1,399 results on '"Wingood, Gina"'
Search Results
2. Intersectional Stigma, Fear of Negative Evaluation, Depression, and ART Adherence Among Women Living with HIV Who Engage in Substance Use: A Latent Class Serial Mediation Analysis
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Stringer, Kristi Lynn, Norcini Pala, Andrea, Cook, Robert L., Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wilson, Tracey E., Tien, Phyllis C., Wingood, Gina, Neilands, Torsten B., Johnson, Mallory O., Logie, Carmen H., Weiser, Sheri D., Turan, Janet M., and Turan, Bulent
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- 2024
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3. “As I Grew Older, My Life Got Better”: Conceptions of Successful Aging among Older Women Living with or at Risk of HIV
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Rubtsova, Anna A., Taylor, Tonya N., Wingood, Gina, Ofotokun, Ighovwerha, Gustafson, Deborah, Vance, David E., and Holstad, Marcia
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- 2024
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4. Mutual capacity building model for adaptation (MCB-MA): a seven-step procedure for bidirectional learning and support during intervention adaptation
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Jack, Helen E., Giusto, Ali, Rose, Alexandra L., Mwamuka, Rukudzo, Brown, Imani, Bere, Tarisai, Verhey, Ruth, Wainberg, Milton, Myers, Bronwyn, Kohrt, Brandon, Wingood, Gina, DiClemente, Ralph, and Magidson, Jessica F.
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- 2024
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5. Reach and Capacity of Black Protestant Health Ministries as Sites of Community-Wide Health Promotion: A Qualitative Social Ecological Model Examination
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Fuller, Tyler J., Lambert, Danielle N., DiClemente, Ralph J., and Wingood, Gina M.
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- 2024
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6. Rape Victimization and High Risk Sexual Behaviors: A Longitudinal Study of African-American Adolescent Females
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Lang, Delia, Sales, Jessica, Salazar, Laura, Hardin, James, DiClemente, Ralph, and Wingood, Gina
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sexual victimization ,sexual risk ,STI/HIV ,African-American ,adolescent females ,Medicine ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Objectives: African-American women are affected by disproportionately high rates of violence and sexually transmitted infections (STI)/human immunodeficiency virus (HIV) infection. It is imperative to address the intersection of these two urgent public health issues, particularly as these affect African-American adolescent girls. This study assessed the prevalence of rape victimization (RV) among a sample of African-American adolescent females and examined the extent to which participants with a history of RV engage in STI/HIV associated risk behaviors over a 12-month time period.Methods: Three hundred sixty-seven African-American adolescent females ages 15-21, seeking sexual health services at three local teenager-oriented community health agencies in an urban area of the Southeastern United States, participated in this study. Participants were asked to complete an audio computer-assisted self-interview (ACASI) at baseline, six- and 12-month follow-up. We assessed sociodemographics, history of RV and sexual practices. At baseline, participants indicating they had experienced forced sex were classified as having a history of RV.Results: Twenty-five percent of participants reported a history of RV at baseline. At six- and 12-months, victims of RV had significantly lower proportions of condom-protected sex (p=.008), higher frequency of sex while intoxicated (p=.005), more inconsistent condom use (p=.008), less condom use at last sex (p=.017), and more sex partners (p=.0001) than non-RV victims. Over the 12-month follow-up period, of those who did not report RV at baseline, 9.5% reported that they too had experienced RV at some point during the 12-month time frame.Conclusion: African-American adolescent females who experience RV are engaging in more risky sexual behaviors over time than non-RV girls, thereby placing themselves at higher risk for contracting STIs. In light of the results from this unique longitudinal study, we discuss considerations for policies and guidelines targeting healthcare, law enforcement and educational and community settings. The complexities of RV screening in healthcare settings are examined as is the need for tighter collaboration between healthcare providers and law enforcement. Finally, we consider the role of prevention and intervention programs in increasing awareness about RV as well as serving as an additional safe environment for screening and referral. [West J Emerg Med. 2011;12(3):333-342.]
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- 2011
7. Resilience and Optimism as Moderators of the Negative Effects of Stigma on Women Living with HIV
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Turan, Bulent, Budhwani, Henna, Yigit, Ibrahim, Ofotokun, Igho, Konkle-Parker, Deborah J, Cohen, Mardge H, Wingood, Gina M, Metsch, Lisa R, Adimora, Adaora A, Taylor, Tonya N, Wilson, Tracey E, Weiser, Sheri D, Kempf, Mirjam-Colette, Brown-Friday, Janet, Gange, Stephen, Kassaye, Seble, Pence, Brian W, and Turan, Janet M
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Health Services and Systems ,Public Health ,Health Sciences ,Behavioral and Social Science ,Sexually Transmitted Infections ,Mental Health ,HIV/AIDS ,Women's Health ,Infectious Diseases ,Mental Illness ,Depression ,Brain Disorders ,Good Health and Well Being ,Female ,Humans ,Cross-Sectional Studies ,HIV Infections ,Social Stigma ,Surveys and Questionnaires ,HIV ,stigma ,resilience ,depression ,trust ,optimism ,moderation ,provider ,Public Health and Health Services ,Virology ,Clinical sciences ,Public health - Abstract
Resilience and optimism may not only have main effects on health outcomes, but may also moderate and buffer negative effects of stressors. We examined whether dispositional resilience and optimism moderate the associations between HIV-related stigma in health care settings and health-related outcomes (trust in HIV health care providers and depression symptoms) among women living with HIV (WLHIV). One thousand four hundred five WLHIV in nine US cities completed validated questionnaires for cross-sectional analyses. Higher self-reported experienced and anticipated stigma and lower resilience and optimism were associated with higher depression symptoms and with lower trust in HIV providers. Importantly, resilience moderated the effects of experienced stigma (but not of anticipated stigma): When resilience was high, the association of experienced stigma with higher depression symptoms and lower trust in HIV providers was weaker compared with when resilience was low. Further, significant moderation effects suggested that when optimism was high, experienced and anticipated stigma was both less strongly associated with depression symptoms and with lower trust in one's HIV care providers compared with when optimism was low. Thus, the effects of experienced stigma on depression symptoms and provider trust were moderated by both resilience and optimism, but the effects of anticipated stigma were moderated only by optimism. Our findings suggest that in addition to their main effects, resilience and optimism may function as buffers against the harmful effects of stigma in health care settings. Therefore, optimism and resilience may be valuable intervention targets to reduce depression symptoms or improve trust in providers among populations that experience or anticipate stigma, such as WLHIV.
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- 2022
8. Intersectional stigmas are associated with lower viral suppression rates and antiretroviral therapy adherence among women living with HIV
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Pala, Andrea Norcini, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wilson, Tracey E, Tien, Phyllis C, Wingood, Gina, Neilands, Torsten B, Johnson, Mallory O, Weiser, Sheri D, Logie, Carmen H, Turan, Janet M, and Turan, Bulent
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Medical Microbiology ,Biomedical and Clinical Sciences ,Health Sciences ,Mental Health ,Behavioral and Social Science ,Social Determinants of Health ,HIV/AIDS ,Infectious Diseases ,Health Disparities ,Sexually Transmitted Infections ,Clinical Research ,Infection ,Anti-Retroviral Agents ,Bayes Theorem ,Cross-Sectional Studies ,Female ,HIV Infections ,Humans ,Medication Adherence ,Social Stigma ,Viral Load ,antiretroviral therapy ,HIV ,intersectional stigmas ,women with HIV ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Virology ,Biomedical and clinical sciences ,Health sciences - Abstract
ObjectivesTo explore the associations between intersectional poverty, HIV, sex, and racial stigma, adherence to antiretroviral therapy (ART), and viral suppression among women with HIV (WHIV).DesignWe examined intersectional stigmas, self-report ART adherence, and viral suppression using cross-sectional data.MethodsParticipants were WHIV ( N = 459) in the Women's Adherence and Visit Engagement, a Women's Interagency HIV Study substudy. We used Multidimensional Latent Class Item Response Theory and Bayesian models to analyze intersectional stigmas and viral load adjusting for sociodemographic and clinical covariates.ResultsWe identified five intersectional stigma-based latent classes. The likelihood of viral suppression was approximately 90% lower among WHIV who experienced higher levels of poverty, sex, and racial stigma or higher levels of all intersectional stigmas compared with WHIV who reported lower experiences of intersectional stigmas. ART adherence accounted for but did not fully mediate some of the associations between latent intersectional stigma classes and viral load.ConclusionThe negative impact of intersectional stigmas on viral suppression is likely mediated, but not fully explained, by reduced ART adherence. We discuss the research and clinical implications of our findings.
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- 2022
9. Impacts of Medicaid Expansion on Health Insurance and Coverage Transitions among Women with or at Risk for HIV in the United States
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Edmonds, Andrew, Belenky, Nadya, Adedimeji, Adebola A, Cohen, Mardge H, Wingood, Gina, Fischl, Margaret A, Golub, Elizabeth T, Johnson, Mallory O, Merenstein, Daniel, Milam, Joel, Konkle-Parker, Deborah, Wilson, Tracey E, and Adimora, Adaora A
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Public Health ,Health Sciences ,Clinical Research ,Infectious Diseases ,Prevention ,Clinical Trials and Supportive Activities ,HIV/AIDS ,Good Health and Well Being ,Female ,HIV Infections ,Health Services Accessibility ,Humans ,Insurance Coverage ,Insurance ,Health ,Medicaid ,Patient Protection and Affordable Care Act ,United States ,Paediatrics and Reproductive Medicine ,Public Health and Health Services ,Midwifery ,Public health ,Policy and administration - Abstract
BackgroundAs employment, financial status, and residential location change, people can gain, lose, or switch health insurance coverage, which may affect care access and health. Among Women's Interagency HIV Study participants with HIV and participants at risk for HIV attending semiannual visits at 10 U.S. sites, we examined whether the prevalence of coverage types and rates of coverage changes differed by HIV status and Medicaid expansion in their states of residence.MethodsGeocoded addresses were merged with dates of Medicaid expansion to indicate, at each visit, whether women lived in Medicaid expansion states. Age-adjusted rate ratios (RRs) and rate differences of self-reported insurance changes were estimated by Poisson regression.ResultsFrom 2008 to 2018, 3,341 women (67% Black, 71% with HIV) contributed 43,329 visits at aged less than 65 years (27% under Medicaid expansion). Women with and women without HIV differed in their proportions of visits at which no coverage (14% vs. 19%; p
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- 2022
10. How Does Poverty Stigma Affect Depression Symptoms for Women Living with HIV? Longitudinal Mediating and Moderating Mechanisms
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Turan, Bulent, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wilson, Tracey E., Tien, Phyllis C., Wingood, Gina, Neilands, Torsten B., Johnson, Mallory O., Logie, Carmen H., Weiser, Sheri D., and Turan, Janet M.
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- 2023
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11. Patient Health Literacy and Communication with Providers Among Women Living with HIV: A Mixed Methods Study
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Budhwani, Henna, Gakumo, C Ann, Yigit, Ibrahim, Rice, Whitney S, Fletcher, Faith E, Whitfield, Samantha, Ross, Shericia, Konkle-Parker, Deborah J, Cohen, Mardge H, Wingood, Gina M, Metsch, Lisa R, Adimora, Adaora A, Taylor, Tonya N, Wilson, Tracey E, Weiser, Sheri D, Sosanya, Oluwakemi, Goparaju, Lakshmi, Gange, Stephen, Kempf, Mirjam-Colette, Turan, Bulent, and Turan, Janet M
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Health Services and Systems ,Public Health ,Health Sciences ,Clinical Research ,HIV/AIDS ,Behavioral and Social Science ,Health Services ,7.1 Individual care needs ,Management of diseases and conditions ,8.1 Organisation and delivery of services ,Health and social care services research ,Infection ,Generic health relevance ,Good Health and Well Being ,Anti-Retroviral Agents ,Communication ,Female ,HIV Infections ,Health Literacy ,Humans ,Trust ,United States ,Health communication ,Health literacy ,HIV ,African American ,Latina ,Public Health and Health Services ,Social Work ,Public health - Abstract
In this mixed-methods study, we examine the relationship between provider communication and patient health literacy on HIV continuum of care outcomes among women living with HIV in the United States. We thematically coded qualitative data from focus groups and interviews (N = 92) and conducted mediation analyses with quantitative survey data (N = 1455) collected from Women's Interagency HIV Study participants. Four qualitative themes related to provider communication emerged: importance of respect and non-verbal cues; providers' expressions of condescension and judgement; patient health literacy; and unclear, insufficient provider communication resulting in diminished trust. Quantitative mediation analyses suggest that higher health literacy is associated with higher perceived patient-provider interaction quality, which in turn is associated with higher levels of trust in HIV providers, improved antiretroviral medication adherence, and reduced missed clinical visits. Findings indicate that enhancing provider communication and bolstering patient health literacy could have a positive impact on the HIV continuum of care.
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- 2022
12. Bias in Online Recruitment and Retention of Racial and Ethnic Minority Men Who Have Sex With Men
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Sullivan, Patrick S, Khosropour, Christine M, Luisi, Nicole, Amsden, Matthew, Coggia, Tom, Wingood, Gina M, and DiClemente, Ralph J
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Computer applications to medicine. Medical informatics ,R858-859.7 ,Public aspects of medicine ,RA1-1270 - Abstract
BackgroundThe Internet has become an increasingly popular venue for men who have sex with men (MSM) to meet potential sex partners. Given this rapid increase in online sex-seeking among MSM, Internet-based interventions represent an important HIV (human immunodeficiency virus) prevention strategy. Unfortunately, black and Hispanic MSM, who are disproportionately impacted by the HIV epidemic in the United States, have been underrepresented in online research studies. ObjectiveOur objective was to examine and quantify factors associated with underrecruitment and underretention of MSM of color in an online HIV behavioral risk research study of MSM recruited from an online social networking site. MethodsInternet-using MSM were recruited through banner advertisements on MySpace.com targeted at men who reported in their MySpace profile their age as at least 18 and their sexual orientation as gay, bisexual, or unsure. Multivariable logistic regression models were used to estimate the odds stratified by race and ethnicity of the MySpace user clicking through the banner advertisement. To characterize survey retention, Kaplan-Meier survival curves and multivariable Cox proportional hazards models identified factors associated with survey dropout. ResultsOver 30,000 MySpace users clicked on the study banner advertisements (click-through rate of 0.37%, or 30,599 clicks from 8,257,271 impressions). Black (0.36% or 6474 clicks from 1,785,088 impressions) and Hispanic (0.35% or 8873 clicks from 2,510,434 impressions) MySpace users had a lower click-through rate compared with white (0.48% or 6995 clicks from 1,464,262 impressions) MySpace users. However, black men had increased odds of click-through for advertisements displaying a black model versus a white model (adjusted odds ratio [OR] = 1.83, 95% confidence interval [CI] 1.72 - 1.95), and Hispanic participants had increased odds of click-through when shown an advertisement displaying an Asian model versus a white model (adjusted OR = 1.70, 95% CI 1.62 - 1.79). Of the 9005 men who consented to participate, 6258 (69%) completed the entire survey. Among participants reporting only male sex partners, black non-Hispanic and Hispanic participants were significantly more likely to drop out of the survey relative to white non-Hispanic participants (hazard ratio [HR] = 1.6, 95% CI 1.4 - 1.8 and HR = 1.3, 95% CI 1.1 - 1.4, respectively). Men with a college-level of education were more likely to complete the survey than those with a high-school level of education (HR = 0.8, 95% CI 0.7 - 0.9), while men who self-identified as heterosexual were more likely to drop out of the survey compared with men who self-identified as gay (HR = 2.1, 95% CI 1.1 - 3.7). ConclusionsThis analysis identified several factors associated with recruitment and retention of MSM in an online survey. Differential click-through rates and increased survey dropout by MSM of color indicate that methods to recruit and retain black and Hispanic MSM in Internet-based research studies are paramount. Although targeting banner advertisements to MSM of color by changing the racial/ethnic composition of the advertisements may increase click-through, decreasing attrition of these study participants once they are engaged in the survey remains a challenge.
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- 2011
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13. Examining the Relationships Between Experienced and Anticipated Stigma in Health Care Settings, Patient–Provider Race Concordance, and Trust in Providers Among Women Living with HIV
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Budhwani, Henna, Yigit, Ibrahim, Ofotokun, Igho, Konkle-Parker, Deborah J, Cohen, Mardge H, Wingood, Gina M, Metsch, Lisa R, Adimora, Adaora A, Taylor, Tonya N, Wilson, Tracey E, Weiser, Sheri D, Kempf, Mirjam-Colette, Sosanya, Oluwakemi, Gange, Stephen, Kassaye, Seble, Turan, Bulent, and Turan, Janet M
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Health Services and Systems ,Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Health Services ,HIV/AIDS ,Clinical Research ,Infection ,Good Health and Well Being ,Anti-Retroviral Agents ,Female ,HIV Infections ,Humans ,Medication Adherence ,Social Stigma ,Trust ,HIV ,health equity ,race ,women living with HIV ,moderation analysis ,WIHS ,Public Health and Health Services ,Virology ,Clinical sciences ,Public health - Abstract
Stigma in health care settings can have negative consequences on women living with HIV, such as increasing the likelihood of missed visits and reducing trust in their clinical providers. Informed by prior stigma research and considering knowledge gaps related to the effect of patient-provider race concordance, we conducted this study to assess if patient-provider race concordance moderates the expected association between HIV-related stigma in health care settings and patients' trust in their providers. Moderation analyses were conducted using Women's Interagency HIV Study data (N = 931). We found significant main effects for patient-provider race concordance. Higher experienced stigma was associated with lower trust in providers in all patient-provider race combinations [White-White: B = -0.89, standard error (SE) = 0.14, p = 0.000, 95% confidence interval, CI (-1.161 to -0.624); Black patient-White provider: B = -0.19, SE = 0.06, p = 0.003, 95% CI (-0.309 to -0.062); and Black-Black: B = -0.30, SE = 0.14, p = 0.037, 95% CI (-0.575 to -0.017)]. Higher anticipated stigma was also associated with lower trust in providers [White-White: B = -0.42, SE = 0.07, p = 0.000, 95% CI (-0.552 to -0.289); Black patient-White provider: B = -0.17, SE = 0.03, p = 0.000, 95% CI (-0.232 to -0.106); and Black-Black: B = -0.18, SE = 0.06, p = 0.002, 95% CI (-0.293 to -0.066)]. Significant interaction effects indicated that the negative associations between experienced and anticipated HIV-related stigma and trust in providers were stronger for the White-White combination compared with the others. Thus, we found that significant relationships between HIV-related experienced and anticipated stigma in health care settings and trust in providers exist and that these associations vary across different patient-provider race combinations. Given that reduced trust in providers is associated with antiretroviral medication nonadherence and higher rates of missed clinical visits, interventions to address HIV-related stigma in health care settings may improve continuum of care outcomes.
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- 2021
14. Quality of care for Black and Latina women living with HIV in the U.S.: a qualitative study
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Rice, Whitney S, Fletcher, Faith E, Akingbade, Busola, Kan, Mary, Whitfield, Samantha, Ross, Shericia, Gakumo, C Ann, Ofotokun, Igho, Konkle-Parker, Deborah J, Cohen, Mardge H, Wingood, Gina M, Pence, Brian W, Adimora, Adaora A, Taylor, Tonya N, Wilson, Tracey E, Weiser, Sheri D, Kempf, Mirjam-Colette, Turan, Bulent, and Turan, Janet M
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Health Services and Systems ,Public Health ,Health Sciences ,Clinical Research ,Clinical Trials and Supportive Activities ,Behavioral and Social Science ,Health Services ,Health and social care services research ,8.1 Organisation and delivery of services ,Generic health relevance ,Infection ,Good Health and Well Being ,Adult ,Black or African American ,Attitude ,Attitude of Health Personnel ,Consumer Behavior ,Female ,Focus Groups ,HIV Infections ,Health Equity ,Hispanic or Latino ,Humans ,Middle Aged ,Midwestern United States ,New England ,Patient Participation ,Patient Safety ,Qualitative Research ,Quality of Health Care ,Southeastern United States ,Women's Health ,Quality of health care ,Patient satisfaction ,Women living with HIV ,Engagement in care ,HIV ,AIDS ,Qualitative ,African American ,Black ,Hispanic ,HIV/AIDS ,Public Health and Health Services ,Sociology ,Health services and systems ,Public health ,Policy and administration - Abstract
BackgroundEnding the HIV epidemic requires that women living with HIV (WLWH) have access to structurally competent HIV-related and other health care. WLWH may not regularly engage in care due to inadequate quality; however, women's perspectives on the quality of care they receive are understudied.MethodsWe conducted 12 focus groups and three in-depth interviews with Black (90%) and Latina (11%) WLWH enrolled in the Women's Interagency HIV Study in Atlanta, GA, Birmingham, AL, Brooklyn, NY, Chapel Hill, NC, Chicago, IL, and Jackson, MS from November 2017 to May 2018 (n = 92). We used a semi-structured format to facilitate discussions about satisfaction and dissatisfaction with health care engagement experiences, and suggestions for improvement, which were audio-recorded, transcribed, and coded using thematic analysis.ResultsThemes emerged related to women's health care satisfaction or dissatisfaction at the provider, clinic, and systems levels and across Institute of Medicine-defined quality of care domains (effectiveness, efficiency, equity, patient-centeredness, safety and timeliness). Women's degree of care satisfaction was driven by: 1) knowledge-based care resulting in desired outcomes (effectiveness); 2) coordination, continuity and necessity of care (efficiency); 3) perceived disparities in care (equity); 4) care delivery characterized by compassion, nonjudgment, accommodation, and autonomous decision-making (patient-centeredness); 5) attention to avoiding side effects and over-medicalization (safety); and 6) limited wait time (timeliness).ConclusionsQuality of care represents a key changeable lever affecting engage in care among WLWH. The communities most proximally affected by HIV should be key stakeholders in HIV-related quality assurance. Findings highlight aspects of the health care experience valued by WLWH, and potential participatory, patient-driven avenues for improvement.
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- 2020
15. Resilience and HIV Treatment Outcomes Among Women Living with HIV in the United States: A Mixed-Methods Analysis
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Fletcher, Faith E, Sherwood, Nicholas R, Rice, Whitney S, Yigit, Ibrahim, Ross, Shericia N, Wilson, Tracey E, Weiser, Sheri D, Johnson, Mallory O, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wingood, Gina, Turan, Janet M, and Turan, Bulent
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Prevention ,Mental Health ,Depression ,Mental Illness ,Minority Health ,HIV/AIDS ,Behavioral and Social Science ,Women's Health ,Clinical Research ,Infectious Diseases ,Substance Misuse ,Brain Disorders ,Social Determinants of Health ,Health Disparities ,Sexually Transmitted Infections ,Good Health and Well Being ,Adaptation ,Psychological ,Adult ,Anxiety ,Depressive Disorder ,Discrimination ,Psychological ,Female ,HIV Infections ,Humans ,Medication Adherence ,Minority Groups ,Resilience ,Psychological ,Social Stigma ,Substance-Related Disorders ,Treatment Outcome ,United States ,HIV ,resilience ,women living with HIV ,mixed methods ,HIV outcomes ,Public Health and Health Services ,Virology ,Clinical sciences ,Public health - Abstract
Resilience is defined as the ability and process to transform adversity into opportunities for growth and adaptation. Resilience may be especially important for people living with HIV (PLWH), who are susceptible to anxiety and depressive disorders, which are commonly linked to risk behaviors (i.e., alcohol and drug abuse), poor adherence to medical regimens, increased risk of morbidity and mortality, and related stigma and discrimination. To date, few studies have examined the impact of resilience on health-related behaviors and outcomes among PLWH, particularly among minority women living with HIV (WLWH) who are dealing with multiple stressors impacting their health. This study used a convergent parallel mixed-methods design to collect, analyze, and integrate qualitative and quantitative data from a subsample of WLWH enrolled in the Women's Interagency HIV Study (WIHS). The aims of the study were to (1) qualitatively examine the resilience perspectives of 76 marginalized WLWH, and; (2) quantitatively assess the associations of resilience with HIV health outcomes-adherence to antiretroviral therapy and viral suppression-in the context of differing levels of internalized HIV-related stigma and depressive symptoms (n = 420). Findings from this mixed-methods study suggest that resilience is an important resource that can aid WLWH in coping constructively with adversity by capitalizing on intrapersonal traits and states, interpersonal and institutional resources, and spiritual and/or religious practices. Given the complex medical and social needs of marginalized WLWH, intervention strategies should focus on mitigating psychosocial burdens of stigma and depression, in addition to building resilience.
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- 2020
16. Longitudinal assessment of abnormal Papanicolaou test rates among women with HIV.
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Massad, Leslie S, Xie, Xianhong, Minkoff, Howard, Kassaye, Seble, Karim, Roksana, Darragh, Teresa M, Golub, Elizabeth T, Adimora, Adaora, Wingood, Gina, Fischl, Margaret, Konkle-Parker, Deborah, and Strickler, Howard D
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Reproductive Medicine ,Biomedical and Clinical Sciences ,HIV/AIDS ,Prevention ,Clinical Research ,Infectious Diseases ,Aetiology ,2.4 Surveillance and distribution ,Adult ,Colposcopy ,Comorbidity ,Female ,HIV Infections ,Humans ,Logistic Models ,Longitudinal Studies ,Middle Aged ,Multivariate Analysis ,Papanicolaou Test ,Papillomavirus Infections ,Prevalence ,Prospective Studies ,Risk Factors ,United States ,Uterine Cervical Neoplasms ,Vaginal Smears ,Uterine Cervical Dysplasia ,HIV infection in women ,Papanicolaou test ,Women's Interagency HIV Study ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Virology ,Biomedical and clinical sciences ,Health sciences - Abstract
ObjectiveTo describe longitudinal changes in the prevalence of abnormal Papanicolau testing among women living with HIV.DesignProspective cohort study with sequential enrollment subcohorts.MethodsFour waves of enrollment occurred in the Women's Interagency HIV Study, the US women's HIV cohort (1994-1995, 2001-2002, 2011-2012, 2013-2015). Pap testing was done at intake, with colposcopy prescribed for any abnormality. Rates of abnormal Pap test results (atypical squamous cells of uncertain significance or worse) and cervical intraepithelial neoplasia grade 2 (CIN2) or worse were calculated. Logistic regression models assessed changes in prevalence across cohorts after controlling for severity of HIV disease and other risk factors for abnormal Pap tests.ResultsThe unadjusted prevalence of any Pap abnormality was 679/1769 (38%) in the original cohort, 195/684 (29%) in the 2001-2002 cohort, 46/231 (20%) in the 2011-2012 cohort, and 71/449 (16%) in the 2013-2015 cohort. In multivariable analysis, compared with risk in the 1994-1995 cohort, the adjusted risk in the 2001-2002 cohort was 0.79 (95% CI 0.59-1.05), in the 2011-2012 cohort was 0.67 (95% CI 0.43-1.04), and in the 2013-2015 cohort was 0.41 (95% CI 0.27-0.62) with P for trend less than 0.0001.ConclusionRates of abnormal cytology among women with HIV have fallen during the past two decades.
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- 2020
17. An Exploration of Geographic Access to Substance Use Treatment Programs and Violence Against Women
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St. Vil, Noelle M., primary, Haley, Danielle F., additional, Montgomery, Brooke, additional, Williams, Michael, additional, Watson, Lakeshia, additional, Zhang, Shuaiqi, additional, and Wingood, Gina M., additional
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- 2024
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18. Poverty stigma is associated with suboptimal HIV care and treatment outcomes among women living with HIV in the U.S.
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Leddy, Anna M, Turan, Janet M, Johnson, Mallory O, Neilands, Torsten B, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wingood, Gina, Tien, Phyllis C, Wilson, Tracey E, Logie, Carmen H, Weiser, Sheri D, and Turan, Bulent
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Infectious Diseases ,Behavioral and Social Science ,Health Disparities ,Sexually Transmitted Infections ,HIV/AIDS ,Clinical Research ,Prevention ,Infection ,Adult ,Anti-Retroviral Agents ,CD4 Lymphocyte Count ,Cross-Sectional Studies ,Drug Utilization ,Female ,HIV Infections ,Humans ,Middle Aged ,Poverty ,Prospective Studies ,Social Stigma ,Sustained Virologic Response ,Treatment Outcome ,United States ,Viral Load ,HIV care and treatment ,poverty stigma ,women living with HIV ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Virology ,Biomedical and clinical sciences ,Health sciences - Abstract
ObjectiveTo examine whether experienced poverty stigma is associated with worse HIV care and treatment outcomes.DesignWe analyzed cross-sectional data from 433 women living with HIV enrolled in the Women's Adherence and Visit Engagement substudy of the Women's Interagency HIV Study.MethodsExposure was experienced poverty stigma, measured using the Perceived Stigma of Poverty Scale. Outcomes were viral suppression, CD4 cell count at least 350 cells/μl, and attending all HIV care visits in the past 6 months. Multivariable logistic regression models adjusted for income, age, race/ethnicity, education, substance use, months taking antiretroviral therapy (ART), number of antiretroviral pills in ART regimen, unstable housing, relationship status, and exchanging sex for money, drugs, or shelter. We also explored whether self-reported at least 95% ART adherence mediated the relationship between poverty stigma and viral suppression and CD4 cell count at least 350 cells/μl.ResultsExperienced poverty stigma was associated with lower adjusted odds of viral suppression [adjusted odds ratio (aOR) 0.76; 95% confidence interval (CI) 0.61-0.96], CD4 cell count at least 350 cells/μl (aOR 0.69; 95% CI 0.52-0.91), and attending all HIV care visits (aOR 0.73; 95% CI: 0.54-0.98). Exploratory mediation analysis suggests that at least 95% ART adherence significantly mediates the relationship between experienced poverty stigma and viral suppression and CD4 cell count at least 350 cells/μl.ConclusionLongitudinal research should assess these relationships over time. Findings support interventions and policies that seek to reduce poverty stigma among people living with HIV.
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- 2019
19. Neighborhood Racial Diversity, Socioeconomic Status, and Perceptions of HIV-Related Discrimination and Internalized HIV Stigma Among Women Living with HIV in the United States
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Crockett, Kaylee B, Edmonds, Andrew, Johnson, Mallory O, Neilands, Torsten B, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wingood, Gina, Tien, Phyllis C, Cohen, Mardge, Wilson, Tracey E, Logie, Carmen H, Sosanya, Oluwakemi, Plankey, Michael, Golub, Elizabeth, Adimora, Adaora A, Parish, Carrigan, Weiser, Sheri D, Turan, Janet M, and Turan, Bulent
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Public Health ,Health Sciences ,Women's Health ,Clinical Research ,Basic Behavioral and Social Science ,Behavioral and Social Science ,Pediatric ,Mental Health ,Infectious Diseases ,Health Disparities ,Prevention ,Social Determinants of Health ,HIV/AIDS ,Sexually Transmitted Infections ,Adult ,Aged ,Anti-HIV Agents ,Cross-Sectional Studies ,Discrimination ,Psychological ,Female ,Geographic Mapping ,HIV Infections ,Humans ,Male ,Middle Aged ,Race Factors ,Residence Characteristics ,Social Class ,Social Isolation ,Social Stigma ,United States ,geocoding ,racial diversity ,HIV ,internalized stigma ,discrimination ,women ,Public Health and Health Services ,Virology ,Clinical sciences ,Public health - Abstract
Relationships that traverse sociodemographic categories may improve community attitudes toward marginalized groups and potentially protect members of those groups from stigma and discrimination. The present study evaluated whether internalized HIV stigma and perceived HIV-related discrimination in health care settings differ based on individual- and neighborhood-level characteristics of women living with HIV (WLHIV). We also sought to extend previous conceptual and empirical work to explore whether perceived HIV-related discrimination mediated the association between neighborhood racial diversity and internalized HIV stigma. A total of 1256 WLHIV in the Women's Interagency HIV Study (WIHS) attending 10 sites in metropolitan areas across the United States completed measures of internalized HIV stigma and perceived HIV-related discrimination in health care settings. Participants also provided residential information that was geocoded into Federal Information Processing Standard (FIPS) codes and linked with census-tract level indicators. In cross-sectional analyses, greater neighborhood racial diversity was associated with less internalized HIV stigma and less perceived HIV-related discrimination regardless of individual race. Neighborhood median income was positively associated with internalized HIV stigma and perceived discrimination, while individual income was negatively associated with perceptions of stigma and discrimination. In an exploratory mediation analysis, neighborhood racial diversity had a significant indirect effect on internalized HIV stigma through perceived HIV-related discrimination. An indirect effect between neighborhood income and internalized stigma was not supported. These findings suggest that greater neighborhood racial diversity may lessen HIV stigma processes at the individual level and that HIV stigma-reduction interventions may be most needed in communities that lack racial diversity.
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- 2019
20. A Mixed Methods Study of Anticipated and Experienced Stigma in Health Care Settings Among Women Living with HIV in the United States
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Rice, Whitney S, Turan, Bulent, Fletcher, Faith E, Nápoles, Tessa M, Walcott, Melonie, Batchelder, Abigail, Kempf, Mirjam-Colette, Konkle-Parker, Deborah J, Wilson, Tracey E, Tien, Phyllis C, Wingood, Gina M, Neilands, Torsten B, Johnson, Mallory O, Weiser, Sheri D, and Turan, Janet M
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Health Services and Systems ,Public Health ,Health Sciences ,Behavioral and Social Science ,Prevention ,Sexually Transmitted Infections ,HIV/AIDS ,Mental Health ,Women's Health ,Infectious Diseases ,Clinical Research ,7.1 Individual care needs ,Management of diseases and conditions ,Infection ,Good Health and Well Being ,Adaptation ,Psychological ,Aged ,Anti-Retroviral Agents ,Depression ,Fear ,Female ,HIV Infections ,Humans ,Interviews as Topic ,Medication Adherence ,Middle Aged ,Patient Compliance ,Qualitative Research ,Social Stigma ,Surveys and Questionnaires ,United States ,Young Adult ,HIV ,AIDS ,antiretroviral therapy ,mixed methods ,adherence ,stigma ,mental health ,Public Health and Health Services ,Virology ,Clinical sciences ,Public health - Abstract
Among places where people living with HIV experience and anticipate HIV-related stigma, stigma in health care settings may be particularly harmful. Utilizing an exploratory sequential mixed methods approach, we conducted interviews (n = 76) and questionnaires (N = 460) with older adult women living with HIV enrolled in the Women's Interagency HIV Study in Birmingham, AL; Jackson, MS; Atlanta, GA; and San Francisco, CA. Interviews addressed facilitators and barriers to HIV treatment adherence, including HIV-related stigma. Qualitative data were coded using thematic analysis. Questionnaires assessed self-reported antiretroviral therapy (ART) adherence and experienced and anticipated HIV-related stigma from various sources (i.e., health care personnel, family, partner, and community). Covariate-adjusted logistic regression analyses examined total and mediated effects of stigma on ART adherence. Interviewees described fears and experiences of stigma in health care settings; including privacy violations, disrespect for patient autonomy, and reproductive coercion; and how these influenced their adherence to HIV treatment recommendations. Experienced and anticipated HIV-related stigma in health care settings were associated with suboptimal (or
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- 2019
21. Longitudinal association between internalized HIV stigma and antiretroviral therapy adherence for women living with HIV
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Turan, Bulent, Rice, Whitney S, Crockett, Kaylee B, Johnson, Mallory, Neilands, Torsten B, Ross, Shericia N, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wingood, Gina, Tien, Phyllis C, Cohen, Mardge, Wilson, Tracey E, Logie, Carmen H, Sosanya, Oluwakemi, Plankey, Michael, Golub, Elizabeth, Adimora, Adaora A, Parish, Carrigan, Weiser, Sheri D, and Turan, Janet M
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Mental Health ,Pediatric ,HIV/AIDS ,Clinical Research ,Depression ,Behavioral and Social Science ,Adult ,Anti-Retroviral Agents ,Female ,HIV Infections ,Humans ,Longitudinal Studies ,Medication Adherence ,Middle Aged ,Social Stigma ,United States ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Virology ,Biomedical and clinical sciences ,Health sciences - Abstract
ObjectiveWe investigated whether internalized HIV-related stigma predicts adherence to antiretroviral therapy (ART) longitudinally in women living with HIV in the United States, and whether depression symptoms mediate the relationship between internalized stigma and suboptimal ART adherence.DesignObservational longitudinal study utilizing data from the Women's Interagency HIV Study cohort.MethodsA measure of internalized HIV-related stigma was added to the battery of Women's Interagency HIV Study measures in 2013. For current analyses, participants' first assessment of internalized HIV-related stigma and assessments of other variables at that time were used as baseline measures (Time one or T1, visit occurring in 2013/14), with outcomes measured approximately 2 years later (T3, 2015/16; n = 914). A measure of depression symptoms, assessed approximately 18 months after the baseline (T2, 2014/15), was used in mediation analyses (n = 862).ResultsHigher internalized HIV-related stigma at T1 predicted lower odds of optimal ART adherence at T3 (adjusted odds ratio = 0.61, P = 0.001, 95% confidence interval [0.45, 0.82]). Results were similar when ART adherence at T1 was added as a control variable. Mediation analysis revealed a significant indirect effect of internalized HIV stigma at T1 on ART adherence at T3 through depression symptoms at T2 (while controlling for depression symptoms and ART adherence at T1; B = -0.05, SE = 0.03, 95% confidence interval [-0.11, -0.006]).ConclusionThese results provide strong longitudinal support for the hypothesis that internalized HIV-related stigma results in suboptimal ART adherence in a large sample of women living with HIV in the United States, working through the pathway of increased depression symptoms.
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- 2019
22. Buffering Internalization of HIV Stigma
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Turan, Bulent, Crockett, Kaylee B, Buyukcan-Tetik, Asuman, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wilson, Tracey E, Tien, Phyllis C, Wingood, Gina, Neilands, Torsten B, Johnson, Mallory O, Weiser, Sheri D, and Turan, Janet M
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Epidemiology ,Public Health ,Health Sciences ,HIV/AIDS ,Brain Disorders ,Prevention ,Behavioral and Social Science ,Social Determinants of Health ,Infectious Diseases ,Mental Illness ,Sexually Transmitted Infections ,Mental Health ,Clinical Research ,Good Health and Well Being ,Adult ,Aged ,Anti-HIV Agents ,Anti-Retroviral Agents ,Depression ,Female ,HIV Infections ,Humans ,Male ,Medication Adherence ,Middle Aged ,Social Stigma ,Virus Internalization ,Young Adult ,negative evaluation ,attachment ,resilience ,HIV ,stigma ,adherence ,Clinical Sciences ,Public Health and Health Services ,Virology ,Clinical sciences ,Public health - Abstract
BackgroundOne mechanism through which social stigma of HIV affects health outcomes for people living with HIV (PLWH) is through internalization of stigma. However, this transformation of social stigma in the community into internalized stigma may not be of the same magnitude for all PLWH. We examined the moderating effects of 3 personality traits-fear of negative social evaluation, attachment-related anxiety, and dispositional resilience-in transforming perceived stigma in the community into internalized stigma. Furthermore, we investigated downstream effects of these moderated associations on depressive symptoms and antiretroviral treatment (ART) adherence.Setting/methodsIn study 1, data from 203 PLWH in the Southeast United States were analyzed controlling for age, sex, education, race, and time on ART. In study 2, data from 453 women in a multisite study were analyzed controlling for age, education, race, time on ART, and substance use.ResultsIn both studies, fear of negative evaluation and attachment-related anxiety moderated the effect of perceived HIV stigma in the community on internalized HIV stigma: People higher on those moderating variables had stronger associations between perceived stigma in the community and internalized stigma. In study 2, resilience was assessed and also moderated the effect of perceived HIV stigma in the community on internalized stigma. In moderated mediation models, fear of negative evaluation, attachment-related anxiety, and resilience moderated the indirect effect of perceived HIV stigma in the community on ART adherence and depression through internalized stigma.ConclusionsInterventions to assuage internalization of HIV stigma should focus on bolstering attachment-related security, social competence, and resilience.
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- 2019
23. INTERNALIZED HIV STIGMA PREDICTS PAIN AMONG WOMEN LIVING WITH HIV IN THE UNITED STATES: THE MEDIATING ROLE OF DEPRESSIVE SYMPTOMS
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Crockett, Kaylee B, Esensoy, Turkan Alinea, Johnson, Mallory, Neilands, Torsten, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wingood, Gina, Tien, Phyllis, Cohen, Mardge, Wilson, Tracey, Logie, Carmen, Sosanya, Oluwakemi, Plankey, Michael, Golub, Elizabeth, Adimora, Adaora, Parish, Carrigan, Weiser, Sheri, Turan, Janet, and Turan, Bulent
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Public Health and Health Services ,Social Work ,Public Health ,Public health - Abstract
Pain is common in women with HIV, though little research has focused on psychosocial experiences contributing to pain in this population. In the present study we examined whether internalized HIV stigma predicts pain, and whether depressive symptoms mediate this relationship among women with HIV. Data were drawn from the Women’s Interagency HIV Study (WIHS), for 1,364 women with HIV who completed three study visits between 2015 and 2016. We used a sequential longitudinal design to assess the relationship between internalized HIV stigma at time 1 on pain at time 3 through depressive symptoms at time 2. Analyses revealed internalized HIV stigma was prospectively associated with greater pain, B = 5.30, 95% CI [2.84, 7.60]. The indirect effect through depressive symptoms supported mediation, B = 3.68, 95% CI [2.69, 4.79]. Depression is a modifiable risk factor that can be addressed to improve pain prevention and intervention for women with HIV.
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- 2019
24. Internal Working Models of Attachment Relationships and HIV Outcomes Among Women Living With HIV
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Turan, Bulent, Crockett, Kaylee B, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wilson, Tracey E, Tien, Phyllis C, Wingood, Gina, Neilands, Torsten B, Johnson, Mallory O, Weiser, Sheri D, and Turan, Janet M
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Mental Health ,HIV/AIDS ,Infectious Diseases ,Clinical Research ,Sexually Transmitted Infections ,Behavioral and Social Science ,7.1 Individual care needs ,Management of diseases and conditions ,Adult ,Aged ,Aged ,80 and over ,Anti-HIV Agents ,CD4 Lymphocyte Count ,Cross-Sectional Studies ,Female ,HIV Infections ,Humans ,Medication Adherence ,Middle Aged ,Models ,Psychological ,Object Attachment ,Patient Compliance ,Sexual Partners ,Viral Load ,attachment ,HIV ,psychosocial ,insecurity ,avoidance ,anxiety ,Clinical Sciences ,Public Health and Health Services ,Virology ,Clinical sciences ,Epidemiology ,Public health - Abstract
BackgroundTreatment adherence and viral suppression remain suboptimal in the United States. Attachment insecurity may be one understudied factor affecting adherence. According to attachment theory, people develop generalized internal working models of interpersonal relationships, which shape their perceptions of the availability of others at times of stress and how they handle stressors as an individual. Two dimensions of attachment insecurity are attachment-related avoidance (avoidance of intimacy with others and avoidance of negative emotions) and attachment-related anxiety (feeling unable to deal with stressors without others' help). For people living with chronic stressful health conditions that require life-long self-management, attachment-related avoidance and attachment-related anxiety may diminish the ability to cope with stressors as an individual leading to negative health outcomes.MethodsWe examined cross-sectional associations of the 2 attachment-related insecurity dimensions with antiretroviral treatment (ART) adherence, HIV visit adherence, CD4 cell counts, and viral suppression. Survey and clinical data from 453 women living with HIV in 4 US cities were analyzed controlling for age, education, income, time on ART, illicit drug use, and race.ResultsAttachment-related avoidance was the only unique predictor of suboptimal ART adherence, viral failure, and low CD4 count, and attachment-related anxiety was the only unique predictor of missed HIV care visits. These effects were over and above the effects of all covariates. ART adherence mediated the association of attachment-related avoidance with both viral failure and low CD4 counts.ConclusionsInterventions may need to focus on the vulnerable subpopulation with high attachment insecurity and incorporate existing strategies that address insecure attachment models.
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- 2019
25. Feasibility, acceptability, and short-term impact of a brief sexually transmitted infection intervention targeting U.S. Military personnel and family members
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Kunz, Anjali, Moodley, Amber, Colby, Donn J., Soltis, Michele, Robb-McGrath, Wesley, Fairchok, Alexandra, Faestel, Paul, Jungels, Amanda, Bender, Alexis A., Kamau, Edwin, Wingood, Gina, DiClemente, Ralph, and Scott, Paul
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- 2022
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26. Mutual capacity building model for adaptation (MCB-MA): a seven-step procedure bidirectional learning and support during intervention adaptation.
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Jack, Helen E., Giusto, Ali, Rose, Alexandra L., Mwamuka, Rukudzo, Brown, Imani, Bere, Tarisai, Verhey, Ruth, Wainberg, Milton, Myers, Bronwyn, Kohrt, Brandon, Wingood, Gina, DiClemente, Ralph, and Magidson, Jessica F.
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- 2024
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27. Perceptions of intersectional stigma among diverse women living with HIV in the United States
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Rice, Whitney S, Logie, Carmen H, Napoles, Tessa M, Walcott, Melonie, Batchelder, Abigail W, Kempf, Mirjam-Colette, Wingood, Gina M, Konkle-Parker, Deborah J, Turan, Bulent, Wilson, Tracey E, Johnson, Mallory O, Weiser, Sheri D, and Turan, Janet M
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Public Health ,Health Sciences ,Human Society ,Basic Behavioral and Social Science ,Health Disparities ,Women's Health ,Social Determinants of Health ,Infectious Diseases ,HIV/AIDS ,Prevention ,Minority Health ,Behavioral and Social Science ,Sexually Transmitted Infections ,Mental Health ,Clinical Research ,Good Health and Well Being ,Reduced Inequalities ,Gender Equality ,Adult ,Aged ,Female ,HIV Infections ,Healthcare Disparities ,Humans ,Income ,Middle Aged ,Perception ,Qualitative Research ,Racism ,Sexism ,Social Marginalization ,Social Stigma ,United States ,Stigma ,Discrimination ,Intersectionality ,HIV ,Women ,Qualitative research ,Health disparities ,Medical and Health Sciences ,Economics ,Studies in Human Society ,Health sciences ,Human society - Abstract
Attitudes and behavior that devalue individuals based upon their HIV status (HIV-related stigma) are barriers to HIV prevention, treatment, and wellbeing among women living with HIV. Other coexisting forms of stigma (e.g., racism, sexism) may worsen the effects of HIV-related stigma, and may contribute to persistent racial and gendered disparities in HIV prevention and treatment. Few studies examine perceptions of intersectional stigma among women living with HIV. From June to December 2015, we conducted 76 qualitative interviews with diverse women living with HIV from varied socioeconomic backgrounds enrolled in the Women's Interagency HIV Study (WIHS) in Birmingham, Alabama; Jackson, Mississippi; Atlanta, Georgia; and San Francisco, California. Interview guides facilitated discussions around stigma and discrimination involving multiple interrelated identities. Interviews were audio-recorded, transcribed verbatim, and coded using thematic analysis. Interviewees shared perceptions of various forms of stigma and discrimination, most commonly related to their gender, race, and income level, but also incarceration histories and weight. Women perceived these interrelated forms of social marginalization as coming from multiple sources: their communities, interpersonal interactions, and within systems and structures. Our findings highlight the complexity of social processes of marginalization, which profoundly shape life experiences, opportunities, and healthcare access and uptake among women living with HIV. This study highlights the need for public health strategies to consider community, interpersonal, and structural dimensions across intersecting, interdependent identities to promote the wellbeing among women living with HIV and to reduce social structural and health disparities.
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- 2018
28. Healthcare Empowerment and HIV Viral Control: Mediating Roles of Adherence and Retention in Care
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Wilson, Tracey E, Kay, Emma Sophia, Turan, Bulent, Johnson, Mallory O, Kempf, Mirjam-Colette, Turan, Janet M, Cohen, Mardge H, Adimora, Adaora A, Pereyra, Margaret, Golub, Elizabeth T, Goparaju, Lakshmi, Murchison, Lynn, Wingood, Gina M, and Metsch, Lisa R
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Medical Microbiology ,Health Services and Systems ,Biomedical and Clinical Sciences ,Health Sciences ,Clinical Research ,Health Services ,Sexually Transmitted Infections ,Substance Misuse ,Behavioral and Social Science ,HIV/AIDS ,Infectious Diseases ,Prevention ,7.1 Individual care needs ,Management of diseases and conditions ,Infection ,Good Health and Well Being ,Ambulatory Care Facilities ,Anti-HIV Agents ,Female ,HIV Infections ,Humans ,Longitudinal Studies ,Medication Adherence ,Middle Aged ,Power ,Psychological ,Prospective Studies ,Retention in Care ,Viral Load ,Medical and Health Sciences ,Education ,Public Health ,Biomedical and clinical sciences ,Health sciences - Abstract
IntroductionThis study assessed longitudinal relationships between patient healthcare empowerment, engagement in care, and viral control in the Women's Interagency HIV Study, a prospective cohort study of U.S. women living with HIV.MethodsFrom April 2014 to March 2016, four consecutive 6-month visits were analyzed among 973 women to assess the impact of Time 1 healthcare empowerment variables (Tolerance for Uncertainty and the state of Informed Collaboration Committed Engagement) on Time 2 reports of ≥95% HIV medication adherence and not missing an HIV primary care appointment since last visit; and on HIV RNA viral control across Times 3 and 4, controlling for illicit drug use, heavy drinking, depression symptoms, age, and income. Data were analyzed in 2017.ResultsAdherence of ≥95% was reported by 83% of women, 90% reported not missing an appointment since the last study visit, and 80% were categorized as having viral control. Logistic regression analyses revealed a significant association between the Informed Collaboration Committed Engagement subscale and viral control, controlling for model covariates (AOR=1.08, p=0.04), but not for the Tolerance for Uncertainty subscale and viral control (AOR=0.99, p=0.68). In separate mediation analyses, the indirect effect of Informed Collaboration Committed Engagement on viral control through adherence (β=0.04, SE=0.02, 95% CI=0.02, 0.08), and the indirect effect of Informed Collaboration Committed Engagement on viral control through retention (β=0.01, SE=0.008, 95% CI=0.001, 0.030) were significant. Mediation analyses with Tolerance for Uncertainty as the predictor did not yield significant indirect effects.ConclusionsThe Informed Collaboration Committed Engagement healthcare empowerment component is a promising pathway through which to promote engagement in care among women living with HIV.
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- 2018
29. Correlates of Unmet Need for Modern Contraception Among Reproductive-Aged Women Involved in New York City Criminal Legal Systems
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Slavin, Melissa N., primary, West, Brooke S., additional, Schreiber-Gregory, Deanna, additional, Levin, Frances R., additional, Wingood, Gina, additional, Martino, Steve, additional, Tzilos Wernette, Golfo, additional, Black, Chermaine, additional, and El-Bassel, Nabila, additional
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- 2024
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30. Correction: Mobile Phone Technology for Preventing HIV and Related Youth Health Problems, Sexual Health, Mental Health, and Substance Use Problems in Southwest Uganda (Youth Health SMS)- Protocol for a Pilot Randomized Controlled Trial
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Kreniske, Philip, primary, Namuyaba, Olive Imelda, additional, Kasumba, Robert, additional, Namatovu, Phionah, additional, Ssewamala, Fred, additional, Wingood, Gina, additional, Wei, Ying, additional, Ybarra, Michele L, additional, Oloya, Charlotte, additional, Tindyebwa, Costella, additional, Ntulo, Christina, additional, Mujune, Vincent, additional, Chang, Larry W, additional, Mellins, Claude A, additional, and Santelli, John S, additional
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- 2024
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31. Psychosocial Mechanisms of Self-rated Successful Aging with HIV: A Structural Equation Model
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Rubtsova, Anna A., Wingood, Gina, Ofotokun, Ighovwerha, Mehta, C. Christina, Gustafson, Deborah, Vance, David E., Sharma, Anjali, Adimora, Adaora A., and Holstad, Marcia
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- 2021
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32. Evidence for HIV transmission across key populations: a longitudinal analysis of HIV and AIDS rates among Black people who inject drugs and Black heterosexuals in 84 large U.S. metropolitan areas, 2008–2016
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Ibragimov, Umedjon, Beane, Stephanie, Friedman, Samuel R., Tempalski, Barbara, Williams, Leslie D., McKetta, Sarah, Adimora, Adaora A., Wingood, Gina M., Stall, Ron D., Hall, H. Irene, Johnson, Anna Satcher, and Cooper, Hannah L.F.
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- 2021
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33. Correction: Mobile Phone Technology for Preventing HIV and Related Youth Health Problems, Sexual Health, Mental Health, and Substance Use Problems in Southwest Uganda (Youth Health SMS)- Protocol for a Pilot Randomized Controlled Trial (Preprint)
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Kreniske, Philip, primary, Namuyaba, Olive Imelda, additional, Kasumba, Robert, additional, Namatovu, Phionah, additional, Ssewamala, Fred, additional, Wingood, Gina, additional, Wei, Ying, additional, Ybarra, Michele L, additional, Oloya, Charlotte, additional, Tindyebwa, Costella, additional, Ntulo, Christina, additional, Mujune, Vincent, additional, Chang, Larry W, additional, Mellins, Claude A, additional, and Santelli, John S, additional
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- 2023
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34. BARRIERS TO SUCCESSFUL AGING AMONG OLDER WOMEN AND MEN LIVING WITH HIV
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Rubtsova, Anna, primary, Taylor, Tonya, additional, Wingood, Gina, additional, Ofotokun, Ighovwerha, additional, Gustafson, Deborah, additional, Vance, David, additional, Jeste, Dilip, additional, and Moore, David, additional
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- 2023
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35. Internalized HIV Stigma and Pain among Women with HIV in the United States: The Mediating Role of Depressive Symptoms
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Crockett, Kaylee B., Esensoy, T. Alinea, Johnson, Mallory O., Neilands, Torsten B., Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wingood, Gina, Tien, Phyllis C., Cohen, Mardge, Wilson, Tracey E., Logie, Carmen H., Sosanya, Oluwakemi, Plankey, Michael, Golub, Elizabeth, Adimora, Adaora A., Parish, Carrigan, D. Weiser, Sheri, Turan, Janet M., and Turan, Bulent
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- 2020
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36. Socioeconomic, Psychosocial, and Clinical Factors Associated With Employment in Women With HIV in the United States: A Correlational Study
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Wise, Jenni M., Azuero, Andres, Konkle-Parker, Deborah, Raper, James L., Heaton, Karen, Vance, David E., Adimora, Adaora A., Wingood, Gina, Golub, Elizabeth, Levin, Susanna, Wilson, Tracey E., Merenstein, Daniel, Yelin, Ed, Weber, Kathleen M., Fischl, Margaret, and Kempf, Mirjam-Colette
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- 2022
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37. A Qualitative Exploration of Religion, Gender Norms, and Sexual Decision-Making within African American Faith-Based Communities
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Piper, Kaitlin N., Fuller, Tyler J., Ayers, Amy A., Lambert, Danielle N., Sales, Jessica M., and Wingood, Gina M.
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- 2020
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38. The Relationship Between Discrimination and Missed HIV Care Appointments Among Women Living with HIV
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Cressman, Andrew E., Howe, Chanelle J., Nunn, Amy S., Adimora, Adaora A., Williams, David R., Kempf, Mirjam-Colette, Chandran, Aruna, Wentz, Eryka L., Blackstock, Oni J., Kassaye, Seble G., Cohen, Jennifer, Cohen, Mardge H., Wingood, Gina M., Metsch, Lisa R., and Wilson, Tracey E.
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- 2020
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39. Relationship of Racial Residential Segregation to Newly Diagnosed Cases of HIV among Black Heterosexuals in US Metropolitan Areas, 2008–2015
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Ibragimov, Umedjon, Beane, Stephanie, Adimora, Adaora A., Friedman, Samuel R., Williams, Leslie, Tempalski, Barbara, Stall, Ron, Wingood, Gina, Hall, H. Irene, Johnson, Anna Satcher, and Cooper, Hannah L. F.
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- 2019
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40. State minimum wage laws and newly diagnosed cases of HIV among heterosexual black residents of US metropolitan areas
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Cloud, David H., Beane, Stephanie, Adimora, Adaora, Friedman, Samuel R., Jefferson, Kevin, Hall, H. Irene, Hatzenbuehler, Mark, Johnson, Anna Satcher, Stall, Ron, Tempalski, Barbara, Wingood, Gina M., Wise, Akilah, Komro, Kelli, and Cooper, Hannah L.F.
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- 2019
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41. Associations between county-level voter turnout, county-level felony voter disenfranchisement, and sexually transmitted infections among women in the Southern United States
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Haley, Danielle F., Edmonds, Andrew, Schoenbach, Victor J., Ramirez, Catalina, Hickson, DeMarc A., Wingood, Gina M., Bolivar, Hector, Golub, Elizabeth, and Adimora, Adaora A.
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- 2019
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42. HIV and symptoms of depression are independently associated with impaired glucocorticoid signaling
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Bekhbat, Mandakh, Mehta, C. Christina, Kelly, Sean D., Vester, Aimee, Ofotokun, Ighovwerha, Felger, Jennifer, Wingood, Gina, Anastos, Kathryn, Gustafson, Deborah R., Kassaye, Seble, Milam, Joel, Aouizerat, Bradley, Weber, Kathleen, Golub, Elizabeth T., Moore, Michelle Floris, Diclemente, Ralph, Fischl, Margaret, Kempf, Mirjam-Colette, Maki, Pauline, and Neigh, Gretchen N.
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- 2018
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43. Neighborhood Health Care Access and Sexually Transmitted Infections Among Women in the Southern United States : A Cross-Sectional Multilevel Analysis
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Haley, Danielle F., Edmonds, Andrew, Belenky, Nadya, Hickson, DeMarc A., Ramirez, Catalina, Wingood, Gina M., Bolivar, Hector, Golub, Elizabeth, and Adimora, Adaora A.
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- 2018
44. Policy and Human Rights Implications of Women’s Poverty and Vulnerability in the USA
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Vermund, Sten H., El-Sadr, Wafaa, del Rio, Carlos, Wingood, Gina M., O'Leary, Ann, editor, and Frew, Paula M., editor
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- 2017
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45. Perceptions of intersectional stigma among diverse women living with HIV in the United States
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Rice, Whitney S., Logie, Carmen H., Napoles, Tessa M., Walcott, Melonie, Batchelder, Abigail W., Kempf, Mirjam-Colette, Wingood, Gina M., Konkle-Parker, Deborah J., Turan, Bulent, Wilson, Tracey E., Johnson, Mallory O., Weiser, Sheri D., and Turan, Janet M.
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- 2018
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46. Linking Depressive Symptoms to Viral Non-suppression among Women with HIV through Adherence Self-Efficacy and ART Adherence
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Crockett, Kaylee B., Entler, Kristin J., Brodie, Emilee, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wilson, Tracey E., Tien, Phyllis C., Wingood, Gina, Neilands, Torsten B., Johnson, Mallory O., Weiser, Sheri D., Turan, Janet M., and Turan, Bulent
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- 2020
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47. Mortality under plausible interventions on antiretroviral treatment and depression in HIV-infected women: an application of the parametric g-formula
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Saag, Michael, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Ofotokun, Ighovwerha, Wingood, Gina, Anastos, Kathryn, Minkoff, Howard, Gustafson, Deborah, Cohen, Mardge, French, Audrey, Young, Mary, Kassaye, Seble, Fischl, Margaret, Metsch, Lisa, Adimora, Adaora, Greenblatt, Ruth, Aouizerat, Bradley, Tien, Phyllis, Gange, Stephen, Golub, Elizabeth, Milam, Joel, Lesko, Catherine R., Todd, Jonathan V., Cole, Stephen R., Edmonds, Andrew, Pence, Brian W., Edwards, Jessie K., Mack, Wendy J., Bacchetti, Peter, Rubtsova, Anna, Gange, Stephen J., and Adimora, Adaora A.
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- 2017
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48. The Four Cs of HIV Prevention with African Americans: Crisis, Condoms, Culture, and Community
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Williams, John K., Wyatt, Gail E., and Wingood, Gina
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Medicine & Public Health ,Medicine/Public Health, general ,HIV prevention ,African American ,Culture ,Condoms - Abstract
HIV/AIDS continues to be a devastating epidemic with African American communities carrying the brunt of the impact. Despite extensive biobehavioral research, current strategies have not resulted in significantly decreasing HIV/AIDS cases among African Americans. The next generation of HIV prevention and risk reduction interventions must move beyond basic sex education and condom use and availability. Successful interventions targeting African Americans must optimize strategies that integrate socio-cultural factors and address institutional and historical barriers that hinder or support HIV risk reduction behaviors. Community-based participatory research to decrease the HIV/AIDS disparity by building community capacity and infrastructure and advocating for and distributing equitably, power and resources, must be promoted. Recommendations for paradigm shifts in using innovative theories and conceptual frameworks and for training researchers, clinicians, grant and journal reviewers, and community members are made so that culturally congruent interventions may be tested and implemented at the community level.
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- 2010
49. National Institute of Mental Health Multisite Eban HIV/STD Prevention Intervention for African American HIV Serodiscordant Couples: A Cluster Randomized Trial
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El-Bassel, Nabila, Jemmott, John B, Landis, J Richard, Pequegnat, Willo, Wingood, Gina M, Wyatt, Gail E, and Bellamy, Scarlett L
- Subjects
Clinical Research ,HIV/AIDS ,Pediatric AIDS ,Clinical Trials and Supportive Activities ,Behavioral and Social Science ,Infectious Diseases ,Pediatric ,Sexually Transmitted Infections ,Prevention ,Infection ,Good Health and Well Being ,Adult ,Black or African American ,Condoms ,Female ,HIV ,HIV Infections ,Health Promotion ,Humans ,Male ,National Institute of Mental Health (U.S.) ,Research Design ,Risk Reduction Behavior ,Risk-Taking ,Sexual Behavior ,Sexual Partners ,Sexually Transmitted Diseases ,United States ,NIMH Multisite HIV/STD Prevention Trial for African American Couples Group ,Clinical Sciences ,Opthalmology and Optometry ,Public Health and Health Services - Abstract
BackgroundHuman immunodeficiency virus (HIV) has disproportionately affected African Americans. Couple-level interventions may be a promising intervention strategy.MethodsTo determine if a behavioral intervention can reduce HIV/sexually transmitted disease (STD) risk behaviors among African American HIV serodiscordant couples, a cluster randomized controlled trial (Eban) was conducted in Atlanta, Georgia; Los Angeles, California; New York, New York; and Philadelphia, Pennsylvania; with African American HIV serodiscordant heterosexual couples who were eligible if both partners were at least 18 years old and reported unprotected intercourse in the previous 90 days and awareness of each other's serostatus. One thousand seventy participants were enrolled (mean age, 43 years; 40% of male participants were HIV positive). Couples were randomized to 1 of 2 interventions: couple-focused Eban HIV/STD risk-reduction intervention or attention-matched individual-focused health promotion comparison. The primary outcomes were the proportion of condom-protected intercourse acts and cumulative incidence of STDs (chlamydia, gonorrhea, or trichomonas). Data were collected preintervention and postintervention, and at 6- and 12-month follow-ups.ResultsData were analyzed for 535 randomized couples: 260 in the intervention group and 275 in the comparison group; 81.9% were retained at the 12-month follow-up. Generalized estimating equation analyses revealed that the proportion of condom-protected intercourse acts was larger among couples in the intervention group (0.77) than in the comparison group (0.47; risk ratio, 1.24; 95% confidence interval [CI], 1.09 to 1.41; P = .006) when adjusted for the baseline criterion measure. The adjusted percentage of couples using condoms consistently was higher in the intervention group (63%) than in the comparison group (48%; risk ratio, 1.45; 95% CI, 1.24 to 1.70; P < .001). The adjusted mean number of (log)unprotected intercourse acts was lower in the intervention group than in the comparison group (mean difference, -1.52; 95% CI, -2.07 to -0.98; P < .001). The cumulative STD incidence over the 12-month follow-up did not differ between couples in the intervention and comparison groups. The overall HIV seroconversion at the 12-month follow-up was 5 (2 in the intervention group, 3 in the comparison group) of 535 individuals, which translates to 935 per 100,000 population.ConclusionTo our knowledge, this is the first randomized controlled intervention trial to report significant reductions in HIV/STD risk behaviors among African American HIV serodiscordant couples.Trial registrationclinicaltrials.gov Identifier: NCT00644163.
- Published
- 2010
50. Mobile Phone Technology for Preventing HIV and Related Youth Health Problems, Sexual Health, Mental Health, and Substance Use Problems in Southwest Uganda (Youth Health SMS): Protocol for a Pilot Randomized Controlled Trial (Preprint)
- Author
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Kreniske, Philip, primary, Namuyaba, Olive Imelda, additional, Kasumba, Robert, additional, Namatovu, Phionah, additional, Ssewamala, Fred, additional, Wingood, Gina, additional, Wei, Ying, additional, Ybarra, Michele L, additional, Oloya, Charlotte, additional, Tindyebwa, Costella, additional, Ntulo, Christina, additional, Mujune, Vincent, additional, Chang, Larry W, additional, Mellins, Claude A, additional, and Santelli, John S, additional
- Published
- 2023
- Full Text
- View/download PDF
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