AIDS in Black and White: The Influence of Newspaper Coverage of HIV/AIDS on HIV/AIDS Testing Among African Americans and White Americans, 1993–2007

This study examined the effect of newspaper coverage of HIV/AIDS on HIV testing behavior in a U.S. population. HIV testing data were taken from the Center for Disease Control and Prevention's National Behavioral Risk Factor Surveillance System from 1993 to 2007 (N = 265,557). The authors content-analyzed news stories from 24 daily newspapers and 1 wire service during the same time period. The authors used distributed lagged regression models to estimate how well HIV/AIDS newspaper coverage predicted later HIV testing behavior. Increases in HIV/AIDS newspaper coverage were associated with declines in population-level HIV testing. Each additional 100 HIV/AIDS-related newspaper stories published each month was associated with a 1.7% decline in HIV testing levels in the subsequent month. This effect differed by race, with African Americans exhibiting greater declines in HIV testing subsequent to increased news coverage than did Whites. These results suggest that mainstream newspaper coverage of HIV/AIDS may have a particularly deleterious effect on African Americans, one of the groups most affected by the disease. The mechanisms driving the negative effect deserve further investigation to improve reporting on HIV/AIDS in the media.     

Social Capital,Participation and the Perpetuation of Health Inequalities: Obstacles to African‐Caribbean Participation in ‘Partnerships’ to Improve Mental Health

Objectives. There has recently been much emphasis on the role of ‘partnerships’ between local community ‘stakeholders’ in strategies to redress health inequalities. This paper examines obstacles to participation in such partnerships by African‐Caribbean lay people in local initiatives to improve mental health in a town in southern England. We present a ‘social psychology of participation’ which we use to interpret our data. Our work seeks to illustrate some of the micro‐social mechanisms through which social inequalities are perpetuated, using Bourdieu's conceptualisation of the role played by various forms of capital (economic, social, cultural and symbolic) in perpetuating social inequalities.

Design. Our empirical research consists of a qualitative case study of attitudes to participation in mental‐health‐related partnerships in a deprived community. In‐depth interviews and focus groups were conducted with 30 local community ‘stakeholders’, drawn from the statutory, voluntary, user and lay sectors.

Results. While interviewees expressed enthusiasm about the principles of participation, severe obstacles to its effective implementation were evident. These included severe distrust between statutory and community sectors, and reported disillusionment and disempowerment within the African‐Caribbean community, as well as low levels of community capacity. Moreover, divergent understandings of the meaning of ‘partnership’ suggested that it would be difficult to satisfy both community and statutory sectors at once.

Conclusions. We suggest that disadvantaged and socially excluded communities are often deprived of the social resources which would provide a solid basis for their participation in partnerships with state health services. In the absence of efforts to remove such obstacles, and to generate the necessary resources for participation, partnerships may be ‘set up to fail’, leaving social inequalities to prevail.     

Does Maternal Birth Outcome Differentially Influence the Occurrence of Infant Death Among African Americans and European Americans?

The United States continues to have one of the highest infant mortality rates (IMR). Although studies have examined the association between maternal and infant birth outcomes, few studies have examined the impact of maternal birth outcome on infant mortality. This study was designed to examine the influence of maternal low birth weight and preterm birth on infant mortality. The 1997–2007 Virginia birth and infant death registry was analyzed. The infant birth and death data was linked to maternal birth registry data using the mother’s maiden name and date of birth. From the mother’s birth registry data, the grandmother’s demographic and pregnancy history was obtained. Logistic regression modeling was used to estimate adjusted odds ratios and their 95% confidence intervals. There was a statistically significant association between maternal birth outcome and subsequent infant mortality. Infants born from a mother who was low birth weight were 2.3 times more likely to have an infant die within the first year of life. Similarly, infants born from a mother born preterm were 2.2 times more likely to have an infant die. Stratification by race showed that there was no statistical association between maternal birth weight and infant death among Whites. However, a strong association was observed among Blacks. Maternal birth outcomes may be an important indicator for infant mortality. Future longitudinal studies are needed to understand the underlying cause of these associations.     

The Influence of Maternal Health Literacy and Child’s Age on Participation in Social Welfare Programs

The objective of this study is to determine the influence of maternal health literacy and child’s age on participation in social welfare programs benefiting children. In a longitudinal prospective cohort study of 560 Medicaid-eligible mother-infant dyads recruited in Philadelphia, maternal health literacy was assessed using the test of functional health literacy in adults (short version). Participation in social welfare programs [Temporary Assistance to Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), child care subsidy, and public housing] was self-reported at child’s birth, and at the 6, 12, 18, 24 month follow-up interviews. Generalized estimating equations quantified the strength of maternal health literacy as an estimator of program participation. The mothers were primarily African-Americans (83 %), single (87 %), with multiple children (62 %). Nearly 24 % of the mothers had inadequate or marginal health literacy. Children whose mothers had inadequate health literacy were less likely to receive child care subsidy (adjusted OR = 0.54, 95 % CI 0.34–0.85) than children whose mothers had adequate health literacy. Health literacy was not a significant predictor for TANF, SNAP, WIC or housing assistance. The predicted probability for participation in all programs decreased from birth to 24 months. Most notably, predicted WIC participation declined rapidly after age one. During the first 24 months, mothers with inadequate health literacy could benefit from simplified or facilitated child care subsidy application processes. Targeted outreach and enrollment efforts conducted by social welfare programs need to take into account the changing needs of families as children age.     

Risks and Benefits of Adolescent Girls’ Participation in Online Sexting Survey Research

The increasingly ubiquitous use of sexting among adolescent girls underscores the importance of empirical data on their sexting behaviors, motivations, and outcomes. To date, the majority of sexting studies have been conducted online; however, little is known about the extent to which responding to such socially sensitive questions may cause participant discomfort or distress. Research on this question is critical since in the absence of empirical data, institutional review boards (IRBs) may permit or place restrictions on online sexting studies based on an under- or overestimation of adolescent participation risk. The current online study asked 210 girls (aged 14–18 years, 55% non-Hispanic White, with sexting experience in the past 12 months) who previously registered to take online surveys on (1) their anticipated comfort in responding to a sexting survey include items on sexting motivations, positive and negative sexting consequences, and related sexual behaviors; (2) their perceptions of sexting research benefits/harms; and (3) comfort discussing similar topics in everyday life and with health professionals. Overall, participants were comfortable responding to sexting survey questions, rated sexting research as high benefits and low risks, and felt about the same as or more comfortable completing a sexting survey than discussing similar topics with peers, parents, or healthcare professionals. Findings suggest that anonymous online sexting studies can be classified as minimal risk research for adolescent girls and provide empirical support for IRB decisions to waive guardian permission for participation in such studies.

     

How do urban African Americans and Latinos view the influence of diet on hypertension?

Uncontrolled hypertension and its complications continue to be major health problems that disproportionately affect poor minority communities. Although dietary modification is an effective treatment for hypertension, it is not clear how hypertensive minority patients view diet as part of their treatment, and what barriers affect their abilities to eat healthy diets. We conducted nine focus groups with 88 African American and Latino patients treated for hypertension to assess their knowledge, attitudes, behaviors, and beliefs concerning hypertension. Participants generally agreed that certain foods and food additives play an important role in the cause and treatment of hypertension. However, they found clinician-recommended diets difficult to follow in the context of their family lives, social situations, and cultures. These diets were often considered expensive, an unwelcome departure from traditional and preferred diets, socially isolating, and not effective enough to obviate the need for medications. These findings suggest the importance of culturally sensitive approaches to dietary improvements.     

Predicting Young Adults’ Intentions to Get the H1N1 Vaccine: An Integrated Model

Young adults 19 through 24 years of age were among the populations that had the highest frequency of infection from the 2009 H1N1 pandemic. However, over the 2009–2010 flu season, H1N1 vaccine uptake among college students nationwide was around 8%. To explore the social cognitive factors that influenced their intentions to get the H1N1 vaccine, this study compares the predictive power of the theory of planned behavior (TPB), the health belief model (HBM), and an integrated model. The final model shows that several HBM variables influenced behavioral intentions through the TPB variables. The results suggest that even though the TPB seemed a superior model for behavior prediction, the addition of the HBM variables could inform future theory development by offering health-specific constructs that potentially enhance the predictive validity of TPB variables.     

Shedding light on a HIV blind spot: Factors associated with men’s HIV testing in five African countries

ABSTRACT

Men’s relatively low rates of HIV testing has been termed the ‘HIV blind spot’ and recently declared by UNAIDS as a top priority. This study uses data from five nationally representative Demographic and Health Surveys in Kenya, Malawi, Mozambique, Zambia, and Zimbabwe to explore factors associated with men’s lifetime HIV testing. Between 29.3% and 34.9% of men ages 15–49 in these countries had never tested for HIV and men who held accepting attitudes towards gender-based violence, who lacked HIV knowledge, and who held stigmatising views of HIV were more likely to report never testing for HIV. Findings are interpreted, including a discussion of the possible unintended consequences of current 90-90-90 targets on men’s relatively low testing rates. The results point to possible intervention opportunities to increase HIV testing among men in high-HIV prevalence settings in Eastern and Southern Africa and emphasise the importance of changing men’s perceptions related to stigma and gender norms.     

‘Return to Work’ Coordinator Model and Work Participation of Employees: A Natural Intervention Study in Finland

Journal of Occupational Rehabilitation - Purpose Employers increasingly use ‘return to work’ (RTW) coordinators to support work ability and extend working careers, particularly among...     

Does the High Prevalence of Vitamin D Deficiency in African Americans Contribute to Health Disparities?

African Americans have higher incidence of, and mortality from, many health-related problems than European Americans. They also have a 15 to 20-fold higher prevalence of severe vitamin D deficiency. Here we summarize evidence that: (i) this health disparity is partly due to insufficient vitamin D production, caused by melanin in the skin blocking the UVB solar radiation necessary for its synthesis; (ii) the vitamin D insufficiency is exacerbated at high latitudes because of the combination of dark skin color with lower UVB radiation levels; and (iii) the health of individuals with dark skin can be markedly improved by correcting deficiency and achieving an optimal vitamin D status, as could be obtained by supplementation and/or fortification. Moderate-to-strong evidence exists that high 25-hydroxyvitamin D levels and/or vitamin D supplementation reduces risk for many adverse health outcomes including all-cause mortality rate, adverse pregnancy and birth outcomes, cancer, diabetes mellitus, Alzheimer’s disease and dementia, multiple sclerosis, acute respiratory tract infections, COVID-19, asthma exacerbations, rickets, and osteomalacia. We suggest that people with low vitamin D status, which would include most people with dark skin living at high latitudes, along with their health care provider, consider taking vitamin D₃ supplements to raise serum 25-hydroxyvitamin D levels to 30 ng/mL (75 nmol/L) or possibly higher.     

Reproductive Factors and Risk of Thyroid Cancer in Women: An Analysis in the Nurses’ Health Study II

BackgroundThe incidence of thyroid cancer in women is increasing at an alarming rate, with greatest risk in the reproductive years. Establishing relationships of hormonally related reproductive factors with thyroid cancer has been difficult. We aimed to elucidate potential risk factors for thyroid cancer in a large cohort of women.MethodsAmong 116,228 women in the Nurses’ Health Study II followed from 1989 to 2013, 620 cases of thyroid cancer were identified. We examined reproductive and hormone-related factors, including age at menarche, age at menopause, parity, oral contraceptive use, and postmenopausal hormone therapy use. Pregnancy, reproductive years, and months of breastfeeding were used as surrogate markers for exposure to endogenous reproductive hormones. We used multivariable Cox models to calculate relative risks and 95% confidence intervals for the associations between these factors and risk of thyroid cancer.ResultsNumber of reproductive years of 41 years or more was associated with more than double the risk of thyroid cancer compared with 30 years or fewer (relative risk, 2.20; 95% confidence interval, 1.19–4.06). The other variables analyzed (parity number, months of breastfeeding, age at menarche, menopausal status, and postmenopausal hormone therapy) were not associated with the risk of thyroid cancer. Women who entered menopause at age 45 years or older had a higher risk of thyroid cancer compared with women who entered menopause at a younger age. This result did not reach statistical significance; however, there was a linear trend between later age at menopause and increased risk of thyroid cancer (p_trend = .009).ConclusionsThis study used a unique large, longitudinal dataset to assess thyroid cancer risk factors and potential confounders over an extended time frame. Our key finding suggests increased risk of thyroid cancer may be associated with a variety of indicators of longer reproductive years. The Nurses’ Health Study II has provided new insights into the hormonal risks associated with thyroid cancer.     

Formative Process Evaluation for Implementing a Social Marketing Intervention to Increase Walking Among African Americans in the Positive Action for Today’s Health Trial

Objectives. Evaluating programs targeting physical activity may help to reduce disparate rates of obesity among African Americans. We report formative process evaluation methods and implementation dose, fidelity, and reach in the Positive Action for Today’s Health trial.Methods: We applied evaluation methods based on an ecological framework in 2 community-based police-patrolled walking programs targeting access and safety in underserved African American communities. One program also targeted social connectedness and motivation to walk using a social marketing approach. Process data were systematically collected from baseline to 12 months.Results: Adequate implementation dose was achieved, with fidelity achieved but less stable in both programs. Monthly walkers increased to 424 in the walking-plus-social marketing program, indicating expanding program reach, in contrast to no increase in the walking-only program. Increased reach was correlated with peer-led Pride Strides (r = .92; P < .001), a key social marketing component, and program social interaction was the primary reason for which walkers reported participating.Conclusions: Formative process evaluation demonstrated that the walking programs were effectively implemented and that social marketing increased walking and perceived social connectedness in African American communities.Intervention programs targeting neighborhood walking and physical activity (PA) have the potential to prevent obesity in underserved African American communities.1–3 African Americans experience the highest rates of obesity and the lowest rates of PA,1,4 and face increased barriers to PA, including a lack of access to safe places to be active and a lack of community support for PA.5–7 Formative process evaluation can inform program implementation and may lead to more effective health interventions for PA and obesity. In addition, social marketing (SM) approaches have been linked to increased effectiveness of health promotion interventions.8–11 The purpose of this study was to describe the application of systematic evaluation methods in the Positive Action for Today’s Health (PATH) trial, which adopted an innovative SM approach to promote walking in underserved (low-income, high-crime) African American communities,12 and to report evaluation data from the PATH walking programs. An additional aim was to present a framework for the evaluation of SM approaches that target a variety of public health issues.Consistent with an ecological approach,13 the PATH trial developed a community-based intervention to address access and safety barriers to neighborhood walking in underserved African American communities, with one program including an additional SM component to increase social connectedness and motivation for walking. Process evaluation methods were developed to assess program implementation and reach. Social marketing strategies14,15 were developed with community input,12 and focus groups conducted in the PATH communities suggested that the strategies would meet community needs and would be culturally relevant.16,17 Additionally, the utility of incorporating evaluation methods based on ecological theory has increasingly been recognized,18–21 as has the effectiveness of SM approaches.8–10 Although ecological factors significantly influence implementation practices and program outcomes,22 fewer than half of the studies targeting minority PA have evaluated them,23 and only a handful of studies implementing SM strategies have reported summative24–29 or formative process evaluation outcomes.8,23,30 Such limitations can decrease the accuracy with which program mechanisms, efficacy, and effectiveness are understood.As community-based interventions become more complex in design (e.g., by focusing on multiple ecological levels and components) and integrate strategies from varied disciplines (e.g., public health, marketing), evaluation becomes increasingly necessary for determining which levels and components affect outcomes, and to what extent,31 before dissemination.32 Evaluation of program implementation relies on the measurement of program dose, fidelity, and reach, which, respectively, quantify the completeness of program implementation, whether a program is delivered as intended, and the percentage of the target group engaged in the program.A growing literature has reported evaluation methods for community-based PA programs targeting African American adults. The WATCH project promoted increased PA through participation in church-based walking groups and used process evaluation to demonstrate that intervention activities were implemented with varying degrees of dose and fidelity.33 The Health-e AME church–based, multisite intervention assessed implementation and indicated that fidelity varied by site and was positively associated with meeting PA recommendations.34 In the H.U.B. City Steps and Healthy Body, Healthy Spirit community-based trials that targeted walking and PA, formative process evaluation methods were based in part on an ecological framework, with ongoing feedback provided to counselors to address lapses in fidelity.35,36 Finally, an intervention targeting PA adopted a media-based, community-based prevention marketing approach to promote walking and PA among women.37 By contrast, the PATH trial adopted a community-based grassroots marketing approach and focused on neighborhood access, safety, and social connectedness rather than individual factors. The media-based program used process evaluation to demonstrate that campaign exposure significantly increased walking, PA, and use of a walking trail.37In this study, we expand on previous research by reporting formative process evaluation for monitoring the implementation of a community-based intervention that integrated grassroots SM strategies to improve perceptions of access and safety, and to increase social connectedness and motivation for neighborhood walking in underserved African American communities. We present evaluation methods and dose, fidelity, and reach data from baseline to 12 months in both PATH walking programs.     

Influence of Behavioral and Environmental Factors on the Development of Obesity in Three-year-old Children —A Case-Control Study Based on Toyama Study—

Obesity in children seems to be a risk factor for chronic diseases in adulthood. From the viewpoint of preventive medicine, factors influencing the development of obese children should be removed early in life. The purpose of this study was to the elucidate relationship between obesity in 3-year-old children and both behavioral and environmental factors by conducting a case-control study. Subjects were selected from the Toyama study. Matched-pair comparisons were performed between obese children whose Kaup’s index was 18 or more (N=117) and control children (N=234) . Multivariate stepwised logistic regression analysis also applied to assess influence of confounding factors. The results indicated that the following 6 factors significantly influenced the development of obese 3-year-old children in exact Fisher’s method analysis (p<0.05): person other than the mother responsible for taking care of the child, short sleep duration (9 hours or less), physical inactivity, eating snacks irregularly, overweight father (BMI≥24), and overweight mother (BMI≥24). For both sexes, after adjusting for confounders by multivariate stepwise logistic analysis, overweight mother (OR 2.54, 95 % CI 1.64-3.95), birth overweight (birth weight≥3,500g; OR 1.76, 95 % CI 1.15-2.69), the mother not responsible for taking care of the child (OR 1.65, 95% CI 1.10-2.48), overweight father (OR 1.62, 95%CI 1.09-2.40), eating snacks irregularly (OR 1.56, 95% CI 1.04-2.33), and gender (female;OR 0.51, 95% CI 0.34-0.77) had significant relationships with obesity in childhood. For boys, overweight mother (OR 2.53, 95 % CI 1.47-4.35), birth overweight (OR 2.03, 95%CI 1.22-3.39), eating snacks irregularly (OR 1.94, 95 %CI 1.19-3.18), and birth month (36-41 months; OR 0.47, 95 % CI 0.23-0.96) had significant relationships. For girls, overweight mother (OR 2.62, 1.28-5.35), and short sleep duration (OR 2.24, 1.11-4.52) had significant relationships. In neither Fisher’s exact method nor multivariate logistic models, time to wake up, bedtime, duration of playing outdoors, regularity of meals, care about salty food, or frequency of eating snacks had significant relations with obesity in 3-year-old children (p<0.05).     

Notes on the concepts of ‘serodiscordance’ and ‘risk’ in couples with mixed HIV status

Abstract

Serodiscordant primary relationships, in which one partner is HIV-positive and the other is HIV-negative, are increasingly recognised as a key context for the transmission of HIV globally. Yet insights into the dynamics of serodiscordance remain relatively limited. I argue that to understand what makes serodiscordant couples engage in sexual practices that increase the chance of transmission, we need to examine what HIV ‘risk’ actually means in different cultures and contexts. A ‘socially situated’ approach to HIV risk moves beyond its scientific conceptualisation as an objective ‘fact’, revealing a diversity of perceptions and competing risks. It also reveals that couples do not necessarily perceive their mixed HIV status in terms of ‘difference’, a common assumption that predetermines serodiscordance and thereby obscures its many and complex enactments. I draw on examples from the social research literature to illustrate how serodiscordance is shaped in different ways by local practices, priorities, and meanings. I argue that it is within these lived contexts that perceptions and negotiations of ‘risk’ arise and, thus, where couples’ sexual practices need to be situated and understood. Such insights are timely as HIV research and prevention grapple with emerging scientific data that challenge traditional understandings about HIV transmission risk.     

Communities of color? Client-to-client racial concordance in the selection of mental health programs for Caucasians and African Americans

A discrete-choice logit model was applied to study the determinants of mental health provider choice using data from a large urban county in the Northeast US. The study subjects were 9,544 adult Medicaid recipients who received outpatient treatment from the 20 Community Mental Health Center (CMHC) programs in 2001. In addition to a conventional set of variables representing client and provider characteristics, the regression model included several interaction terms to examine whether racial concordance level among patients influences the choice of an outpatient program. The results revealed that racial concordance among the clients seems to be a factor in choosing a program. In particular, Caucasian clients are much more likely to select a program with a higher percentage of Caucasian clients, even though they have to travel further. More generally, our results suggest that program choice may be driven more by the racial composition of the clients served than by spatial proximity to the program.     

Doing More Good than Harm? The Effects of Participation in Sex Research on Young People in the Netherlands

Ethical guidelines for research with human participants stress the importance of minimizing risks and maximizing benefits. In order to assist Institutional Review Boards (IRBs) and researchers to make more informed risk/benefit analyses with regard to sex research among adolescents, the current study examined the effects of participation in sex research among 899 young people (15-25 years old). Participants completed three questionnaires on a wide range of sexuality-related measures. They also completed scales measuring their levels of distress, need for help, and positive feelings due to their research participation. In general, negative effects of research participation seemed limited, while benefits of participation appeared substantial. Several differences with regard to sociodemographic characteristics were found (e.g., females experienced more distress then males and younger or lower educated participants experienced more positive feelings). In addition, victims of sexual coercion reported more distress and need for help due to their participation, but also experienced more positive feelings. No significant differences were found in relation to experience with sexual risk behaviors (e.g., experience with one-night-stands). Several limitations of the study were discussed, as were implications for future research. Overall, the findings caution IRBs and researchers against being overly protective regarding the inclusion of young people in sex research.     

Potential Effects of California’s New Vaccine Exemption Law on the Prevalence and Clustering of Exemptions

Exemptions from childhood immunizations required for school entry have continued to increase among California kindergartners, and exemptions show spatial clustering within the state. A 2014 change in California’s school-entry vaccine exemption law requires parents filing for an exemption to submit signed documents from a health care provider. However, the evidence presented here suggests that the policy change will probably not be sufficient to reverse the growing trend in vaccine refusals.State-mandated immunization requirements for school entry have been instrumental in achieving high immunization coverage rates and ensuring herd immunity against infectious disease outbreaks.1 However, in most states parents can obtain a personal beliefs exemption (PBE) from school-entry requirements.2 A growing trend of parental vaccine hesitancy has led to an increase in PBE rates, and such increases are associated with higher risks of disease outbreaks.3 In California, for example, rates of PBEs among children entering kindergarten increased by 380% from 1996 to 2010 (from 0.5% to 2.3%).4,5In response to rising PBE rates, California passed Assembly Bill 2109 (AB2109) in September 2012.6 California’s previous law allowed a parent to obtain a PBE by signing an affidavit stating that immunization is contrary to the parent’s beliefs.7 This affidavit was preprinted on the California School Immunization Record, making exemptions readily accessible. Previous research demonstrates an association between easier state exemption procedures and higher exemption rates.8,9 Authored by state assembly member and pediatrician Richard Pan, AB2109 requires parents filing an exemption to submit an attestation signed by a health care provider stating that they have been provided information about the risks and responsibilities of refusing vaccination and an attestation signed by parents indicating receipt of this information.6 AB2109 went into effect in January 2014.It is not yet known whether this policy change will reverse or slow the trend of increasing PBE rates in California, although a similar regulatory change in Washington appears to have reduced PBEs.10 Here we present the most recent data on PBEs in California and demonstrate continued spatial variation in PBE rates statewide. These data represent the last kindergarten cohort before AB2109 was passed, so they will provide a useful baseline as the new law takes effect. We also discuss the implications of spatial clustering for the potential effectiveness of AB2109.     

The Influence of Attraction to Partner on Heterosexual Women’s Sexual and Relationship Satisfaction in Long-Term Relationships

Previous research has consistently found that attraction is important in the formation of relationships though research on attraction in long-term relationships is less well understood. This article examined the predictive value of self-reported attraction to partner and change in attraction to partner on sexual and relationship satisfaction in 176 women in committed heterosexual relationships using online survey methodology. Participants’ age ranged from 21 to 56 (M = 34.5) years and their relationship length ranged from 5 to 35 (M = 11.75) years. Hierarchical multiple regression results indicated that change in attraction to partner was the most salient predictor of sexual satisfaction, with current attraction to partner also related to women’s sexual satisfaction, accounting for 20 % of the variance. Current attraction to partner was the only significant predictor of women’s relationship satisfaction, accounting for 22 % of the variance. Additionally, attraction variables accounted for variance above and beyond the impact of relationship and sexual satisfaction. These findings suggest that self-reported attraction to partner is an important contributor to women’s satisfaction outcomes in long-term relationships. Further studies in the area of attraction to partner that include couple dynamics and longitudinal data are encouraged and implications for therapists, clinicians, and educators are discussed.     

Faith leaders’ messaging is essential to enhance HIV prevention among black Americans: results from the 2016 National Survey on HIV in the black community (NSHBC).

Background

To investigate whether religious service attendance and faith leaders’ messages about HIV and same-sex relationships are associated with acceptance of HIV prevention strategies.

Methods

Multivariable Poisson regression assessed whether attending religious services, faith leaders’ messages about HIV and same-sex relationships, and supportiveness of those messages were associated with HIV testing, as well as knowledge of and willingness to use pre-exposure prophylaxis (PrEP) among 868 Black Americans [45% men; M (SD)?=?34 (9) years-old] in the 2016 National Survey on HIV in the Black Community, USA.

Results

Participants who reported attending services monthly and/or hearing faith leaders’ messages that were supportive of same-sex relationships had a significantly higher likelihood of willingness to use PrEP (adjusted Rate Ratio[ARR]?=?1.76; 95% confidence interval [CI]?=?1.09, 2.48) and aRR?=?2.19; 95% CI?=?1.35, 3.55, respectively), independent of HIV risk. Homophobia was significantly associated with higher likelihood of being aware of PrEP and testing for HIV testing in the past 12?months.

Conclusions

Faith leaders’ messaging can influence Black Americans’ perceptions and uptake of HIV prevention strategies. Faith institutions and faith leaders should be involved in designing and disseminating HIV prevention strategies.