AIDS in America—Forgotten but not gone

International Center for AIDS Care and Treatment Programs, Mailman School of Public Health, and the Department of Medicine, Harlem Hospital and College of Physicians and Surgeons, Columbia University, New York, USA.
New England Journal of Medicine (Impact Factor: 55.87). 02/2010; 362(11):967-70. DOI: 10.1056/NEJMp1000069
Source: PubMed
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Available from: Kenneth Mayer
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    • "In high-income countries AIDS has disproportionately impacted MSM. MSM account for the preponderance of prevalent AIDS cases in the United States, Canada, the European Union, Australia, and New Zealand [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11]. In contrast, in many low-and middle-income countries the HIV epidemic is driven by heterosexual sex, injection drug use, and/or contaminated blood collection and transfusion, with MSM comprising a small proportion of all HIV cases [10] [11] [12]. "

    Full-text · Article · Jun 2014 · BioMed Research International
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    • "The HIV/AIDS epidemic continues to disproportionately affect African American communities in the US, particularly those located in urban areas [1,2]. Of all racial/ethnic groups in the United States, African Americans have experienced the greatest burden due to HIV/AIDS, accounting for greatest proportion of HIV infections at all stages of the disease. "
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    ABSTRACT: Background: The HIV/AIDS epidemic continues to disproportionately affect African American communities in the US, particularly those located in urban areas. Despite the fact that HIV is often transmitted from one sexual partner to another, most HIV prevention interventions have focused only on individuals, rather than couples. This five-year study investigates community-based implementation, effectiveness, and sustainability of 'Eban II,' an evidence-based risk reduction intervention for African-American heterosexual, serodiscordant couples. Methods/design: This hybrid implementation/effectiveness implementation study is guided by organizational change theory as conceptualized in the Texas Christian University Program Change Model (PCM), a model of phased organizational change from exposure to adoption, implementation, and sustainability. The primary implementation aims are to assist 10 community-based organizations (CBOs) to implement and sustain Eban II; specifically, to partner with CBOs to expose providers to the intervention; facilitate its adoption, implementation and sustainment; and to evaluate processes and determinants of implementation, effectiveness, fidelity, and sustainment. The primary effectiveness aim is to evaluate the effect of Eban II on participant (n = 200 couples) outcomes, specifically incidents of protected sex and proportion of condom use. We will also determine the cost-effectiveness of implementation, as measured by implementation costs and potential cost savings. A mixed methods evaluation will examine implementation at the agency level; staff members from the CBOs will complete baseline measures of organizational context and climate, while key stakeholders will be interviewed periodically throughout implementation. Effectiveness of Eban II will be assessed using a randomized delayed enrollment (waitlist) control design to evaluate the impact of treatment on outcomes at posttest and three-month follow-up. Multi-level hierarchical modeling with a multi-level nested structure will be used to evaluate the effects of agency- and couples-level characteristics on couples-level outcomes (e.g., condom use). Discussion: This study will produce important information regarding the value of the Eban II program and a theory-guided implementation process and tools designed for use in implementing Eban II and other evidence-based programs in demographically diverse, resource-constrained treatment settings. Trial registration: NCT00644163.
    Full-text · Article · Jun 2014 · Implementation Science
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    • "Healthy social norm building can be achieved by diffusing most relevant health information via available and accessible social media like websites or text messages to promote testing in Chinese MSM [31] [49] [50]. The extent of the risk of acquiring HIV in the United States today is largely defined by a person's sexual network rather than his or her individual behaviors [51]. Group intervention with targeting the behaviors and beliefs from community perspective might be promising as an avenue for prevention in China [52]. "
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    ABSTRACT: Objective: To investigate barriers and correlates of the use of HIV prevention services and HIV testing behaviors among men who have sex with men in Chongqing. Methods: Three consecutive cross-sectional surveys provided demographic, sexual behavior, HIV/syphilis infection, HIV prevention service, and testing behavior data. Results: Of 1239 participants, 15.4% were infected with HIV, incidence was 12.3 per 100 persons/year (95% CI: 9.2-15.3), 38% of the participants reported ever having unprotected insertive anal sex, 40% ever received free condom/lubricants in the past year, and 27.7% ever obtained free sexually transmitted infection examination/treatment in the past year. Multivariable logistic regression revealed that lower levels of HIV/AIDS related stigmatizing/discriminatory attitudes, full-time jobs, and sex debut with men at a younger age were independently associated with use of free condom/lubricants. Large social networks, higher incomes, and sexual debut with men at a younger age were associated with use of any HIV prevention and HIV testing services. Lower levels of stigmatizing/discriminatory attitudes were also associated with HIV testing. Fearing needles and being unaware of the venues for testing were top barriers for testing service utilization. Conclusion: It is imperative to address HIV/AIDS related stigmatizing/discriminatory attitudes and other barriers while delivering intervention and testing services.
    Full-text · Article · Mar 2014
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