We examined resilience associated with the avoidance of psychosocial health conditions (i.e., syndemics) that increase vulnerability for HIV among young Black gay and bisexual men. We used analytic induction to compare a sample of 23 men who showed no evidence of syndemic conditions to a sample of 23 men who experienced syndemic conditions. The men who avoided syndemics reported supportive relationships with people who helped them to develop a strong sense of identity, provided them with opportunities to give back to their communities, and promoted positive norms about health. In contrast, the men experiencing syndemic conditions described numerous instances of trauma and oppression that infringed upon their desire to form positive relationships. Among these men, experiences of oppression were associated with shame, identity incongruence, social isolation, relational disconnection, mistrust of men, and expectations of further marginalization. We examined participants' experiences through the framework of the psychosocial sense of community. Results of this study provide evidence for using strength-based intervention strategies to prevent syndemic conditions. Findings suggest that to attenuate socio-structural barriers to health and comorbid psychosocial health concerns, interventions must address young men's social isolation and promote positive identity and sense of community. Keywords SyndemicsHIV prevention Gay and bisexual men Black men Resilience Adolescents and young adults
Reducing HIV incidence among adolescents represents an urgent global priority. Structural change approaches to HIV prevention may reduce youth risk by addressing the economic, social, cultural, and political factors that elevate it. We assessed whether achievement of structural changes made by eight Connect-to-Protect (C2P) coalitions were associated with improvements in youth’s views of their community over the first 4 years of coalitions’ mobilization. We recruited annual cross-sectional samples of targeted youth from each C2P community. We sampled youth in neighborhood venues. We interviewed a total of 2461 youth over 4 years. Males (66 %) and youth of color comprised the majority (52 % Hispanic/Latinos; 41 % African Americans) of those interviewed. By year 4, youth reported greater satisfaction with their community as a youth-supportive setting. They reported their needs were better met by available community resources compared with year 1. However, these findings were moderated by risk population such that those from communities where C2P focused on young men who have sex with men (YMSM) reported no changes over time whereas those from communities focused on other at-risk youth reported significant improvements over time in satisfaction and resource needs being met. Internalized HIV stigma increased over time among those from communities serving other at-risk youth and was unchanged among those from YMSM communities. The very different results we observe over time between communities focused on YMSM versus other at-risk youth may suggest it is unreasonable to assume identical chains of structural causality across youth populations who have such different historical relationships to HIV and who encounter very different kinds of entrenched discrimination within their communities.
BackgroundCell-to-cell communication between the blastocyst and endometrium is critical for implantation. In recent years, evidence has emerged from studies in humans and several other animal species that exosomes are secreted from the endometrium and trophoblast cells and may play an important role in cell-to-cell communication maternal-fetal interface during early pregnancy. Exosomes are stable extracellular lipid bilayer vesicles that encapsulate proteins, miRNAs, and mRNAs, with the ability to deliver their cargo to near and distant sites, altering cellular function(s). Furthermore, the exosomal cargo can be altered in response to environmental cues (e.g. hypoxia). The current study aims to develop an in vitro system to evaluate maternal-embryo interactions via exosomes (and exosomal cargo) produced by bovine endometrial stromal cells (ICAR) using hypoxia as a known stimulus associated with the release of exosomes and alterations to biological responses (e.g. cell proliferation).MethodsICAR cells cultured under 8 % O2 or 1 % O2 for 48 h and changes in cell function (i.e. migration, proliferation and apoptosis) were evaluated. Exosome release was determined following the isolation (via differential centrifugation) and characterization of exosomes from ICAR cell-conditioned media. Exosomal proteomic content was evaluated by mass spectrometry.ResultsUnder hypoxic conditions (i.e. 1 % O2), ICAR cell migration and proliferation was decreased (~20 and ~32 %, respectively) and apoptotic protein caspase-3 activation was increased (∼1.6 fold). Hypoxia increased exosome number by ~3.6 fold compared with culture at 8 % O2. Mass spectrometry analysis identified 128 proteins unique to exosomes of ICAR cultured at 1 % O2 compared with only 46 proteins unique to those of ICAR cultured at 8 % O2. Differential production of proteins associated with specific biological processes and molecular functions were identified, most notably ADAM10, pantetheinase and kininogen 2.ConclusionsIn summary, we have shown that a stimulus such as hypoxia can alter both the cellular function and exosome release of ICAR cells. Alterations to exosome release and exosomal content in response to stimuli may play a crucial role in maternal-fetal crosstalk and could also affect placental development.
The purpose of this study was to examine one interpersonal relationship—natural mentoring relationships—that may promote healthy development among young Black men who have sex with men (YBMSM), a population at disproportionate risk of multiple psychosocial health issues. We analyzed data from interviews with 168 YBMSM. We used content analysis to identify who participants cited as mentors, their personal characteristics, and the functions they played in youths’ lives. Participants frequently cited women and family members as mentors. Participants preferred as mentors people with whom they shared key attributes and who they considered successful and resilient. Mentors played roles in participant’s identity construction, cognitive development, and emotional development. Findings suggest that mentors have significant influence in the development of YBMSM. Incorporating natural mentors into health promotion interventions may be one means of enhancing the cultural relevance of interventions for this population.
Over the prior decade, structural change efforts have become an important component of community-based HIV prevention initiatives. However, these efforts may not succeed when structural change initiatives encounter political resistance or invoke conflicting values, which may be likely when changes are intended to benefit a stigmatized population. The current study sought to examine the impact of target population stigma on the ability of 13 community coalitions to achieve structural change objectives. Results indicated that coalitions working on behalf of highly stigmatized populations had to abandon objectives more often than did coalitions working for less stigmatized populations because of external opposition to coalition objectives and resultant internal conflict over goals. Those coalitions that were most successful in meeting external challenges used opposition and conflict as transformative occasions by targeting conflicts directly and attempting to neutralize oppositional groups or turn them into strategic allies; less successful coalitions working on behalf of stigmatized groups struggled to determine an appropriate response to opposition. The role of conflict transformation as a success strategy for working on behalf of stigmatized groups is discussed.
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