Incarceration, African Americans and HIV: Advancing a research agenda

Department of Research, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.
Journal of the National Medical Association (Impact Factor: 0.91). 02/2008; 100(1):57-62.
Source: PubMed

ABSTRACT Incarceration is a crisis among African Americans, and the prevalence of HIV/AIDS in incarcerated men and women is 3-5 times that of the general population. We explore the potential implications of the widespread incarceration of African Americans on HIV risk and HIV outcomes in: 1) the current and formerly incarcerated, 2) their sexual partners, and 3) the communities impacted by incarceration. We set forth a research agenda for understanding and ameliorating the negative impacts incarceration and conclude that the African-American population's ability to successfully address the HIV/AIDS epidemic requires a coordinated and evidence-based response to the challenge of effectively preventing, managing and treating HIV in populations affected by incarceration.

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    • "as shown in Figure 1, and more than half of persons who tested positive were MSM. This is consistent with the current HIV literature that reflects an overrepresentation of positive MSM and minority males, as well as disparities, discrimination, and social inequalities that may contribute to disproportionately high rates of HIV/AIDS in the Black/AA population in the South [40] [45] [46]. Additionally, as only 14% of persons who tested positive in this sample were motivated for testing by perceived high risk behavior, and timely utilization of HIV testing services among MSM has been observed in other studies, it may be valuable to expand high impact prevention strategies for this population by providing individual and couples testing services for MSM as well as offering PrEP to persons with higher risk behaviors [47] [48] [49]. "
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    ABSTRACT: The Southern states experience the highest rates of HIV and AIDS in the US, and point-of-care (POC) testing outside of primary care may contribute to status awareness in medically underserved populations in this region. To evaluate POC screening and linkage to care at an urban south site, analyses were performed on a dataset of 3,651 individuals from an integrated rapid-result HIV testing and linkage program to describe this test-seeking cohort and determine trends associated with screening, results, and linkage to care. Four percent of the population had positive results. We observed significant differences by test result for age, race and gender, reported risk behaviors, test location, and motivation for screening. The overall linkage rate was 86%, and we found significant differences for clients who were linked to HIV care versus persons whose linkage could not be confirmed with respect to race and gender, location, and motivation. The linkage rate for POC testing that included a comprehensive intake visit and colocated primary care services for in-state residents was 97%. Additional research on integrated POC screening and linkage methodologies that provide intake services at time of testing is essential for increasing status awareness and improving linkage to HIV care in the US.
    AIDS research and treatment 09/2013; 2013:789413. DOI:10.1155/2013/789413
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    • "For instance, high incarceration rates among Black men, including Black men who have sex with men, are attributable to the cumulative effects of poverty, under-education, racialized policing, disparate sentencing laws and discrimination within the criminal justice system (Harawa and Adimora 2008). These factors related to race contribute to increased risk for HIV among Black men who have sex with men (Harawa and Adimora 2008). In addition, cultural and institutionalized homophobia is a driving factor in the disproportionate impact of HIV among men who have sex with men (Stall et al. 2003). "
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    ABSTRACT: This study investigated the role of incarceration in HIV/STD risk among 197 Black men who have sex with men in Massachusetts, USA. More than half (51%) reported a history of incarceration (28% < 90 days in jail/prison; 23% ≥ 90 days in jail/prison). Multivariable logistic regression models adjusted for age and sexual orientation examined associations between demographic, behavioural, social-psychological and cultural factors and incarceration history. Factors associated with < 90 days of incarceration were: unprotected sex with a man, STD history, injection drug use and substance abuse treatment. Factors associated with ≥ 90 days of incarceration were: unprotected sex with a woman, crack use during sex, STD history, injection drug use, substance abuse treatment, depressive symptoms, post-traumatic stress symptoms, HIV fatalism and social capital. Black men who have sex with men with incarceration histories may be at increased risk for HIV/STDs compared to those without such histories. HIV prevention efforts that focus on individual risk and cultural-contextual issues among Black men who have sex with men are warranted.
    Culture Health & Sexuality 12/2011; 14(3):329-45. DOI:10.1080/13691058.2011.639902 · 1.55 Impact Factor
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    ABSTRACT: Nearly three decades since the onset of AIDS epidemic in the United States (US), men who have sex with men (MSM) have represented a significant disproportionate number of cases of HIV and AIDS.1 Within this context, MSM refer to gay, bisexually, and heterosexually identified men who engage in sexual behavior with other men. With the advent of HIV antiretroviral therapies (e.g., HAART or highly active antiretroviral therapies), AIDS-related morbidity and mortality in MSM initially decreased during the 1990s.2 Yet, recent epidemiological data have demonstrated that there has been an accelerated increase in rates of HIV and AIDS, as well as other sexually transmitted infections (STIs) in MSM.1 For instance, in 2005, MSM represented 71% of the overall HIV infections among adult and adolescent males in the US; MSM also accounted for the highest HIV transmission category, which yielded 67% of male-to-male sexual contact when compared to 15% for heterosexual transmission and 13% for injection drug use.3 MSM of Color (identified as Asian/Pacific Islander, black, Latino, and Native American/Alaska Native men) have been significantly impacted by AIDS epidemic in the United States.4 – 9 Much of the HIV epidemiological data have demonstrated that black and Latino MSM – in particular – have experienced substantial disproportionate rates of HIV and AIDS in the US, with the rates of black MSM comparable to some of the highest rates observed in some resource-limited countries.10 By race/ethnicity, of the 207,810 MSM cases of HIV/AIDS in 2005, 32% represented black MSM, when compared to 50% for white MSM, 16% for Latino MSM, 1% for Asian/Pacific Islander MSM, and less than 1% for Native American/Alaska Native MSM.3 However, incidence and prevalence rates of HIV/AIDS have been underestimated in specific racial/ethnic groups, including Asian/Pacific Islander and Native American communities, due to inadequate methodological approaches (e.g., research design, measurement, and sampling procedures) including but not limited to misclassification of racial/ethnic groups, surveillance systems not collecting data on specific groups, and failure to disaggregate within-group data to assess specific HIV-related health disparities.8 , 11 , 12
    01/1970: pages 179-211;
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