Search

INTRODUCTION Transgender people, including transgender women (TGW), are disproportionately affected by HIV [1–3] and face distinct challenges accessing HIV prevention and treatment services. In 2021, the relative risk of acquiring [...], : Introduction: We sought to characterize social and structural drivers of HIV vulnerability for transgender women (TGW) in Zimbabwe, where TGW are not legally recognized, and explore differences in vulnerability by feminine presentation. Methods: A secondary analysis was conducted with a sub‐sample of participants recruited from a 2019 respondent‐driven sampling survey that comprised men who have sex with men, TGW and genderqueer individuals assigned male sex at birth, from two cities in Zimbabwe. Survey questionnaires captured information related to socio‐demographics, sexual and substance use behaviours, and social and structural barriers to HIV services. Secondary analyses were restricted to participants who identified as female, transfemale or transwomen (236/1538) and were unweighted. Descriptive statistics were used to calculate sample estimates and chi‐square and Fisher's exact tests were used to assess differences in vulnerability by feminine presentation. Results: Among 236 TGW, almost half (45.3%) presented as feminine in the 6 months preceding the survey and 8.5% had ever used hormones to affirm their gender identities. Median age among TGW was 23 years (interquartile range: 20–26). Feminine presenting TGW in our sample had higher prevalence of arrest (15.9% vs. 3.9%), rejection by family/friends (38.3% vs. 14.0%), employment termination (11.2% vs. 3.9%), employment refusal (14.0% vs. 3.9%), denial of healthcare (16.8% vs. 2.3%), physical, sexual or verbal harassment or abuse (59.8% vs. 34.1%), alcohol dependence (32.7% vs. 12.4%), recent transactional sex with a male or TGW partner (30.8% vs. 13.3%) and recent non‐injection drug use (38.3% vs. 20.2%) than non‐feminine presenting TGW (all p‐value Conclusions: Findings suggest that TGW, particularly feminine presenting TGW, experience social and structural inequities which may contribute to HIV vulnerability. Interventions aimed at addressing inequities, including trans competency training for providers and gender‐affirming, psychosocial and legal support services for TGW, might mitigate risk.

Youth social movements for racial justice, especially against police violence, are on the rise. And this broader policy landscape is reflective of how youth are addressing racism in policing in their local context. Therefore, by drawing upon scholarship related to Black Radicalism, activism, and social movements, this study examines how youth of color activists are fighting against the overpolicing of their schools and communities in two specific contexts: Wake County, North Carolina and Chicago, Illinois. This study demonstrates how context shapes youth of color social movement building, that youth are strategic in how they employ activism, and ultimately adults can either impede or help advance youth's demands for justice.

While international guidelines recommend integration of family planning (FP) and HIV services, limited research has been done to explore how healthcare providers perceive the feasibility and utility of integrated services. To address this gap, we administered a standardized questionnaire to 85 providers from 6 HIV clinics in Lusaka, Zambia, before (April–May 2018) and after (May–June 2019) implementing an enhanced model of FP/HIV service integration. We tested for differences in FP knowledge, attitudes and practices between the two time periods with tests appropriate for paired observations. The proportion of providers self-reporting direct provision of contraceptives increased significantly for several methods including oral contraceptives (14% vs. 26%, p = 0.03), injectables (9% vs. 25%, p < 0.001), implants (2% vs. 13%, p = 0.007) and intra-uterine devices (2% vs. 13%, p = 0.007). In-depth interviews were also conducted post-integration with 109 providers to solicit their feedback on the benefits and challenges of offering integrated services. While providers were highly supportive of integrated services, they identified several challenges including widespread belief in FP myths among female clients, the need to consult a male partner prior to starting FP, lack of trained staff and space, and frequent stockouts of contraceptives and equipment. Addressing these challenges will be critical in designing future services. [ABSTRACT FROM AUTHOR]

This paper considers how the practice of culturally relevant pedagogy may have predated the theory's coinage. Using scholarly accounts of Black women teachers in de jure segregated Black schools in the Jim Crow South, the authors suggest that these educators engaged a critical, politically and culturally informed pedagogy; their praxis built on and affirmed their students' cultural, racial, and political knowledge, worldviews, and assets. Despite the white supremacist regime of antiBlack terrorism that hampered many material aspects of Black segregated schools, this paper documents intangible dimensions that partly defined during the Jim Crow era the tradition of "African American pedagogical excellence." Demonstrating pedagogical alignment across each of the theory's three propositions, we use scholarly examples to indicate how in de jure segregated Black schools, Black women teachers' praxis reflected culturally relevant pedagogy before the label was introduced to the education research community. Highlighting what Black women teachers' historic labor offers the current educational landscape, this paper's implications call for education researchers to excavate this rich site of knowledge to inform and enhance the current education of students of Color broadly and Black students specifically.

1 | INTRODUCTION Zimbabwe has made substantial progress towards reaching the UNAIDS 95-95-95 targets: 87% of adult people living with HIV (PLHIV) are aware of their HIV status; of these, [...], Introduction: Zimbabwe is scaling up pre-exposure prophylaxis (PrEP) for key populations, including men who have sex with men (MSM) and transgender women (TGW). To assess implementation and inform HIV programming, we evaluated gaps in PrEP awareness, uptake and use, and correlates of awareness and uptake among a sample of MSM, TGW and genderqueer individuals (GQ) in Harare and Bulawayo, Zimbabwe. Methods: Respondent-driven sampling was used to recruit 1194 MSM and 344 TGW/GQ aged >18 to participate in a cross-sectionalsurvey assessing HIV-related outcomes in 2019. Consenting participants completed a questionnaire on sociodemographic information, sexualrisk practices and engagement in HIV services and underwent HIV testing. Descriptive statistics were used to assess the PrEP cascade. Multiple logistic regression models were used to identify factors associated with PrEP awareness and uptake among HIV-negative participants. Data were unweighted as the sample did not reach convergence on key estimates. Results: Among the 1167 HIV-negative participants, most (79.2%) were MSM compared to TGW/GQ (20.8%). Median age was 24 years. Overall, 45.8% were aware of PrEP and of those, 31.3% had ever taken PrEP. Most (71.1%) reporting never taking PrEP were willing to start PrEP; the main reasons for never starting PrEP included not knowing where to access it (24.8%) and fearing side effects (20.4%). Among those who had ever taken PrEP, 74.9% had taken PrEP in the last 6 months; of these, 42.4% had taken PrEP the day of or day preceding the survey. Side effects represented the most common (59.5%) reason for discontinuing PrEP. MSM (adjusted odds ratio [aOR]: 2.5, 95% confidence interval [CI]: 1.8-3.6) and TGW/GQ in Harare (aOR: 3.1, 95% CI: 2.1-4.7), and TGW/GQ in Bulawayo (aOR: 2.4, 95% CI: 1.1-5.3) had higher awareness of PrEP than MSM in Bulawayo. Overall, TGW/GQ were more likely to have ever taken PrEP compared to MSM (aOR: 1.6, 95% CI: 1.01-2.4). Conclusions: Findings emphasize the need for tailored interventions to promote PrEP among key populations. As HIV programs in Zimbabwe continue to expand PrEP services, these data, including barriers to starting and continuing PrEP, can inform strategies to address gaps along the PrEP cascade. Keywords: PrEP; men who have sex with men; transgender people; HIV prevention; Africa; key and vulnerable populations

INTRODUCTION Persons living with HIV (PLWH), including those in low? and middle?income countries, have experienced extended life expectancies due to the success of antiretroviral (ARV) therapies [1]. In 2014, the [...], : Introduction: Achieving optimal HIV outcomes, as measured by global 90?90?90 targets, that is awareness of HIV?positive status, receipt of antiretroviral (ARV) therapy among aware and viral load (VL) suppression among those on ARVs, respectively, is critical. However, few data from sub?Saharan Africa (SSA) are available on older people (50+) living with HIV (OPLWH). We examined 90?90?90 progress by age, 15?49 (as a comparison) and 50+ years, with further analyses among 50+ (55?59, 60?64, 65+ vs. 50?54), in 13 countries (Cameroon, Cote d&apos;Ivoire, Eswatini, Ethiopia, Kenya, Lesotho, Malawi, Namibia, Rwanda, Tanzania, Uganda, Zambia and Zimbabwe). Methods: Using data from nationally representative Population?based HIV Impact Assessments, conducted between 2015and 2019, participants from randomly selected households provided demographic and clinical information and whole blood specimens for HIV serology, VL and ARV testing. Survey weighted outcomes were estimated for 90?90?90 targets. Country?specific Poisson regression models examined 90?90?90 variation among OPLWH age strata. Results: Analyses included 24,826 HIV?positive individuals (15?49 years: 20,170; 50+ years: 4656). The first, second and third 90 outcomes were achieved in 1, 10 and 5 countries, respectively, by those aged 15?49, while OPLWH achieved outcomes in 3, 13 and 12 countries, respectively. Among those aged 15?49, women were more likely to achieve 90?90?90 targets than men; however, among OPLWH, men were more likely to achieve first and third 90 targets than women, with second 90 achievement being equivalent. Country?specific 90?90?90 regression models among OPLWH demonstrated minimal variation by age stratum across 13 countries. Among OLPWH, no first 90 target differences were noted by age strata; three countries varied in the second 90 by older age strata but not in a consistent direction; one country showed higher achievement of the third 90 in an older age stratum. Conclusions: While OPLWH in these 13 countries were slightly more likely than younger people to be aware of their HIV?positive status (first 90), this target was not achieved in most countries. However, OPLWH achieved treatment (second 90) and VL suppression (third 90) targets in more countries than PLWH

Black feminist survivors and advocates of sexual violence have been integral in recognizing their intersecting identity, using their voice and stories to enlighten society and to reinforce the importance of visibility and inclusion in the sexual violence research, prevention, intervention, and treatment. Despite the historical and present-day sexual violence against the Black female body, this population continues to find ways to heal and overcome the attack on her personhood. This article highlights the identities, unique needs, and considerations of the Black female survivor of childhood sexual abuse (CSA) in relation to the racism, sexism, and overarching oppression that are often added layers for this population. This article also explores the personal narrative of a Black female survivor of CSA, the discovery of self, and an encouragement to speak ones' truth after victimization, into survival, and beyond. The article concludes with a focus on the significance of the Black female survivors' reconnection to culture and the ancestors as a tool for healing. [ABSTRACT FROM AUTHOR]

Background: Socioeconomic status (SES) impacts health outcomes. The Youth Risk Behavior Survey (YRBS), like many school-based data sources, lacks individual-level poverty information. We propose using school-level percentages of student eligibility for free/reduced-price meals (%FRPM) as a proxy for individual-level poverty. Methods: Using the New York City (NYC) 2009 YRBS, we created school-level poverty quartiles to append to individual YRBS records by ranking schools by %FRPM. We compared this with 2 other school-level poverty measures using students' home and school neighborhood-level poverty and measured the association of these 3 school-level proxies with individual's household income. Last, we evaluated health outcomes by race/ethnicity and poverty to demonstrate the importance of accounting for poverty. Results: The school-level measure that used %FRPM had the strongest association with household income. When the school-level individual poverty proxy was included in illustrative analyses using YRBS data, patterns by poverty within race/ethnicity emerged that were not seen when looking at race/ethnicity alone. Conclusions: Using a poverty measure to analyze school-based data will provide a better understanding of the impact of SES on health outcomes. Based on our evaluation, when individual-level information is not available, we propose using school-level %FRPM, which are publicly available throughout the United States.

High school students who participate in social justice education have a greater awareness of inequities that impact their school, community, and society, and learn tools for taking action to address these inequities. Also, a classroom that consist of students with a diverse set of identities creates an ideal circumstance in which a teacher can build upon student differences in order to facilitate meaningful discussions about social justice, especially issues of race. Therefore, in this article we use qualitative case study approaches to examine a high school course on social justice education, paying specific attention to the classroom pedagogy and dialogue on issues of race, power, and privilege. The course was purposefully diverse in enrollment, which brought students together who might not have had interactions with each other prior to the class. We employ Hackman's (2005) five components of social justice education (SJE) as a framework for the analysis of the pedagogy and discussions constructed in the classroom, as well as a common language for what constitutes as social justice education in our research inquiry. Students in the course developed a facility for defining and identifying various forms of oppression and injustice. However, we questioned to what extent these very same issues played out in the class dialogue. Due to the level of student diversity, the course was a unique space to learn about racism and intersecting issues of social justice. However, there was still some student resistance to acknowledging certain aspects of racism. In conclusion, we discuss how social justice education is not absolved from, but rife with complex racial politics.

This paper describes an initiative, Becoming Teacher Educators (BTE), which is a group for doctoral students who want to become teacher educators. The group is composed of two professors and 12 doctoral students. The various activities in which the group has engaged over the past three years are described. This article brings to light a few key elements of the BTE group, namely, its strengths as a community, the importance of shared leadership, the opportunity to develop knowledge of teacher education, the improvement of research skills, the influence on identity, and improvement in practices as beginning teacher educators.