Browsing by Subject "HIV prevention"

Utilizing data from The National Longitudinal Study of Adolescent Health (Add Health), the current study examined the relationship between cultural values, coping behavior, and HIV risk behaviors among African-American/Black and Hispanic/Latino adolescents (N = 437). The goal of this research was to provide the first step towards testing the construct validity of a theoretical model in which values and cultural context contribute to coping behaviors and coping, in turn, mediates the association between values and HIV risk profile. African-American participants endorsed higher levels of Africentric and religious values than did Hispanic participants and endorsed higher utilization of religious coping. Cultural values including familismo and religiosity were associated with more adaptive coping behavior and lower sexual and substance use risk behaviors across racial/ethnic groups. Results for other cultural values were inconsistent. Coping behavior predicted substance use risk behaviors but was not associated with sexual risk behaviors. Mediation was not supported except in the case of religious coping and religiosity. Implications for HIV prevention and directions for future research are discussed.

African-American young men who have sex with men (YMSM) are seven and three times more likely than their White and Hispanic counterparts, respectively, to be infected with HIV. Once-daily oral co-formulated tenofovir disoproxil fumarate and emtricitabine [FTC/TDF], for HIV pre-exposure prophylaxis, known as PrEP has been demonstrated to be an effective method of reducing rates of new HIV infections within this population. Despite this breakthrough in HIV prevention, African American YMSM use PrEP at a much lower and disproportionate rate in comparison to white MSM. Therefore, the aim of this dissertation was to develop a deeper understanding of the HIV prevention needs of African American YMSM as it relates to PrEP. This study was conducted using a descriptive qualitative approach, which was guided by a naturalistic design to explore and understand African American YMSM’s cognitive and emotional processes as it relates to PrEP, and how these responses influence their likely future use of PrEP as an HIV prevention method. The findings revealed important individual-, social-, cultural-, and structural-level factors that affect African American YMSM’s likely future use of PrEP. These findings revealed opportunities for future research and interventions to address the disparate rates of future PrEP use for African American YMSM.

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Pastoral leaders in African American contexts often play a critical role in conveying messages about what is vital to black and brown people. Pastoral leadership has always been the driving force behind change within the Black Church, especially in times of community suffering. Health disparities such as the HIV epidemic in the Black community have created a crisis just as alarming as the COVID pandemic, and the key to addressing this issue will require pastoral leadership. This research aims to examine the framework of pastoral leadership through the theological model of the Munus Triplex and how it can be utilized and maximized within the congregational context to transform its culture into one in that is HIV competent and inculcated into the cultural fabric of the church.My thesis will focus on the significance of pastoral leadership in the areas of proactive and preventative HIV education, and how the pastor’s influence within the congregation can be best used to positively influence and generate outcomes leading to inclusive practices among members of the congregation in response to HIV stigmas. By examining the work of Christ through the lens of the Munus Triplex, we can ascertain some of the leadership competencies that constitute his roles as priest, prophet, and king. In turn, this can serve as a foundational model for pastoral leadership today. I will explore how each distinctive role of the Munus Triplex informs the pastor’s work towards affecting change within the congregational context. Based upon this work, I will propose a leadership paradigm approach for African American religious leaders to help them embrace their vocational responsibility to care for the whole person free of stigma and harmful theological rhetoric in response to the HIV epidemic.

Problem: Gay, bisexual, and queer (GBQ) adolescent males are disproportionately affected by negative sexual health outcomes compared to their heterosexual counterparts. Their sex education needs are not sufficiently addressed in the home and the larger ecological systems. The omission of their sex education needs at a time when they are forming a sexual identity during adolescence compels GBQ males to seek information in unsupervised settings. Evidence-based interventions aimed at ensuring positive sexual health outcomes through sex communication cannot be carried out with these youth as research on how parents and GBQ males discuss sex in the home has been largely uninvestigated.

Methods: This naturalistic qualitative study focused on the interpretive reports of 15- to 20-year-old GBQ males’ discussions about sex-related topics with their parents. From a purposive sample of 30 male adolescents who self-identified as GBQ, participants who could recall at least one conversation about sex with their parents were recruited for one-time interviews and card sorts. This strategy revealed, using Bronfenbrenners’ Bioecological Theory, their perceptions about sex communication in the context of their reciprocal relationship and the ecological systems that GBQ males and their parents navigate.

Results: Parents received poor ratings as sex educators, were generally viewed as not confident in their communication approach, and lacked knowledge about issues pertinent to GBQ sons. Nevertheless, participants viewed parents as their preferred source of sex information and recognized multiple functions of sex communication. The value placed by GBQ youth on sex communication underscores their desire to ensure an uninterrupted parent-child relationship in spite of their GBQ sexual orientation. For GBQ children, inclusive sex communication is a proxy for parental acceptance.

Results show that the timing, prompts, teaching aids, and setting of sex communication for this population are similar to what has been reported with heterosexual samples. However, most GBQ sons rarely had inclusive guidance about sex and sexuality that matched their attraction, behavior, and identities. Furthermore, the assumption of heterosexuality resulted in the early awareness of being different from their peers which led them to covertly search for sex information. The combination of assumed heterosexuality and their early reliance on themselves for applicable information is a missed parental opportunity to positively impact the health of GBQ sons. More importantly, due to the powerful reach of new media, there is a critical period of maximum receptiveness that has been identified which makes inclusive sex communication paramount in the pre-sexual stage for this population. Our findings also indicate that there are plenty of opportunities for systemic improvements to meet this population’s sexual education needs.