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BackgroundAfrican Americans are disproportionally affected by HIV and have poorer rates of antiretroviral therapy (ART) adherence compared to other racial or ethnic groups in the United States. Factors associated with poor HIV disease outcomes are commonly associated with sociostructural barriers that prevent engagement with and retention in HIV care. SMS text messaging interventions to promote ART adherence among predominantly non-Hispanic White persons with HIV (PWH) have been shown to be efficacious; however, limited research has been devoted to culturally tailoring interventions for underrepresented racial/ethnic groups. Considering African Americans show poorer engagement along the HIV care continuum, we developed an individualized and culturally tailored two-way SMS text messaging intervention to improve ART adherence and associated virologic suppression among African American PWH.ObjectiveIn this paper we describe the protocol of a culturally tailored individualized Texting for Adherence Building (iTAB) intervention in a 24- to 48-week, single-arm study.MethodsWe developed a culturally tailored iTAB intervention, which we are implementing in a 24- to 48-week, single-arm study. Participants were recruited from the Family Health Centers of San Diego (FHCSD), a federally qualified health center. Patient inclusion criteria were (1) receiving care at the FHCSD, (2) living with HIV, (3) self-identification as Black, African American, or of African ancestry, (4) English speaking, (5) age 18 or older, (6) currently on ART, and (7) able to provide informed consent. Study enrollment began in November 2017 and closed in July 2019. A total of 90 participants from the FHCSD enrolled in the iTAB intervention, and we anticipate completing data collection in July 2020. Participants were assisted in individualizing and customizing their SMS text message preferences at the baseline study visit. Self-assessment measures are collected at baseline, interim, and final study visits. Problems related to sending/receiving SMS text messages and barriers to ART adherence are assessed at each interim study visit. The FHCSD staff monitors and tracks participants' daily SMS text message responses to ART adherence reminders using a clinical dashboard.ResultsWe hypothesize that the proportion of individuals achieving HIV virologic suppression (viral load

This paper investigates efforts to engage grassroots groups in the political arena from the perspective of the state. Whereas most of the current literature conceptualizes grassroots mobilization as a bottom-up phenomenon, in Brazil the state has taken an active role in mobilizing new groups that simultaneously provide social services and make policy demands on government. This paper describes the exemplary case of mobilization around AIDS in Brazil to suggest that under certain conditions the state may take an active role in breaking down socioeconomic barriers toward accessing the political arena.Specifically, I suggest that government bureaucrats in Brazil are engaging a wide array of associations in AIDS policy as organized interests, due to a strong dependence on collaboration with grassroots associations to further their policy goals. Moreover, I highlight three principal strategies through which the Brazilian state is targeting associations for mobilization: by creating new formal “participatory” political institutions; by developing informal channels of communication between state bureaucrats and grassroots leaders; and by using large amounts of public funding to support grassroots AIDS associations. I describe in detail both the state’s role in engaging associations to participate in AIDS policy and the motivations behind this effort as a way to explore the dynamics of what may be a broader phenomenon occurring in Brazil.The empirical data used in the paper draws from a broader research project that took place over one and a half years of fieldwork conducted in Brazil, involving in-depth interviews with approximately 90 grassroots leaders and key government officials in Rio de Janeiro, São Paulo, Brasília, and Washington, D.C.,,observation of major political and policymaking meetings, and an ongoing mixed-mode (paper and internet) survey which to date has garnered 90 responses (39% of the sample) from directors of grassroots associations in Rio de Janeiro and São Paulo.

Purpose The purpose of this paper is to use secondary data from qualitative interviews that examined the sexual behaviors, HIV attitudes, and condom use of 17 gay, bisexual, and transgender women housed in a protective custody unit in the Los Angeles County Jail (Harawa et al., 2010), to develop a better understanding of the consensual sexual behaviors of male prisoners. Design/methodology/approach Study eligibility included: report anal or oral sex with another male in the prior six months; speak and understand English; and incarcerated in the unit for at least two weeks. Data analysis consisted of an inductive, qualitative approach. Findings Findings illuminate participants' experiences concerning how the correctional facility shaped their sexual choices and behaviors, and the HIV-risk reduction strategies they employed. Originality/value This study contributes to the prison-sex literature, and is timely, given current federal and local HIV/AIDS priorities. Recommendations that address male prisoners' sexual and health needs and risks are posed.

Although stigma is considered to be one of the major barriers to reducing the AIDS epidemic in India, efforts to reduce stigma have not been sufficiently examined. In response, a partially computer-administered three-session stigma reduction intervention was developed and is currently being tested. This paper describes the technological design, development, implementation, and management of these in-person tablet-administered assessment and intervention sessions that are being used to evaluate the efficacy of this innovative stigma reduction intervention among nursing students and ward attendants in India.

Little is known about migration during pregnancy related to intimate partner violence (IPV). In this paper, we examine issues of agency in relation to pregnant women's migrations in a high HIV prevalence area of Kenya. We qualitatively explored forced migration among pregnant women, using data from in-depth interviews, focus groups and IPV screening forms. To quantitatively examine migration during pregnancy, we analysed data from a prospective study of 614 pregnant women. The qualitative data revealed that women had varied responses to violence in pregnancy, with some being able to leave the marital home voluntarily as a strategy to escape violence. Others were 'sent packing' from their marital homes when they dared to exercise autonomy, in some cases related to HIV status. Quantitative analyses revealed that pregnant women who migrated were more educated, less likely to be living with a partner and had fewer children than other women. Migration among pregnant women in Kenya illustrates the complexity of understanding women's agency in the context of IPV. The findings indicate that there is not a dichotomy between 'victim' and 'agent', but rather a complex dynamic between and within pregnant women, who may sequentially or simultaneously experience aspects of victimhood and/or agentic response.

Little is known about migration during pregnancy related to intimate partner violence (IPV). In this paper, we examine issues of agency in relation to pregnant women's migrations in a high HIV prevalence area of Kenya. We qualitatively explored forced migration among pregnant women, using data from in-depth interviews, focus groups and IPV screening forms. To quantitatively examine migration during pregnancy, we analysed data from a prospective study of 614 pregnant women. The qualitative data revealed that women had varied responses to violence in pregnancy, with some being able to leave the marital home voluntarily as a strategy to escape violence. Others were 'sent packing' from their marital homes when they dared to exercise autonomy, in some cases related to HIV status. Quantitative analyses revealed that pregnant women who migrated were more educated, less likely to be living with a partner and had fewer children than other women. Migration among pregnant women in Kenya illustrates the complexity of understanding women's agency in the context of IPV. The findings indicate that there is not a dichotomy between 'victim' and 'agent', but rather a complex dynamic between and within pregnant women, who may sequentially or simultaneously experience aspects of victimhood and/or agentic response.

An observational study of the Oakland Eligible Metropolitan Area (EMA) and its Ryan White Title I HIV health services planning council, officially known as the Alameda/Contra Costa HIV Planning Council, has been in progress since October 1992. This paper reports on the background, methodology, and several preliminary findings of this research. It is argued that a Title I planning council's organizational form fits precisely the definition of a minimalist organization, and that the environment in which a planning council must function is turbulent. We identify several aspects of a planning council's turbulent environ- ment and the consequences for a planning council of a catastrophic loss of experienced and knowledgeable membership. We note that both internal and external environmental forces can seriously impair a planning council's functioning as an organization, or even culminate in its dissolution or sudden collapse, to be followed by its swift replacement by a newly appointed successor planning council. Furthermore, the planning council replacement procedure that we identify, when adroitly performed, apparently can be completed without jeopardizing either the EMA's Title I status and eligibility or the delivery of Title I-funded health and social services in the EMA. We conclude that the planning council replacement procedure is an example of environmental selection as hypothesized by theorists of the organizational ecology perspective. Several implications of these findings for practitioners are offered, as well as one warning.