Medicine and Health Commons^™

The Relationship Between Religion, Substance Misuse, And Mental Health Among Black Youth, Dexter R. Voisin

Faculty Scholarship

Studies suggest that religion is a protective factor for substance misuse and mental health concerns among Black/African American youth despite reported declines in their religious involvement. However, few studies have investigated the associations among religion, substance misuse, and mental health among Black youth. Informed by Critical Race Theory, we evaluated the correlations between gender, depression, substance misuse, and unprotected sex on mental health. Using multiple linear regression, we assessed self-reported measures of drug use and sex, condom use, belief in God, and religiosity on mental health among a sample of Black youth (N = 638) living in a large midwestern …

A Novel Approach To Assessment Of Us Pediatric Trauma System Development., Mary E. Fallat, Colin Traeger, Sophie Humphrey, Lindsey Gumer, Kahir Jawad, Elissa Butler, Frederick B. Rogers, Frederick P. Rivara, Amelia T. Collings

Faculty Scholarship

Importance Mature trauma systems are critical in building and maintaining national, state, and local resilience against all-hazard disasters. Currently, pediatric state trauma system plans are not standardized and thus are without concrete measures of potential effectiveness.

Objective To develop objective measures of pediatric trauma system capability at the state level, hypothesizing significant variation in capabilities between states, and to provide a contemporary report on the status of national pediatric trauma system planning and development.

Design, Setting, and Participants A national survey was deployed in 2018 to perform a gap analysis of state pediatric trauma system capabilities. Four officials from each …

The Longitudinal Relationship Between Broken Windows And Sexual Behaviors Among African American Girls In Juvenile Detention: The Moderating Effects Of Sexual Sensation Seeking And Parental Monitoring, Dexter R. Voisin

Faculty Scholarship

Objective: Broken windows theory has been applied in public health to understand how neighborhood disadvantage contributes to health risk and disparities. This longitudinal study examined the relationship between a broken windows index (i.e., a proxy for neighborhood disadvantage) and sexual behaviors and whether sexual sensation-seeking behaviors and parental monitoring moderated that relationship. Method: Participants were 188 African American adolescent girls incarcerated in a short-term detention facility in Atlanta, GA. Participants completed audio computer-assisted self-interviews at baseline, 3, and 6 months; interviews assessed neighborhood disadvantage, sexual risk behaviors, sexual sensation seeking, parental monitoring, and demographics. Results: Longitudinal findings indicate that the …

Examining The Causal Impact Of Prenatal Home Visiting On Birth Outcomes: A Propensity Score Analysis, Elizabeth R. Anthony, Robert L. Fischer

Faculty Scholarship

Objectives: In Ohio, African American babies die at 2.5–3 times the rate of White babies. Preterm birth and low birth weight are the leading causes of infant mortality. Home visiting is an evidence-based strategy for serving low-income pregnant women; however, there are relatively few rigorous studies examining its effect on birth outcomes. Methods: This study uses a propensity score technique to estimate the causal effect of participation in home visiting on prematurity and low birth weight among a low-income, predominantly African American sample (N = 26,814). Results: We found that participation in home visiting significantly reduced the odds of experiencing …

Correlates Of Depression Among Black Girls Exposed To Violence, Dexter R. Voisin

Faculty Scholarship

Depression rates for youth remanded to juvenile detention is double that of the general population and Black girls are especially vulnerable. A dearth of literature analyzes the factors that are correlated with depression among system-involved Black girls, ages 12–17 years old. We utilized personal agency to examine the relationship between risk factors (i.e., abuse history, and fear of condom negotiation) and protective factors (i.e., condom self-efficacy, and perceived social support) that might correlate with depression among Black girls exposed to violence. Findings indicate that fear of condom negotiation, abuse history and low condom self-efficacy are correlated with depressive symptomology while …

Conceptualizing The Effects Of Continuous Traumatic Violence On Hiv Continuum Of Care Outcomes For Young Black Men Who Have Sex With Men In The United States, Dexter R. Voisin

Faculty Scholarship

The United States (US) is on track to achieve the 90-90-90 targets set forth by UNAIDS and the National HIV/AIDS strategy, yet significant racial disparities in HIV care outcomes remain, particularly for young Black men who have sex with men (YBMSM). Research has demonstrated that various types of violence are key aspects of syndemics that contribute to disparities in HIV risk. However, little research has looked collectively at cumulative violent experiences and how those might affect HIV treatment and care outcomes. Drawing on extant literature and theoretical underpinnings of syndemics, we provide a conceptual model that highlights how continuous traumatic …

Racial And Ethnic Comparison Of Ecological Risk Factors And Youth Outcomes: A Test Of The Desensitization Hypothesis, Dexter R. Voisin

Faculty Scholarship

Minority youth, because of structural, ecological, and societal inequalities, are at heightened risk of reporting depression and experiencing negative sanctions associated with delinquency. Sociological theories suggest that greater exposure to ecological risk factors at the peer, family, school and community levels are associated with elevated rates of youth depression and delinquency. Desensitization theory posits that repeated exposures to ongoing stressors result in a numbing of psychological and behavioral responses. Thus, it remains unclear whether racial/ethnic differences exist with regards to how contextual stressors correlate with depression and delinquency. Using a sample of 616 Black, 687 Latinx, and 1,318 White youth, …

Art Adherence Among Men Who Have Sex With Men Living With Hiv: Key Challenges And Opportunities, Dexter R. Voisin

Faculty Scholarship

Purpose of Review: In the USA, gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV. High levels of adherence to antiretroviral therapy (ART) can dramatically improve outcomes for persons living with HIV and reduce the risk of HIV transmission to others. Yet, there are numerous individual, social, and structural barriers to optimal ART adherence. Many of these factors disproportionately impact Black MSM and may contribute to their poorer rates of ART adherence. This review synthesizes the key challenges and intervention opportunities to improve ART adherence among MSM in the USA. Recent Findings: Key …

Peer Victimization And Illicit Drug Use Among African American Adolescents In Chicago: The Moderating Effects Of Religious Affiliation, Dexter R. Voisin

Faculty Scholarship

Objective: Investigators have examined the moderating effects of young people’s relationships with parents, teachers, and peers on victimization and on adverse outcomes such as drug use. However, the moderating influence of religious affiliation on the association between peer victimization and illicit drug use, the focus of this paper, has seldom been examined. Method: Participants were 638 low-income African American youth ages 12–22 (mean age = 15.8; 54% female and 46% male) in Chicago, IL. We conducted hierarchical logistic regression analyses to examine the moderating effect of religious affiliation on the relationship between peer victimization and illicit drug use. Results: Youths …

Social Networks Moderate The Syndemic Effect Of Psychosocial And Structural Factors On Hiv Risk Among Young Black Transgender Women And Men Who Have Sex With Men, Dexter R. Voisin

Faculty Scholarship

The interaction between the cumulative effect of psychosocial and structural factors (i.e. syndemic effect) and social networks among young Black transgender women and men who have sex with men (YBTM) remains understudied. A representative cohort of 16–29 year-old YBTM (n = 618) was assessed for syndemic factors [i.e. substance use; community violence; depression; poverty; justice system involvement (JSI)], social network characteristics, condomless anal sex (CAS), group sex (GS), and HIV-infection. The syndemic index significantly increased the odds of CAS, GS, and HIV-infection, and these effects were moderated by network characteristics. Network JSI buffered the effect on CAS, romantic network members …

Exposure To Community Violence And Substance Use Among Black Men Who Have Sex With Men: Examining The Role Of Psychological Distress And Criminal Justice Involvement, Dexter R. Voisin

Faculty Scholarship

Young Black MSM (YBMSM) are disproportionately affected by violence, criminal justice involvement, and other structural factors that also increase vulnerability to HIV. This study examined associations between exposure to community violence (ECV) and substance use, psychological distress, and criminal justice involvement (CJI) among YBMSM in Chicago, IL. Respondent driven sampling was used to recruit a sample of 618 YBMSM (aged 16–29) from the South Side of Chicago between June 2013 and July 2014. Weighted logistic regression assessed the direct effects of ECV, CJI, and psychological distress on substance use outcomes. Indirect effects were assessed via path analysis with mean and …

A Longitudinal Examination Of Factors Associated With Network Bridging Among Ymsm: Implications For Hiv Prevention, Dexter R. Voisin

Faculty Scholarship

Social-environmental factors may be associated with social network stability, which has implications for HIV acquisition. However, the link between social-environmental factors, network composition and HIV risk has not been examined previously among a city-population based sample of young Black men who have sex with Men (YBMSM). Respondent driven sampling was used to recruit a cohort of 618 YMBSM. Respondents were evaluated at baseline, 9 and 18 months beginning June 2013. A logistic regression model was used to assess the relationship between bridging (i.e. having non-redundant contacts in one’s network, indicating network instability) and social-environmental factors and HIV risk factors between …

The Relationship Between Black And Gay Community Involvement And Hiv-Related Risk Behaviors Among Black Men Who Have Sex With Men, Dexter R. Voisin

Faculty Scholarship

Black gay men must navigate identities and stigmas related to being gay and Black, and report higher HIV incidence relative to their White male counterparts although they report lower rates of drug use and risky sexual behaviors. This study examined whether closeness to the gay or Black community correlated with HIV-related risk and protective behaviors. Data were drawn from uConnect, a population-based cohort study of young Black men who have sex with men (YBMSM) on Chicago's South Side. The sample consists of 618 Black MSM ranging in age from 16 to 29. Cross-sectional measures for this study include Black and …

Pathways To Delinquency And Substance Use Among African American Youth: Does Future Orientation Mediate The Effects Of Peer Norms And Parental Monitoring?, Dexter R. Voisin

Faculty Scholarship

The following study assessed whether future orientation mediated the effects of peer norms and parental monitoring on delinquency and substance use among 549 African American adolescents. Structural equation modeling computed direct and indirect (meditational) relationships between parental monitoring and peer norms through future orientation. Parental monitoring significantly correlated with lower delinquency through future orientation (B = −.05, standard deviation =.01, p <.01). Future orientation mediated more than quarter (27.70%) of the total effect of parental monitoring on delinquency. Overall findings underscore the importance of strengthening resilience factors for African American youth, especially those who live in low-income communities.

Project Ngage: Results Of A Randomized Controlled Trial Of A Dyadic Network Support Intervention To Retain Young Black Men Who Have Sex With Men In Hiv Care, Dexter R. Voisin

Faculty Scholarship

HIV-positive young black MSM (YBMSM) experience poor outcomes along the HIV care continuum, yet few interventions have been developed expressly for YBMSM retention in care. Project nGage was a randomized controlled trial conducted across five Chicago clinics with 98 HIV-positive YBMSM aged 16–29 between 2012 and 2015. The intervention used a social network elicitation approach with index YBMSM (n = 45) to identify and recruit a support confidant (SC) to the study. Each index-SC dyad met with a social worker to improve HIV-care knowledge, activate dyadic social support, and develop a retention in care plan. Each index and SC also …

Gender Differences In Virologic Response After Antiretroviral Therapy In Treatment-Naïve Hiv-Infected Individuals: Results From The 550 Clinic Hiv Cohort Study., Andrea Reyes-Vega, Alejandra Loban, Kavitha Srinivasan, Stephen P. Furmanek, Conner English, Mary Bishop, Cathy Spencer, Daniel Truelove, Julio A. Ramirez, Anupama Raghuram, Paula Peyrani

Faculty Scholarship

Background

Controversy still exists regarding gender differences in virologic response between treatment-na•ve HIV-infected individuals. The objective of this study was to evaluate gender difference in virologic and immunologic response to antiretroviral therapy in treatment-na•ve HIV-infected individuals. Methods

This was a retrospective, observational study of treatment-na•ve HIV-infected individuals managed at the 550 clinic who started antiretroviral therapy (ART) between January 1st, 2010 and December 31, 2015. Patients with available viral load and CD4 counts before and one year after initiating ART were included in this study. Virologic suppression was defined as < 48 HIV-1 RNA copies/mL, and mmunologic recovery was defined as a CD4 count increase of at least 150 cells/mm3. Dichotomous variables were reported in number and percentages and analyzed using Chi-squared tests and Fisher’s exact (whichever was appropriate). Continuous variables were reported as median and interquartile range (IQR) and analyzed using Wilcox rank-sum tests. Multivariate analyses performed were logistic regressions with adjustment for other covariates. P value <0.05 was considered statistically significant. R version 3.3.2 was used for the statistical analysis. Results

A total of 70 women and 90 men were included …

A Longitudinal Analysis Of Antiretroviral Adherence Among Young Black Men Who Have Sex With Men, Dexter R. Voisin

Faculty Scholarship

Purpose: Young black men who have sex with men (YBMSM) experience poorer antiretroviral therapy (ART) medication adherence relative to their white counterparts. However, few studies have longitudinally examined factors that may correlate with various classifications of ART adherence among this population, which was the primary aim of this study. Methods: Project nGage was a randomized controlled trial conducted across five Chicago clinics from 2012 to 2015. Survey and medical records data were collected at baseline and 3- and 12-month periods to assess whether psychological distress, HIV stigma, substance use, family acceptance, social support, and self-efficacy predicted ART medication adherence among …

Involvement In The Juvenile Justice System For African American Adolescents: Examining Associations With Behavioral Health Problems, Dexter R. Voisin

Faculty Scholarship

While researchers have found that African American youth experience higher levels of juvenile justice involvement at every system level (arrest, sentencing, and incarceration) relative to their other ethnic counterparts, few studies have explored how juvenile justice involvement and number of contacts might be correlated with this broad range of problems. A convenience sample of 638 African American adolescents living in predominantly low-income, urban communities participated in a survey related to juvenile justice involvement. Major findings using logistic regression models indicated that adolescents who reported juvenile justice system involvement versus no involvement were 2.3 times as likely to report mental health …

The Relationship Between Life Stressors And Drug And Sexual Behaviors Among A Population-Based Sample Of Young Black Men Who Have Sex With Men In Chicago, Dexter R. Voisin

Faculty Scholarship

Younger Black men who have sex with men (YBMSM) have the highest rates of HIV incidence in the U.S. and are also exposed to high life stressors (e.g., unemployment, incarceration, and exposure to communality). This study assessed whether life stressors were related to drug use and sexual risk behaviors among a representative sample of YBMSM. The South Side of Chicago and selected adjacent suburbs represents the most populous contiguous Black community in the U.S. Over 10% of the estimated YBMSM population in this geographic region were sampled. Major findings indicated that higher life stress was significantly associated with greater odds …

Marijuana Use Among Young Black Men Who Have Sex With Men And The Hiv Care Continuum: Findings From The Uconnect Cohort, Dexter R. Voisin

Faculty Scholarship

Background: Young Black men who have sex with men (YBMSM) are at highest risk for HIV seroconversion in the United States. Successful movement through the HIV care continuum is an important intervention for limiting onwards HIV transmission. Objective: Little data exists on how substances most commonly used by YBMSM, such as marijuana, are related to the HIV continuum, which represents the primary aim of this study. Methods: A cohort of YBMSM (n = 618) was generated through respondent-driven sampling. Frequency of marijuana use and marijuana use as a sex-drug were assessed across the HIV care continuum using weighted logistic regression …

Multiple Dimensions Of Stigma And Health Related Factors Among Young Black Men Who Have Sex With Men, Dexter R. Voisin

Faculty Scholarship

This study is among the first to examine the association between multiple domains of HIV-related stigma and health-related correlates including viral load and medication adherence among young Black men who have sex with men (N = 92). Individual logistic regressions were done to examine the hypothesized relationships between HIV-related stigma and various health and psychosocial outcomes. In addition to examining total stigma, we also examined four domains of HIV stigma. Findings revealed the various domains of stigma had differential effects on health-related outcomes. Individuals who reported higher levels of total stigma and personalized stigma were less likely to be virally …

I Get Height With A Little Help From My Friends: Herd Protection From Sanitation On Child Growth In Rural Ecuador [Post-Print], James Fuller, Eduardo Villamor, William Cevallos, James A. Trostle, Joseph Eisenberg

Faculty Scholarship

Background: Infectious disease interventions, such as vaccines and bed nets, have the potential to provide herd protection to non-recipients. Similarly, improved sanitation in one household may provide community-wide benefits if it reduces contamination in the shared environment. Sanitation at the household level is an important predictor of child growth, but less is known about the effect of sanitation coverage in the community.

Methods: From 2008 to 2013, we took repeated anthropometric measurements on 1314 children under 5 years of age in 24 rural Ecuadorian villages. Using mixed effects regression, we estimated the association between sanitation coverage in surrounding households and …

Psychological Distress, Drug Use, Sexual Risks And Medication Adherence Among Young Hiv-Positive Black Men Who Have Sex With Men: Exposure To Community Violence Matters, Dexter R. Voisin

Faculty Scholarship

In the USA, Black males are disproportionately affected by community violence and HIV. The aim of this study was to assess whether exposures to community violence are related to psychological distress, drug use, sexual risk behaviors, and medication adherence among a sample of HIV-positive young Black men who had sex with men (YBMSM). Data are from 98 YBMSM ages 18–29 years recruited from Chicago who completed measures on demographics, exposures to community violence, psychological distress, drug use, condomless anal intercourse, and medication adherence. Rates of exposure to community violence were high and youth reported victimization and witnessing numerous types of …

We Have The Tools To End Hiv: Benefits, Barriers, And Solutions To Expanded Utilization Of Pre-Exposure Prophylaxis (Prep) In The Us Deep South, Jason Ervin, Allison Weller Tikare, Carolyn Mcallaster

Faculty Scholarship

No abstract provided.

Assessing The Deployment Of Home Visiting: Learning From A State-Wide Survey Of Home Visiting Programs, Robert L. Fischer, Elizabeth R. Anthony, Nina Lalich, Paul Bakaki, Siran Koroukian-Hajinazarian

Faculty Scholarship

Objectives: Large-scale planning for health and human services programming is required to inform effective public policy as well as deliver services to meet community needs. The present study demonstrates the value of collecting data directly from deliverers of home visiting programs across a state. This study was conducted in response to the Patient Protection and Affordable Care Act, which requires states to conduct a needs assessment of home visiting programs for pregnant women and young children to receive federal funding. In this paper, we provide a descriptive analysis of a needs assessment of home visiting programs in Ohio. Methods: All …

A Synthesis Of 20 Years Of Research On Sexual Risk Taking Among Asian/Pacific Islander Men Who Have Sex With Men In Western Countries, Dexter R. Voisin

Faculty Scholarship

Over the past two decades, there has emerged a body of literature documenting a number of risk factors associated with Asian/Pacific Islander men who have sex with men’s unsafe sexual behaviors. This study aims to systematically review existing empirical studies and synthesize research results into a social–ecological framework using a mixed research synthesis. Empirical research articles published in peer-reviewed journals between January 1990 and June 2013 were identified in six databases, including PubMed, Ovid MEDLINE, PsycINFO, Social Work Abstract, CINAL, and Web of Knowledge. Both quantitative and qualitative studies were included. Two analysts independently reviewed the articles, and findings were …

One Size Does Not Fit All: What Does High Impact Prevention Funding Mean For Community-Based Organizations In The Deep South?, Carolyn Mcallaster, Jerry Fang

Faculty Scholarship

No abstract provided.

Hiv Infrastructure Study Birmingham, Alabama, Susan S. Reif, Kristen Sullivan, Carolyn Mcallaster, Miriam Berger

Faculty Scholarship

No abstract provided.

Hiv Infrastructure Study Jackson, Mississippi, Susan S. Reif, Elena Wilson, Carolyn Mcallaster, Miriam Berger

Faculty Scholarship

No abstract provided.

Correlates Of Gang Involvement And Health-Related Factors Among African American Females With A Detention History, Dexter R. Voisin

Faculty Scholarship

Background: Prior studies have assessed relationships between gang membership and health-related factors. However, the existing literature has largely failed to consider how individual and broader social contextual factors might be related to such gang involvement among African American females. Thus, the aim of the present study was to identify empirically driven correlates of gang involvement and then better understand the relationship between gang membership and health-related behaviors for African American females, after controlling for covariates of gang involvement. Methods: Data were collected from a convenience sample of detained African American adolescents females, between the ages of 13-17, currently incarcerated in …