International Journal of Environmental Research and Public Health

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22 pages, 549 KiB

Open AccessArticle

Dimensions of Sexual Health Conversations among U.S. Black Heterosexual Couples

by Natalie M. Leblanc, Noelle M. St. Vil, Keosha T. Bond, Jason W. Mitchell, Adrian C. Juarez, Faith Lambert, Sadandaula R. Muheriwa and James McMahon

Int. J. Environ. Res. Public Health 2023, 20(1), 588; https://doi.org/10.3390/ijerph20010588 - 29 Dec 2022

Viewed by 2105

Abstract

Sexual health communication is an important feature of healthy intimate relationships; however, some couples may avoid discussing difficult matters (e.g., HIV/STI testing, sexual satisfaction) to minimize interpersonal conflict. From October 2018 to May 2019 in New York State, we conducted a multi-method descriptive [...] Read more.

Sexual health communication is an important feature of healthy intimate relationships; however, some couples may avoid discussing difficult matters (e.g., HIV/STI testing, sexual satisfaction) to minimize interpersonal conflict. From October 2018 to May 2019 in New York State, we conducted a multi-method descriptive pilot study to characterize Black heterosexual couples’ (N = 28) sexual health conversations. Partners individually completed an online sexual health/relationship survey before engaging in-person for a joint dyadic qualitative in-depth interview. Quantitative descriptive statistics demonstrated that most absolute score differences among couple’s preferences for sexual health outcomes, communal coping and sexual relationship power were mainly small, but greatest regarding extra-dyadic sexual behaviors. A qualitative descriptive approach discerned, motivation and norms for sexual health conversations, and communication patterns. Thematic and content analysis revealed two central themes: initiating and sustaining sexual health conversations, and leveraging features of the couples to promote sexual health. Integrated findings indicate that couples possess varied communication patterns that operate with motivations for sexual health conversations toward subsequent sexual health promotion. Equitable and skewed communication patterns emerged as relationship assets that can be leveraged to optimize sexual health. There is also opportunity for future work to address communication regarding extra-dyadic behavior and preferences. Asset-based considerations are discussed. Full article

(This article belongs to the Special Issue Optimizing Sexual Health and Wellness: The Role of Interpersonal Relationships and Communication)

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15 pages, 752 KiB

Open AccessArticle

Exploring the Role of Provider–Patient Communication in Women’s Sexual Health and Pre-Exposure Prophylaxis Care in the Primary Care Settings in New York State of the United States

by Chen Zhang, Kevin Fiscella and Yu Liu

Int. J. Environ. Res. Public Health 2022, 19(13), 8084; https://doi.org/10.3390/ijerph19138084 - 1 Jul 2022

Cited by 1 | Viewed by 2619

Abstract

Background: Women shoulder a disproportionate burden of HIV infection in the United States and worldwide. Pre-exposure prophylaxis (PrEP) is an effective tool for HIV prevention, but its use is suboptimal. Primary care providers (PCP) are considered the ideal PrEP caregivers, but they generally [...] Read more.

Background: Women shoulder a disproportionate burden of HIV infection in the United States and worldwide. Pre-exposure prophylaxis (PrEP) is an effective tool for HIV prevention, but its use is suboptimal. Primary care providers (PCP) are considered the ideal PrEP caregivers, but they generally underperform in PrEP care implementation. Methods: From 2020 to 2022, we employed semi-structured in-depth interviews to collect information about barriers and facilitators in PrEP care and beliefs and opinions regarding sexual wellness among 18 PCP and 29 PrEP-eligible women. We employed content analysis and thematic analysis to explore the transcribed narrative data. Results: The current study was guided by the “Communication Pathways” Framework. We studied how communication functions affect PrEP care and women’s sexual wellness on the pathways. We identified several specific pathways between communication and PrEP care implementation in primary care settings, including patient knowledge, linkage to care, therapeutic alliance, and decision making on PrEP care. A paradox regarding who should initiate the discussion regarding sexual history and PrEP care was identified. Conclusions: Findings suggested that a navigation and assistance system for PrEP care in patients and providers is urgently needed. Future studies should facilitate PrEP discussion, engagement, and monitoring in primary care settings. Full article

(This article belongs to the Special Issue Optimizing Sexual Health and Wellness: The Role of Interpersonal Relationships and Communication)

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13 pages, 355 KiB

Open AccessArticle

Associations between Home- and School-Based Violent Experiences and the Development of Sexual Behavior in Young Adolescent Girls in the Rural Southern Region of Malawi

by Sadandaula Rose Muheriwa Matemba, Rosina Cianelli, Natalie M. Leblanc, Chen Zhang, Joseph De Santis, Natalia Villegas Rodriguez and James M. McMahon

Int. J. Environ. Res. Public Health 2022, 19(10), 5809; https://doi.org/10.3390/ijerph19105809 - 10 May 2022

Cited by 2 | Viewed by 1948

Abstract

Studies show that adolescent girls who experience violence grow up with fear and develop survival mechanisms that increase their susceptibility to sexually transmitted infections including HIV. However, the relationship between violence and the development of sexual behavior in young adolescent girls is under-investigated. [...] Read more.

Studies show that adolescent girls who experience violence grow up with fear and develop survival mechanisms that increase their susceptibility to sexually transmitted infections including HIV. However, the relationship between violence and the development of sexual behavior in young adolescent girls is under-investigated. We examined the Malawi Schooling and Adolescent Study data to explore the associations between home- and school-based violence and sexual behaviors in 416 young adolescent girls in rural Southern Malawi. Bivariate Logistic Regression analysis was applied to determine associations. Of 353 (84.9%) girls who had sex with a male partner, 123 (34.8%) experienced home-based violence, and 53 (15%) experienced school-based violence. The odds of girls who experienced home-based violence (OR = 2.46, 95% CI = 1.21, 5.01) and those who first experienced home-based violence between 13 and 14 years (OR = 2.78, 95% CI = 1.35, 5.74) were higher among girls who had multiple sexual partners than those with a single sexual partner. With school-based violence, sexual initiation, having multiple sexual partners, and not using protection were positively associated with experiencing teasing, sexual comments, punching, and touching in private areas in transit to school and by a teacher. These results suggest that home- and school-based violence should be essential components of research and biobehavioral interventions targeting the sexual behaviors of young adolescent girls. Full article

(This article belongs to the Special Issue Optimizing Sexual Health and Wellness: The Role of Interpersonal Relationships and Communication)

10 pages, 320 KiB

Open AccessArticle

Optimizing PrEP Continuance: A Secondary Analysis Examining Perceived Autonomy Support and Care Coordination Quality among Black MSM in HPTN 073

by S. Raquel Ramos, Geetha Beauchamp, Darrell P. Wheeler, Leo Wilton, Darren L. Whitfield, Donte T. Boyd, Lisa Hightow-Weidman, Sheldon D. Fields, LaRon E. Nelson and on behalf of the HPTN 073 Team

Int. J. Environ. Res. Public Health 2022, 19(8), 4489; https://doi.org/10.3390/ijerph19084489 - 8 Apr 2022

Cited by 2 | Viewed by 2909

Abstract

At the end of year 2018, it was estimated that in the United States over 1 million people were living with HIV. Although Black/African American individuals comprise an estimated 13.4% of the US population, as of 2019, they represented an estimated 42% of [...] Read more.

At the end of year 2018, it was estimated that in the United States over 1 million people were living with HIV. Although Black/African American individuals comprise an estimated 13.4% of the US population, as of 2019, they represented an estimated 42% of all new HIV diagnoses in 2018. PrEP use among Black men who have sex with men has not reached levels sufficient to have a population impact on HIV incidence. The purpose of this study was to examine whether high perceived autonomy support and care coordination quality were associated with PrEP continuation. Secondary analyses were conducted on data with 226 Black MSM in three US cities. Participants who were PrEP users and scored higher on autonomy support at week 8 were significantly more likely to continue PrEP (OR 1.48; 95% CI 1.04–2.11). Perception of coordination quality did not differ between PrEP users and non-users at any of the visits. Although coordination quality was not statistically significant, greater than half of PrEP users and non-PrEP users utilized the C4 services. Addressing social, individual, and structural barriers to PrEP may benefit Black MSM irrespective of their PrEP use. Full article

(This article belongs to the Special Issue Optimizing Sexual Health and Wellness: The Role of Interpersonal Relationships and Communication)

12 pages, 326 KiB

Open AccessArticle

Let Me Prep You to PREP Me: Amplifying the Voices of Black Women and Their Providers to Consider PrEP as an HIV Prevention Option

by Rasheeta Chandler, Dominique Guillaume, Jessica Wells and Natalie Hernandez

Int. J. Environ. Res. Public Health 2022, 19(3), 1414; https://doi.org/10.3390/ijerph19031414 - 27 Jan 2022

Cited by 26 | Viewed by 5067

Abstract

Despite the high efficacy of pre-exposure prophylaxis (PrEP) in preventing HIV acquisition, PrEP uptake among Black cisgender women remains low. Our qualitative study assessed Black cisgender women’s perspectives, attitudes, and acceptability towards PrEP, in addition to exploring PrEP-related attitudes, facilitators, and barriers to [...] Read more.

Despite the high efficacy of pre-exposure prophylaxis (PrEP) in preventing HIV acquisition, PrEP uptake among Black cisgender women remains low. Our qualitative study assessed Black cisgender women’s perspectives, attitudes, and acceptability towards PrEP, in addition to exploring PrEP-related attitudes, facilitators, and barriers to PrEP access among health care staff. This study was conducted to ascertain data to inform the development of our HIV prevention app—Savvy HER—which is being designed for Black cisgender women. Our findings indicated that Black women had low levels of PrEP acceptability and high levels of misconceptions, inaccurate knowledge, and stigma towards PrEP. Health care providers in our sample confirmed barriers of stigma, misconceptions, and knowledge among their patients coupled with difficulty accessing PrEP due to structural barriers. Our study indicated that there is a critical need to heighten Black cisgender women’s PrEP knowledge and HIV risk perception in order to increase PrEP acceptability and uptake. Full article

(This article belongs to the Special Issue Optimizing Sexual Health and Wellness: The Role of Interpersonal Relationships and Communication)

11 pages, 329 KiB

Open AccessArticle

Assessing Different Types of HIV Communication and Sociocultural Factors on Perceived HIV Stigma and Testing among a National Sample of Youth and Young Adults

by Gamji M’Rabiu Abubakari, Martez D. R. Smith, Donte T. Boyd, S. Raquel Ramos, Courtney Johnson, Juan L. Benavides, Megan Threats, Junior L. Allen and Camille R. Quinn

Int. J. Environ. Res. Public Health 2022, 19(2), 1003; https://doi.org/10.3390/ijerph19021003 - 17 Jan 2022

Cited by 5 | Viewed by 3068

Abstract

In the United States, racial/ethnic and sexual youth and young adults (YYA) of color are disproportionately affected by HIV. Subsequently, YYA experience HIV stigma and engage in increased risk behaviors and reduced HIV testing. HIV communication has been identified as a potential buffer [...] Read more.

In the United States, racial/ethnic and sexual youth and young adults (YYA) of color are disproportionately affected by HIV. Subsequently, YYA experience HIV stigma and engage in increased risk behaviors and reduced HIV testing. HIV communication has been identified as a potential buffer to HIV stigma, resulting in health-seeking behaviors, such as HIV testing. In this study, we respond to a meaningful gap in the literature by examining different types of HIV communication and their impact on HIV stigma and HIV testing in a diverse sample of YYA. We analyzed secondary data from the Kaiser Family Foundation National Survey of Teens and Young Adults on HIV/AIDS. A 40-question, web-based survey was conducted with 1437 youth (ages 15–24). Recruitment included a dual sampling method from households with: (1) listed phone numbers, (2) unlisted phone numbers, (3) telephones, (4) no telephone, and (5) only cell phone access. The purpose of the survey was to establish participants’ HIV knowledge, communication, experiences, and testing behaviors. Findings suggested an association between intimate-partner HIV communication, increased HIV testing, and reduced HIV stigma. We also identified differentials in HIV testing and stigma based on gender, income, age, and sexual minority status, explained by HIV communication. Further research is needed that examines ways to use intimate-partner HIV communication to reduce stigma and increase HIV testing among YYA of different sociodemographic characteristics and sexual orientations. Full article

(This article belongs to the Special Issue Optimizing Sexual Health and Wellness: The Role of Interpersonal Relationships and Communication)

17 pages, 5146 KiB

Open AccessArticle

Parents ASSIST: Acceptability and Feasibility of a Video-Based Educational Series for Sexuality-Inclusive Communication between Parents and Gay, Bisexual, and Queer Sons

by Dalmacio D. Flores, Kate Hennessy, Andre Rosario, Jamie Chung, Sarah Wood, Trace Kershaw, Antonia Villarruel and Jose Bauermeister

Int. J. Environ. Res. Public Health 2022, 19(1), 379; https://doi.org/10.3390/ijerph19010379 - 30 Dec 2021

Cited by 4 | Viewed by 3355

Abstract

Young men who have sex with men (YMSM) between the ages of 13 and 24 are a key population for HIV prevention. The parents of gay, bisexual, and queer (GBQ) adolescent males and the sex communication they have with their sons has yet [...] Read more.

Young men who have sex with men (YMSM) between the ages of 13 and 24 are a key population for HIV prevention. The parents of gay, bisexual, and queer (GBQ) adolescent males and the sex communication they have with their sons has yet to be explored as an HIV prevention intervention. We developed an online video series called Parents ASSIST (Advancing Supportive and Sexuality-Inclusive Sex Talks) to educate parents about sexual health topics pertinent to GBQ males. We pilot tested the series with a sample of 54 parents of GBQ males using a single-group post-test design. Participants viewed the videos and completed a survey measuring the acceptability and feasibility of an online video series to educate parents. Most of the parents (70.4%) believed that the videos would make parents more likely to initiate talking about sex with their sons. The results suggest that online videos are an acceptable way for parents to learn about GBQ sexual health topics. Full article

(This article belongs to the Special Issue Optimizing Sexual Health and Wellness: The Role of Interpersonal Relationships and Communication)

14 pages, 1449 KiB

Open AccessArticle

Gender Differences in How Parents, Peers, and Exposure to Sexually Explicit Materials Influence the Intention to Engage in Casual Sex among Adolescents and Young Adults in Taiwan: Applying the Theory of Planned Behavior

by Ying-Hua Tseng, Wen-Li Hou, Shih-Hsien Kuo, Yu-Hsiang Liu, Hui-Ling Wang, Ray C. Hsiao, Fan-Hao Chou and Cheng-Fang Yen

Int. J. Environ. Res. Public Health 2021, 18(24), 13089; https://doi.org/10.3390/ijerph182413089 - 11 Dec 2021

Cited by 1 | Viewed by 2850

Abstract

The aims of this study were to examine gender differences in how parent–child discussions on sex issues, peer interactions around sexual issues, and exposure to sexually explicit materials affect the intention to engage in casual sex among adolescents and young adults in Taiwan. [...] Read more.

The aims of this study were to examine gender differences in how parent–child discussions on sex issues, peer interactions around sexual issues, and exposure to sexually explicit materials affect the intention to engage in casual sex among adolescents and young adults in Taiwan. This cross-sectional survey study recruited 767 participants (348 men and 419 women) aged 15–24 years. The survey collected data on participants’ intention to engage in casual sex, their attitude toward and perception of casual sex based on the theory of planned behavior (TPB) (favorable attitude, perceiving positive social norms toward casual sex, and perceived control over involvement), parent–child and peer discussions about sexual issues, and exposure to sexually explicit materials. The results of multiple regression analysis revealed that parent–child discussions on sex issues, peer interactions around sexual issues, and exposure to sexually explicit materials were significantly associated with the intention to engage in casual sex. The results of structural equation modeling (SEM) further supported that favorable attitude, perceiving positive social norms toward casual sex, and control over involvement mediated the associations. For men, decreased favorable attitude mediated the negative association between parent–child discussions and casual sex intention; increased favorable attitudes and decreased control over involvement mediated the positive associations between peer interactions and casual sex intention. For women, decreased control over involvement mediated the positive association between exposure to sexually explicit materials and casual sex intention. The associations between peer interaction and subjective norms of acceptance, perceived control over involvement, and casual sex intention were stronger in men than in women; the association of favorable attitudes with casual sex intention was also stronger in men than in women. Full article

(This article belongs to the Special Issue Optimizing Sexual Health and Wellness: The Role of Interpersonal Relationships and Communication)

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14 pages, 372 KiB

Open AccessArticle

Reframing Sexual Health for Black Girls and Women in HIV/STI Prevention Work: Highlighting the Role of Identity and Interpersonal Relationships

by Ijeoma Opara, Jasmine A. Abrams, Kristina Cross and Ndidiamaka Amutah-Onukagha

Int. J. Environ. Res. Public Health 2021, 18(22), 12088; https://doi.org/10.3390/ijerph182212088 - 18 Nov 2021

Cited by 13 | Viewed by 5114

Abstract

While Black girls and women are disproportionately impacted by sexual health disparities, there continues to be an overwhelming focus on individual risk behaviors within prevention initiatives, which offers a fragmented narrative of the multidimensional nature of risk and plausibly limits effectiveness of prevention [...] Read more.

While Black girls and women are disproportionately impacted by sexual health disparities, there continues to be an overwhelming focus on individual risk behaviors within prevention initiatives, which offers a fragmented narrative of the multidimensional nature of risk and plausibly limits effectiveness of prevention programs and attenuates reductions in disparities. Because sexual health is experienced within an individual’s beliefs/values, interpersonal relationships, and behaviors and reflects larger social and cultural systems, it is important to critically examine common theories used to inform HIV/STI prevention interventions for Black women and girls. To fill this gap in the literature, we critique two commonly used theories in HIV/STI prevention interventions, namely the social cognitive theory and the theory of gender and power, by highlighting theoretical and practical strengths and weaknesses. We propose research implications that incorporate key strengths of the two theories while adding new concepts grounded in the intersectionality theory. The overall goal is to introduce a more comprehensive conceptual model that is reflective of and applicable to the multidimensional sexual experiences of Black girls and women within the evolving definition of sexual health and behavior. Full article

(This article belongs to the Special Issue Optimizing Sexual Health and Wellness: The Role of Interpersonal Relationships and Communication)

16 pages, 1030 KiB

Open AccessArticle

Participatory Design of a Web-Based HIV Oral Self-Testing Infographic Experiment (HOTIE) for Emerging Adult Sexual Minority Men of Color: A Mixed Methods Randomized Control Trial

by S. Raquel Ramos, David T. Lardier, Jr., Keosha T. Bond, Donte T. Boyd, Olivia M. O’Hare, LaRon E. Nelson, Barbara J. Guthrie and Trace Kershaw

Int. J. Environ. Res. Public Health 2021, 18(22), 11881; https://doi.org/10.3390/ijerph182211881 - 12 Nov 2021

Cited by 4 | Viewed by 3503

Abstract

Health communication is a key health promotion approach for translating research findings into actionable information. The purpose of this study was to use participatory design to create and then test the usability and comprehension of an HIV self-testing infographic in a sample of [...] Read more.

Health communication is a key health promotion approach for translating research findings into actionable information. The purpose of this study was to use participatory design to create and then test the usability and comprehension of an HIV self-testing infographic in a sample of 322 emerging adult, sexual minority men of color. Our study objectives addressed three challenges to HIV self-testing: (1) correct usage of the test stick, (2) understanding the number of minutes to wait before reading the result, and (3) how to correctly interpret a negative or a positive HIV result. This study was a two-phase, sequential, mixed methods, pilot, online, randomized controlled trial. Results suggested a significant mean difference between the control and intervention groups on HIV self-testing knowledge, with the control group outperforming the intervention group. However, two-thirds or better of the participants in the intervention group were able to comprehend the three critical steps to HIV self-testing. This was a promising finding that has resulted in the authors’ development of additional recommendations for using participatory design for visual aid development in HIV prevention research. Participatory design of an HIV self-testing infographic is a rigorous approach, as a health communication strategy, to address public health priorities. Full article

(This article belongs to the Special Issue Optimizing Sexual Health and Wellness: The Role of Interpersonal Relationships and Communication)

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17 pages, 947 KiB

Open AccessArticle

How Can Unintended Pregnancies Be Prevented among Adolescents Who Engaged in Sexual Intercourse at Earlier Ages? The Role of Female Education and Partner Age Difference

by Raquel Pires, Anabela Araújo-Pedrosa, Joana Pereira and Maria Cristina Canavarro

Int. J. Environ. Res. Public Health 2021, 18(20), 10631; https://doi.org/10.3390/ijerph182010631 - 11 Oct 2021

Cited by 2 | Viewed by 2928

Abstract

Several studies have identified explicative factors for adolescents’ sexual risk behaviors and related outcomes such as unintended pregnancy; however, less is known about the mechanisms through which such factors act. Our study explored the role of female education and partner age difference as [...] Read more.

Several studies have identified explicative factors for adolescents’ sexual risk behaviors and related outcomes such as unintended pregnancy; however, less is known about the mechanisms through which such factors act. Our study explored the role of female education and partner age difference as explicative mechanisms of the association between age at first sexual intercourse (AFSI) and unintended pregnancy while controlling for the role of other contextual factors (i.e., socioeconomic status, ethnicity, religious beliefs, and place of residence) and sexual-related mechanisms (i.e., number of sexual partners) that are known to be associated with adolescent pregnancy. The sample consisted of 613 sexually experienced female adolescents who did not intend to become pregnant: 349 were pregnant for the first time, and 264 had never been pregnant. Mediation and moderation analyses were performed. An earlier AFSI was associated with unintended pregnancy 1–6 years after first sexual intercourse by increasing the adolescents’ likelihood of having less education and being involved with partners older than themselves. There was no significant direct effect of AFSI on pregnancy occurrence after controlling for the mediators. Our findings bring to light nonsexual mechanisms that must be considered in public health interventions aimed at preventing unintended pregnancies among adolescents who engaged in sexual intercourse at early ages. Specific implications are discussed. Full article

(This article belongs to the Special Issue Optimizing Sexual Health and Wellness: The Role of Interpersonal Relationships and Communication)

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13 pages, 919 KiB

Open AccessArticle

Psychological Morbidity in Endometriosis: A Couple’s Study

by Maria Graça Pereira, Inês Ribeiro, Hélder Ferreira, Filipa Osório, Cristina Nogueira-Silva and Ana C. Almeida

Int. J. Environ. Res. Public Health 2021, 18(20), 10598; https://doi.org/10.3390/ijerph182010598 - 10 Oct 2021

Cited by 7 | Viewed by 3166

Abstract

Endometriosis is a chronic gynecological disease that impacts more than 176 million women worldwide, having a strong impact on psychological morbidity. This study aimed to evaluate the contribution of psychological morbidity, in women with endometriosis, taking into consideration the duration of the couple’s [...] Read more.

Endometriosis is a chronic gynecological disease that impacts more than 176 million women worldwide, having a strong impact on psychological morbidity. This study aimed to evaluate the contribution of psychological morbidity, in women with endometriosis, taking into consideration the duration of the couple’s relationship and the duration of the disease and also examined whether women’s sexual satisfaction had an impact on their psychological morbidity (actor effect) and on their sexual partners’ psychological morbidity (partner effect) and vice versa. Participants were 105 women and their partners, who answered the Hospital Anxiety and Depression Scale (HADS); Couple Satisfaction Index (CSI-4) and the Global Measure of Sexual Satisfaction (GMSEX). The results revealed a direct effect between the perception of symptom severity, marital satisfaction, and women’s psychological morbidity. Sexual activity and the presence of infertility had an indirect effect on the relationship between sexual satisfaction, diagnosis duration, and psychological morbidity, respectively. Finally, women’s sexual satisfaction had a direct effect on their own and their partner’s marital satisfaction that predicted less psychological morbidity, in both. Thus, a multidisciplinary intervention focused on the couple’s sexual and marital relationship is needed to promote psychological well-being in this population. Full article

(This article belongs to the Special Issue Optimizing Sexual Health and Wellness: The Role of Interpersonal Relationships and Communication)

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15 pages, 357 KiB

Open AccessArticle

Ending the Epidemic: Assessing Sexual Health Communication, Personal Agency, and HIV Stigma among Black and Latino Youth in the U.S

by Lance Keene and Donte Boyd

Int. J. Environ. Res. Public Health 2021, 18(12), 6319; https://doi.org/10.3390/ijerph18126319 - 11 Jun 2021

Cited by 3 | Viewed by 3342

Abstract

Sexual health communication warrants greater attention as it may help to reduce the rates of HIV incidence among youth. A growing body of literature suggests that conversations about sexual health among Black and Latino youth may serve as a potential strategy for HIV [...] Read more.

Sexual health communication warrants greater attention as it may help to reduce the rates of HIV incidence among youth. A growing body of literature suggests that conversations about sexual health among Black and Latino youth may serve as a potential strategy for HIV prevention. The current study investigates whether sexual health communication—in particular, conversations about sexual health and HIV—influences Black and Latino youth’s personal agency regarding their role in achieving an HIV-free generation. For this secondary data analysis, we used the National Survey of Teens and Young Adults on attitudes towards HIV/AIDS (n = 701). Participants included youth between the ages 15 and 24, and the average was 20 years. We used a multiple regression analysis to examine whether sexual health communication contributed to youth knowledge and awareness of (1) the national plan for EHE, and (2) their role in ending the epidemic”. (1) knowledge and awareness of the national plan for EHE, and (2) role in ending the epidemic. The final multiple regression model was statistically significant [R² = 0.16 F (12, 701) = 001, p < 0.001] for both outcomes. Study results found that sexual health communication was positively related to Black and Latino youth’s awareness of efforts to end the HIV epidemic (EHE) and their belief that they could play a role in achieving EHE. In addition, HIV stigma influenced personal agency and whether youth were aware of efforts to achieve EHE. Our results demonstrated that openly communicating about sexual health and HIV may contribute to a sense of personal agency among Black and Latino youth. In addition, understanding whether sexual health communication contributes to a sense of personal agency among youth may inform HIV prevention efforts to achieve the goals set forth by the national EHE plan for the U.S. Full article

(This article belongs to the Special Issue Optimizing Sexual Health and Wellness: The Role of Interpersonal Relationships and Communication)

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14 pages, 668 KiB

Open AccessProtocol

HIV Education, Empathy, and Empowerment (HIVE³): A Peer Support Intervention for Reducing Intersectional Stigma as a Barrier to HIV Testing among Men Who Have Sex with Men in Ghana

by Gamji M’Rabiu Abubakari, Francis Owusu-Dampare, Adedotun Ogunbajo, Joseph Gyasi, Michael Adu, Patrick Appiah, Kwasi Torpey, Laura Nyblade and LaRon E. Nelson

Int. J. Environ. Res. Public Health 2021, 18(24), 13103; https://doi.org/10.3390/ijerph182413103 - 12 Dec 2021

Cited by 19 | Viewed by 4493

Abstract

Men who have sex with men (MSM) in Ghana remain at heightened risk of HIV infection, and face challenges in accessing HIV prevention and care services. Previous research in Ghana shows that MSM face intersectional stigma across ecological levels (family, peers, healthcare settings, [...] Read more.

Men who have sex with men (MSM) in Ghana remain at heightened risk of HIV infection, and face challenges in accessing HIV prevention and care services. Previous research in Ghana shows that MSM face intersectional stigma across ecological levels (family, peers, healthcare settings, and community level) and the criminalization of same-gender sexual behaviors in the country. To protect their wellbeing from exposure to stigma, many MSM avoid interactions with healthcare systems and services, which inadvertently inhibits their opportunities for early detection and treatment of HIV. Consequently, MSM in Ghana carry a disproportionate burden of HIV prevalence (18%) compared to the general population (2%), highlighting the need for culturally relevant processes in HIV/STI prevention, and care communication to optimize sexual health and wellness among MSM in Ghana. To this effect, we collaborated with community partners to use the Assessment, Decision, Adaptation, Production, Topical Experts, Training, Testing (ADAPT-ITT) model to modify a theory-driven smartphone-based peer support intervention to enhance its focus on intersectional stigma reduction, and improve HIV health-seeking behaviors among MSM, including HIV testing and linkage to care. We used the Dennis Peer Support Model to develop the peer support components (emotional, informational, and appraisal support) to increase peer social support, decrease social isolation, and minimize intersectional stigma effects on HIV-related healthcare-seeking behaviors. This paper shows the preliminary acceptability and effectiveness of employing culturally relevant techniques and communication strategies to provide secure peer support to improve HIV prevention and care among key populations in highly stigmatized environments. Full article

(This article belongs to the Special Issue Optimizing Sexual Health and Wellness: The Role of Interpersonal Relationships and Communication)

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