Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-14 (of 14 Records) |
Query Trace: Jeffries WL[original query] |
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Sociodemographic correlates of self-reported discrimination in HIV health care settings among persons with diagnosed HIV in the United States, Medical Monitoring Project, 2018-2019
McCree DH , Beer L , Jeffries WL 4th , Tie Y , Fagan J , Crim SM . J Acquir Immune Defic Syndr 2021 88 (5) 457-464 BACKGROUND: HIV-related discrimination in health care settings is associated with negative health outcomes among persons with HIV (PWH). This paper describes and compares differences in the prevalence of self-reported experiences with discrimination in health care settings by sociodemographic and clinical care factors among persons with diagnosed HIV in the United States. METHODS: We analyzed interview and medical record data collected 6/2018-5/2019 from 3850 PWH who had received HIV care in the past 12 months. We calculated weighted percentages and associated 95% confidence intervals and assessed the association between any experience of discrimination and selected sociodemographic and clinical characteristics using prevalence ratios with predicted marginal means. RESULTS: About 25% of PWH who had an HIV care visit in the past 12 months reported experiencing any discrimination. Experiences with discrimination were significantly more prevalent among persons 18-29 years (34%); transgender persons (41%); persons of gay (25%), bisexual (31%), or other (40%) sexual orientations; and persons who did not have a regular provider (39%), lived at/below poverty level (28%), were homeless (39%) or incarcerated (37%) in the past 12 months. PWH who experienced discrimination were more likely to have missed at least one HIV care visit, not be taking ART, and have missed ART doses. Recent and sustained viral suppression were not significantly associated with experiencing any discrimination. CONCLUSIONS: Interventions that address the sociocultural and structural factors associated with discrimination in all health care settings are needed to improve health outcomes among PWH and end the HIV epidemic in the United States. |
Trends in diagnosis of HIV infection, linkage to medical care, and viral suppression among men who have sex with men, by race/ethnicity and age - 33 jurisdictions, United States, 2014-2018
Jeffries WL 4th , Dailey AF , Jin C , Carter JW Jr , Scales L . MMWR Morb Mortal Wkly Rep 2020 69 (38) 1337-1342 During 2018, gay, bisexual, and other men who have sex with men (MSM) accounted for 69.4% of all diagnoses of human immunodeficiency virus (HIV) infection in the United States (1). Moreover, in all 42 jurisdictions with complete laboratory reporting of CD4 and viral load results,* percentages of MSM linked to care within 1 month (80.8%) and virally suppressed (viral load <200 copies of HIV RNA/mL or interpreted as undetected) within 6 months (68.3%) of diagnosis were below target during 2018 (2). African American/Black (Black), Hispanic/Latino (Hispanic), and younger MSM disproportionately experience HIV diagnosis, not being linked to care, and not being virally suppressed. To characterize trends in these outcomes, CDC analyzed National HIV Surveillance System(†) data from 2014 to 2018. The number of diagnoses of HIV infection among all MSM decreased 2.3% per year (95% confidence interval [CI] = 1.9-2.8). However, diagnoses did not significantly change among either Hispanic MSM or any MSM aged 13-19 years; increased 2.2% (95% CI = 1.0-3.4) and 2.0% (95% CI = 0.6-3.3) per year among Black and Hispanic MSM aged 25-34 years, respectively; and were highest in absolute count among Black MSM. Annual percentages of linkage to care within 1 month and viral suppression within 6 months of diagnosis among all MSM increased (2.9% [95% CI = 2.4-3.5] and 6.8% [95% CI = 6.2-7.4] per year, respectively). These findings, albeit promising, warrant intensified prevention efforts for Black, Hispanic, and younger MSM. |
Sociodemographic characteristics of Risk and receipt of prevention services associated with HIV testing history in heterosexually active black men at high risk for HIV infection in the United States, 2016
McCree DH , Henny KD , Jeffries WL 4th , Hickey T , Sionean C . Prev Med 2020 139 106232 The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Conflicts of Interest and Source of Funding: There are none to declare. The research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. |
Racial/ethnic disparities in HIV preexposure prophylaxis among men who have sex with men - 23 urban areas, 2017
Kanny D , Jeffries WL 4th , Chapin-Bardales J , Denning P , Cha S , Finlayson T , Wejnert C . MMWR Morb Mortal Wkly Rep 2019 68 (37) 801-806 In 2017, preliminary data show that gay, bisexual, and other men who have sex with men (MSM) accounted for 67% of new diagnoses of human immunodeficiency virus (HIV) infection, that MSM who inject drugs accounted for an additional 3%, and that African American/black (black) and Hispanic/Latino (Hispanic) MSM were disproportionately affected (1). During 2010-2015, racial/ethnic disparities in HIV incidence increased among MSM; in 2015, rates among black and Hispanic MSM were 10.5 and 4.9 times as high, respectively, as the rate among white MSM (compared with 9.2 and 3.8 times as high, respectively, in 2010) (2). Increased use of preexposure prophylaxis (PrEP), which reduces the risk for sexual acquisition of HIV infection by approximately 99% when taken daily as prescribed,* would help to reduce these disparities and support the Ending the HIV Epidemic: A Plan for America initiative(dagger) (3). Although PrEP use has increased among all MSM since 2014 (4), racial/ethnic disparities in PrEP use could increase existing disparities in HIV incidence among MSM (5). To understand racial/ethnic disparities in PrEP awareness, discussion with a health care provider, and use (steps in the HIV PrEP continuum of care) (6), CDC analyzed 2017 National HIV Behavioral Surveillance (NHBS) data. Black and Hispanic MSM were significantly less likely than were white MSM to be aware of PrEP, to have discussed PrEP with a health care provider, or to have used PrEP within the past year. Among those who had discussed PrEP with a health care provider within the past year, 68% of white MSM, 62% of Hispanic MSM, and 55% of black MSM, reported PrEP use. Prevention efforts need to increase PrEP use among all MSM and target eliminating racial/ethnic disparities in PrEP use.( section sign). |
Reducing the African American HIV disease burden in the deep south: Addressing the role of faith and spirituality
Nunn A , Jeffries WL 4th , Foster P , McCoy K , Sutten-Coats C , Willie TC , Ransome Y , Lanzi RG , Jackson E , Berkley-Patton J , Keefer M , Coleman JD . AIDS Behav 2019 23 319-330 Nearly half of HIV infections in the United States are concentrated among African Americans, and over half of new HIV infections occur in the South. African Americans have poorer outcomes in the entire continua of HIV and PrEP care. Complex social, structural, and behavioral factors contribute to our nation's alarming racial disparities in HIV infection, particularly in the Deep South. Despite the importance of faith, spirituality and religious practice in the lives of many African Americans, there has been little scientific investment exploring how African Americans' religious participation, faith and spirituality may impact our nation's HIV epidemic. This article summarizes the state of the science on this critical issue. We also identify opportunities for new scholarship on how faith, spirituality and religious participation may impact HIV care continuum outcomes in the South and call for greater federal research investment on these issues. |
Learning by doing: Lessons from the Care and Prevention in the United States Demonstration Project
Williams KM , Taylor RD , Painter T , Jeffries WL , Prather C , Spikes P , Mulatu MS , Henny K , Hoyte T , Flores SA . Public Health Rep 2018 133 18s-27s Major advances have been made in reducing HIV-related morbidity and mortality since the first infections were reported in the United States more than 36 years ago.1,2 However, racial/ethnic minority populations are disproportionately affected.3,4 The Care and Prevention in the United States (CAPUS) Demonstration Project (hereinafter, CAPUS; 2012-2016) aimed to reduce HIV-related morbidity, mortality, and health disparities among these priority populations in 8 states: Georgia, Illinois, Louisiana, Mississippi, Missouri, North Carolina, Tennessee, and Virginia.5 State health departments collectively received $42.8 million through the US Department of Health and Human Services Secretary’s Minority AIDS Initiative Fund6 to expand and improve HIV testing capacity and optimize linkage to, retention in, and reengagement with care and prevention services for people with HIV (PWH).5 Eligibility for funding was based on the high HIV disease burden among racial/ethnic minority populations, the disproportionate rate of AIDS diagnoses and associated mortality, and the pervasive effect of social and structural determinants of health within a jurisdiction. |
Latent classes of sexual risk among black men who have sex with men and women
Dangerfield DT 2nd , Harawa NT , Smith LR , Jeffries WL 4th , Baezconde-Garbanati L , Bluthenthal R . Arch Sex Behav 2018 47 (7) 2071-2080 Black men who have sex with men and women (BMSMW) are at high risk for HIV and other sexually transmitted infections (STIs). Despite knowing that HIV/STI risk varies by sexual positioning practices, limited data have characterized the risk profiles of BSMW. This study utilized latent class analysis (LCA) to explore BMSMW's sexual risk profiles regarding condomless sexual positioning practices. Participants were BMSMW in intervention studies in Los Angeles, Chicago, and Philadelphia. LCA was used to characterize their sexual risk profiles. Age, study location, HIV status, social support, and internalized homophobia were used as covariates in a multinomial regression model predicting the likelihood of class membership. Among the 546 participants, three latent classes of risk were identified: Seropositive Serosorters, Seronegative/unknown Serosorters, and Main Partners Only. All groups had the greatest probabilities of condomless sex with main partners. Seropositive Serosorters had the highest probabilities of condomless sex with HIV-positive partners. Seronegative/unknown Serosorters had the highest probabilities of condomless sex with HIV-negative or unknown status partners. HIV-positive BMSMW had 87% lower odds of being classified as Seronegative/unknown Serosorters than Seropositive Serosorters than HIV-negative/unknown status BMSMW (AOR = 0.13, 95% CI 0.06, 0.28). HIV-positive BMSMW had 71% lower odds of being classified as Main Partners Only than Seropositive Serosorters than HIV-negative/unknown status BMSMW (AOR = 0.29, 95% CI 0.16, 0.51). Findings highlight opportunities for clinicians to promote condom use and risk reduction among BMSMW with differing sexual risk profiles. Increased understanding of sexual positioning practices among BMSMW might help address HIV/STIs among this group. |
Internalized homonegativity and substance use among U.S. men who have sex with men only (MSMO) and men who have sex with men and women (MSMW)
Jeffries WL , Johnson OD . Subst Use Misuse 2017 53 (4) 1-6 BACKGROUND: Internalized homonegativity may promote substance use among U.S. men who have sex with men only (MSMO) and men who have sex with men and women (MSMW). However, studies have produced mixed findings, used non-representative samples, and not adequately examined MSMW. OBJECTIVES: We investigated (1) internalized homonegativity in relation to substance use and (2) the extent of temporal change in internalized homonegativity among MSMO and MSMW. METHODS: Using merged 2002, 2006-2010, and 2011-2013 cycles of the National Survey of Family Growth-a nationally representative U.S. sample of persons aged 15-44 years-we acquired subsamples of MSMO (n = 419) and MSMW (n = 195). Rao-Scott chi-square tests examined internalized homonegativity in relation to past-month binge drinking and use of marijuana. These tests examined past-year use of any illicit substance, cocaine, crack, injection drugs, and methamphetamine. Multivariable logistic regression models controlled for covariates. Rao-Scott chi-square tests examined temporal changes in internalized homonegativity. RESULTS: Among MSMO, internalized homonegativity was associated with increased odds of using any illicit substance, cocaine, and methamphetamine. Among MSMW, however, internalized homonegativity was associated with decreased odds of using any illicit substance, cocaine, crack, injection drugs, and methamphetamine. The proportion of MSMO and MSMW who expressed internalized homonegativity did not significantly change during 2002-2013. Conclusions/Importance: Internalized homonegativity may be positively associated with substance use among MSMO, but negatively associated with substance use among MSMW. Future studies should seek to better understand internalized homonegativity and other determinants of substance use among MSMO and MSMW. |
Implementation of evidence-based HIV interventions for gay, bisexual, and other men who have sex with men
Jeffries WL IV , Garrett S , Phields M , Olubajo B , Lemon E , Valdes-Salgado R , Collins CB Jr . AIDS Behav 2017 21 (10) 3000-3012 The Centers for Disease Control and Prevention provides trainings to support implementation of five evidence-based HIV prevention interventions (EBIs) for men who have sex with men (MSM): d-up: Defend Yourself!; Many Men, Many Voices; Mpowerment; Personalized Cognitive Counseling; and Popular Opinion Leader. We evaluated trainees' implementation of these EBIs and, using multivariable logistic regression, examined factors associated with implementation. Approximately 43% of trainees had implemented the EBIs for which they received training. Implementation was associated with working in community-based organizations (vs. health departments or other settings); acquiring training for Mpowerment or Popular Opinion Leader (vs. Personalized Cognitive Counseling); having ≥3 funding sources (vs. one); and having (vs. not having) sufficient time and necessary EBI resources. Findings suggest that implementation may vary by trainee characteristics, especially those related to employment setting, EBI training, funding, and perceived implementation barriers. Efforts that address these factors may help to improve EBI implementation among trainees. |
The impact of racism on the sexual and reproductive health of African American women
Prather C , Fuller TR , Marshall KJ , Jeffries WL . J Womens Health (Larchmt) 2016 25 (7) 664-71 African American women are disproportionately affected by multiple sexual and reproductive health conditions compared with women of other races/ethnicities. Research suggests that social determinants of health, including poverty, unemployment, and limited education, contribute to health disparities. However, racism is a probable underlying determinant of these social conditions. This article uses a socioecological model to describe racism and its impact on African American women's sexual and reproductive health. Although similar models have been used for specific infectious and chronic diseases, they have not described how the historical underpinnings of racism affect current sexual and reproductive health outcomes among African American women. We propose a socioecological model that demonstrates how social determinants grounded in racism affect individual behaviors and interpersonal relationships, which may contribute to sexual and reproductive health outcomes. This model provides a perspective to understand how these unique contextual experiences are intertwined with the daily lived experiences of African American women and how they are potentially linked to poor sexual and reproductive health outcomes. The model also presents an opportunity to increase dialog and research among public health practitioners and encourages them to consider the role of these contextual experiences and supportive data when developing prevention interventions. Considerations address the provision of opportunities to promote health equity by reducing the effects of racism and improving African American women's sexual and reproductive health. |
Unhealthy environments, unhealthy consequences: experienced homonegativity and HIV infection risk among young men who have sex with men
Jeffries WL IV , Gelaude DJ , Torrone EA , Gasiorowicz M , Oster AM , Spikes PS Jr , McCree DH , Bertolli J . Glob Public Health 2015 12 (1) 1-14 Unfavourable social environments can negatively affect the health of gay, bisexual, and other men who have sex with men (MSM). We described how experienced homonegativity - negative perceptions and treatment that MSM encounter due to their sexual orientations - can increase HIV vulnerability among young MSM. Participants (n = 44) were young MSM diagnosed with HIV infection during January 2006-June 2009. All participants completed questionnaires that assessed experienced homonegativity and related factors (e.g. internalised homonegativity). We focus this analysis on qualitative interviews in which a subset of participants (n = 28) described factors that they perceived to have placed them at risk for HIV infection. Inductive content analysis identified themes within qualitative interviews, and we determined the prevalence of homonegativity and related factors using questionnaires. In qualitative interviews, participants reported that young MSM commonly experienced homonegativity. They described how homonegativity generated internalised homonegativity, HIV stigma, silence around homosexuality, and forced housing displacement. These factors could promote HIV risk. Homonegative experiences were more common among young Black (vs. non-Black) MSM who completed questionnaires. Results illustrate multiple pathways through which experienced homonegativity may increase HIV vulnerability among young MSM. Interventions that target homonegativity might help to reduce the burden of HIV within this population. |
HIV stigma experienced by young men who have sex with men (MSM) living with HIV infection
Jeffries WL , Townsend ES , Gelaude DJ , Torrone EA , Gasiorowicz M , Bertolli J . AIDS Educ Prev 2015 27 (1) 58-71 Stigma can compromise the health of persons living with HIV. Although HIV is increasingly affecting young men who have sex with men (MSM), little is known about their experiences with HIV stigma. We used narrative data to examine HIV stigma experienced by young MSM living with HIV. Data came from 28 qualitative interviews with young MSM. We used inductive content analysis to identify themes across these interviews. Participants commonly discussed negative perceptions and treatment of persons living with HIV. Stigma could result in nondisclosure of HIV status, internalized stigma, and avoidance of HIV-related things. Some men discussed strategies that might combat stigma. Findings suggest that HIV stigma might challenge young MSM's health by undermining health-conducive resources (e.g., social support) and contributing to HIV vulnerability. Interventions that counteract HIV stigma may help to create environments that promote well-being among young MSM living with HIV. |
Increased HIV and primary and secondary syphilis diagnoses among young men - United States, 2004-2008
Torrone EA , Bertolli JM , Li J , Sweeney PA , Jeffries WL , Ham DC , Peterman TA . J Acquir Immune Defic Syndr 2011 58 (3) 328-35 OBJECTIVES: National data document increases in HIV and syphilis diagnoses in young black men who have sex with men (MSM), but trends could be driven by increases in a few large areas. We describe the extent to which metropolitan areas of varying population sizes have reported increases in HIV and syphilis diagnoses in young MSM. METHODS: We examined trends in HIV and primary and secondary syphilis case reports from 2004 to 2008 in metropolitan areas having more than 500,000 persons and at least 500 black men aged 13-24 years (n=73). We examined differences by age at diagnosis, race/ethnicity, and area size. RESULTS: Comparing 2004/2005 to 2007/2008, HIV diagnoses increased in 85% (n=62) of areas among black MSM aged 13-24 years; primary and secondary syphilis diagnoses in young black men increased in 70% of areas (n=51). Areas had an average percentage increase of 68.7% (Interquartile range (IQR): 25.0, 103.1) in HIV diagnoses among young black MSM and an average increase of 203.5% (IQR: 0.0, 192.7) in primary and secondary syphilis. Across area size strata, the youngest group of black men had the highest average percentage increase in diagnoses of HIV and syphilis as well as the highest percentage of areas with increases in diagnoses. CONCLUSIONS: HIV and syphilis diagnoses increased among young black men in almost all areas, suggesting widespread increases across metropolitan areas of different sizes. Findings highlight the need for continued prevention efforts for young MSM, particularly young black MSM. |
Mistaken assumptions and missed opportunities: correlates of undiagnosed HIV infection among black and Latino men who have sex with men
Millett GA , Ding H , Marks G , Jeffries WL , Bingham T , Lauby J , Murrill C , Flores S , Stueve A . J Acquir Immune Defic Syndr 2011 58 (1) 64-71 OBJECTIVE: To identify demographic, behavioral, and psychological variables associated with being HIV-positive unaware among black and Latino men who have sex with men (MSM). METHODS: Participants recruited in 3 cities completed a computer-assisted interview and were tested for HIV infection (OraSure Technologies, Bethlehem, PA). HIV-positive unaware MSM were compared with MSM who tested HIV-negative in bivariate and multivariate analyses. RESULTS: Of 1208 MSM (597 black and 611 Latino), 11% were HIV-positive unaware (18% of blacks and 5% of Latinos). In multivariate analysis of the Latino MSM, being HIV-positive unaware was associated with non-gay identity, high perceived risk of currently being HIV-positive, and belief that sex with other Latino men reduces HIV transmission risk. Among black MSM, being HIV-positive unaware was associated with gay identity, moderately higher income, having health insurance, sexuality disclosure to a current healthcare provider, fewer than 3 lifetime HIV tests, high perceived risk of testing HIV-positive, and belief that sex with other black men reduces HIV transmission risk. CONCLUSIONS: HIV prevention efforts should address misperceptions among those black and Latino MSM who believe that assortative (i.e. intraracial) sexual mixing reduces risk of HIV infection. Our findings also revealed missed opportunities to diagnose black MSM with HIV infection who were already engaged in care and had disclosed their sexuality to their healthcare provider. Clinicians should offer HIV testing to all MSM, particularly black MSM, who disclose engaging in recent sex with other men to facilitate earlier diagnosis of HIV infection and reduce transmission risk to sexual partners. |
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