Dataset Information

Multilevel Resilience and HIV Virologic Suppression Among African American/Black Adults in the Southeastern United States.

ABSTRACT:

Objective

To assess overall and by neighborhood risk environments whether multilevel resilience resources were associated with HIV virologic suppression among African American/Black adults in the Southeastern United States.

Setting and methods

This clinical cohort sub-study included 436 African American/Black participants enrolled in two parent HIV clinical cohorts. Resilience was assessed using the Multilevel Resilience Resource Measure (MRM) for African American/Black adults living with HIV, where endorsement of a MRM statement indicated agreement that a resilience resource helped a participant continue HIV care despite challenges or was present in a participant's neighborhood. Modified Poisson regression models estimated adjusted prevalence ratios (aPRs) for virologic suppression as a function of categorical MRM scores, controlling for demographic, clinical, and behavioral characteristics at or prior to sub-study enrollment. We assessed for effect measure modification (EMM) by neighborhood risk environments.

Results

Compared to participants with lesser endorsement of multilevel resilience resources, aPRs for virologic suppression among those with greater or moderate endorsement were 1.03 (95% confidence interval: 0.96-1.11) and 1.03 (0.96-1.11), respectively. Regarding multilevel resilience resource endorsement, there was no strong evidence for EMM by levels of neighborhood risk environments.

Conclusions

Modest positive associations between higher multilevel resilience resource endorsement and virologic suppression were at times most compatible with the data. However, null findings were also compatible. There was no strong evidence for EMM concerning multilevel resilience resource endorsement, which could have been due to random error. Prospective studies assessing EMM by levels of the neighborhood risk environment with larger sample sizes are needed.

SUBMITTER: Park JW

PROVIDER: S-EPMC10092932 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Multilevel Resilience and HIV Virologic Suppression Among African American/Black Adults in the Southeastern United States.

Park Jee Won JW Wilson-Barthes Marta G MG Dulin Akilah J AJ Hogan Joseph W JW Mugavero Michael J MJ Napravnik Sonia S Carey Michael P MP Fava Joseph L JL Dale Sannisha K SK Earnshaw Valerie A VA Johnson Bernadette B Dougherty-Sheff Sarah S Agil Deana D Howe Chanelle J CJ

Journal of racial and ethnic health disparities 20230412 1

<h4>Objective</h4>To assess overall and by neighborhood risk environments whether multilevel resilience resources were associated with HIV virologic suppression among African American/Black adults in the Southeastern United States.<h4>Setting and methods</h4>This clinical cohort sub-study included 436 African American/Black participants enrolled in two parent HIV clinical cohorts. Resilience was assessed using the Multilevel Resilience Resource Measure (MRM) for African American/Black adults liv ...[more]

PMID: 37043167

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Project description:IntroductionBlack/African American men who have sex with other men (BMSM) are disproportionately affected by HIV, experience significant disparities in HIV incidence, and face significant barriers to accessing HIV treatment and care services, including pre-exposure prophylaxis (PrEP). Despite evidence of individual and structural barriers to PrEP use in the Midwest, no review has synthesized this finding to have a holistic view of PrEP uptake and barriers. This review examines patterns of, barriers to, and facilitators of PrEP uptake among BMSM in the Midwest, United States (US).MethodsFive databases (CINAHL Plus, PUBMED, PsycINFO, SCOPUS, and Web of Science) were searched in March 2023. We included studies that focused on BMSM in the Midwestern states; only empirical studies (either quantitative or qualitative or both) were considered. We synthesized the qualitative data and teased out some of the factors inhibiting or facilitating PrEP uptake among BMSM.ResultsWe screened 850 articles, and only 22 (quantitative: 12; qualitative: 8; mixed methods: 2) met our set eligibility criteria. Most of the studies were conducted in Chicago. Most BMSM use oral than injectable PrEP. Uptake of PrEP ranged from 3.0 to 62.8%, and the majority reported a prevalence of less than 15%. The barriers include PrEP awareness, PrEP access, PrEP stigma, side effects, PrEP preference, socioeconomic status, medical insurance and support, partner trust, trust in the health system, and precautions with sexual partners. The identified PrEP facilitators include PrEP use until HIV is eradicated, friend influence, experience with dating men living with HIV, safety, phobia for HIV, disdain for condoms, and power to make decisions.ConclusionOur review summarized patterns of, barriers to, and facilitators of PrEP uptake among BMSM in the Midwest, United States. The low PrEP uptake of BMSM was primarily attributed to mistrust in the health system and low socioeconomic status. Multimodal and multilevel strategies are needed to improve PrEP uptake among BMSM, including improving the marketing of PrEP to BMSM and removing financial barriers to accessing PrEP service.

Dataset Information

Multilevel Resilience and HIV Virologic Suppression Among African American/Black Adults in the Southeastern United States.

Objective

Setting and methods

Results

Conclusions

Publications

Multilevel Resilience and HIV Virologic Suppression Among African American/Black Adults in the Southeastern United States.

Similar Datasets

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