Older African Americans and the HIV Care Continuum: A Systematic Review of the Literature, 2003–2018

Sangaramoorthy, Thurka; Jamison, Amelia M.; Dyer, Typhanye V.

doi:10.1007/s10461-018-2354-4

Cited by 19 publications

(34 citation statements)

References 58 publications

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“…Research based on the Theory of Planned Behavior found that, among Black American women, fear of condom negotiation was negatively associated with behavioral intent and condom use [ 30 ]. Still, later investigations suggest that barriers such as HIV stigma, lack of social support, and negative perceptions of healthcare providers are substantial barriers to engagement in the HIV continuum of care for Black individuals living with HIV [ 31 , 32 ]. On the other hand, having social support, having a good relationship with healthcare providers, and reassurance about one’s health served as facilitating factors of care engagement [ 31 , 33 ].…”

Section: A Proposed Alternative Approach For Black American Healthmentioning

confidence: 99%

Black Lives Matter Principles as an Africentric Approach to Improving Black American Health

Anderson-Carpenter

2020

J. Racial and Ethnic Health Disparities

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Although public health has made substantial advances in closing the health disparity gap, Black Americans still experience inequalities and inequities. Several theoretical frameworks have been used to develop public health interventions for Black American health; yet the existing paradigms do not fully account for the ontology, epistemology, or axiology of Black American populations. The Black Lives Matter (BLM) movement provides a basis for understanding the constructs that may contribute to Black American health. By drawing from the 13 BLM principles, this paper presents an alternative approach for developing, implementing, and evaluating public health interventions for Black populations in the USA. Furthermore, the approach may inform future public health research and policies to reduce health disparities within and across Black populations in the USA. Keywords Public health interventions. African American. Black American. Population health. Health disparities. Black Lives Matter "When Black people get free, everybody gets free." Alicia Garza, co-founder of the Black Lives Matter movement 1 Although there is disagreement on whether to use Black or African American, I will use the Black identifier throughout this article to underscore that some people of African descent living in the USA are descendants of Africans from across the transatlantic slave trade.

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Section: A Proposed Alternative Approach For Black American Healthmentioning

confidence: 99%

Black Lives Matter Principles as an Africentric Approach to Improving Black American Health

Anderson-Carpenter

2020

J. Racial and Ethnic Health Disparities

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“…This finding is likely multifactorial and could be a reflection of larger racial disparities in the healthcare system stemming from both systemic racism and individual experiences of discrimination. It has been noted that older African Americans are less likely to be engaged in care compared with older populations of other races [ 33 ]. This disparity is concerning because engagement in care is associated with improvement in quality of life, increased longevity, and decreased HIV transmission [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…Older African Americans in the United States face a disproportionate risk of acquiring HIV and have higher rates of morbidity and mortality compared with non-black older adults [ 35 ]. A recent systematic review about older African Americans’ engagement in the HIV care continuum highlighted some obstacles to engagement and retention in care as societal and structural barriers such as stigma, poverty, and lack of access to transportation and healthcare [ 33 ]. The presence of multimorbidity was also cited as a barrier to engagement and retention in HIV care [ 33 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…A recent systematic review about older African Americans’ engagement in the HIV care continuum highlighted some obstacles to engagement and retention in care as societal and structural barriers such as stigma, poverty, and lack of access to transportation and healthcare [ 33 ]. The presence of multimorbidity was also cited as a barrier to engagement and retention in HIV care [ 33 , 36 ]. This relationship between engagement in care and race was not present in the later cohort.…”

Section: Discussionmentioning

confidence: 99%

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Human Immunodeficiency Virus (HIV) and Aging: Multimorbidity in Older People With HIV in One Nonurban Southeastern Ryan White HIV/AIDS Program Clinic

Arant

Harding

Geba

et al. 2020

Open Forum Infectious Diseases

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Background Age-related chronic conditions are becoming more concerning for people with human immunodeficiency virus (PWH). We aimed to identify characteristics associated with multimorbidity and evaluate for association between multimorbidity and human immunodeficiency virus (HIV) outcomes. Methods Cohorts included PWH aged 45–89 with ≥1 medical visit at one Ryan White HIV/AIDS Program (RWHAP) Southeastern HIV clinic in 2006 (Cohort 1) or 2016 (Cohort 2). Multimorbidity was defined as ≥2 chronic diseases. We used multivariable logistic regression to assess for associations between characteristics and multimorbidity and between multimorbidity and HIV outcomes. Results Multimorbidity increased from Cohort 1 (n = 149) to Cohort 2 (n = 323) (18.8% vs 29.7%, P < .001). Private insurance was associated with less multimorbidity than Medicare (Cohort 1: adjusted odds ratio [aOR] = 0.15, 95% confidence interval [CI] = 0.02–0.63; Cohort 2: aOR = 0.53, 95% CI = 0.27–1.00). In Cohort 2, multimorbidity was associated with female gender (aOR, 2.57; 95% CI, 1.22–5.58). In Cohort 1, black participants were less likely to be engaged in care compared with non-black participants (aOR, 0.72; 95% CI, 0.61–0.87). In Cohort 2, participants with rural residences were more likely to be engaged in care compared with those with urban residences (aOR, 1.23; 95% CI, 1.10–1.38). Multimorbidity was not associated with differences in HIV outcomes. Conclusions Although PWH have access to RWHAP HIV care, PWH with private insurance had lower rates of multimorbidity, which may reflect better access to preventative non-HIV care. In 2016, multimorbidity was higher for women. The RWHAP and RWHAP Part D could invest in addressing these disparities related to insurance and gender.

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“…and colleagues' ethnographic research among aging women and men, for example, suggests that medications and their weathering effects might be responsible for other chronic conditions, frailty, and disability. 38,41,42,43 Controlling rising and new infections in certain groups in the US South and the Global South, where many HIV-positive people reside and most new infections occur, is challenged by health systems that are fragmented and under-resourced in ways that make the interventions outlined in the Ending the HIV Epidemic strategy difficult. 44 The US South, for example, simply does not have the human, infrastructural, and organizational resources to develop comprehensive prevention programs, nor has it been adequately equipped to provide quality and timely care for the management of HIV.…”

Section: Hiv/aids Exceptionalismmentioning

confidence: 99%

Exceptionalism at the End of AIDS

Benton

Sangaramoorthy

2021

AMA Journal of Ethics

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HIV/AIDS exceptionalism promoted compassion, garnered funding, built institutions, and shaped regulatory and research agendas under emergency conditions. Globally, however, HIV/AIDS exceptionalism has further fragmented fragile health service delivery systems in vulnerable, marginalized communities and created perverse incentives to influence seropositive individuals' behaviors. Even where HIV epidemics are viewed as "controlled" or "resolved" (as in the United States), ending AIDS requires eliminating exceptionalism, normalizing justice-based approaches to HIV care, and explicitly acknowledging how power dynamics shape popular narratives and practices.To claim one AMA PRA Category 1 Credit TM for the CME activity associated with this article, you must do the following: (1) read this article in its entirety, (2) answer at least 80 percent of the quiz questions correctly, and (3) complete an evaluation. The quiz, evaluation, and form for claiming AMA PRA Category 1 Credit TM are available through the AMA Ed Hub TM .HIV/AIDS Research When we began planning this essay, we talked about the experiences that led us to HIV/AIDS research.A.B.: In 1997, I enrolled in my first (and only) undergraduate anthropology course, "AIDS in International Perspective." It was a small seminar-no more than a dozen studentsfor which we read hundreds of pages per week and, on a weekly basis, met someone from the AIDS community in southern New England. The course's instructors also required us to volunteer in one of the many AIDS programs in our small state. I joined an AIDS peer-education group geared toward out-of-school youth and became the group's co-leader the following year. Over the next 5 years, I worked for prison doctors who specialized in HIV treatment, interned in the Department for HIV/AIDS Prevention at the Centers for Disease Control and Prevention (CDC), and consulted for a range of HIV/AIDS programs for international nongovernmental organizations in sub-Saharan Africa. Ten years after that first anthropology course, I completed dissertation fieldwork among HIV-positive Sierra Leoneans, funded by an AIDS training grant from the National Institutes of Health (NIH).

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Older African Americans and the HIV Care Continuum: A Systematic Review of the Literature, 2003–2018

Cited by 19 publications

References 58 publications

Black Lives Matter Principles as an Africentric Approach to Improving Black American Health

Black Lives Matter Principles as an Africentric Approach to Improving Black American Health

Human Immunodeficiency Virus (HIV) and Aging: Multimorbidity in Older People With HIV in One Nonurban Southeastern Ryan White HIV/AIDS Program Clinic

Exceptionalism at the End of AIDS

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