Integrating Individual and Contextual Factors to Explain Disparities in HIV/STI Among Heterosexual African American Youth: A Contemporary Literature Review and Social Ecological Model

Banks, Devin E.; Hensel, Devon J.; Zapolski, Tamika C. B.

doi:10.1007/s10508-019-01609-6

Cited by 23 publications

(42 citation statements)

References 265 publications

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“…This study had limitations. Although participants did not discuss the stage of the HCV epidemic in the prison setting, several HIV researchers have demonstrated how the epidemic stage of HIV is reflected through the individual, network and community level of the framework [ 21 , 26 , 66 ]. As expected, there was limited discussion by participants of the policy level implications on HCV transmission as this study only included prisoner participants and did not include other stakeholder participants such as correctional administrators and policymakers.…”

Section: Discussionmentioning

confidence: 99%

Violence and hepatitis C transmission in prison—A modified social ecological model

Sazzad

McCredie²,

Treloar

et al. 2020

PLoS ONE

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Background Transmission of hepatitis C virus (HCV) among the prisoner population is most frequently associated with sharing of non-sterile injecting equipment. Other blood-to-blood contacts such as tattooing and physical violence are also common in the prison environment, and have been associated with HCV transmission. The context of such non-injecting risk behaviours, particularly violence, is poorly studied. The modified social-ecological model (MSEM) was used to examine HCV transmission risk and violence in the prison setting considering individual, network, community and policy factors. Methods The Australian Hepatitis C Incidence and Transmission Study in prisons (HITS-p) cohort enrolled HCV uninfected prisoners with injecting and non-injecting risk behaviours, who were followed up for HCV infection from 2004–2014. Qualitative interviews were conducted within 23 participants; of whom 13 had become HCV infected. Deductive analysis was undertaken to identify violence as risk within prisons among individual, network, community, and public policy levels. Results The risk context for violence and HCV exposure varied across the MSEM. At the individual level, participants were concerned about blood contact during fights, given limited scope to use gloves to prevent blood contamination. At the network level, drug debt and informing on others to correctional authorities, were risk factors for violence and potential HCV transmission. At the community level, racial influence, social groupings, and socially maligned crimes like sexual assault of children were identified as possible triggers for violence. At the policy level, rules and regulations by prison authority influenced the concerns and occurrence of violence and potential HCV transmission. Conclusion Contextual concerns regarding violence and HCV transmission were evident at each level of the MSEM. Further evidence-based interventions targeted across the MSEM may reduce prison violence, provide opportunities for HCV prevention when violence occurs and subsequent HCV exposure.

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Section: Discussionmentioning

confidence: 99%

Violence and hepatitis C transmission in prison—A modified social ecological model

Sazzad

McCredie²,

Treloar

et al. 2020

PLoS ONE

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Section: Introductionmentioning

confidence: 99%

“…14 Racial/ethnic disparities in condom use and STI diagnoses continue to persist, which may be at least partially explained by medical mistrust, as well as disparities in access to culturally tailored care and comprehensive sexual health education among AYA of color. 7,[15][16][17] The goal of the current study was to determine trends over time in demographics, sexual behaviors, condom use, and STIs among AYA presenting to an STI clinic.…”

Section: Introductionmentioning

confidence: 99%

Trends in risk behaviors and sexually transmitted infections among youth presenting to a sexually transmitted infection clinic in the United States, 2013–2017

et al. 2022

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Background: Sexually transmitted infections (STIs) are increasing among adolescents and young adults (AYA) across the United States. However, data are scarce on trends in condom use, number of partners, and other STI risk factors among AYA. The present study evaluated associations between sexual behaviors and STI diagnoses over time among AYA. Methods: We evaluated linked encounters of AYA aged 13–26 attending an urban Northeast public STI clinic from 2013–2017. Demographics, risk behaviors, self-reported past year and lifetime STI, and STI diagnosis during clinic encounter (positive test for urine, oral, or anal chlamydia; urine, oral, or anal gonorrhea; urine trichomonas; HIV; and syphilis) were extracted from electronic health records. We estimated prevalence and performed trend analyses of the repeated cross-sectional data. Cochran–Armitage and Kruskal–Wallis trend test were conducted for categorical and continuous variables, respectively. Results: Among 3822 encounters, clinical STIs demonstrated statistically significant increases including chlamydia (+9%, p = 0.001), gonorrhea (+5%, p = 0.008), and syphilis (+3%, p = 0.006) all of which significantly increased over time, as did any STI (+10%, p < 0.001). HIV and trichomonas rates remained low and unchanged. Self-reported STI increased as well, both past year (+9%) and lifetime (+14%). Greater proportions of AYA reported multiple partners (+9%, p < 0.001), and condomless oral (+12%, p = 0.001) and vaginal/anal (+7%, p = 0.001) sex. Conclusion: Among AYA presenting to a STI clinic, the proportion who engaged in condomless sex and had multiple partners increased over a 5 year period, which corresponded to increased STI prevalence during this period. Preventions efforts for AYA should continue to emphasize the importance of condoms and partner selection.

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“…Further, examining how distinct risk profiles differ by racial category could inform race-conscious social ecological models (SEMs) of STI risk. 4,5 Importantly, these SEMs highlight the understudied roles of structural, community, and social contextual factors in risk for STI, including structural inequities and racism that disproportionately impact Black individuals in this country.…”

mentioning

confidence: 97%

“…These structural factors can have downstream effects on community-and social-level risk factors, which in turn influence individual-level STI risk. 4,5 At the structural level, socio-economic status (e.g., public assistance use) represents a salient STI risk factor among Black individuals. 4,5,8 Socio-economic disadvantage experienced by certain subgroups might reflect the impact of structural racism on economic opportunities and access to healthcare that increase STI risk.…”

mentioning

confidence: 99%

Profiles of Young Women's Alcohol and Cannabis use Linked to Risk for Sexually Transmitted Infection Highlight the Importance of Multi-Level Targeted Interventions: Findings from the Pittsburgh Girls Study

et al. 2022

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Background: Social ecological models designed to understand disparities in sexually transmitted infection (STI) prevalence highlight understudied structural and community risk factors. Guided by a social ecological model, this study identified profiles based on substance use-related STI risk, and examined associations of the profiles with selected indicators of structural-, community-, and individual-level STI risk factors. Methods: Repeated measures latent class analysis was applied to Pittsburgh Girls Study data (n ¼ 2,138; 58% Black, 42% White) at ages 18-20. Profile indicators included: women's and partner's alcohol and cannabis use, women's sexual risk behavior, and selfreported STI. Profile predictors included racial background, structural-, community-, and individuallevel risk factors. Results: Two of the five identified profiles had low STI likelihood: "Low Use" of alcohol and cannabis (25.5%; overrepresented by Black women), and "Alcohol Only" (19.1%; overrepresented by White women). Three profiles, all representing co-use of alcohol and cannabis, had higher STI likelihood: "Co-Use: Increasing Alcohol and Occasional Cannabis use" (16.5%; overrepresented by White women), "Co-Use: Occasional Alcohol and Cannabis use" (26.1%; overrepresented by Black women), and "Co-Use: Frequent Cannabis and Occasional Alcohol use" (12.8%; overrepresented by Black women). Structural STI risk (household use of public assistance at wave 1) was associated with "Low Use" and "Co-Use: Frequent Cannabis and Occasional Alcohol use" profiles. STI risk at multiple levels (structural, neighborhood, individual) was associated with the "Co-Use: Frequent Cannabis and Occasional Alcohol use" profile. Conclusions: Co-use of alcohol and cannabis is an important target for STI prevention efforts. Results also highlight structural-and community-level STI risk factors that disproportionately impact Black women, and the importance of multi-level interventions that are targeted to profile of risk to optimize the effectiveness of interventions.

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Integrating Individual and Contextual Factors to Explain Disparities in HIV/STI Among Heterosexual African American Youth: A Contemporary Literature Review and Social Ecological Model

Cited by 23 publications

References 265 publications

Violence and hepatitis C transmission in prison—A modified social ecological model

Violence and hepatitis C transmission in prison—A modified social ecological model

Trends in risk behaviors and sexually transmitted infections among youth presenting to a sexually transmitted infection clinic in the United States, 2013–2017

Profiles of Young Women's Alcohol and Cannabis use Linked to Risk for Sexually Transmitted Infection Highlight the Importance of Multi-Level Targeted Interventions: Findings from the Pittsburgh Girls Study

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