The four Cs of HIV prevention with African Americans: crisis, condoms, culture, and community

John K Williams, Gail E Wyatt, Gina Wingood, John K Williams, Gail E Wyatt, Gina Wingood

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.

References

    1. Centers for Disease Control and Prevention Updates to racial/ethnic disparities in diagnosis of HIV/AIDS—33 states, 2001–2005. MMWR. 2007;56:189–193.
    1. U.S. Census Bureau: Quick facts, 2000. Available at . Accessed May 2010.
    1. Centers for Disease Control and Prevention: Compendium of HIV prevention interventions with evidence of effectiveness. US Department of Health and Human Services 2001. Available at . Accessed May 2010.
    1. Coates TJ, Stall RD, Catania JA, Kegeles SM. Behavioral factors in the spread of HIV infection. AIDS. 1988;2(Suppl 1):239–246. doi: 10.1097/00002030-198800001-00037.
    1. Des Jarlais DC, Friedman SR. HIV infection among intravenous drug users: epidemiology and risk reductions. AIDS. 1987;1:67–76.
    1. Centers for Disease Control and Prevention: HIV/AIDS surveillance report, 2006. US Department of Health and Human Services 2008, 18.
    1. Calsyn DA, Meinecke C, Saxon AJ, Stanton V. Risk reduction in sexual behavior: a condom giveaway program in a drug abuse treatment clinic. Am J Public Health. 1992;82:1536–1538. doi: 10.2105/AJPH.82.11.1536.
    1. Prochaska JO. What causes people to change from unhealthy to health enhancing behavior? Cancer Prevention. 1990;1:38–42.
    1. Pequegnat W, Stover E. Behavioral prevention is today’s AIDS vaccine! AIDS. 2000;14:51–57. doi: 10.1097/00002030-200001070-00006.
    1. Darbes L, Crepaz N, Lyles C, et al. The efficacy of behavioral interventions in reducing HIV risk behaviors and incident sexually transmitted diseases in heterosexual African Americans. AIDS. 2008;22:1177–1194. doi: 10.1097/QAD.0b013e3282ff624e.
    1. Veniegas R, Kao UY, Rosales R. Adapting HIV prevention evidence-based interventions in practice settings: an interview study. Implement Sci. 2009;4:76–84. doi: 10.1186/1748-5908-4-76.
    1. Wyatt GE. Enhancing cultural and contextual intervention strategies to reduce HIV/AIDS among African Americans. Am J Public Health. 2009;99:1941–1945. doi: 10.2105/AJPH.2008.152181.
    1. Airhihenbuwa C, DiClemente R, Wingood G, Lowe A. HIV/AIDS education and prevention among African Americans: a focus on culture. AIDS Educ Prev. 1992;4:267–276.
    1. Wingood G, Hunter-Gamble D, DiClemente R. A pilot study of sexual communication and negotiation among young African American women: implications for HIV prevention. J Black Psychol. 1993;19:190–203. doi: 10.1177/00957984930192008.
    1. Wyatt GE. The sociocultural relevance of sex research: challenges for the 1990’s and beyond. Am Psychol. 1994;49:748–754. doi: 10.1037/0003-066X.49.8.748.
    1. Wilson BDM, Miller RL. Examining strategies for culturally grounded HIV prevention: a review. AIDS Educ Prev. 2003;15:184–202. doi: 10.1521/aeap.15.3.184.23838.
    1. El-Bassel N, Jemmott JB, Wingood GM, et al.: NIMH multisite HIV/STD prevention trial for African American couples group: a cluster randomized trial. Arch Intern Med 2010, In press.
    1. Adimora AA, Schoenbach VJ, Martinson FEA, et al. Heterosexually transmitted HIV infection among African Americans in North Carolina. J Acquired Immune Defic Syndr. 2006;41:616–623. doi: 10.1097/01.qai.0000191382.62070.a5.
    1. Adimora AA, Schoenbach VJ, Doherty I. Concurrent sexual partnerships among men in the United States. Am J Public Health. 2007;97:2230–2237. doi: 10.2105/AJPH.2006.099069.
    1. Williams JK, Harawa NT, Ramamurthi HC, Manago C. Learning from successful interventions: a culturally congruent HIV risk-reduction intervention for African American men who have sex with men and women. Am J Public Health. 2009;99:1008–1012. doi: 10.2105/AJPH.2008.140558.
    1. Marín G, Burhansstipanov L, Connell CM, et al. A research agenda for health education among underserved populations. Health Educ Q. 1995;22:346–363.
    1. Kreuter MW, Lukwago SN, Bucholtz RD, et al. Achieving cultural appropriateness in health promotion programs: targeted and tailored approaches. Health Educ Behav. 2003;30:133–146. doi: 10.1177/1090198102251021.
    1. Pasick RJ. Socioeconomic and cultural factors in the development and use of theory. In: Glanz K, Lewis FM, Rimer BK, editors. Health Behavior and Health Education: Theory, Research, and Practice. San Francisco: Jossey-Bass Inc; 1997. pp. 425–440.
    1. Johnson RL, Roter D, Powe NR, Cooper LA. Patient race/ethnicity and quality of patient-physician communication during medical visits. Am J Public Health. 2004;94:2084–2090. doi: 10.2105/AJPH.94.12.2084.
    1. Kreuter MW, McClure S. The role of culture in health communication. Ann Rev Public Health. 2004;25:439–455. doi: 10.1146/annurev.publhealth.25.101802.123000.
    1. Wyatt GE, Williams JK, Meyers HF. African American sexuality and HIV/AIDS: recommendations for future research. J Natl Med Assoc. 2008;100:44–51.
    1. Airhihenbuwa CO. Health promotion and disease prevention strategies for African Americans: a conceptual model. In: Braithwaite RL, Taylor SE, editors. Health Issues in the Black Community. San Francisco: Jossey-Bass; 1992. pp. 267–280.
    1. Peterson JL, Bakeman R. AIDS and IV drug use among ethnic minorities. J Drug Issues. 1989;19:27–37.
    1. DiClemente RJ, Wingood GM. Randomized controlled trial of an HIV sexual risk-reduction intervention for young African-American women. JAMA. 1995;274:1271–1276. doi: 10.1001/jama.274.16.1271.
    1. Herek G, Gillis JR, Glunt EK, et al. Culturally sensitive AIDS educational videos for African American audiences: effects of source, message, receiver, and context. Am J Community Psychol. 1998;26:705–744. doi: 10.1023/A:1022157914906.
    1. Wyatt GE, Guthrie D, Notgrass CM. Differential effects of women’s child sexual abuse and subsequent sexual revictimization. J Consult Clin Psychol. 1992;60:167–173. doi: 10.1037/0022-006X.60.2.167.
    1. Freire P. Pedagogy of the Oppressed. New York, NY: Continuum; 1983.
    1. James SA, Hartnett SA, Kalsbeek WD. John Henryism and blood pressure differences among black men. J Behav Med. 1983;6:259–278. doi: 10.1007/BF01315113.
    1. Geronimus AT, Hicken M, Keene D, Bound J. “Weathering” and age patterns of allostatic load scores among Blacks and Whites in the United States. Am J Public Health. 2006;96:826–833. doi: 10.2105/AJPH.2004.060749.
    1. Parrish DD, Kent CK. Access to care issues for African American communities: implications for STD disparities. Sex Transm Dis. 2008;35:S19–S22.
    1. Heslin KC, Andersen RM, Ettner SL, Cunningham WE. Racial and ethnic disparities in access to physicians with HIV-related expertise: findings from a nationally representative study. J Gen Intern Med. 2005;20:283–289. doi: 10.1111/j.1525-1497.2005.40109.x.
    1. National Institutes of Health: Dissemination, implementation, and operational research for HIV prevention interventions (R01). PA-08-166. Available at . Accessed May 2010.
    1. Taylor J, Moore C, Lezin N, et al. Making Proud Choices Adaptation Kit. Santa Cruz, CA: ETR Associates; 2010.
    1. Wingood GM, DiClemente RJ. The ADAPT-ITT model: a model for adapting evidence-based HIV interventions. J Acquir Immune Defic Syndr. 2008;47(Suppl):S40–S46. doi: 10.1097/QAI.0b013e3181605df1.
    1. Greenhalgh T, Robert G, MacFarlane F, et al. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004;82:581–629. doi: 10.1111/j.0887-378X.2004.00325.x.
    1. Proctor EK, Landsverk J, Aarons G, et al. Implementation research in mental health services: an emerging science with conceptual, methodological, and training challenges. Adm Policy Ment Health. 2009;36:24–34. doi: 10.1007/s10488-008-0197-4.
    1. Gandelman A, DeSantis L, Rietmeijer C. Assessing community needs and agency capacity—an integral part of implementing effective evidence-based interventions. AIDS Educ Prev. 2006;18(Suppl A):32–43. doi: 10.1521/aeap.2006.18.supp.32.
    1. Viswanathan M, Ammerman A, Eng E, et al.: Community-based Participatory Research: Assessing the Evidence. Evidence Report/Technology Assessment No. 99 (Prepared by RTI-University of North Carolina Evidence-based Practice Center under Contract No. 290-02-0016). AHRQ Publication No. 04-E022. Rockville, MD: Agency for Healthcare Research and Quality; August 2004.
    1. Lehman WE, Greener JM, Simpson DD. Assessing organizational readiness for change. J Subst Abuse Treat. 2002;22:197–209. doi: 10.1016/S0740-5472(02)00233-7.
    1. Rosenthal MS, Lucas GI, Tinney B, et al. Teaching community-based participatory research principles to physicians enrolled in a health services research fellowship. Acad Med. 2009;84:478–484. doi: 10.1097/ACM.0b013e31819a89e8.
    1. Jones L, Wells K. Strategies for academic and clinician engagement in community-participatory partnered research. JAMA. 2007;297:407–410. doi: 10.1001/jama.297.4.407.
    1. Friedman SR, Cooper HLF, Osborne AH. Structural and social contexts of HIV risk among African Americans. Am J Public Health. 2009;99:1002–1008. doi: 10.2105/AJPH.2008.140327.
    1. Wyatt GE, Williams JK, Henderson T, Sumner L. On the outside looking in: promoting U.S. African American investigator-initiated HIV/AIDS research. Am J Public Health. 2009;99(S1):S48–S53. doi: 10.2105/AJPH.2007.131094.
    1. Forsyth AD, Stoff DM. Key issues in mentoring in HIV prevention and mental health for new investigators from underrepresented racial/ethnic groups. Am J Public Health. 2009;99(S1):S87–S91. doi: 10.2105/AJPH.2008.155085.
    1. National Advisory Mental Health Council Workgroup on Racial/Ethnic Diversity in Research Training and Health Disparities Research: An investment in America’s future: racial/ethnic diversity in mental health research careers. Rockville, MD: National Institute of Mental Health; 2001.

Source: PubMed

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