M Christina Santana

Boston University, Boston, Massachusetts, United States

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Publications (11)27.96 Total impact

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    ABSTRACT: The purpose of this study is to determine if experiences of physical violence during early and late adolescence (12-21 years) places urban Black males at increased risk for interpersonal violence perpetration beyond young adulthood (30 years and older). Participants of this cross-sectional study were Black and African American men (N = 455) between the ages of 30 and 65 years, recruited from four urban clinical sites in the Northeast. Multivariate logistic regression models were used to analyze the relation of adolescent experiences of violence to: (1) past 6 month street violence involvement and (2) past year intimate partner violence perpetration. Ten percent of the sample reported that they experienced adolescent victimization. Men reporting adolescent victimization were significantly more likely to report past 6-month street violence involvement (Adjusted Odds Ratio (AOR) = 3.2, 95 % CI = 1.7-6.3) and past 6 month intimate partner violence perpetration (AOR = 2.8, 95 % CI = 1.8-5.4) compared to men who did not report such victimization. Study findings suggest that in order to prevent adulthood perpetration of violence, more work is needed to address experiences of victimization among young Black males, particularly violence experienced during adolescence.
    Journal of Urban Health 05/2013; · 1.89 Impact Factor
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    ABSTRACT: This study aimed to examine racial discrimination and relation to sexual risk for HIV among a sample of urban Black and African American men. Participants of this cross-sectional study were Black and African American men (N = 703) between the ages of 18 and 65 years, recruited from four urban clinical sites in the northeast. Multivariate logistic regression models were used to analyze the relation of reported racial discrimination to the following: (1) sex trade involvement, (2) recent unprotected sex, and (3) reporting a number of sex partners in the past 12 months greater than the sample average. The majority of the sample (96 %) reported racial discrimination. In adjusted analyses, men reporting high levels of discrimination were significantly more likely to report recent sex trade involvement (buying and/or selling) (adjusted odds ratio (AOR) range = 1.7-2.3), having recent unprotected vaginal sex with a female partner (AOR = 1.4, 95 % confidence interval (CI), 1.1-2.0), and reporting more than four sex partners in the past year (AOR = 1.4, 95 % CI, 1.1-1.9). Findings highlight the link between experiences of racial discrimination and men's sexual risk for HIV.
    Journal of Urban Health 06/2012; · 1.89 Impact Factor
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    ABSTRACT: We sought to measure time and identify predictors of timely follow-up among a cohort of racially/ethnically diverse inner city women with breast and cervical cancer screening abnormalities. Eligible women had an abnormality detected on a mammogram or Papanicolaou (Pap) test between January 2004 and December 2005 in 1 of 6 community health centers in Boston, Massachusetts. Retrospective chart review allowed us to measure time to diagnostic resolution. We used Cox proportional hazards models to develop predictive models for timely resolution (defined as definitive diagnostic services completed within 180 days from index abnormality). Among 523 women with mammography abnormalities and 474 women with Pap test abnormalities, >90% achieved diagnostic resolution within 12 months. Median time to resolution was longer for Pap test than for mammography abnormalities (85 vs 27 days). Site of care, rather than any sociodemographic characteristic of individuals, including race/ethnicity, was the only significant predictor of timely follow-up for both mammogram and Pap test abnormalities. Site-specific community-based interventions may be the most effective interventions to reduce cancer health disparities when addressing the needs of underserved populations.
    Cancer 02/2010; 116(4):913-21. · 5.20 Impact Factor
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    ABSTRACT: Violence disproportionately affects African American men and their communities. Research is needed to inform programming efforts to reduce racial/ethnic disparities in violence exposure, involvement, and victimization. The current study examined involvement in and perceptions of neighborhood violence and relation to perpetration of intimate partner violence (IPV) among a sample of urban, African American men. Participants of this cross-sectional study were sexually active African American men (n=703) between the ages of 18 and 65years, recruited from urban community health centers. Age-adjusted logistic regression models were used to assess associations between neighborhood violence variables and perpetration of IPV. In age-adjusted logistic regression models, involvement with street violence in the previous 6months (Odds Ratio (OR)=3.0; 95% Confidence Interval (CI): 1.9–4.6), ever being involved with gangs (OR=2.0; 95% CI: 1.3–3.2), and perceptions/beliefs that violence occurs in one’s neighborhood (ORs=2.0–3.1) were found to be significantly associated with IPV perpetration. Findings demonstrate that involvement in neighborhood violence as well as perceptions/beliefs that violence occurs in one’s neighborhood are associated with increased likelihood of IPV perpetration among urban, African American men. While socioeconomics and substance use contribute to high rates of these forms of violence, the relation between these forms of violence and perpetration of IPV was significant beyond the influences of these factors. Findings suggest that future violence prevention and treatment efforts will be most successful by addressing multiple forms of violence.
    Journal of Community Health 08/2009; 34(4):328-335. · 1.28 Impact Factor
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    ABSTRACT: Studies on the mechanisms of the association between illicit drug use and HIV/STI provide important insight into why there are disproportionate rates of HIV/STI among heterosexual African American men; far less work has been conducted to examine the associations between binge alcohol use and HIV/STI risks in this population. To assess whether binge alcohol use is associated with risky sexual behaviors and recent HIV/STI diagnosis among heterosexual African American men reporting multiple sex partners in the past year. Participants (n=672) were heterosexually active African American men age 18-65 years recruited from urban health centers and clinics in Boston, MA, and who participated in a health survey. Logistic regression analyses were used to assess associations between past 30 day binge drinking and the following outcome variables: unprotected sex, six or more sex partners in the past year, sex trade involvement, and past 6 month HIV/STI diagnosis. Analyses were adjusted to control demographics, incarceration history, illicit drug use, and injection drug use. Significant associations were observed between binge alcohol use and unprotected vaginal sex with non-main female partners (AOR=1.7, 95% CI=1.2-2.3), unprotected anal sex with non-main female partners (AOR=2.3, 95% CI=1.4-4.0), sex trade involvement (AOR=2.1, 95% CI=1.3-3.5), and recent HIV/STI diagnosis (AOR=1.9; 95% CI=1.05-3.6). Heterosexual African American men engaging in binge alcohol use may be at increased risk for HIV/STI; findings support the need for integrating alcohol risk reduction into HIV prevention programs targeting this population.
    Drug and alcohol dependence 01/2009; 101(1-2):101-6. · 3.60 Impact Factor
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    ABSTRACT: Evidence indicates that abusive male partners pose increased risk for sexually transmitted infection (STI)/HIV among females. However, research with males on this issue is limited. The objective of this study was to assess the associations between intimate partner violence (IPV) perpetration and recent STI/HIV diagnosis, unprotected sex, and sex trade involvement among heterosexual African American men. In this cross-sectional study, heterosexual African American males aged 18 to 65 years who reported two or more sex partners in the past year were recruited from urban health clinics to complete a computerized survey assessing sociodemographic characteristics, IPV perpetration history, risky sexual behaviors, and substance use. Multivariate logistic regression analyses assessed associations between IPV perpetration and STI/HIV risk. More than half of participants in this sample (61%) were unemployed; 28.2% had less than a high school education and 23.1% were homeless. One-fifth of the sample (21.2%) reported IPV perpetration in their current relationship. IPV perpetration was significantly associated with recent STI/HIV diagnosis, unprotected anal sex, and buying sex. IPV perpetration is pervasive among heterosexually at-risk African American men presenting for clinical care, and those perpetrating IPV are at heightened risk for STI/HIV.
    American journal of men's health 10/2008; 2(3):291-5. · 1.15 Impact Factor
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    ABSTRACT: To examine racial discrimination and its relation to violence involvement among a sample of urban African American men. Participants of this cross-sectional study were African American men (N = 703) between the ages of 18 and 65 years, recruited from four urban community health centers and two hospital-based clinics within an urban center in the Northeast. Multivariate logistic regression models were used to assess the relation of reported racial discrimination to recent perpetration of intimate partner violence (IPV), street violence involvement, and gang involvement. Racial discrimination was measured via 7 items assessing everyday and lifetime experiences of racial discrimination. In logistic regression models adjusted for age and homelessness, men reporting high levels of discrimination (scores above the sample median) were significantly more likely to report IPV perpetration (Adjusted Odds Ratio (AOR) = 1.9; 95% Confidence Interval (CI): 1.2-2.9) and street violence involvement (AOR = 1.5; 95% CI: 1.1-2.2) as compared to men reporting lower levels of discrimination. No relation was found between experiencing discrimination and gang involvement. Findings showcase the potential relevance of racial discrimination to efforts focused on reducing racial disparities related to violence.
    Journal of Immigrant and Minority Health 07/2008; 12(3):319-26. · 1.16 Impact Factor
  • JAIDS Journal of Acquired Immune Deficiency Syndromes 02/2008; 47(1):131-4. · 4.65 Impact Factor
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    ABSTRACT: We assessed the association between intimate partner violence (IPV) perpetration and sexual risk behaviors and fatherhood (having fathered children) among young men. Sexually active men aged 18 to 35 years who visited an urban community health center and who reported having sexual intercourse with a steady female partner during the past 3 months (N = 283) completed a brief self-administered survey about sexual risk behaviors, IPV perpetration, and demographics. We conducted logistic regression analyses adjusted for demographics to assess associations between IPV and sexual risk behaviors and fatherhood. Participants were predominantly Hispanic (74.9%) and Black (21.9%). Participants who reported IPV perpetration during the past year (41.3%) were significantly more likely to report (1) inconsistent or no condom use during vaginal and anal sexual intercourse, (2) forcing sexual intercourse without a condom, (3) having sexual intercourse with other women, and (4) having fathered 3 or more children. IPV perpetration was common among our sample and was associated with increased sexual risk behaviors. Urban community health centers may offer an important venue for reaching this at-risk population.
    American Journal of Public Health 11/2006; 96(10):1873-8. · 3.93 Impact Factor
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    ABSTRACT: The current study of South Asians in the United States was designed to assess quantitatively the association between intimate partner violence (IPV) and emotional abuse by in-laws (n=169) and to qualitatively identify via in-depth interviews with battered women (n=23) forms of abuse perpetrated by in-laws. Quantitative findings demonstrate a significant relationship between IPV and abuse from in-laws (odds ratio=5.7, 95% confidence interval=1.5-21.5). Qualitative data demonstrate that abuse by in-laws includes emotional abuse (e.g., isolation, social and economic control, and domestic servitude), awareness or support of IPV, and direct physical abuse. Domestic violence interventions with South Asian women must consider abuse from in-laws and IPV experiences.
    Violence Against Women 11/2006; 12(10):936-49. · 1.33 Impact Factor
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    ABSTRACT: This study sought to assess the association between traditional masculine gender role ideologies and sexual risk and intimate partner violence (IPV) perpetration behaviors in young men's heterosexual relationships. Sexually active men age 18-35 years attending an urban community health center in Boston were invited to join a study on men's sexual risk; participants (N=307) completed a brief self-administered survey on sexual risk (unprotected sex, forced unprotected sex, multiple sex partners) and IPV perpetration (physical, sexual and injury from/need for medical services due to IPV) behaviors, as well as demographics. Current analyses included men reporting sex with a main female partner in the past 3 months (n=283). Logistic regression analyses adjusted for demographics were used to assess significant associations between male gender role ideologies and the sexual risk and IPV perpetration behaviors. Participants were predominantly Hispanic (74.9%) and Black (21.9%); 55.5% were not born in the continental U.S.; 65% had been in the relationship for more than 1 year. Men reporting more traditional ideologies were significantly more likely to report unprotected vaginal sex in the past 3 months (OR(adj) = 2.3, 95% CI = 1.2-4.6) and IPV perpetration in the past year (OR(adj) = 2.1, 95% CI = 1.2-3.6). Findings indicate that masculine gender role ideologies are linked with young men's unprotected vaginal sex and IPV perpetration in relationships, suggesting that such ideologies may be a useful point of sexual risk reduction and IPV prevention intervention with this population.
    Journal of Urban Health 08/2006; 83(4):575-85. · 1.89 Impact Factor