PrEP Demographics and Disparity: The Race, Ethnicity, Gender Identity, Sex Assigned at Birth, Sexual Orientation and Age of Current PrEP Use

Hamilton, Kate; Hasney, Lara; Cohn, Tanya; Posnak, J P

doi:10.1080/07370016.2022.2073791

Cited by 4 publications

(3 citation statements)

References 32 publications

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“…Significant disparities exist both between PrEP eligibility and uptake. For example, there are significant racial disparities with low PrEP uptake for Black individuals compared to people with other racial identities [ 16 ]. Hispanic and Latinx populations face similar disparities in PrEP use; people assigned female at birth, transgender populations, and bisexual and heterosexual populations also experience lower odds of PrEP use compared to their counterparts despite their not insignificant HIV incidence rates [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…For example, there are significant racial disparities with low PrEP uptake for Black individuals compared to people with other racial identities [ 16 ]. Hispanic and Latinx populations face similar disparities in PrEP use; people assigned female at birth, transgender populations, and bisexual and heterosexual populations also experience lower odds of PrEP use compared to their counterparts despite their not insignificant HIV incidence rates [ 16 ]. A variety of factors impede efforts to increase PrEP and substance use treatment access among CLI populations including discrimination based on one’s racial or ethnic identity, misinformation about HIV transmission and treatment, stigma related to an individual’s intersecting identities (eg, CLI status, substance use, race, and ethnicity), distrust of the CL and medical systems, psychiatric symptoms, inability to pay for transportation, lack of familial and social support, and inconsistent access to health care [ 17 - 20 ].…”

Section: Introductionmentioning

confidence: 99%

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eHealth-Enhanced Peer Navigation for Substance Use Treatment and HIV Prevention Service Linkage for Young Adults Surveilled by the Criminal Legal System: Protocol for a Pilot Randomized Trial Study

Creasy,

Sweet,

Myers

et al. 2024

JMIR Res Protoc

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Background In the United States, the proportion of criminal legal–involved (CLI) adults with a substance use disorder reaches 72%, and ~150,000 persons with HIV pass through a carceral setting annually, which represents 16% of the HIV-infected population nationally. Despite the high need for substance use treatment and HIV prevention services, few carceral settings successfully link CLI individuals to treatment upon release. Young adults represent 41.9% of the adults incarcerated in the United States and have the highest HIV incidence rates nationally. Peer patient navigation has successfully increased community-based care linkage for people living with HIV leaving jail; yet, peer-led navigation for HIV prevention among HIV-negative CLI populations is undeveloped and untested. eHealth approaches to substance use and HIV prevention services hold promise because they improve access to effective intervention services, particularly for younger people. Objective This paper describes a protocol for a pilot randomized controlled trial that aims to improve linkage to substance use treatment and HIV prevention services using peer navigation and a codeveloped eHealth technology adjunct. Methods The three aims of this study are to (1) adapt an existing evidence-based navigator model and incorporate codeveloped eHealth technology to refer and link young adults (18 to 29 years) surveilled by the criminal legal system to substance use and pre-exposure prophylaxis (PrEP) services; (2) refine and test the intervention with criminal legal–involved young adults (CLI-YAs); and (3) assess the feasibility, acceptability, and impact of the intervention. Data to inform the intervention will be collected via system partner interviews (n=4) and focus groups with CLI-YAs (n=24). Next, an open trial (n=10) will be conducted. The intervention will be refined via interviews with participants and facilitators, and a randomized pilot trial (n=75) will be conducted to assess the feasibility, acceptability, and preliminary impact of the eHealth-enhanced navigation on substance use and PrEP services linkage. Exit interviews conducted with a subsample of intervention participants (n=10), the navigator (n=1), and system partners (n=4) will assess intervention acceptability and suggestions for improvement. A community of practice, a group of system partners with an interest in working toward solutions to common problems, will inform each phase of the study. Results The project is currently ongoing. The project was funded in September 2022. Internal review board approval was received on March 21, 2022. The first results from early study aims are expected to be published in 2025. Conclusions This study provides an opportunity to reduce HIV acquisition and improve access to substance use treatment in a systemically marginalized group: young CLI-YAs. The results will contribute to the development and testing of a future multilevel randomized controlled trial. International Registered Report Identifier (IRRID) DERR1-10.2196/54815

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

eHealth-Enhanced Peer Navigation for Substance Use Treatment and HIV Prevention Service Linkage for Young Adults Surveilled by the Criminal Legal System: Protocol for a Pilot Randomized Trial Study

Creasy,

Sweet,

Myers

et al. 2024

JMIR Res Protoc

View full text Add to dashboard Cite

show abstract

“…Comparative gender analyses have shown that pain tolerance, discomfort patterns, and mental stress are generally experienced differently between men and women with chronic disease (Hamilton et al, 2022). Women are twice as likely as men to experience depression and this increased risk is likely related to gender influences (Eid et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Male and female Asians living with HIV: a text-mining analysis comparing their concerns

Chen

Barbour

2023

Front. Psychol.

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IntroductionAsians are “a forgotten population” whose HIV prevention and treatment needs have long been ignored. Studies on people living with HIV/AIDS (PLWHA) have primarily reported on physical and psychological conditions among men and gender minorities.MethodsWe used data-mining to select words and word patterns from pooled in-depth interviews conducted with 33 women and 12 men (n = 45) who were HIV positive and residing in San Francisco, United States, Shanghai, Beijing, or Taipei, China. We analyzed gender-based data (male vs. female) within the participant responses.ResultsDisclosure of HIV serostatus was discussed by both genders of PLWHA. Participants were concerned whether they should disclose their diagnosis and how to disclose it to their family members. Specifically, for women, family relationships and financial burdens were discussed most often. In terms of men, HIV disclosure was the key concern followed by disclosure of their sexual preference and concerns over what people were saying about them in the community.ConclusionThis project compared and contrasted concerns of Asian HIV-positive men and women. As healthcare providers promoting self-management by HIV-positive individuals of both genders, it is important to consider that there may be significant differences between them. Future interventions should consider how gender role influences self-management strategies in PLWHA and how support can be targeted to achieve a better quality of life for PLWHA.

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Assessing Structural Racism and Discrimination Along the Pre-exposure Prophylaxis Continuum: A Systematic Review

Seyedroudbari,

Ghadimi,

Grady

et al. 2024

AIDS Behav

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Structural racism and discrimination (SRD) is deeply embedded across U.S. healthcare institutions, but its impact on health outcomes is challenging to assess. The purpose of this systematic literature review is to understand the impact of SRD on pre-exposure prophylaxis (PrEP) care continuum outcomes across U.S. populations who could benefit from HIV prevention. Guided by PRISMA guidelines, we conducted a systematic review of the published literature up to September 2023 using PubMed and PsycInfo and included peer-reviewed articles meeting inclusion criteria. At least two authors independently screened studies, performed quality assessments, and abstracted data relevant to the topic. Exposure variables included race/ethnicity and any level of SRD (interpersonal, intra- and extra-organizational SRD). Outcomes consisted of any steps of the PrEP care continuum. A total of 66 studies met inclusion criteria and demonstrated the negative impact of SRD on the PrEP care continuum. At the interpersonal level, medical mistrust (i.e., lack of trust in medical organizations and professionals rooted from current or historical practices of discrimination) was negatively associated with almost all the steps across the PrEP care continuum: individuals with medical mistrust were less likely to have PrEP knowledge, adhere to PrEP care, and be retained in care. At the intra-organizational level, PrEP prescription was lower for Black patients due to healthcare provider perception of higher sex-risk behaviors. At the extra-organizational level, factors such as homelessness, low socioeconomic status, and incarceration were associated with decreased PrEP uptake. On the other hand, healthcare provider trust, higher patient education, and access to health insurance were associated with increased PrEP use and retention in care. In addition, analyses using race/ethnicity as an exposure did not consistently show associations with PrEP continuum outcomes. We found that SRD has a negative impact at all steps of the PrEP care continuum. Our results suggest that when assessing the effects of race/ethnicity without the context of SRD, certain relationships and associations are missed. Addressing multi-level barriers related to SRD are needed to reduce HIV transmission and promote health equity.

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PrEP Demographics and Disparity: The Race, Ethnicity, Gender Identity, Sex Assigned at Birth, Sexual Orientation and Age of Current PrEP Use

Cited by 4 publications

References 32 publications

eHealth-Enhanced Peer Navigation for Substance Use Treatment and HIV Prevention Service Linkage for Young Adults Surveilled by the Criminal Legal System: Protocol for a Pilot Randomized Trial Study

eHealth-Enhanced Peer Navigation for Substance Use Treatment and HIV Prevention Service Linkage for Young Adults Surveilled by the Criminal Legal System: Protocol for a Pilot Randomized Trial Study

Male and female Asians living with HIV: a text-mining analysis comparing their concerns

Assessing Structural Racism and Discrimination Along the Pre-exposure Prophylaxis Continuum: A Systematic Review

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