A county-level analysis of persons living with HIV in the southern United States

Gray, Seymour J.; Massaro, Tyler; Chen, Isabel; Edholm, Christina J.; Grotheer, Rachel; Zheng, Yu; Chang, Howard H.

doi:10.1080/09540121.2015.1080793

Cited by 13 publications

(11 citation statements)

References 27 publications

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“…There are multiple personal and social factors that contribute to the high rates of HIV in the African American community. These include poverty, lack of access to quality health care, inadequate housing, low HIV testing rates, substance use, stigma, fear, discrimination, and homophobia (Abbott & Williams, 2015; Foster & Gaskins, 2009; Gray et al, 2016; Maulsby et al, 2014; Webel et al, 2014). Southern states struggle with disparities in health care coverage, health status, and health care relative to other areas of the United States.…”

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confidence: 99%

Exploring Experiences and Perceptions of Older African American Males Aging With HIV in the Rural Southern United States

2016

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The HIV (human immunodeficiency virus) epidemic in the United States remains a serious public health concern. Despite treatment and prevention efforts, approximately 50,000 new HIV cases are transmitted each year. Estimates indicate that 44% of all people diagnosed with HIV are living in the southern region of the United States. African Americans represent 13.2% of the United States population; however, 44% (19,540) of reported new HIV cases in 2014 were diagnosed within this ethnic group. The majority of cases were diagnosed in men (73%, 14,305). In the United States, it is estimated that 21% of adults living with HIV are 50 years or older. There exists limited data regarding how well African American men are aging with HIV disease. The purpose of this study was to explore the perceptions and experiences of older African American men living with HIV in rural Georgia. Data were collected from 35 older African American men living with HIV using focus groups and face-to-face personal interviews. Qualitative content analysis revealed six overlapping themes: (1) Stigma; (2) Doing Fine, Most of the Time; (3) Coping With Age-Related Diseases and HIV; (4) Self-Care; (5) Family Support; and (6) Access to Resources. The findings from this study provide new insights into the lives of rural HIV-infected African American men, expands our understanding of how they manage the disease, and why many return to or remain in rural communities.

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confidence: 99%

Exploring Experiences and Perceptions of Older African American Males Aging With HIV in the Rural Southern United States

2016

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“…It is well-documented that HIV disproportionately affects the Black community in the US at large -a disparity that persisted decades beyond the start of the HIV epidemic (13)(14)(15). Unfortunately, our study ndings add to the body of literature highlighting a critical need to adopt new strategies to address these persistent and pervasive racial disparities in HIV outcomes.…”

Section: Discussionmentioning

confidence: 70%

“…Importantly, disparities among racial/ethnic group have persisted in the US over decades, with non-Hispanic Blacks typically performing worse than other racial/ethnic groups across the entire continuum of care (11,12). Racial disparities have been variably attributed to higher rates of poverty, unemployment, and stigma -inequities that are even more pronounced in the Southern US -and thus might drive some of TN's poor performance on linkage to HIV care (11)(12)(13)(14)(15). There are limited data characterizing whether and to what extent signi cant racial disparities in HIV outcomes remain after accounting for both individual and county-level factors known to be associated with poor health outcomes, and disproportionately impacting racial minorities (14,15).…”

Section: Introductionmentioning

confidence: 99%

“…Racial disparities have been variably attributed to higher rates of poverty, unemployment, and stigma -inequities that are even more pronounced in the Southern US -and thus might drive some of TN's poor performance on linkage to HIV care (11)(12)(13)(14)(15). There are limited data characterizing whether and to what extent signi cant racial disparities in HIV outcomes remain after accounting for both individual and county-level factors known to be associated with poor health outcomes, and disproportionately impacting racial minorities (14,15). Such studies are important in the Southern US, home to both a higher rate of incident HIV and more pronounced racial disparities in HIV-related health outcomes than other regions in the US (16).…”

Section: Introductionmentioning

confidence: 99%

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Individual, Community, and Structural Factors Associated With Linkage to HIV Care Among People Diagnosed with HIV in Tennessee

Ahonkhai

Rebeiro

Jenkins

et al. 2020

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Background We assessed trends and identified individual- and county-level factors associated with linkage to HIV care in Tennessee (TN). Methods TN residents diagnosed with HIV from 2012–2016 were included in the analysis (n = 3,750). Linkage was defined by the first CD4 or HIV RNA test date at or after HIV diagnosis. We used modified Poisson regression to estimate probability of 30-day linkage to care at the individual- and county-levels. Results Both MSM (aRR 1.16, 95%CI 1.01–1.32) and women who reported heterosexual sex risk factors (aRR 1.28, 95%CI 1.11–1.48) were more likely to link to care within 30-days than heterosexual males. Non-Hispanic Black individuals had poorer linkage than White individuals (aRR 0.77, 95%CI 0.72–0.83). County-level mentally unhealthy days were negatively associated with linkage (aRR 0.59, 95%CI 0.40–0.88). Conclusions Disparities persist at both individual and county levels and may warrant structural interventions to address racism and mental health needs.

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“…Poverty also plays a role in the Southern HIV epidemic; eight of the ten poorest US states (as measured by lowest median income) are Southern [6]. Poverty may lead to HIV risk in a multitude of ways including direct associations-in one recent study based in the US South, poverty at the county-level was correlated with HIV prevalence [7]. Finally, policies related to health insurance and delivery of healthcare services contribute to regional disparities as well.…”

Section: Introductionmentioning

confidence: 99%

Homonegativity Experienced over the Life Course by Young Black Gay, Bisexual and Other Men Who Have Sex with Men (YB-GBMSM) Living with HIV in Atlanta, Georgia

et al. 2019

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Minority stress theory posits that homonegativity-whether experienced, anticipated, or internalized-adversely impacts health. We conducted qualitative interviews with 28 YB-GBMSM living with HIV to explore manifestations of homonegativity over the life course. Thematic analysis identified patterns in the ways that homonegativity was discussed at different points in participants' lives. Stifling, and sometimes traumatic, familial and religious environments led to experienced homonegativity early in life. These experiences led to anticipated and internalized homonegativity, which in turn shaped sexual identity formation processes in adolescence and into young adulthood. Ultimately, many participants distanced themselves from home environments, seeking and often finding extrafamilial support. Most participants eventually reached self-acceptance of both their sexuality and HIV status. In conclusion, experienced, anticipated and internalized homonegativity were pervasive as YB-GBMSM navigated family and religious environments over the life course. Future interventions should work with youth, families, and churches to prevent these harmful experiences. Keywords Sexual minority health • HIV/AIDS ResumenLa teoría del estrés de las minorías postula que la homonegatividad, ya sea experimentada, anticipada o internalizada, afecta negativamente a la salud. Realizamos entrevistas cualitativas con 28 YB-GBMSM que viven con el VIH para explorar las manifestaciones de homonegatividad a lo largo del curso de la vida. El análisis temático identificó patrones en las formas en que se discutió la homonegatividad en diferentes puntos de la vida de los participantes. Los ambientes sofocantes, a veces traumáticos, familiares y religiosos causaron a una homonegatividad experimentada en la vida temprana. Estas experiencias causaron a una homonegatividad interna e anticipada, que a su vez dio forma a los procesos de formación de la identidad sexual en la adolescencia y en la edad adulta temprana. En última instancia, muchos participantes se distanciaron de los entornos del hogar, buscando y con frecuencia encontrando apoyo extrafamiliar. La mayoría de los participantes finalmente llegaron a la autoaceptación de su sexualidad y su estado de VIH. En conclusión, la homonegatividad experimentada, anticipada e internalizada fue generalizada en los entornos familiares y religiosos de YB-GBMSM durante el curso de la vida. Las intervenciones futuras deberían trabajar con los jóvenes, las familias y las iglesias para prevenir estas experiencias dañinas.

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A county-level analysis of persons living with HIV in the southern United States

Cited by 13 publications

References 27 publications

Exploring Experiences and Perceptions of Older African American Males Aging With HIV in the Rural Southern United States

Exploring Experiences and Perceptions of Older African American Males Aging With HIV in the Rural Southern United States

Individual, Community, and Structural Factors Associated With Linkage to HIV Care Among People Diagnosed with HIV in Tennessee

Homonegativity Experienced over the Life Course by Young Black Gay, Bisexual and Other Men Who Have Sex with Men (YB-GBMSM) Living with HIV in Atlanta, Georgia

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