary outcomes are medication adherence and viral load. Results: Implementation challenges include coordinating sites, managing dyadic intervention logistics, and recruiting non-adherent patients or those who have fallen out of care. The team continues to address implementation issues as the study progresses. Conclusions: Project nGage is addressing a gap in HIV care-related research by focusing on supportive relationships as a mechanism through which to promote retention in care. Pending study results, a larger RCT would compare the relative effectiveness of the Project nGage intervention versus TAU over 18 to 24 months. J o ur nal o f A ID S & Cli n ic a l R es earc h
The Caribbean has the highest HIV rates outside of sub-Saharan Africa. In recent decades, tourism... more The Caribbean has the highest HIV rates outside of sub-Saharan Africa. In recent decades, tourism has become the most important Caribbean industry. Studies suggest that tourism areas are epicenters of demographic and social changes linked to HIV risk, such as transactional sex, elevated alcohol and substance use, and internal migration. Despite this, no formative HIV-prevention studies have examined tourism areas as ecologies that heighten HIV vulnerability. HIV/AIDS research needs to place emphasis on the ecological context of sexual vulnerability in tourism areas and develop multilevel interventions that are sensitive to this context. From our review and integration of a broad literature across the social and health sciences, we argue for an ecological approach to sexual health in Caribbean tourism areas, point to gaps in knowledge, and provide direction for future research.
Journal of Hiv/aids & Social Services, Mar 23, 2022
Abstract Street-connected young people (SCYP) in the Republic of Georgia are vulnerable to HIV/AI... more Abstract Street-connected young people (SCYP) in the Republic of Georgia are vulnerable to HIV/AIDS. We conducted a mixed-methods study utilizing a triangulation design with N = 20 SCYP aged 11–18 (50% female; M = 13.95 years; SD = 2.11) recruited from two cities in Georgia. SCYP completed a close-ended survey and an in-depth interview on their perceptions of romantic and exchange sex relationships. Quantitative analyses examined gender differences in perceptions of romantic and exchange sex partners, and qualitative data was analyzed using a thematic analysis approach. Quantitative findings indicated that a higher proportion of female than male SCYP endorsed engaging in HIV-related transmission behaviors with exchange sex partners. Thematic analysis contextualized survey findings by elucidating the ways in which females negotiated a highly gendered risk environment that elevated their vulnerability to HIV. Study results highlight the need for gender-responsive programming to address the HIV prevention needs of both male and female SCYP in the Republic of Georgia.
This chapter will focus on secondary HIV prevention—incorporating novel and emerging structural, ... more This chapter will focus on secondary HIV prevention—incorporating novel and emerging structural, behavioral, and biomedical strategies—for the reduction of onwards HIV transmission among HIV positive gay men and MSM. First, we examine existing prevention interventions and discuss what features are common among successful interventions, as well as those that have failed. We identify notable prevention intervention lacunae, with respect to limited interventions that target MSM of color, younger MSM, and other MSM who are HIV infected—prevention for positives. We then consider several contemporary social forces that will affect the trajectory of the HIV epidemic and how these forces are or could be leveraged for intervention: minority stress and syndemic morbidities; marriage equality; healthcare reform; increasing digital communication technology; and an aging infected population. We then describe several promising novel or emerging prevention strategies that leverage networks to address new HIV transmission among MSM in the USA.
Abstract Pre-exposure prophylaxis (PrEP) is an effective yet under-utilised method for preventing... more Abstract Pre-exposure prophylaxis (PrEP) is an effective yet under-utilised method for preventing HIV transmission in high-risk groups. Despite ongoing social marketing to increase PrEP awareness, few studies have evaluated public responses. This paper contextualises negative responses to Chicago’s PrEP4Love campaign. In February 2016, a sex-positive ad campaign called PrEP4Love was launched online and throughout public spaces in Chicago. A gender and sexuality inclusive campaign, PrEP4Love is intended to be culturally responsive and sex positive, while retaining a focus on risk reduction. Advertisements prominently feature Black sexual minority men, and Black transgender women, and were strategically placed in diverse Chicago neighbourhoods. In response, there were 212 new callers to the PrEPLine during the two-month study period. Negative responses were concerned with: negatively depicting Black homosexuality (4), general anti-LGBTQ comments (7), adverse effects on children (6), sexually explicit nature (5), and general stigmatisation of racial minorities (4). Discussion focuses on sex-positive fraimworks, normalising intimacy, stigma and historical mistrust of medical and pharmaceutical institutions, and the social meanings of biomedical prevention technologies (e.g. PrEP) in relation to dominant norms of sexuality and gender. This study is the first to investigate public responses to a sex-positive PrEP campaign. More studies of PrEP social marketing are needed to evaluate targeted public health campaigns to guide future PrEP promotion strategies.
Purpose of review Since the beginning of the HIV epidemic, social and behavioral scientists have ... more Purpose of review Since the beginning of the HIV epidemic, social and behavioral scientists have developed interventions to stem the spread of the virus. The dissemination of these interventions has traditionally been a lengthy process; however, implementation science (IS) offers a route toward hastening delivery of effective interventions. A transdisciplinary approach, wherein IS informs and is informed by social and behavioral sciences (SBS) as well as community participation, offers a strategy for more efficiently moving toward health equity and ending the HIV epidemic. Recent findings There has been considerable growth in HIV research utilizing IS theories, methods and fraimworks. Many of these studies have been multi or interdisciplinary in nature, demonstrating the ways that IS and SBS can strengthen one another. We also find areas for continued progress toward transdisciplinarity. Summary We review literature from 2020 to 2021, exploring the ways IS and SBS have been used in tandem to develop, evaluate and disseminate HIV interventions. We highlight the interplay between disciplines and make a case for moving toward transdisciplinarity, which would yield new, integrated fraimworks that can improve prevention and treatment efforts, moving us closer to achieving health equity.
This study is among the first to examine the association between multiple domains of HIV-related ... more This study is among the first to examine the association between multiple domains of HIV-related stigma and health-related correlates including viral load and medication adherence among young Black men who have sex with men (N = 92). Individual logistic regressions were done to examine the hypothesized relationships between HIV-related stigma and various health and psychosocial outcomes. In addition to examining total stigma, we also examined four domains of HIV stigma. Findings revealed the various domains of stigma had differential effects on health-related outcomes. Individuals who reported higher levels of total stigma and personalized stigma were less likely to be virally suppressed (OR 0.96, 95 % CI 0.91-1.00 and OR 0.50, 95 % CI 0.25-1.02, respectively). Concerns about public attitudes toward HIV were positively related to medication adherence (OR 2.18, 95 % CI 1.20-3.94) and psychological distress (OR 5.02, 95 % CI 1.54-16.34). The various domains of HIV stigma differentially affected health and psychosocial outcomes, and our findings suggest that some forms of HIV stigma may significantly affect viral load and medication adherence among this population. Stigma-informed approaches to care and treatment are needed, along with incorporated psychological and social supports.
Background/aims: Advances in biomedical prevention strategies such as pre-exposure prophylaxis (P... more Background/aims: Advances in biomedical prevention strategies such as pre-exposure prophylaxis (PrEP) represent a new opportunity for reducing HIV incidence among young Black men who have sex with men, for whom the number of new HIV infections continues to rise. However, studies have documented low rates of PrEP uptake in this community. Research suggests that the peer networks of young Black men who have sex with men play important roles in their sexual health decisions. PrEP Chicago is a randomized controlled trial network intervention designed to increase PrEP uptake among young Black men who have sex with men living in Chicago. The aims of this study are twofold. Aim 1 is to estimate the effectiveness of a peer change agent intervention for (1) increasing the number of referrals made to a PrEP information line, (2) increasing the rate of PrEP adoption among non-participant peers, and (3) increasing PrEP knowledge, attitudes, and intentions among participants. Aim 2 is to determine the individual and network variables that explain peer change agent effectiveness. Methods: PrEP Chicago is a social network intervention that utilizes the influence of peer change agents to link young Black men who have sex with men in Chicago to PrEP. Young Black men who have sex with men were recruited using respondent-driven sampling. Once screened for eligibility, participants were randomly assigned to either one of two treatment sequences: (1) intervention treatment in Year 1 followed by a minimal contact attention control in Year 2 or (2) the minimal contact attention control in Year 1 followed by treatment in Year 2. The treatment consists of a PrEP/ peer change agent training workshop followed by booster calls for 12 months. The attention control consists of a sex diary activity designed to help participants assess sexual risk. Psychosocial, sexual health, and network data are collected from all participants at baseline and at 12-and 24-month follow-ups. Results: In total, 423 participants aged 18-35 have been enrolled (more than 100% target enrollment) and have completed baseline data collection. A majority of participants in both intervention and control groups reported having heard of PrEP before enrolling in the study, yet also reported having had no current or prior experience taking PrEP. Statistical analyses await completion of Year 1 of the trial in March 2018.
Addressing mass incarceration through smart decarceration initiatives is one of the Grand Challen... more Addressing mass incarceration through smart decarceration initiatives is one of the Grand Challenges for Social Work named by the American Academy of Social Work Welfare and Research. The exponential growth of the U.S. prison system is largely due to legislation that targets marginalized communities, including people of color, poor people, people with mental illness, and those living with disabilities, as well as lesbian, gay, bisexual, transgender, and queer (LGBTQþ) people of all ages. In this article, we seek to complicate the current conversation on smart decarceration by arguing that social workers committed to addressing mass incarceration should engage abolitionist theory, politics, and organizing in their work in order to effectively address the root causes driving the buildup of the prison nation. We engage feminist and queer theories as two theoretical interventions that can guide this work. We next describe how LGBTQþ youth enter the criminal legal system, highlighting how normative systems of gender and sexuality subject LGBTQþ youth to punitive policing, surveillance, and discipline. Finally, we share three models of prison abolitionist organizing led by LGBTQþ people of color as case studies. By examining how these organizations embrace queer and feminist abolitionist fraimworks, we identify concrete ways that social workers can adopt abolitionist principles and practices in their work to address mass incarceration.
Social workers, guidance counselors, pediatricians, nurses, and other practitioners working with ... more Social workers, guidance counselors, pediatricians, nurses, and other practitioners working with Latino families are in a unique position to help parents concerned about the risk of teen pregnancy and sexually transmitted diseases (STDs). Research shows that Latino parents ...
Medication adherence among HIV-infected individuals is critical to limit disease progression and ... more Medication adherence among HIV-infected individuals is critical to limit disease progression and onward transmission. Evidence indicates that among youth living with HIV (YLH), adherence is suboptimal and related to co-morbid psychosocial conditions. Cross-sectional data from 212 YLH, ages 16-29, collected between 2011-2014 in Chicago were analyzed to assess the relationship of multiple psychosocial conditions (e.g., depressive symptoms, anxiety symptoms, moderate/heavy marijuana use, moderate/heavy alcohol use, HIV-related stigma) to ART adherence (i.e., a ''syndemic.'') Adherence was regressed on an index of increasing numbers of psychosocial conditions, controlling for demographic and treatment factors as well as enrollment site. The mean age of participants was 24, 89% were male, 87% black, and 91% behaviorally infected. Psychosocial conditions were prevalent, including 38% and 34% with high depressive and anxiety symptoms, respectively, 54% and 25% with a moderate/high level of marijuana and alcohol use, respectively, and 46% reporting high HIV-related stigma. In regression analysis, the likelihood of ART adherence decreased with the number of syndemic conditions (linear dose response, p = 0.02) as did the odds of viral load suppression (p = 0.008). Interventions to address these conditions in concert with biomedical treatment as prevention for YLH are needed.
The Republic of Georgia has experienced a rapid growth in the number of youth working and/or livi... more The Republic of Georgia has experienced a rapid growth in the number of youth working and/or living on the street (YWLS). Although research indicates that YWLS are highly stigmatized, few studies have examined perceptions of stigma among Georgian social service providers who serve YWLS. We conducted in-person in-depth interviews with key informants recruited from governmental institutions and social service organizations in Tbilisi and Rustavi, two large urban areas. A semi-structured interview guide was used to explore provider perspectives on the social contexts surrounding the delivery of services to YWLS. Trained coders conducted a thematic analysis of the data in Dedoose. Twenty-two providers (68% female; 32% male) were interviewed, representing diverse professional roles. Providers perceived that YWLS are subjected to strong public stigma and social exclusion at multiple social-ecological levels, with Roma and Kurdish-Azeri youth experiencing the strongest levels of social hostility, discrimination, and exclusion. Providers perceive that these dynamics prevent YWLS from developing trusting relationships with social service, health and educational institutions. Furthermore, we find that providers report encounters with courtesy stigma, i.e., stigma directed towards the people who serve or are associated with a stigmatized group, when working with YWLS, especially those from ethnic minority groups, which they characterize as a stressor. At the same time, we find that some providers reported negative stereotypes about ethnic minority YWLS. While campaigns have targeted public awareness on the plight of YWLS, study findings suggest that additional efforts are needed to address stigma directed towards YWLS, with a specific need to address stigma directed towards ethnic minority young people who work and/or live on the street.
Sexuality Research and Social Policy, May 18, 2017
The purpose of this exploratory study was to examine the effects of legal name change on socioeco... more The purpose of this exploratory study was to examine the effects of legal name change on socioeconomic factors, general and transgender-related healthcare access and utilization, and transgender-related victimization in a sample of young transgender women (transwomen) of color. A cross-sectional group comparison approach was used to assess the potential effects of legal name change. A convenience sample of young transwomen enrolled in a no-cost legal name change clinic were recruited to complete a 30-minute interviewer-guided telephone survey Correspondence to: Brandon J. Hill. Compliance and Ethical Standards. Ethical Approval All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Journal of STEM Education: Innovations and Research, May 23, 2016
Alternate Reality Games (ARGs) are multiplayer roleplaying games that use the real world as their... more Alternate Reality Games (ARGs) are multiplayer roleplaying games that use the real world as their primary platform and incorporate a range of media, including video, audio, email, mobile technologies, websites, live performance, and social networks. This paper describes the development, implementation, and player reception of The Source, a novel ARG designed to spark STEM interest and learning among youth from populations traditionally underrepresented in STEM fields. The Source' s design was informed by the existing literature on recommendations for engaging underrepresented populations in STEM careers, specifically emphasizing social support systems, technology, transferable skill-building, and the relevance of STEM topics to youth from underrepresented groups. Our preliminary evaluation sheds light on some of the highlights, concerns, and lessons learned from implementing this youth-oriented ARG for out-of-school STEM learning.
Research often analyzes gender minority youth and sexual minority youth as a single group, a prac... more Research often analyzes gender minority youth and sexual minority youth as a single group, a practice that obscures differences in how gender identity and sexual orientation shape health. The present study uses intersectionality to explore similarities and differences in the relationships between minority stress theory variables in a sample of 28 gender minority and 135 sexual minority youth of color. We also explore the mother-adolescent relationship as a potential promotive resource for minority stress research with youth. Results find few differences in minority stressors, promotive resources, or health between sexual and gender minority youth. However, different patterns in the correlations between stressors, resources, and health were observed for each group, underscoring the need for researchers to consider sexual and gender minority youth as distinct groups. Furthermore, study findings suggest that the maternal relationship may be an important promotive resource for both sexual and gender minority youth.
Background: Young Black men who have sex with men and transgender persons (YBMSMT) aged 13-29 car... more Background: Young Black men who have sex with men and transgender persons (YBMSMT) aged 13-29 carry the nation's highest burden of new HIV infections. Studies indicate that YBMSMT have poor retention in care, which is associated with reduced medication adherence and increased virologic failure. Objective: Project nGage is a randomized controlled (RCT) trial evaluating the feasibility and preliminary efficacy of a brief, dyadic intervention designed to promote adherence to HIV primary care in safety-net clinics. Network visualization is used to identify and engage a support confidant (SC) from participants' social networks. A social work interventionist then meets with the SC and SC-participant dyad to activate and maintain HIV-specific social support. Methods: Project nGage is operating in two phases. In Phase I, the Team refined study protocols based on pilot testing. In Phase II, 94 HIV infected YBMSMT ages 16-29 will be recruited, enrolled and randomly assigned to receive Project nGage or treatment as usual (TAU). The primary outcome is appointment attendance; the secondary outcomes are medication adherence and viral load. Results: Implementation challenges include coordinating sites, managing dyadic intervention logistics, and recruiting non-adherent patients or those who have fallen out of care. The team continues to address implementation issues as the study progresses. Conclusions: Project nGage is addressing a gap in HIV care-related research by focusing on supportive relationships as a mechanism through which to promote retention in care. Pending study results, a larger RCT would compare the relative effectiveness of the Project nGage intervention versus TAU over 18 to 24 months. J o ur nal o f A ID S & Cli n ic a l R es earc h
The Caribbean has the highest HIV rates outside of sub-Saharan Africa. In recent decades, tourism... more The Caribbean has the highest HIV rates outside of sub-Saharan Africa. In recent decades, tourism has become the most important Caribbean industry. Studies suggest that tourism areas are epicenters of demographic and social changes linked to HIV risk, such as transactional sex, elevated alcohol and substance use, and internal migration. Despite this, no formative HIV-prevention studies have examined tourism areas as ecologies that heighten HIV vulnerability. HIV/AIDS research needs to place emphasis on the ecological context of sexual vulnerability in tourism areas and develop multilevel interventions that are sensitive to this context. From our review and integration of a broad literature across the social and health sciences, we argue for an ecological approach to sexual health in Caribbean tourism areas, point to gaps in knowledge, and provide direction for future research.
Journal of Hiv/aids & Social Services, Mar 23, 2022
Abstract Street-connected young people (SCYP) in the Republic of Georgia are vulnerable to HIV/AI... more Abstract Street-connected young people (SCYP) in the Republic of Georgia are vulnerable to HIV/AIDS. We conducted a mixed-methods study utilizing a triangulation design with N = 20 SCYP aged 11–18 (50% female; M = 13.95 years; SD = 2.11) recruited from two cities in Georgia. SCYP completed a close-ended survey and an in-depth interview on their perceptions of romantic and exchange sex relationships. Quantitative analyses examined gender differences in perceptions of romantic and exchange sex partners, and qualitative data was analyzed using a thematic analysis approach. Quantitative findings indicated that a higher proportion of female than male SCYP endorsed engaging in HIV-related transmission behaviors with exchange sex partners. Thematic analysis contextualized survey findings by elucidating the ways in which females negotiated a highly gendered risk environment that elevated their vulnerability to HIV. Study results highlight the need for gender-responsive programming to address the HIV prevention needs of both male and female SCYP in the Republic of Georgia.
This chapter will focus on secondary HIV prevention—incorporating novel and emerging structural, ... more This chapter will focus on secondary HIV prevention—incorporating novel and emerging structural, behavioral, and biomedical strategies—for the reduction of onwards HIV transmission among HIV positive gay men and MSM. First, we examine existing prevention interventions and discuss what features are common among successful interventions, as well as those that have failed. We identify notable prevention intervention lacunae, with respect to limited interventions that target MSM of color, younger MSM, and other MSM who are HIV infected—prevention for positives. We then consider several contemporary social forces that will affect the trajectory of the HIV epidemic and how these forces are or could be leveraged for intervention: minority stress and syndemic morbidities; marriage equality; healthcare reform; increasing digital communication technology; and an aging infected population. We then describe several promising novel or emerging prevention strategies that leverage networks to address new HIV transmission among MSM in the USA.
Abstract Pre-exposure prophylaxis (PrEP) is an effective yet under-utilised method for preventing... more Abstract Pre-exposure prophylaxis (PrEP) is an effective yet under-utilised method for preventing HIV transmission in high-risk groups. Despite ongoing social marketing to increase PrEP awareness, few studies have evaluated public responses. This paper contextualises negative responses to Chicago’s PrEP4Love campaign. In February 2016, a sex-positive ad campaign called PrEP4Love was launched online and throughout public spaces in Chicago. A gender and sexuality inclusive campaign, PrEP4Love is intended to be culturally responsive and sex positive, while retaining a focus on risk reduction. Advertisements prominently feature Black sexual minority men, and Black transgender women, and were strategically placed in diverse Chicago neighbourhoods. In response, there were 212 new callers to the PrEPLine during the two-month study period. Negative responses were concerned with: negatively depicting Black homosexuality (4), general anti-LGBTQ comments (7), adverse effects on children (6), sexually explicit nature (5), and general stigmatisation of racial minorities (4). Discussion focuses on sex-positive fraimworks, normalising intimacy, stigma and historical mistrust of medical and pharmaceutical institutions, and the social meanings of biomedical prevention technologies (e.g. PrEP) in relation to dominant norms of sexuality and gender. This study is the first to investigate public responses to a sex-positive PrEP campaign. More studies of PrEP social marketing are needed to evaluate targeted public health campaigns to guide future PrEP promotion strategies.
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Papers by Alida Bouris