Gentrification results in higher tax revenues, but also the displacement of longstanding residents. Housing insecurity has been associated with medication nonadherence among people with HIV; however, the existing literature does not assess neighborhood level variables (e.g., indicators of gentrification) in tandem with individual level variables to adequately assess the risk of displacement and its association with health outcomes. This study examines estimated displacement risk in relation to mental health symptoms, HIV medication adherence, and HIV viral load among Black women living with HIV (BWLWH). Baseline data was collected (2019–2020) among 151 Black women enrolled in a cohort study in Miami, FL on mental health symptoms, medication adherence, HIV viral load, and sociodemographic variables (e.g., income). We combine changes in zip code level data (2014–2019) on Black individuals, White individuals, bachelor’s degree, owner occupied house, median gross rent, and Airbnb fees (2015–2019) for apartment, condominium, and houses to assess estimated displacement risk (dichotomized [0, 1]). Spatial analyses and nonlinear regression models accounting for robust standard errors are used to assess estimated risk of displacement and its association with health outcomes. Results indicate that higher estimated risk of displacement is related to (a) higher depressive symptoms, (b) higher trauma exposure, (c) higher symptoms of post-traumatic stress disorder, and (d) lower medication adherence. Our novel findings reiterate the importance of future research examining indicators of gentrification that may impact the risk of displacement for BWLWH and ultimately their well-being and health outcomes.
Latino sexual minority men (LSMM) experience HIV health disparities and co-occurring intimate partner violence, depression, and substance use disparities that worsen HIV-related outcomes. One possibility for addressing these co-occurring health concerns among LSMM through a common intervention point could be strengthening LSMM’s romantic and sexual relationship skills. The purpose of this study was to assess the acceptability, appropriateness, feasibility, and preliminary outcomes of Hombre a Hombre (HaH), a culturally adapted relationship education program delivered to a group of LSMM (N = 16). Quantitative assessments indicated HaH was highly acceptable and appropriate (all rating above the “agree” anchor point). We explored intervention outcomes, which non-significantly shifted in the expected direction for relationship outcomes (e.g., sexual agreement self-efficacy) and minority stress/resilience outcomes (e.g., internalized homonegativity, community connectedness). Participants reported high engagement with biomedical prevention/treatment at all time points, limiting our ability to detect changes across time. Exit interview themes underscored the acceptability and appropriateness of HaH for LSMM, while also identifying opportunities to culturally adapt the program to a greater extent, refine the program’s structure, and support peer facilitators. Overall, this initial study suggests HaH’s promise for potential sexual health impacts on LSMM via theoretically linked constructs. The study also informed refinements that could enhance HaH’s impact a fully powered trial focused on LSMM with HIV acquisition or transmission risk. Clinical Trial Registry This study was registered with clinicaltrials.gov (NCT06056661) on September 20, 2023.
Injection drug use is a key risk factor for HIV among people who use drugs (PWUD). Recent reports suggest PWUD may be shifting from injection to non-injection routes, particularly for opioids, but long-term trends and patterns for stimulant use remain understudied. We analyzed seven serial cross-sectional surveys from the Seattle-area National HIV behavioral surveillance (NHBS) that recruited PWUD between 2005 and 2024. For heroin, fentanyl, methamphetamine, powder cocaine, and crack cocaine, respondents reported past-year injection and non-injection frequency and were classified into five ordinal consumption categories: exclusive injection, primary injection, equal injection and non-injection, primary non-injection, and exclusive non-injection. Trends across cycles were assessed using proportional odds logistic regression. Beginning in 2015 there was a progressive shift toward non-injection heroin use. By 2024, respondents who used heroin had 88
Self-efficacy (SE) is central to sexual health behavior change and may be important for pre-exposure prophylaxis (PrEP) adherence among men who have sex with men (MSM). This study examines factors associated with three PrEP self-efficacy domains: routine adherence (RA), medication management (MM), and overcoming psychosocial challenges (OPC). Three hundred U.S. MSM, who either initiated daily oral PrEP or reported anticipated adherence difficulties, and who all experienced at least one psychosocial syndemic condition, were recruited as part of a randomized controlled trial. Baseline assessments included PrEP SE and psychosocial, structural, and sociodemographic variables. Bayesian variable selection and multiple linear regression identified several predictors. Younger age (RA: b = 0.048, 95
The health and wellbeing of children and adolescents living with HIV (CALHIV) in resource-constrained settings relies heavily on informal caregivers, predominantly women. Sustainable solutions are needed to address the gendered caregiving burden. We examined the effectiveness of cash transfers plus gender-transformative economic empowerment workshops versus cash transfers alone on gender equity among informal caregivers of CALHIV in KwaZulu-Natal, South Africa. In a cluster randomized trial conducted between June 2023-July 2024, 273 women caregivers received either monthly cash transfers plus gender-transformative economic empowerment workshops (intervention) or monthly cash transfers alone (control) over 6 months. Gender equity was measured using the Sexual Relationship Power Scale (SRPS) and the Ideas about Gender Relations Scale (IGRS), scored on continua from 1 to 4 (SRPS) and 12–48 (IGRS) with higher scores indicating greater gender equity. Linear mixed-effects models compared effect sizes between groups, adjusting for baseline ART and partnership status. Baseline mean SRPS score was 3.07 [SD = 0.74] and 3.06 [SD = 0.75] among caregivers in the intervention and control arms, respectively; mean IGRS score was 37.1 [SD = 5.48] and 35.4 [SD = 4.57], respectively. At follow-up, SRPS scores increased by 0.27 (95
