HIV/AIDS Knowledge and Perceptions Among African American Male and Female College Students at a Historical Black University

Abstract

With the incidence of HIV/AIDS infection continuing to increase among young, African Americanmen andwomen, it is necessary to examine the breadth of their knowledge on HIV prevention strategies.

This study assesses the reported knowledge, attitudes, and behaviors of students attending a Southern urban commuter campus at a Historically Black University. Major differences among males and females, as well as factors influencing testing, issues of safer sex, and perceptions of being HIV infected are examined. The cross-sectional survey data was collected using a self-administered instrument with 238 African American female and male students. Knowledge of transmission was relatively accurate. The majority of students were aware of testing services available to them, though less than 50% of the students reported using services on campus or in their community. There were several significant genderdifferences in attitudes and knowledge about social supports and condom use. The findings are important for social service providers to consider when developing and/or integrating HIV prevention into a culturally responsive service delivery approach.     

Uric Acid Excretion Predicts Increased Blood Pressure Among American Adolescents of African Descent

Background

Hyperuricemia predicts the incidence of hypertension in adults and its treatment has blood pressure (BP)-lowering effects in adolescents. To date, no studies have examined the predictive usage of hyperuricemia or urinary uric acid excretion on BP changes in adolescents. Mechanistic models suggest that uric acid impairs both endothelial function and vascular compliance, which would potentially exacerbate a myriad of hypertensive mechanisms, yet little is known about interaction of uric acid and other hypertension risk factors.

An examination of women's retirement: African American women

This paper examines the retirement of African American women with regard to their attitudes toward retirement and experiences with retirement in light of their education, family relationships and job experiences. Twenty-one older African American women were interviewed between 1991 and 1993 in their homes using a semi-structured interview format and question areas used in an earlier study of older white women's retirement experiences. We identified several patterns of why these women retired and several patterns of post-retirement reactions. In comparison to the white retirees, they shared similar reasons for retirement in that they were anticipators, resistors, and continued to work far into their aging years. They shared similar retirement experiences in that many enjoyed retirement, although some felt a loss of status. There were some significant differences, particularly in the extent to which the black women were involved with their families during their work years and following retirement, and the number of African American women who went back to work following their formal retirement. These data suggest the need to examine the meaning of retirement as it varies within genders and racial and ethnic categories.     

Risk Factors for Asthma Prevalence Among Urban and Nonurban African American Children

Urban residence is a risk factor for asthma. We examined multiple risk factors simultaneously among African American children. We interviewed 2409 African American mothers of newborns who had at least 1 child at home under 18 years of age. Sixteen percent reported at least 1 child with physician-diagnosed asthma. Significantly associated with an asthmatic child were maternal asthma and allergies, maternal cigarette smoking, a humidifying device, and a gas range or oven in the home. Urban residence was related to asthma but became nonsignificant once other factors were controlled for. Asthma associated with urban residence may be explained by identifiable factors.     

Psychological Correlates of Trading Sex for Money Among African American Crack Cocaine Smokers

This article compares demographic characteristics, sexual practices, and psychosocial status among 193 African American female crack cocaine users who currently, previously, or never traded sex for money. Current traders were less likely to have a main sexual partner, more likely to have a casual sexual partner, and more likely to smoke larger quantities of crack. There was a significant trend towards current traders reporting lower self-esteem, greater depression and anxiety, poorer decision-making confidence, more hostility, less social conformity, greater risk taking behaviors, and more problems growing up, compared to previous and never traders. These differences suggest that interventions should address self-esteem, risk-taking practices, depression and anxiety as well as other psychosocial factors.     

Hematologic reference values for African American children and adolescents

Anemia is prevalent among African American children. When evaluating pediatric patients for anemia, clinicians refer to the normative hematological reference values in reference textbooks. These reference values are used in spite of evidence that healthy African American people of all ages have average hemoglobin concentrations from 0.5 to 0.73 g/dl below those of Whites. In an earlier study, using samples from 2,161 healthy African American children from 2 to 18 years old, we found a statistically significant difference (P < 0.0001) in the mean hemoglobin value for each age group as compared to reference normative mean hemoglobin values. Here we present the results of a comparative analysis of the data set from our previous study and the data set from the National Health and Nutrition Examination Surveys III (NHANES III) 1988-1994. We found no statistically significant difference between these data sets with respect to the hemoglobin values for any age or sex group, confirming that African American children and adolescents have lower mean hemoglobin values than do Whites. Use of the reference hemoglobin values presented here will help prevent the misdiagnosis of anemia in African American children and thereby minimize unnecessary hematological workups and treatment.     

Multiple Pathways of Recovery for African American Men

For decades, tension has existed between addictions counselors and clients based upon a widely held belief by counselors that there is only one way to recover, leading to client resistance to treatment, premature termination, and relapse, as the client's approach to recovery has been commonly ignored. This article outlines multiple pathways of recovery among African American men and also offers clinical recommendations for service providers who work with these men.     

Novel recurrently mutated genes in African American colon cancers

We used whole-exome and targeted sequencing to characterize somatic mutations in 103 colorectal cancers (CRC) from African Americans, identifying 20 new genes as significantly mutated in CRC. Resequencing 129 Caucasian derived CRCs confirmed a 15-gene set as a preferential target for mutations in African American CRCs. Two predominant genes, ephrin type A receptor 6 (EPHA6) and folliculin (FLCN), with mutations exclusive to African American CRCs, are by genetic and biological criteria highly likely African American CRC driver genes. These previously unsuspected differences in the mutational landscapes of CRCs arising among individuals of different ethnicities have potential to impact on broader disparities in cancer behaviors.Colorectal cancer (CRC) is a leading cause of cancer mortality world-wide. CRC incidence and mortality rates are both increased in African Americans (AA) compared with Caucasians Americans (1–3). Although several factors likely play a role, the contribution of potential differences in tumor genetics to this disparity have yet to be fully explored (1, 3). In particular, AA CRCs were notably underrepresented in the four major published CRC sequencing studies (4–7), accounting for only two annotated AA cases of the 333 total CRCs studied (4–7). Accordingly, we initiated this study to compare the mutational landscapes of CRCs from AA individuals versus Caucasians.     

Clinically Significant Depressive Symptoms as a Risk Factor for HIV Infection Among Black MSM in Massachusetts

High rates of depression have been observed among men who have sex with men (MSM) relative to the general adult male population; however, a dearth of research has explored depression among Black MSM. Black MSM (n = 197) recruited via modified respondent-driven sampling between January and July 2008 completed an interviewer-administered quantitative assessment and voluntary HIV counseling and testing. Bivariate and multivariable logistic regression procedures examined the associations of demographics, behavioral HIV risk factors, and psychosocial variables with depressive symptoms by severity, using the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). Adjusting for demographic and behavioral variables, significant factors associated with (1) clinically significant depressive symptoms (33%; CES-D score ≥ 16): being publicly insured by Medicaid, having serodiscordant anal sex with a casual male partner, and being diagnosed with an STD in the prior 12 months; (2) moderate depressive symptoms (19%; CES-D score 16–26): having serodiscordant unprotected anal sex with a casual male partner and being diagnosed with an STD in the prior 12 months; (3) severe depressive symptoms (14%; CES-D score 27+): being publicly insured by Medicaid and reporting difficulty accessing healthcare in the past 12 months. Moderately depressed Black MSM may be more likely to engage in behaviors that place them at increased risk for HIV and other STDs. HIV prevention interventions for Black MSM may benefit from incorporating screening and/or treatment for depression, allowing MSM who are depressed to respond more effectively to behavioral change approaches.     

Devaluation,Loss, and Rage: A Postscript to Urban African American Youth with Substance Abuse

This article explores and discusses the sociocultural dynamics underpinning urban African American youths' use and misuse of substances and its connection to the invisible wounds of race-related trauma. A racially-sensitive framework is discussed as an intervention approach designed to address the special needs of urban Africa American adolescents maligned by, and suffering from, the complex interplay of substance misuse and rage.     

Identification of patient-centered outcomes among African American women with type 2 diabetes

AimsAfrican American women carry a disproportionate diabetes burden, yet there is limited information on strategies to identify outcomes women perceive as important intervention outcomes (patient-centered outcomes). This study presents a brief strategy to solicit these outcomes and to describe outcomes identified using the highlighted strategy.MethodsThirty-four African-American women with type 2 diabetes were enrolled in group-based, diabetes/weight management interventions. A diabetes educator asked participants to write down their intervention expectations followed by verbal sharing of responses. Expectation-related themes were identified using an iterative, qualitative, team analytic approach based on audio-recorded responses.ResultsThe majority of the expectation-related themes (6 of 10) were reflective of self-care education/management and weight loss-related patient-centered outcomes. The remaining themes were associated with desires to help others prevent or manage diabetes, reduce negative diabetes-related emotions, get rid of diabetes, and stop taking diabetes medications.ConclusionThis study adds to a limited body of knowledge regarding patient-centered outcomes among a group that experiences a disproportionate diabetes burden. Future work could include integrating outcomes that are less commonly addressed in diabetes-related lifestyle interventions (e.g., diabetes-related negative emotions), along with more commonly addressed outcomes (e.g., weight loss), to increase the patient-centeredness of the interventions.     

Hypertensive emergencies in diabetic patients from predominantly African American urban communities

Aim: The aim of this study was to identify risk factors for hypertensive emergencies in diabetic patients presenting with severely elevated blood pressure.

Methods: Using electronic medical records, this study identified diabetic patients with hypertensive crisis who presented to the emergency department of Newark Beth Israel Medical Center, Newark, NJ from June 2013 to May 2016. Diabetic patients with hypertensive emergencies were compared with non-diabetic patients based on important demographic and clinical characteristics.

Results: Patients with diabetes accounted for 52.27% of all hypertensive emergencies during the study period. There were 264 diabetic patients with hypertensive emergencies and 519 diabetic patients with hypertensive urgencies. The majority of patients were African Americans (88.6%). The odds of hypertensive emergencies were strikingly higher in diabetic patients with hyperlipidemia (OR 1.66, 95% CI 1.23–2.24), coronary artery disease (OR 2.95, 95% CI 2.15–4.05), congestive heart failure (OR 6.28, 95% CI 4.49–8.80), renal insufficiency (OR 2.84, 95% CI 2.10–3.86) and low hemoglobin (OR 0.9, 95% CI 0.84–0.97). Acute or worsening heart failure was the most frequent acute target organ injury (49.6%) followed by non-ST elevation myocardial infarction (41.7%). Diabetic and non-diabetic patients had similar rates of target organ injuries.

Conclusion: The development of hypertensive emergencies in patients with diabetes was not because of diabetes per se but because of coexisting highly elevated blood pressure. Tight blood pressure control may decrease the risk of hypertensive emergencies in this patient population.     

Identity Development's Impact on Peer-Supported Recovery Among African American Women

The emerging trend of peer-to-peer supported recovery and identity development among African American women in early- and middle-stage recovery has significant clinical implications. In peer-supported recovery, assisting African American women in finding their voices presents special challenges in the recovery-oriented system of care. This article explores the importance of identity development among African American women in early and middle-stage recovery. The core principles of recovery including gender responsive treatment, empowerment, and alumni support within this special population are discussed.     

Text Messaging to Measure Asthma Medication Use and Symptoms in Urban African American Emerging Adults: A Feasibility Study

Objective. Urban African American adolescents and young adults face disproportionate risk of asthma morbidity and mortality. This study was the first to assess the feasibility of Ecological Momentary Assessment via text messaging to measure asthma medication use and symptoms in African Americans aged 18–25 years. Methods. This study used automated text messaging with N = 16 participants for 14 consecutive days. Participants sent event-based messages whenever they experienced asthma symptoms or took asthma rescue or controller medications. They also received time-based messages daily that prompted for a response about asthma medications or symptoms. Results. Feasibility was assessed using response rates and participant feedback. Rates of event-based messages were relatively low (M = 0.85 messages sent per participant/day), but participants were very responsive to time-based messages (78.5%). All participants expressed positive feedback about the program, though 40.0% reported confusion with event-based messages and most preferred time-based messages. The assessment found low medication adherence rates and reasons for missing medication consistent with previous research with youth with asthma. Conclusion. Text messaging may be a useful method to measure medication use and symptoms in “real time,” particularly using time-based prompts. Results could be used to provide personalized feedback on adherence as part of a tailored intervention.     

The effects of nicotine gum and counseling among African American light smokers: a 2 x 2 factorial design

AIM: Approximately 50% of African American smokers are light smokers (smoke < or = 10 cigarettes a day). The prevalence of light smoking in the United States is increasing, yet there has not been a single smoking cessation clinical trial targeting light smokers. The purpose of this 2 x 2 factorial, randomized clinical trial was to evaluate the efficacy of nicotine gum (2 mg versus placebo) and counseling (motivational interviewing versus health education) for African American light smokers. DESIGN: Participants were assigned randomly to one of four study arms: 2 mg nicotine gum plus health education (HE); 2 mg nicotine gum plus motivational interviewing (MI); placebo gum plus HE; and placebo gum plus MI. PARTICIPANTS AND SETTING: A total of 755 African American light smokers (66% female, mean age = 45) were enrolled at a community health center over a 16-month period. INTERVENTION AND MEASUREMENTS: Participants received an 8-week supply of nicotine gum and six counseling sessions during the course of the 26-week study. Biochemical measures included expired carbon monoxide (CO) and serum and salivary cotinine. FINDINGS: Seven-day quit rates for nicotine gum were no better than for the placebo group (14.2% versus 11.1%, P = 0.232) at 6 months. However, a counseling effect emerged, with HE performing significantly better than MI (16.7% versus 8.5%, P < 0.001). These results were consistent across outcome time-points (weeks 1, 8, and 26). CONCLUSIONS: Results highlight the potential positive impact of directive information and advice-oriented counseling on smoking cessation. Studies are needed to assess other interventions that may further improve quit rates among African American light smokers who are motivated to quit.     

Reducing metabolic syndrome through a community-based lifestyle intervention in African American women

Background and aimsMetabolic syndrome (MetS) increases the risk of cardiovascular disease and type 2 diabetes. Despite a higher prevalence of MetS in African American (AA) women, little is known about the effectiveness of lifestyle interventions in improving metabolic markers in this high-risk group. This study investigated the effectiveness of a community-based lifestyle intervention delivered by lay health coaches in reducing MetS among AA women.Methods and resultsA cluster-randomized diabetes prevention program (DPP) was implemented in 11 churches utilizing a community-based participatory research (CBPR) approach to develop and deliver the interventions. A total of 221 adults, AA women who were overweight or obese, and did not have diabetes were included in this study. The prevalence of MetS was 42.08% before receiving the DPP intervention and 31.22% after the intervention that represented a 10.86% absolute reduction and a 25.81% relative reduction from baseline. The adjusted odds ratio (OR) of being free from MetS at post-intervention in contrast to baseline was 2.14 (p = 0.02). Factors that increased the odds of being free from MetS were younger age, reduction in intake of total calories, total fat, saturated and trans-fat, and dietary sodium.ConclusionA faith adapted lifestyle intervention held in church settings and delivered by minimally trained lay health coaches reduced the prevalence of MetS in AA women who were overweight or obese. Findings from this study can be used to translate evidence into public health programs at the community level for the prevention of type 2 diabetes and cardiovascular disease.Clinical trial registration numberNCT 04082702 (www.clinicaltrials.gov).     

A Comparison of Self-Rated and Objectively Measured Successful Aging Constructs in an Urban Sample of African American Older Adults

Sixty-seven (N = 67) urban African American older adults were divided into successful and nonsuccessful aging groups based on objective MacArthur (i.e., physical and cognitive functioning) and on self-rated health criteria. Only 30% of the sample met objective MacArthur criteria for successful aging compared to 63% who rated themselves as successful. Self-rated successful aging was best predicted by regular exercise, whereas objective successful aging was best predicted by demographic characteristics and cognition. Reading ability mediated the relationship between both education and cognition to objectively defined success. Finally, objective successful aging was related to quantity and quality of education, whereas self-rated successful aging was related to a wider variety of variables. Defining successful aging on objective factors alone may limit our understanding of successful aging in urban African American older adults.