Suchergebnisse

Purpose: The incidence of new HIV infections is disproportionately high among Black men who have sex with men (BMSM) in Mississippi. Community-based organizations received funding through the ACCELERATE! initiative to implement interventions aimed at increasing BMSM's access to HIV prevention, treatment and care interventions. Approach: We conducted a mixed methods evaluation of the ACCELERATE! initiative to assess its impact. We also explored factors that act as barriers to and facilitators of BMSM's engagement in HIV prevention interventions. Setting: Interviews were conducted between July 2018 and February 2020. Participants: Thirty-six BMSM and 13 non-grantee key informants who worked in the field of HIV in Mississippi participated. Method: The qualitative data from the interview transcripts was analyzed using an iterative, inductive coding process. Results: We identified 10 key recommendations that were most common across all participants and that were aligned with UNAIDS Global AIDS Strategy strategic priorities. Several recommendations address the reduction of HIV- and LGBT-stigma. Two of the most common recommendations were to increase representation of the target population in health promotion program leadership and to include HIV with other Black health issues in community-based health education programs rather than singling it out. Another recommendation called for programs aimed at addressing underlying factors associated with HIV-risk behaviors, such as mental illness. Conclusion: Our results indicate that HIV education interventions in the Deep South need to be revitalized to enhance their reach and effectiveness.

Purpose.The study uses qualitative research to gain a better understanding of what occurs after low-income women receive an abnormal breast screening and the factors that influence their decisions and behavior. A heuristic model is presented for understanding this complexity.Design.Qualitative research methods used to elicited social and cultural themes related to breast cancer screening follow-up.Setting.Individual telephone interviews were conducted with 16 women with confirmed breast anomaly.Participants.Low-income women screened through a national breast cancer early detection program.Method.Grounded theory using selective coding was employed to elicit factors that influenced the understanding and follow-up of an abnormal breast screening result. Interviews were digitally recorded, transcribed, and uploaded into NVivo 8, a qualitative management and analysis software package.Results.For women (16, or 72% of case management referrals) below 250% of the poverty level, the impact of social and economic inequities creates a psychosocial context underlined by structural and cultural barriers to treatment that forecasts the mechanism that generates differences in health outcomes. The absence of insurance due to underemployment and unemployment and inadequate public infrastructure intensified emotional stress impacting participants' health decisions.Conclusion.The findings that emerged offer explanations of how consistent patterns of social injustice impact treatment decisions in a high-risk vulnerable population that have implications for health promotion research and systems-level program improvement and development.