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Background: Black women are diagnosed, disabled, and die from obesity and associated chronic diseases at higher rates than any other sex or race. Advanced practice registered nurses (APRN) can potentially improve culturally relevant health education and counseling by using health literacy communication tools. Objective: Explore individualized barriers and APRNs' role in providing obesity prevention education and counseling by assessing the efficacy of the Teach-Back Method (TBM) to understand health habits and attitudes. Methods: Black women aged 18–45, previously diagnosed as overweight or obese, and identified with perceived barriers were recruited from a predominantly Black church in Atlanta. They engaged in weekly, 1-hour educational sessions via Zoom, addressing four common barriers identified in the literature. Sessions ended with a 5–10 minute Teach-Back session. Pre- and post-intervention Readiness to Change Questionnaire (RCQ) were completed. Descriptive statistics and quantitative data from surveys and pre- and post-RCQ were analyzed. Results: Twenty women completed the intervention. Paired sample t -test revealed no statistical significance or correlation between pre- and post-RCQ scores after using TBM in educational sessions. However, Pearson's correlation showed positive associations between elevated body mass index levels as one advances their education and annual income, with a p -value of 0.05. Discussion: Increased rates of obesity are experienced despite higher educational attainment or pay. Stress and high-coping mechanisms contributed to disordered eating, decreased physical activity engagement, and decreased motivation toward habit change. Clinicians should be held accountable for delivering culturally sensitive care using the TBM, addressing social determinants of health, performing routine stress assessments, and checking their implicit biases. [ABSTRACT FROM AUTHOR]

Black people represent less than 13% of the population in the United States, but over 15% of COVID-19 deaths, with a mortality rate two times higher than White people. The Black Church system has historically been in a unique position to serve Black communities, particularly during times of crisis. The deep-rooted connection of the Black Church system within Black communities was largely shaped by slavery and segregation. However, there have been questions about the relevance of the Black Church system today. The objective of this commentary is to describe the intersectionality of ministry and health that has been illuminated in a profound way during this pandemic. Those in leadership had to evaluate and disseminate COVID-19 information to congregants, recognizing mistrust of the medical and public health systems still permeates throughout Black communities. Moreover, the death of George Floyd sparked international outcry, which launched church leaders to respond to a second pandemic: systemic racism. Understanding ways the Black Church responded to COVID-19, and systemic racism, is significantly important to public health and medical communities as it addresses the relevance of this system and ways to appropriately support during another public health crisis. [ABSTRACT FROM AUTHOR]

AbstractBackground. African American/Black (hereafter referred to as Black) persons who smoke constitute a tobacco disparities group in the United States. Within the Black population, female smokers experience a disproportionate percentage of these disparities and are less likely to quit cigarettes than their male counterparts. Two factors implicated in female smokers’ relatively worse quit success are (1) motives to smoke to reduce negative affect and (2) expectancies that smoking will reduce negative affect. Objectives. The present study sought to test sex differences in these two clinically relevant cognitive constructs and evaluate the indirect effects of sex and severity of problems when trying to quit via smoking motives and expectancies for negative affect reduction among Black adults who smoke. Participants included 103 Black adults who smoke daily (72% male; Mage = 44.5 years, SD = 11.5 years). Results. Results revealed sex differences in both negative affect reduction motives and expectancies, as well as a partial indirect effect for sex on the severity of problems when trying to quit through negative affect reduction motives (a1b1 = 0.18, 95% CI [0.04, 0.38]) but not negative affect reduction expectancies (a2b2 = −0.01, 95% CI [-0.11, 0.09]) in a simultaneous model of indirect effects. Conclusions. These findings shed light on the complex relationship between race, sex, and severity of problems when trying to quit, particularly when complicated by smoking motives and expectancies. Current data should be considered when developing sex-specific, tailored smoking cessation interventions for Black women. [ABSTRACT FROM AUTHOR]

Background: Awareness and uptake of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) remains low among Black/African American cisgender women, partly due to low self-reported PrEP knowledge and comfort among primary care providers. Ensuring providers are trained on PrEP is crucial, as increased PrEP knowledge is associated with higher rates of PrEP prescription. Objective: We aimed to develop a PrEP training for providers to improve their self-efficacy in discussing and prescribing PrEP for Black women, with the ultimate goal of increasing PrEP awareness and utilization among Black women. Design: In this qualitative study, we conducted focus groups with medical providers at three federally qualified health centers in the Southern and Midwestern United States to identify themes informing the development of a provider PrEP training. Methods: Providers were asked for input on content/design of PrEP training. Transcripts underwent rapid qualitative analysis using the Stanford Lightning Report Method. Themes were identified and presented under the domains of the Consolidated Framework for Implementation Research. Results: Ten providers completed four focus groups. Themes included the individual characteristics of providers (low comfort initiating PrEP discussions, particularly among White providers) and the outer setting of client attitudes (perceptions of potential provider bias/racism, varying levels of concern about HIV acquisition). Opportunities were identified to maximize the benefit of training design (e.g., developing case scenarios to enhance providers' cultural competency with Black women and PrEP knowledge). Conclusion: This comprehensive PrEP training features both didactic material and interactive role-plays to equip providers with the clinical knowledge for prescribing PrEP while building their competency discussing PrEP with Black women. This training is particularly important for providers who have racial or gender discordance with Black women and express lower comfort discussing PrEP with these clients. Provider training could lead to minimizing racial- and gender-based inequities in PrEP use. Plain language summary: Increasing the use of pre-exposure prophylaxis (PrEP) among Black women: a study to improve provider knowledge through PrEP training Why was the study done? Use of pre-exposure prophylaxis (PrEP), a medication that can prevent the transmission of human immunodeficiency virus (HIV), is low among Black/African American women. Part of the reason why is because primary care providers (PCPs) report lower knowledge about PrEP and lower comfort talking about PrEP with clients. Making sure PCPs are trained on PrEP could help increase PrEP use among Black women. What did the researchers do? The research team held focus groups, during which they asked medical providers at federally qualified health centers (FQHCs) in the Southern and Midwestern United States questions about their experiences with discussing PrEP and what information should be included in a training about PrEP for providers to make sure the training would be helpful for them. What did the researchers find? A total of ten providers completed four focus groups. Important points mentioned in the focus groups included low comfort among providers when bringing up PrEP to clients, especially among White providers, as well as different levels of concern about HIV and feelings of potential provider bias/racism among clients. These points helped the researchers design a PrEP training that addresses providers' needs (such as creating case scenarios that help providers practice discussing PrEP with Black women and answering common questions about PrEP). What do the findings mean? A PrEP training for providers should have both information about prescribing PrEP and interactive role-plays to build providers' PrEP knowledge while improving their confidence and skill in talking about PrEP with Black women. This training is particularly important for providers who are a different race or gender than Black women and express lower rates of comfort discussing PrEP with these clients. Provider training could eventually lead to higher PrEP use among Black women. [ABSTRACT FROM AUTHOR]

Background: Pre-exposure prophylaxis (PrEP) is a highly effective pharmaceutical intervention that prevents HIV infection, but PrEP uptake across the US has been slow among men who have sex with men (MSM), especially among Black/African American (B/AA) and Hispanic /Latino (H/L) MSM. This study investigates the acceptability and essential components of a peer-driven intervention (PDI) for promoting PrEP uptake among MSM, with a specific focus on B/AA and H/L communities. Methods: We conducted 28 semi-structured, qualitative interviews with MSM in southern New England to explore the components of a PDI, including attitudes, content, and effective communication methods. A purposive sampling strategy was used to recruit diverse participants who reflect the communities with the highest burden of HIV infection. Results: Of 28 study participants, the median age was 28 years (interquartile range [IQR]: 25, 35). The sample comprised B/AA (39%, n = 11) and H/L (50%, n = 14) individuals. Notably, nearly half of the participants (46%) were current PrEP users. We found that many participants were in favor of using a PDI approach for promoting PrEP. Additionally, several participants showed interest in becoming peer educators themselves. They emphasized the need for strong communication skills to effectively teach others about PrEP. Moreover, participants noted that peer education should cover key topics like how PrEP works, how effective it is, and any possible side effects. Conclusions: Our study shows that effective PDIs, facilitated by well-trained peers knowledgeable about PrEP, could enhance PrEP uptake among MSM, addressing health disparities and potentially reducing HIV transmission in B/AA and H/L communities. [ABSTRACT FROM AUTHOR]

Black women continue to be disproportionally burdened by HIV. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention option, which is underused by Black women. While social network interventions (SNIs) have been widely researched and implemented among some groups vulnerable to HIV, little is known about social network characteristics among Black women. To learn more about the social networks of Black women vulnerable to HIV and their knowledge of and interest in PrEP, we conducted a cross-sectional survey among 109 Black women aged 18–45 years attending a family planning clinic in Chicago, Illinois. In our study, 44% of women reported that they were moderately to extremely concerned about HIV. Over half of participants (53%) had a small personal network size (i.e., less than two). No statistically significant associations between having larger network sizes and having previously heard of PrEP, having an interest in starting PrEP, or having good PrEP knowledge were detected. Open-ended responses revealed high levels of trust in network connections with matters related to sexual health. Additionally, nearly all (94%) of women reported that SNIs were a good idea to promote PrEP. Future network studies are needed to inform the development of effective intervention strategies for women. [ABSTRACT FROM AUTHOR]

Abstract Background Pre-exposure prophylaxis (PrEP) is a highly effective pharmaceutical intervention that prevents HIV infection, but PrEP uptake across the US has been slow among men who have sex with men (MSM), especially among Black/African American (B/AA) and Hispanic /Latino (H/L) MSM. This study investigates the acceptability and essential components of a peer-driven intervention (PDI) for promoting PrEP uptake among MSM, with a specific focus on B/AA and H/L communities. Methods We conducted 28 semi-structured, qualitative interviews with MSM in southern New England to explore the components of a PDI, including attitudes, content, and effective communication methods. A purposive sampling strategy was used to recruit diverse participants who reflect the communities with the highest burden of HIV infection. Results Of 28 study participants, the median age was 28 years (interquartile range [IQR]: 25, 35). The sample comprised B/AA (39%, n = 11) and H/L (50%, n = 14) individuals. Notably, nearly half of the participants (46%) were current PrEP users. We found that many participants were in favor of using a PDI approach for promoting PrEP. Additionally, several participants showed interest in becoming peer educators themselves. They emphasized the need for strong communication skills to effectively teach others about PrEP. Moreover, participants noted that peer education should cover key topics like how PrEP works, how effective it is, and any possible side effects. Conclusions Our study shows that effective PDIs, facilitated by well-trained peers knowledgeable about PrEP, could enhance PrEP uptake among MSM, addressing health disparities and potentially reducing HIV transmission in B/AA and H/L communities.

Community violence exposure (CVE) and its health impact is a public health crisis. Violent crime has steadily increased over recent years and has disproportionately affected Black communities. Emerging adulthood (18–29 years old) is a vulnerable period of development and Black emerging adults may be at increased risk for negative physical and mental health consequences from CVE. This integrative review was conducted to evaluate available evidence on health outcomes in Black emerging adults exposed to CVE. This review appraised published studies (2012–2022) addressing physical and mental health outcomes of Black emerging adults with CVE. Articles were identified using structured search terms in several databases (CINAHL, PubMed, PsycInfo, and Web of Science), a gray literature search, and citation mining. A total of 177 studies were identified for screening and 19 studies met inclusion criteria and were included in the review. The majority of studies found a significant positive association between CVE and adverse mental (n = 12) and physical (n = 7) health outcomes. CVE appears to have both mental and physical health consequences for Black emerging adults. Given that violent crime disproportionately increased in Black communities and Black people are more likely to develop chronic health conditions at younger ages, more work is needed to elucidate the relationship between CVE and health outcomes. [ABSTRACT FROM AUTHOR]

Increases in conversations about race and racial discrimination experiences during adolescence make this a critical developmental period to investigate adolescents' awareness of racism. We examined bidirectional associations between race‐based experiences and awareness of systemic racism—operationalized as understanding systemic causes of racial disparities in education. Adolescents who self‐identified as African American/Black were surveyed in Grade 6 (n = 317; Mage = 11.12; 48% girls) and Grade 8 (n = 247; Mage = 13.15; 56% girls). Cross‐lagged panel analyses revealed that racial barrier messages, but not racial discrimination experiences, in Grade 6 positively predicted awareness of systemic racism in Grade 8. Adolescents' awareness of systemic racism in Grade 6 did not predict racial socialization or racial discrimination experiences in Grade 8. [ABSTRACT FROM AUTHOR]

IntroductionStudies have reported increases in psychological distress during the COVID-19 pandemic. This study aimed to estimate associations between race-ethnicity and psychological distress during the COVID-19 pandemic among nationally representative samples of all major racial-ethnic groups in the United States.MethodsWe conducted a nationally representative cross-sectional survey between December 2020 and February 2021 of Asian, black/African American, Latino (English and Spanish speaking), American Indian/Alaska Native, Native Hawaiian/Pacific Islander, white, and multiracial adults (n=5500). Distress measures included: anxiety-depression (Patient Health Questionnaire-4 [PHQ-4]), stress (modified Perceived Stress Scale), and loneliness-isolation (frequency felt lonely and isolated). Multinomial logistic regression models estimated associations between race-ethnicity and psychological distress, adjusting for demographic and health characteristics.ResultsOverall, 23.7% reported moderate/severe anxiety-depression symptoms, 34.3% reported moderate/severe stress, and 21.3% reported feeling lonely-isolated fairly/very often. Compared with white adults and adjusting for covariates, the prevalence of moderate/severe anxiety-depression was significantly lower among Asian (adjusted odds ratio [aOR]=0.44, 95% confidence interval [CI]=0.34-0.58), black (aOR=0.49, 95% CI=0.38-0.63), English-speaking Latino (aOR=0.62, 95% CI=0.45-0.85), Spanish-speaking Latino (aOR=0.31, 95% CI=0.22-0.44), and Native Hawaiian/Pacific Islander (aOR=0.66, 95% CI=0.49-0.90) adults. Similar trends were seen for moderate/severe stress and feeling lonely-isolated fairly/very often. Worse distress profiles of American Indian/Alaska Native and multiracial adults were attenuated after adjustment.ConclusionsMinoritized groups tended to have less distress than white adults. Collective experiences of cumulative disadvantage could engender shared resiliency/normalization among these groups.

Black adolescent males use available mental health services at a disproportionately lower rate compared to males of other racial groups. This study examines barriers to school-based mental health resource (SBMHR) use among Black adolescent males, as a means of addressing reduced usage of available mental health resources and to improve these resources to better support their mental health needs. Secondary data for 165 Black adolescent males were used from a mental health needs assessment of two high schools in southeast Michigan. Logistic regression was employed to examine the predictive power of psychosocial (self-reliance, stigma, trust, and negative previous experience) and access barriers (no transportation, lack of time, lack of insurance, and parental restrictions) on SBMHR use, as well as the relationship between depression and SBMHR use. No access barriers were found to be significantly associated with SBMHR use. However, self-reliance and stigma were statistically significant predictors of SBMHR use. Participants who identified self-reliance in addressing their mental health symptoms were 77% less likely to use available mental health resources in their school. However, participants who reported stigma as a barrier to using SBMHR were nearly four times more likely to use available mental health resources; this suggests potential protective factors in schools that can be built into mental health resources to support Black adolescent males use of SBMHRs. This study serves as an early step in exploring how SBMHRs can better serve the needs of Black adolescent males. It also speaks to potential protective factors that schools provide for Black adolescent males who have stigmatized views of mental health and mental health services. Future studies would benefit from a nationally representative sample allowing for more generalizable results regarding barriers and facilitators to Black adolescent males use of school-based mental health resources.

Black men who have sex with men (BMSM) and transgender women (BTW) are disproportionately affected by incarceration and HIV. We assessed factors associated with HIV testing and viral suppression among 176 incarcerated BMSM and BTW in Chicago, IL; Los Angeles, CA; and Houston, TX. In multivariable logistic regression, having a sexual orientation of bisexual, heterosexual, or other vs. gay or same-gender loving was associated with higher odds of testing in custody (aOR 8.97; 95% CI 1.95 - 41.24). Binge drinking (aOR 0.19; 95% CI 0.04 - 0.92) and being unemployed prior to incarceration (aOR 0.03; 95% CI 0.00 - 0.23) were associated with lower odds of testing; participants in Los Angeles were also more likely to be tested than those in Chicago. Being housed in protective custody (aOR 3.12; 95% CI 1.09-9.59) and having a prescription for ART prior to incarceration (aOR 2.58; 95% CI 1.01-6.73) were associated with higher odds of viral suppression when adjusted for site and duration of incarceration, though the associations were not statistically significant in the full multivariable model. Future research should examine structural and process level factors that impact engagement in HIV testing and treatment among detained BMSM and BTW.

BackgroundAlthough Black/African American older adults bear significant inequities in prevalence, incidence, and outcomes of Alzheimer's disease and related dementias, they are profoundly under-included in Alzheimer's Disease research. Community-Engaged Research (e.g., equitable community/science partnerships) is an evidence-based approach for improving engagement of underrepresented populations into Alzheimer's Disease research, but has lacked scalability to the national level. As internet use among older adults from underrepresented populations continues to grow, internet-based research shows promise as a feasible, valid approach to engagement and longitudinal assessment. The Community Engaged Digital Alzheimer's Research (CEDAR) study utilizes a community-engaged research approach to increase the engagement and research participation of Black/African American adults in the Brain Health Registry (BHR) and Alzheimer Disease clinical research.ObjectivesTo describe the methods and evaluate the feasibility of the CEDAR culturally-informed digital platform within BHR.DesignAll Black/African American participants in BHR were invited to enroll in CEDAR and to consider serving on a newly convened Community-Scientific Partnership Board to guide the study. The community board guided the development a culturally-informed cadre of engagement materials and strategies to increase research participation. Engagement strategies included incentives for study task completion, culturally-informed communications (e.g., landing page, emails and social media), resources about brain health, and video and written testimonials by CEDAR participants.SettingBHR, an Internet-based registry and cohort.ParticipantsBHR participants self-identifying as Black/African American were invited to enroll. All participants who signed an online informed consent document were enrolled.MeasurementsWe report the number of participants invited, enrolled, completed tasks, and volunteered to join the community board. We compared the demographics, cognitive profile, and baseline BHR task completion rates between CEDAR participants and all those invited to join the study.ResultsOf 3738 invited, 349 (9.34%) enrolled in CEDAR. 134 (37% of CEDAR participants) volunteered to join the community board, of which 19 were selected for the community board. Compared to those invited, the CEDAR cohort had a higher percentage of female participants (84.5%) and a lower percentage of participants who identify as belonging to more than one ethnocultural group (21.8%). Compared to those did not enroll in CEDAR, those enrolled in CEDAR had a higher percentage of participants completing all BHR tasks (22%) and a higher percentage of participants completing at least one cognitive test (76%). Those enrolled in CEDAR also had a higher percentage of participants having an enrolled study partner (18%).ConclusionsA culturally-informed Community-Engaged Research approach, including a remotely-convened community board, to engagement of Black/African American participants in an online research registry is feasible. This approach can be adapted for use in various clinical studies and other settings. Future studies will evaluate the effectiveness of the engagement strategies.

Background and aimsPancreatic cancer (PC) incidence is increasing at a greater rate in young women compared to young men. We performed a race- and ethnicity-specific evaluation of incidence trends in subgroups stratified by age and sex to investigate the association of race and ethnicity with these trends.MethodsAge-adjusted PC incidence rates (IR) from the years 2000 to 2018 were obtained from the SEER 21 database. Non-Hispanic White (White), Non-Hispanic Black (Black) and Hispanic patients were included. Age categories included older (ages ≥ 55) and younger (ages < 55) adults. Time-trends were described as annual percentage change (APC) and average APC (AAPC).ResultsYounger White [AAPC difference = 0.73, p = 0.01)], Black [AAPC difference = 1.96, p = 0.01)] and Hispanic [AAPC difference = 1.55, p = 0.011)] women experienced a greater rate of increase in IR compared to their counterpart men. Younger Hispanic women experienced a greater rate of increase in IR compared to younger Black women [AAPC difference = -1.28, p = 0.028)] and younger White women [AAPC difference = -1.35, p = 0.011)].ConclusionYounger women of all races and ethnicities experienced a greater rate of increase in PC IR compared to their counterpart men; however, younger Hispanic and Black women experienced a disproportionately greater increase. Hispanic women experienced a greater rate of increase in IR compared to younger Black and White women.

While suicide persists as a leading cause of death for Black emerging adults in the U.S., few studies identify specific positive psychological mechanisms that can be leveraged to reduce future risk. The current study, therefore, explores whether religion is related to suicidal ideation via hope and meaning in life among a sample of n = 375 Black emerging adults ages 18–25-years-old (M = 20.79, SD = 2.22). Structural equation modeling techniques were used to measure direct and indirect associations. Primary results indicate that non-organizational religiosity (e.g., reading religious texts, listening to religious music, prayer) was positively associated with hope, presence of meaning in life, and search for meaning in life. Presence of meaning in life was the strongest contributor to decreased suicidal ideation. Further, non-organizational religiosity was indirectly associated with less suicidal ideation via hope and presence of meaning in life. Personal forms of religious involvement, and not service attendance, appear to be the most salient aspects of religion to consider when exploring pathways between religion and suicidality during this particular developmental stage. [ABSTRACT FROM AUTHOR]

Despite increasing advocacy for gender equality, gender prejudice and discrimination persist. The origins of these biases develop in early childhood, but it is less clear whether (1) children's gender attitudes predict discrimination and (2) gender attitudes and discrimination vary by ethnicity and US region. We examine these questions with an ethnically (Asian, Black, Latinx and White) and geographically (Northeast, Pacific Northwest, West, Southeast and Hawaii) diverse sample of 4‐ to 6‐year‐old children (N = 605) who completed measures of gender attitudes and discrimination in a preregistered study. Children, across groups, demonstrated more positive attitudes towards their gender ingroup. Children who showed more pro‐ingroup attitudes also showed more pro‐ingroup behavioural discrimination. Girls showed stronger ingroup favouritism than boys, but ethnic and regional groups generally did not vary in levels of bias. These findings contribute to our understanding of how gender intergroup biases develop and highlight the generalizability of these processes. [ABSTRACT FROM AUTHOR]

Given noted racial disparities in mental health and wellbeing, Black and Latine families are often the focus of prevention and intervention efforts. These efforts are traditionally embedded in deficit perspectives about these communities, ignoring their cultural wealth and collective agency. Yet increasing recognition of the interconnected systems and social determinants that lead to racial disparities and negative outcomes among Black and Latine populations requires counselors and other practitioners to broaden their conceptions of prevention and engage in collaboration to develop more effective and comprehensive prevention efforts. In the current paper, we provide an ecologically informed transdisciplinary model of family empowerment, prevention, and wellbeing with Black and Latine families. We apply this model to counseling practice as a potential roadmap for future counseling prevention work with Black and Latine families. [ABSTRACT FROM AUTHOR]

Introduction: The US Food and Drug Administration is poised to restrict the availability of menthol cigarettes and flavored cigars, products disproportionately used by Black/African American (B/AA) individuals. We examined B/AA youth and adult perceptions regarding factors contributing to tobacco use, as well as prevention/cessation resources. Methods: In 2 mixed-methods studies in Richmond, Virginia, we conducted cross-sectional surveys among youth (n = 201) and adult (n = 212) individuals who were primarily B/AA and reported past 30-day cigar smoking or nontobacco use, followed by focus groups with a subset (youth: n = 30; adults: n = 24). Focus groups were analyzed using a thematic analysis framework, and descriptive survey data provided context to themes. Results: Among focus group participants, 20% of youth and 75% of adults reported current cigar smoking. Six themes emerged across the groups: advertising/brands, sensory experiences, costs, social factors, youth-related factors, and dependence/cessation. Youth and adults perceived cigars as popular; cigar use was attributed to targeted advertising, flavors, affordability, and accessibility. While adults expressed concern regarding youth tobacco use, youth did not perceive tobacco prevention programs as helpful. Adults and youth reported limited access to community tobacco prevention/cessation programs. Discussion: Expanded tobacco prevention and cessation resources for B/AA people who smoke could leverage federal regulatory actions to ban tobacco products targeted toward this group and decrease disparities in tobacco-related morbidity and mortality. [ABSTRACT FROM AUTHOR]

Existing conceptualizations and measures of good sex are varied and inconclusive. Additionally, few studies have defined good sex from the margins, thus definitions are primarily informed from privileged perspectives. People with marginalized racial, gender, and sexual identities can offer culturally informed definitions of good sex that may expand current definitions. This study fills that gap by identifying factors that constitute good sex among Black people with diverse sexual and gender identities. Data were collected from 448 Black individuals who participated in an online Qualtrics survey with demographic, open-ended, and scaled questions. Results indicate a range of descriptors that align with existing sexual wellness literature and include the top 20 words to describe good sex as well as the top 10 words for demographics of interest. Differences in most frequent descriptors based on gender and sexual identities are reported. These results provide a foundation for sexual health practitioners, educators, and therapists to improve societal knowledge about what constitutes good sex among Black people. [ABSTRACT FROM AUTHOR]

Black women continue to be disproportionally burdened by HIV. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention option, which is underused by Black women. While social network interventions (SNIs) have been widely researched and implemented among some groups vulnerable to HIV, little is known about social network characteristics among Black women. To learn more about the social networks of Black women vulnerable to HIV and their knowledge of and interest in PrEP, we conducted a cross-sectional survey among 109 Black women aged 18–45 years attending a family planning clinic in Chicago, Illinois. In our study, 44% of women reported that they were moderately to extremely concerned about HIV. Over half of participants (53%) had a small personal network size (i.e., less than two). No statistically significant associations between having larger network sizes and having previously heard of PrEP, having an interest in starting PrEP, or having good PrEP knowledge were detected. Open-ended responses revealed high levels of trust in network connections with matters related to sexual health. Additionally, nearly all (94%) of women reported that SNIs were a good idea to promote PrEP. Future network studies are needed to inform the development of effective intervention strategies for women.

Physical distancing and face masks remain frontline prevention strategies due to suboptimal vaccine uptake and the highly infectious COVID-19 variants. Communities of color are disproportionately impacted by a chronic disease burden that places them at higher risk of severe COVID-19 disease. Therefore, they can greatly benefit from face mask use and physical distancing, especially if the individual(s) have not received the vaccine. We applied the Health Belief Model to explore barriers and motivators influencing physical distancing and face mask use among high-risk, Black American subgroups during the early COVID-19 pandemic stages. We conducted 62 semi-structured interviews among four Black American subgroups: young adults, individuals with underlying medical conditions, essential workers, and parents. Thematic analysis, guided by the Health Belief Model, yielded six themes: (1) Knowledge on Face Mask Use and Physical Distancing, (2) Perceived Susceptibility and Severity Varies by Subgroup, (3) Experience with and Perceived Self-Efficacy to Engage in Preventive Behavior, (4) Perceived Benefits to engaging in preventive behaviors, (5) Perceived Barriers to engage in preventive behaviors, and (6) Cues to action to increase participation. Each subgroup's unique experience informed multilevel, tailored approaches that can be used by health promotion practitioners to improve face mask use and physical distancing among uniquely vulnerable Black American subgroups in the current and future pandemic. [ABSTRACT FROM AUTHOR]

Black/African American (AA) individuals are a group at risk for co-occurring posttraumatic stress disorder (PTSD) symptoms and alcohol use due to unique cultural and system-level barriers. Although associations between trauma exposure, PTSD symptoms, and alcohol use are well established across various populations, Black/AA individuals are underrepresented in this literature, and related findings in this population are inconclusive. Thus, the goal of this study was to examine the associations among trauma exposure, PTSD symptoms, and alcohol use in a sample of treatment-seeking, Black/AA adults. We hypothesized that trauma exposure and alcohol use would be positively associated and that this relationship would be mediated by PTSD symptoms. This study conducted secondary analysis of screening data from a PTSD and alcohol use disorder clinical trial. Participants were 96 Black/AA adults (57.3% male; 2.0% Hispanic; M age = 44.73, SD = 11.83) who were seeking treatment for alcohol use and endorsed trauma exposure. Associations between trauma exposure, PTSD symptom severity, and quantity and frequency of alcohol use were tested using bivariate correlations and linear regressions. Hypothesized indirect effects were tested using IBM SPSS Statistics Version 27 PROCESS model 4 with bootstrapping. Findings illustrated a significant positive association between trauma exposure and PTSD symptoms and between PTSD symptoms and drinks per typical drinking day. PTSD symptoms were not significantly associated with number of drinking days. Tests of indirect effects were significant for trauma exposure on drinks per typical drinking day through PTSD symptoms. Results from the test of indirect effects suggest that among Black/AA adults with heavy alcohol use and trauma exposure, trauma exposure is associated with PTSD symptoms, which in turn is associated with quantity of alcohol use. These findings are consistent with research conducted with White/mixed groups and align with tenets of the self-medication model of PTSD-AUD comorbidity. These findings support current practices that highlight the importance of screening for and addressing PTSD and alcohol use in individuals exposed to trauma. Findings from this paper provide initial data on understudied relationships in an underserved sample and several suggestions are made to generate future research and improve clinical care for Black/AA adults. Pharmacogenetic Treatment With Anti-Glutaminergic Agents for Comorbid PTSD & AUD; ClinicalTrials.gov Identifier: NCT02884908. [ABSTRACT FROM AUTHOR]

Insufficient attention to protective and risk factors of particular salience for Black youth (e.g., racial identity and racial discrimination) in population-based substance use studies has left gaps in our understanding of alcohol and tobacco use development in Black adolescents. The current study aimed to capture the clustering of such understudied factors and their collective influence on alcohol and tobacco use initiation among Black adolescents. Data were drawn from The National Survey of American Life (n = 1,170; age range = 13-17; 6.9% Afro Caribbean, 93.1% African American; 50.0% female). Latent profile analysis applied to 11 indicators representing family, community, and individual level protective and risk factors revealed (1) High Vulnerability (high risk, low protective factors; 17.5%), (2) Moderate Vulnerability (moderate on both; 63.2%), and (3) Low Vulnerability (high protective, low risk factors; 19.3%) classes. Classes differed significantly by religious community support, school bonding, quality of relationship with mother, religious involvement, and interpersonal trauma. Relative to Class 2, Class 1 had higher odds of alcohol (OR = 1.518, CI:1.092-2.109) and tobacco use (OR = 1.998, CI:1.401-2.848); Class 3 had lower odds of alcohol (OR = 0.659, CI:0.449-0.968) but not tobacco use (OR = 0.965, CI:0.611-1.523). Findings suggest that alcohol and tobacco use initiation among Black adolescents is shaped by the collective influence of community and family level support, with commonly experienced risk factors such as non-interpersonal trauma distinguishing liability to a lesser degree. The equally modest prevalence of tobacco use among low and moderate vulnerability classes further indicates that fostering these connections may be especially effective in reducing tobacco use risk. [ABSTRACT FROM AUTHOR]

Black cisgender women (hereafter referred to as "women") have disproportionately high rates of HIV infection yet low rates of pre-exposure prophylaxis (PrEP) utilization. Barriers to PrEP uptake exist at the system, provider, and individual/client level. To learn how existing training and advertising can be adapted to address race- and sex-based gaps within PrEP service delivery, we conducted focus groups with providers and Black women. Participants were recruited at three health care organizations in the Midwest and South, screened for eligibility, and consented verbally. Focus groups occurred from August 2022 to February 2023. Women were asked about their knowledge and thoughts on PrEP. Providers were asked about factors influencing their decision-making about PrEP. A codebook was developed based on the Consolidated Framework for Implementation Research. Transcripts were coded using the Stanford Lightning Report Method. We completed four focus groups with 10 providers and 9 focus groups with 25 women. Three major themes emerged: (1) low comfort level and limited cultural sensitivity/competency among providers discussing HIV risk and PrEP with Black women, (2) women's concerns about PrEP's side effects and safety during pregnancy, and (3) lack of Black women representation in PrEP advertisement/educational materials. In addition, women in the South reported general medical mistrust and specific misconceptions about PrEP. PrEP trainings for providers need detailed information about the safety of PrEP for women and should include role-playing to enhance cultural competency. Likewise, PrEP advertisements/materials should incorporate information regarding side effects and images/experiences of Black women to increase PrEP awareness and uptake among this population. Clinical Trial Registration Number: NCT05626452. [ABSTRACT FROM AUTHOR]

Abstract Culture is an important determinant of HIV risk and protective behaviors; yet, we know little about how it is integrated in HIV interventions. This scoping review characterizes the integration of culture in HIV prevention and treatment interventions focused on Black/African Americans. We searched MEDLINE, PsycINFO, CINAHL, and Google Scholar for peer-reviewed manuscripts published between July 1, 2011, and June 28, 2021. Twenty-five interventions were identified, with 96% focused on prevention. Most (40%) targeted men who have sex with men or transgender women. Only three were grounded in cultural theory. Although all interventions were labeled “culturally based,” only two explicitly defined culture. Moreover, there was much diversity regarding the ways in which interventions integrated cultural elements, with some conflating race/ethnicity with culture. To improve uptake and HIV-related outcomes, interventions integrating culture are greatly needed. Additionally, HIV interventions purporting to be “culturally based” must include basic information to support rigor and reproducibility.

Black, Latino, Pacific Islander, and American Indian/Alaska Native adults are more likely than White adults to experience SARS-CoV-2-related infections, hospitalizations, and mortality. We assessed intent to be vaccinated and concerns among 7 U.S. racial/ethnic groups (1,000 Black/African American, 500 American Indian/Alaska Native, 1,000 Asian, 1,000 Latino (500 English- and 500 Spanish-speaking), 500 Pacific Islander, 500 multiracial, and 1,000 White adults) in a cross-sectional online survey conducted December 2020-February 2021, weighted to be nationally representative within groups. Intent to be vaccinated was ascertained with: "If a COVID-19 vaccine becomes available, how likely are you to get vaccinated?" (not at all/slightly/moderately/very/extremely likely). Respondents identified which concerns would keep them from being vaccinated: cost, not knowing where, safety, effectiveness, side-effects, and other. Multinomial logistic regression models assessed associations of race/ethnicity with odds of being extremely/very/moderately, slightly likely to be vaccinated (ref = not at all), controlling for demographics and health. Overall, 30% were extremely likely, 22% not at all likely, and 48% unsure. Compared to White respondents, American Indian/Alaska Native (Adjusted Odds Ratio (AOR) = 0.66, 95% CI, 0.47-0.92) and Black/African American (AOR = 0.54, 95% CI, 0.41-0.72) respondents were less likely, and Asian (AOR = 2.21, 95% CI, 1.61-3.02) and Spanish-speaking Latino respondents (AOR = 3.74, 95% CI, 2.51-5.55) were more likely to report being extremely likely to be vaccinated. Side-effects (52%) and safety (45%) were overriding concerns. Intent and vaccination rates are changing rapidly; these results constitute a comprehensive baseline for ongoing vaccination efforts among U.S. racial and ethnic groups.

The ways that parents respond to children's negative emotions shape the development of self‐regulation across early childhood. The objective of this study was to examine child self‐regulation in the context of intimate partner violence (IPV) exposure in a sample of Black, economically marginalized mothers and their young children (aged 3–5 years, N = 99). The study investigates the conditional effects of emotion socialization practices that (1) encourage expression of and problem‐solving around negative affect ("supportive"), and (2) encourage suppression of affective displays ("suppressive") on children's self‐regulation. We found a significant association between higher child self‐regulation and supportive parental reactions in the context of psychological IPV. We also found a significant association between higher child self‐regulation and suppressive parental reactions in the context of psychological IPV. Our findings are consistent with prior research suggesting Black parents who teach varied strategies for emotional expression may promote children's adaptation in high‐stress family environments. Macrosystem factors such as systemic racism and discrimination as well as the threat of family violence may shape how parents approach emotion socialization and the teaching of affective self‐expression and self‐regulation. [ABSTRACT FROM AUTHOR]

Despite its ability to lower the risk of opioid misuse, methadone is viewed by patients with a certain degree of ambivalence. Research has documented a variety of patient attitudes toward methadone, but the majority of these studies have relied on samples with little Black/African American representation. The primary goal of this study, therefore, was to identify and explain the attitudes of Black/African Americans toward methadone treatment. Surveys were used to identify which attitudes were most prevalent while interview data are presented to help explain and provide context to these attitudes. Data were drawn from the Florida Minority Health Survey, a mixed-methods project that included online surveys (n = 303) and in-depth interviews (n = 30). Only persons 18 years old or over who identified as Black/African American and reported past 90-day opioid misuse were eligible to participate. Analyses revealed that negative attitudes largely revolved around methadone's perceived helpfulness and side effects. The most strongly held attitudes were (a) methadone in a treatment program gets you high just like heroin, (b) the sooner a person stops taking methadone, the better, and (c) methadone is a "crutch." These findings contribute to the literature by improving our understanding of why some Black/African Americans may be ambivalent about methadone. Public Policy Relevance Statement: This study is the first to examine methadone-related attitudes specifically among Black/African Americans. Our results document the extent and type of Black/African American's ambivalence toward methadone. Efforts are needed to address methadone-related stigma in Black/African American communities and the policy regulations (e.g., supervised daily dosing) that strengthen this stigma. Providers and policymakers would do well to consider the data presented in this article when developing interventions to destigmatize methadone among Black/African Americans. [ABSTRACT FROM AUTHOR]

Background: Black/African American (B/AA) and Hispanic/Latino (H/L) men who have sex with men (MSM) are significantly less likely than white MSM to initiate pre-exposure prophylaxis (PrEP). A peer-driven intervention (PDI) may be an effective approach to addressing this disparity. In this study, we explored community member perspectives of a PDI to promote PrEP uptake among B/AA and H/L MSM. Methods: We conducted semi-structured interviews with B/AA and H/L HIV-negative MSM between August 2018 and October 2019 in Rhode Island, USA. Participants reported their perspectives and recommendations for a PDI. Data from participant responses were thematically analysed. Results: Of 15 MSM, the median age was 25 years (interquartile range: 22, 33). The majority identified as B/AA (53.3%), H/L (66.7%), and having a college education or above (53.3%). Most participants viewed a PDI positively and were willing to learn and promote PrEP among their peers. Participants identified and supported several potential intervention components, such as education about the benefit of PrEP, emphasising prevention-effective dosing, and clarifying no prevention effect towards other sexually transmitted infections. They preferred in-person meetings to electronic communication. Preferred characteristics of peer educators included compassion, good communication skills, and enthusiasm about PrEP. Conclusions: This in-depth qualitative interview suggested that a PDI approach is promising in promoting PrEP uptake, as it could deliver culturally appropriate education and encourage PrEP uptake via peer influence among B/AA and H/L MSM. Peer approach is effective in promoting health among hard-to-reach populations. This study aims to explore the feasibility of implementing a peer approach for improving pre-exposure prophylaxis (PrEP) use among Black/African American (B/AA) and Hispanic/Latino (H/L) men who have sex with men (MSM). Study findings will be used to develop a peer approach for a real-world implementation. Participants were interviewed for their perspectives on such a peer approach, including willingness to disseminate PrEP knowledge and potential barriers to initiating PrEP. [ABSTRACT FROM AUTHOR]

Culture is an important determinant of HIV risk and protective behaviors; yet, we know little about how it is integrated in HIV interventions. This scoping review characterizes the integration of culture in HIV prevention and treatment interventions focused on Black/African Americans. We searched MEDLINE, PsycINFO, CINAHL, and Google Scholar for peer-reviewed manuscripts published between July 1, 2011, and June 28, 2021. Twenty-five interventions were identified, with 96% focused on prevention. Most (40%) targeted men who have sex with men or transgender women. Only three were grounded in cultural theory. Although all interventions were labeled "culturally based," only two explicitly defined culture. Moreover, there was much diversity regarding the ways in which interventions integrated cultural elements, with some conflating race/ethnicity with culture. To improve uptake and HIV-related outcomes, interventions integrating culture are greatly needed. Additionally, HIV interventions purporting to be "culturally based" must include basic information to support rigor and reproducibility. [ABSTRACT FROM AUTHOR]

From the onset of the pandemic in the United States, racial disparities in COVID-19 outcomes have been evident. In April 2020, several events prompted a concerned group of colleagues to form the Black Equity Coalition (BEC), a Black-led coalition in Allegheny County, Pennsylvania, which brings together professionals from multiple sectors who aim to ensure an equitable response to the COVID-19 pandemic. Several significant milestones have been achieved, and this article describes the development, functioning, and outcomes of the Coalition in the first 15 months of operation (April 2020–June 2021). COVID-19 was the reason for such an unprecedented effort, but this BEC infrastructure will be needed long after COVID-19 is controlled. In addition to short-term activities and reactive measures to prevent and mitigate COVID-19 in Black populations, the BEC is serving as a crucial link between government, health care stakeholders, and communities to produce long-term systemic change. [ABSTRACT FROM AUTHOR]

Our objectives were to evaluate gender-specific associations of racial discrimination with psychological sequelae among middle-aged Blacks and to evaluate the capacity of racial socialization to moderate the association between discrimination and psychological distress, accounting for relevant prospectively assessed childhood factors. We used data from the Child Health and Development Disparities Study that followed a Northern California-based group of Blacks from the prenatal period through midlife (N = 244, 49.6% female). Multiple regression analyses were performed separately by gender to assess (a) the main effects of racial socialization and racial discrimination on adult psychological distress, (b) racial socialization as a moderator of the association between racial discrimination and adult psychological distress, and (c) whether controls for prospectively assessed childhood factors changed conclusions regarding the role of racial socialization. Seventy percent of the middle-aged Blacks in our sample reported having at least one type of major experience of racial discrimination. Increased reports of racial discrimination were positively associated with psychological distress in men, but not in women. Similarly, racial socialization was associated with decreased overall distress for men, but not for women. Discrimination-related distress was attenuated for men who reported higher levels of racial socialization. These findings remained after adjustment for childhood socioeconomic status (SES), childhood internalizing symptoms, parental marital separation, and number of siblings. Findings suggest that racial socialization conferred a protective psychological effect through midlife to Black men who experienced racial discrimination, a commonplace experience in this cohort. Public Policy Relevance Statement: Racial socialization refers to the messages children receive regarding race-related identity, interactions, and hierarchy. These findings suggest that the psychological benefits of racial socialization extend to midlife among Black men who have experienced racial discrimination. Consideration of the gendered resiliency conferred by racial socialization across the life span informs policy and practice from parenting programs to systems of care, education, and justice. [ABSTRACT FROM AUTHOR]

Calls to transform the initial Physical Education Teacher Education (PETE) standards to reflect social justice have garnered little attention. Recent events have magnified the racial injustices inflicted upon Black people in America and their ability to participate as full equals in a society influenced and characterized by white supremacy. Using critical race theory (CRT) as a framework, the authors examine the racial formulation of the historical and current installations of SHAPE America's initial PETE standards. Illustrated is the influence of white supremacy in PETE programs, the relationship to physical literacy, and the impact on Black students. After analysis, the authors integrate culturally relevant frameworks, and provide a blueprint of socially just PETE standards that challenge structural racism, and diversity initiatives promoted by SHAPE America and in higher education. The authors conclude that infusing Black perspectives is essential to the advancement of inclusive social justice standards in PETE. [ABSTRACT FROM AUTHOR]

• Preschool teacher-child racial match may support Black preschoolers' development. • Racialized ecological contexts should also be considered. • Racial match and behavior concerns were higher in Black majority schools. • Racial match predicted better social outcomes only in Black majority schools. • Assistant teacher racial match attenuated behavior concerns in segregated schools. Teacher-child racial match has been shown to benefit young Black children, but less is known about the degree to which the match is with the lead teacher or the assistant, and if the preschool racial context moderates this association. This study utilized existing data collected during the 2014–15 through 2018–19 school years in 20 high-quality preschools that enrolled children from households/families with low-income. Analyses of data from 2553 preschool-age Black children enrolled in 418 classrooms revealed that most Black children (82%) were enrolled in preschools with a majority (>=50%) of Black peers, and children in Black Majority preschools were more likely to experience teacher-child racial match with lead and assistant teachers. Racial match with lead and/or assistant teachers were associated with teacher demographic and beliefs differences but not differences in classroom instructional support or child outcomes. Black Majority preschool enrollment was also associated with more problem-behaviors but not other outcomes. However, within Black Majority schools, behavior concerns were reduced when the assistant teacher was a racial match and child initiative was higher when both the teachers were a match. In sum, the effect of teacher-child racial match for Black children should be considered jointly with co-occurring ecological contexts that typify the proximal effects of systemic racism like the preschool racial composition. [ABSTRACT FROM AUTHOR]

Objective: We sought to identify the sociodemographic and clinical characteristics associated with homelessnesss, and explore the relationship between homelessnesss and treatment outcomes among Black individuals. Methods: This is a secondary analysis of the subgroup of Black participants (n = 73) enrolled in "X:BOT," a 24-week multisite randomized clinical trial comparing the effectiveness of extended-release naltrexone versus sublingual buprenorphine-naloxone (n = 570). Outcomes included medication initiation, return to extramedical use of opioids assessed by both self-report and urine toxicology, and engagement in medications for opioid use disorder (MOUD) treatment at 28 weeks postrandomization. Descriptive statistics were performed. Results: Black participantsweremostly unmarried and male, and about a third were aged 21-30 years. Among people experiencing homelessnesss, more were uninsured (45.5% [10/22] vs 19.6% [10/51]), unemployed (77.3% [17/22] vs 64.7% [33/51]), and reported alcohol (40.9% [9/22] vs 23.5% [12/51]) and sedative use (54.5% [12/22] vs 17.6% [9/51]) within the previous 30 days. Compared with housed Black individuals, a slightly higher proportion of Black individuals experiencing homelessnesss successfully initiated study medication (81.1% [18/22] vs 72.6% [37/51]); similar proportions returned to opioid use during the trial (68.2% [15/22] vs 68.6% [35/51]) and were engaged in MOUD at 28 weeks after trial entry (72.2% [13/18] vs 69.7% [23/33]) among participants located for follow-up. Conclusions: These descriptive results among Black patients participating in a trial of MOUD suggest that efficacious MOUD is possible despite homelessnesss with additional clinical supports such as those provided by a clinical trial. [ABSTRACT FROM AUTHOR]

Histories of 19th-century U.S. education center White experiences, while formal education policy and practice pertaining to Black and Native Americans are treated as marginal phenomena that had little impact on schooling at a national level. Furthermore, current historical framings overwhelmingly analyze Native, White, and Black American education as separate entities, which conceals the political economic character of race as a relational phenomenon. To explore connections between race, school, and nation building, this review presents a relational analysis of scholarship on Native, White, and Black American education through the 19th century. In doing so, it outlines how formal U.S. education expressed, created, and adjusted racial hierarchies through the 19th century; and more importantly, it highlights how America's education system developed in a context where Native, White, and Black American experiences were deeply interrelated. The review ends by identifying paths for new research on the racial dimensions of U.S. education during its foundational years and beyond. [ABSTRACT FROM AUTHOR]

In this study, we use a mixed‐method systematic literature review of articles that include African American counselor education doctoral student participants in the research. From this corpus of inquiry, we provide an opportunity for counselor education researchers to lead the way with inclusive scholarship and the use of strengths‐based frameworks. We examine how to conceptualize research particularly for African American doctoral student participants and offer suggestions on how to write the discussion and implication sections in a way to promote innovation and excellence. [ABSTRACT FROM AUTHOR]

Asthma is a chronic respiratory condition affecting around 300 million people worldwide. In the United States, Black individuals have a higher burden of asthma than White individuals. The goal of this study was to differentiate the burden of asthma between US-born and foreign-born Black residents of New York City (NYC). We use a multivariable Cox proportional hazard model with a robust variance estimate. The results indicate that foreign-born Black NYC residents have a significantly lower asthma prevalence than US-born (PR = 0.40, 95% CI = 0.21–0.76). Additionally, those 65 years and older have a lower prevalence of asthma compared to those 18–34 years old. This study shows that asthma prevalence is higher amongst US-born Black NYC residents than foreign-born, which may indicate that the healthcare needs of the foreign-born may be different from that of the native-born. Further studies are needed to elucidate this result fully. [ABSTRACT FROM AUTHOR]

Previous research based on documented incidents of police uses of lethal force and experimental studies using computer sorting programs have demonstrated that incorrect lethal force decisions tend to occur more frequently with Black relative to White suspects. Using virtual reality, the current study examined the psychophysiology underlying incorrect lethal force decision with Black suspects, and the interactive impact of racial essentialism. Forty-nine White criminal justice majors viewed 360 degree videos of high-pressure suspect interactions in VR, from the perspective of the police officer. A virtual police-issued handgun was used to make and record decisions to shoot; incorrect uses of lethal force were operationalized using signal detection theory. Physiological stress (i.e., variance in pupil dilation) and visual attention were measured with embedded eye tracking in the VR. As predicted, physiological stress led to more incorrect uses of lethal force with Black suspects through fixated visual attention, but only among those who scored high on a racial essentialism survey measure. Findings converge with more recent studies supporting the potent interactive role between cognition (e.g., racial essentialism) and affect (i.e., stress) on lethal force decisions with Black suspects. These studies point to the continued role of psychoeducation and cognitive–behavioral interventions in informing police training interventions aimed at mitigating incorrect uses of lethal force with Black men and women. [ABSTRACT FROM AUTHOR]

We assessed whether disclosure of HIV status is significantly associated with reported HIV sexual risk behaviors among HIV positive Black/African American men who have sex with men (MSM) (Black MSM) in six cities in the USA. Participants from the BROTHERS (HIV Prevention Trials Network [HPTN 061]) study focused on assessing the feasibility and acceptability of a multifaceted HIV prevention intervention to reduce HIV infections among Black MSM enrolled between July 2009 and October 2010. All participants completed a behavioral assessment using an audio computer-assisted self-interview that included questions about HIV status disclosure, HIV sexual risk behaviors, and other behaviors. Biological samples were also collected. This analysis focused on baseline data of HIV-positive Black MSM in the HPTN 061 study. Of the 143 HIV-positive Black MSM (majority ≥ 35 years of age) included in this analysis, 58% reported disclosing their HIV status to their last male anal sex partner. Forty-three percent and 42% reported condomless insertive and receptive anal intercourse respectively with their last male partner; whereas, 17% and 18% of the sample engaged in condomless insertive and receptive anal intercourse with a serodiscordant/unknown status partner, respectively. In multivariable logistic regression models, there was no statistically significant association between HIV status disclosure and condomless insertive anal intercourse (aOR = 0.35, 95% CI 0.11, 1.08; p = 0.30), condomless receptive anal intercourse (aOR = 2.48, 95% CI 0.94, 6.52; p = 0.20), or condomless receptive anal intercourse with a serodiscordant/unknown status partner (aOR = 0.55, 95% CI 0.20, 1.49; p = 0.45). However, HIV status disclosure was significantly associated with lower odds of reporting condomless insertive anal intercourse with a serodiscordant/unknown status partner (aOR = 0.19, 95% CI 0.06, 0.68; p ≤ 0.01). Among this multi-city sample of HIV-positive Black MSM, disclosure of HIV status was common and associated with lower HIV sexual risk behaviors. These findings should motivate and guide research to develop prevention messages to increase HIV status disclosures.

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There is a dearth of research examining how individual-level and systemic racism may lead to elevated diagnostic and symptom rates of paranoia in Black Americans. The present study employed item response theory methods to investigate item- and subscale-level functioning in the Schizotypal Personality Questionnaire (SPQ) in 388 Black and 450 White participants across the schizophrenia-spectrum (i.e., non-psychiatric controls, individuals with schizophrenia, schizoaffective disorder, or schizotypal personality disorder). It was predicted that (1) Black participants would score significantly higher than Whites on the Suspiciousness and Paranoid Ideation subscale of the SPQ, while controlling for total SPQ severity and relevant demographics and (2) Black participants would endorse these subscale items at a lower latent severity level (i.e., total SPQ score) compared to Whites. Generalized linear modeling showed that Black participants endorsed higher scores on subscales sampling paranoia (e.g., Suspiciousness and Paranoid Ideation), while White participants endorsed higher rates within disorganized/positive symptomatology subscales (e.g., Odd or Eccentric Behavior). IRT analyses showed that Black individuals also endorse items within the Suspiciousness and Paranoid Ideation subscale at lower latent severity levels, leading to inflated subscale scores when compared to their White counterparts. Results indicate prominent race effects on self-reported paranoia as assessed by the SPQ. This study provides foundational data to parse what could be normative endorsements of paranoia versus indicators of clinical risk in Black Americans. Implications and recommendations for paranoia research and assessment are discussed. [ABSTRACT FROM AUTHOR]

Objective: People experiencing homelessness are disproportionately impacted by alcohol-related harm. Racially minoritized groups are disproportionately represented in the homeless population and are likewise disproportionately impacted by alcohol-related harm. Most alcohol outcome measures have not been adequately psychometrically studied in this marginalized population and across racial groups. This study documents psychometric properties, including measurement invariance, reliability, and convergent validity, of a measure of alcohol-related harm, the Short Inventory of Problems (SIP-2R), across Black, North American Indigenous (NAI), and White adults experiencing homelessness and alcohol use disorder (AUD).Method: Adults experiencing homelessness and AUD who had participated in one of two randomized controlled trials of harm-reduction treatment (N = 493; NAI = 205, Black = 125, and White = 163) were included in this psychometric study of the 15-item SIP-2R.Results: Multigroup confirmatory factor analysis (MGCFA) indicated that a model comprising one general alcohol-related harm factor overarching five factors, showed close fit and partial scalar invariance, χ²(329, N = 493) = 624.902, p < .001, comparative fit index (CFI) = .966, root-mean-square error of approximation (RMSEA) = .074, 90% CI [.066, .083], standardized root-mean-square residual (SRMR) = .063, confirming acceptable measurement equivalence across racial groups. The SIP-2R showed internal consistency (α = .94, ω = .95) and convergent validity, that is, positive correlation between the total SIP-2R score and the number of drinks consumed the heaviest drinking day, ρ(490) = .30, p < .001.Conclusion: This study provided support for the internal consistency, convergent validity, and cross-group measurement equivalence of the SIP-2R for NAI, Black, and White adults experiencing homelessness with AUD. (PsycInfo Database Record (c) 2022 APA, all rights reserved). [ABSTRACT FROM AUTHOR]