Patricia Stevens - Academia.edu (original) (raw)

Papers by Patricia Stevens

Global Public Health, 2013

The gender inequalities that characterise intimate partner relationships in Malawi, a country wit... more The gender inequalities that characterise intimate partner relationships in Malawi, a country with one of the highest HIV prevalence rates in the world, arguably place marriage as an important risk factor for HIV infection among women, yet few studies detail the complex interactions of marriage and risk. In order to develop HIV-prevention interventions that have lasting impacts in such communities, we need a deeper understanding of the intricacies of women's lives, how and why they are involved in marital relationships, and the implications of these relationships for HIV transmission or prevention. This article describes how women understand marriage's effects on their lives and their HIV risks. Drawing from focus group discussions with 72 women attending antiretroviral clinics in Malawi, we explore why women enter marriage, what women's experiences are within marriage and how they leave spouses for other relationships. Based on their narratives, we describe women's lives after separation, abandonment or widowhood, and report their reflections on marriage after being married two or three times. We then review women's narratives in light of published work on HIV, and provide recommendations that would minimise the risks of HIV attendant on marriage.

Health Care For Women International, Oct 29, 2010

The narrative case analysis of HIV infection in a battered woman, taken from a qualitative study ... more The narrative case analysis of HIV infection in a battered woman, taken from a qualitative study of women's experiences living with HIV/AIDS, conveys unusual insights into the context of violence that surrounded this woman's exposure to HIV. In her narrative, she describes the complex web of abuse she lived with day-to-day and the road she travels with AIDS as a result. Her abuse perpetrator infected her with HIV, and the whole atmosphere of violence, annihilation of self-worth, and oppressive restrictions likely contributed to the late-stage identification and treatment of her HIV-related disease. The discussion explores how domestic violence may place battered women at increased risk of becoming HIV infected. Clinical recommendations suggest that efforts to stop the battering of women and to prevent the spread of HIV in women must be combined to offer effective protection for women.

Nursing Research and Practice, 2013

Journal of Clinical Nursing, 2007

International Journal of Men's Health, 2006

... Living with HIV/AIDS AARON G. BUSEH SHERYL T. KELBER JEANNE B. HEWITT PATRICIA E. STEVENS Uni... more ... Living with HIV/AIDS AARON G. BUSEH SHERYL T. KELBER JEANNE B. HEWITT PATRICIA E. STEVENS University of Wisconsin-Milwaukee CHANG GI PARK University of Illinois at Chicago ... In one multi-ethnic study, however, Portillo et al. ...

Clinical Nursing Research, 2001

Nine mothers of diabetic children participated in a qualitative study about the factors that infl... more Nine mothers of diabetic children participated in a qualitative study about the factors that influenced them to consent to have their children involved in clinical research. They were asked to describe how they made decisions about involving their children in research, what motivated them to keep their children in research once they were enrolled, and how they evaluated the clinical studies their children had been in. Results suggest that mothers engage in a personal calculus before making a choice to consent.

ABSTRACT In this study we focused on the health of women in poverty who had participated in the U... more ABSTRACT In this study we focused on the health of women in poverty who had participated in the U.S. welfare system. The current work-based welfare program, Temporary Assistance for Needy Families (TANF), presents community health and public health challenges that have been largely ignored. Aims: The study aim was to analyze assets and constraints impoverished, community dwelling women perceive in themselves and their environments, which influence their capacity to care for and support themselves and their children. Methods: This longitudinal study used a narrative interview design as the dominant research method. The setting was a large urban county in the Midwest, and participants were 41 women who were terminated from TANF after using up their 5-year lifetime limit of cash support. Instruments were a semi-structured interview guide, and the HANES General Well-Being Schedule. Participants were interviewed up to four times over the course of a year; 157 interviews were collected between 2007 and 2009. Interviews were transcribed verbatim, and entered into NVIVO software to facilitate data management. Coded data were analyzed using multi-stage narrative analysis. Results: Findings suggest 1) health deficits, marginalization, limited social supports, and socioeconomic instability put excessive burdens on impoverished families and limit their ability to self management, and 2) a measure of responsibility for failures lies with the social policy itself. Conclusions: The study provides policy makers and health care decision makers with information about the health impact of welfare reform policy, and suggests innovative nursing solutions that are health protective of low income women with children.

Qualitative Health Research, 2009

American Journal of Public Health, 2009

Issues in mental health nursing, 2016

This study describes the psychosocial distress experiences of HIV-positive women in Kenya. In-dep... more This study describes the psychosocial distress experiences of HIV-positive women in Kenya. In-depth narrative interviews were conducted three times over six months between 2009 and 2010 with 54 HIV-positive women living in Kenya to explore how the women perceived psychological distress and the steps they took to find support to cope with their HIV-positive diagnosis. Thematic analysis revealed that the women described psychological distress as: physical and emotional shock, worry, and hopelessness and suicidality. The women reported receiving support to cope through spiritual connections, family and friends, others coping with HIV/AIDS, and health care agencies. This study heightens awareness of the critical value of understanding culturally relevant mental health evaluations in a limited mental health access context.

Qualitative health research, Jan 28, 2015

A key source of resiliency within HIV-affected African American communities is informal social su... more A key source of resiliency within HIV-affected African American communities is informal social support. Data from dyadic conversations and focus groups were used to address the following research question: What are HIV-positive African Americans' social support experiences within their informal social networks in response to HIV-related problems? Circumstances that exacerbated HIV-related problems included others' fear of contagion, reticence to be involved, judgment and rejection, and disregard for privacy. Support from HIV-negative others buffered the impact of problems when others communicate interest, take the initiative to help, or make a long-term investment in their success. Support from other HIV-positive persons was helpful given the shared connection because of HIV, the opportunity to commiserate about what is mutually understood, and the fight for mutual survival. Based on these findings, we offer suggestions for future research and social network interventions ai...

International Journal of Health Promotion and Education, Sep 26, 2013

Early HIV testing is critical to prevention and timely treatment. Missed opportunities for HIV di... more Early HIV testing is critical to prevention and timely treatment. Missed opportunities for HIV diagnosis can result in unnecessary deaths at a time when access to antiretroviral treatment proves life saving. While HIV prevention and treatment research has increased, less research exists on women's experiences with HIV diagnosis, despite the fact that women are most affected. Insights from local women are critical in designing culturally meaningful interventions that thwart missed opportunities for early HIV diagnosis. The purpose of our study was to uncover steps women took to know their HIV diagnosis. Using narrative inquiry methodology informed by post-colonial feminism, we interviewed 40 HIV- positive women in Kenya. Five themes emerged related to uptake of HIV testing for women: (a) spouse's critical illness or death; (b) years of suffering from HIV-related symptoms; (c) sick children; (d) prenatal testing; and (e) personal desire to know one's HIV status. These findings centered on women experiences provide an important basis for health promotion interventions related to HIV prevention, earlier detection, and treatment.

Http Dx Doi Org 10 1300 J013v44n03_01, Oct 9, 2008

HIV stigma is widely regarded as a major obstacle to effective HIV prevention, risk reduction, te... more HIV stigma is widely regarded as a major obstacle to effective HIV prevention, risk reduction, testing, and treatment. Research is urgently needed to anticipate, understand, and combat HIV stigma in the African American cultural context because African Americans have the highest HIV incidence, HIV/AIDS prevalence, and HIV mortality. The purpose of this analysis was to explore African American women's narratives of living with HIV to understand how they experienced and responded to HIV stigma. Twenty-nine HIV-infected African American women participated in this longitudinal qualitative study. Each narrated her life since HIV diagnosis in ten open-ended interviews conducted over the course of two years. A multi-staged narrative analysis was used. HIV stigma, which these African American women experienced on multiple levels, manifested internally as existential despair, socially as shunning and callousness, and institutionally as disregard. While participants were constrained by this multi-layered hegemonic cultural negativity about HIV, they refused to be determined by it. Their stories demonstrate how they resisted stigma. Over time, by enlisting support, facing the illness, disclosing only at strategic times, redefining stigma as ignorance, and becoming advocates, they were able to challenge and oppose the shame and discredit that HIV infection had brought into their lives. The elements of stigma resistance described in this study may be starting points for designing participatory interventions for and with African American women living with HIV.

ABSTRACT Malawi bears one of the heaviest HIV burdens globally (10.6% adult prevalence). The pres... more ABSTRACT Malawi bears one of the heaviest HIV burdens globally (10.6% adult prevalence). The presence of sexually transmitted infections (STI) increases HIV transmission, making controlling the spread of STIs critical. In a non-equivalent control group effectiveness study (SAGE4Health), we examined how a structural microfinance, food security, and gender empowerment intervention may temper HIV vulnerability in Malawi. We assessed two self-report outcomes: (1) new STI symptoms (reporting one of six STI symptoms at 18-month or 36-month follow-up), (2) new STI diagnosis (clinician-diagnosed with either one of six STIs at 18-month or 36-month follow-up) in intervention participants (N=600) and control participants (N=300). We used Chi-Square tests to analyze the categorical variables and logistic regressions to examine the intervention effect on new STI symptoms and diagnoses. Compared to the control group, the intervention group was less likely (OR=.51, 95% CI=.33-.79) to report having new STI symptoms at 36-month, controlling for symptoms presented at 18-month. This holds true for intervention men and women compared to control. Although not statistically significant, participants in the intervention group reported a higher percentage of newly diagnosed STIs at 36-month than the control. Among six STIs assessed, syphilis was the most commonly reported STI diagnosis (prevalence 2.3%-5.3%). This combined structural intervention appears to have contributed to a decrease in newly presented STI symptoms. Coupled with the increase in new STI diagnoses, this could mean that the intervention contributed to an increase in STI testing and a decrease in undiagnosed STIs in the intervention group.

Nurs Res, 1995

In this feminist narrative study using in-depth interviews and focus groups, a racially and econo... more In this feminist narrative study using in-depth interviews and focus groups, a racially and economically diverse sample of 45 lesbians described their access to and experience with health care. The multistaged narrative analysis revealed structural and interpersonal conditions uniquely faced by lesbians in obtaining health care services. At the macrolevel, heterosexist structuring of health care delivery was obstructive to lesbians' health care seeking, health knowledge, and health behaviors. At the micro, or individual level, health care providers' heterosexual assumptions competed against potentially supportive interactions with lesbian clients.

Background: Enrollment of diverse participants in genetic/genomic studies is a formidable task. W... more Background: Enrollment of diverse participants in genetic/genomic studies is a formidable task. With advancement in genetic science, questions persist regarding equitable distributions of benefits from discoveries to all sub-populations. U.S. Black African immigrants/refugees, who bear disproportionate disease burden, participate at low rates. Participation of Black African immigrants/refugees in genetics initiatives is desired to move the science forward. Purpose: This study explores barriers and enablers of Black African immigrants/refugees towards participating in genetic studies and suggests implications for public health research, policy, and practice. Methods: As the second stage of a community-based participatory research mixed methods study, in-depth interviews were conducted with (n = 34) Black African immigrants/refugees exploring perceptions of genetic/genomic research, approaches for achieving equitable distribution of benefits in discoveries and strategies to promote su...

Cultural diversity & ethnic minority psychology, Jan 6, 2015

Social support is an important resource that has been associated with better mental and physical ... more Social support is an important resource that has been associated with better mental and physical health outcomes among HIV-positive people. However, researchers have not adequately explored how social support functions among HIV-positive African Americans. The purpose of the current study was to understand whether HIV-related support resources are associated with relational functioning and HIV-related problems among a sample of HIV-infected African American dyads. Exactly 34 HIV-infected (i.e., seroconcordant) dyads compromised of HIV-positive African American adults and their HIV-positive adult "informal supporters" from 3 Midwestern urban cities completed psychosocial questionnaires and a communication task. Using the actor-partner interdependence model, we analyzed dyadic data to determine whether there were actor and/or partner effects within dyadic relationships on measures of conflict and HIV-related problems, communication about these problems, and health symptoms. ...

Malawi bears one of the heaviest HIV burdens globally (10.6% adult prevalence). The presence of s... more Malawi bears one of the heaviest HIV burdens globally (10.6% adult prevalence). The presence of sexually transmitted infections (STI) increases HIV transmission, making controlling the spread of STIs critical. In a non-equivalent control group effectiveness study (SAGE4Health), we examined how a structural microfinance, food security, and gender empowerment intervention may temper HIV vulnerability in Malawi. We assessed two self-report outcomes: (1) new STI symptoms (reporting one of six STI symptoms at 18-month or 36-month follow-up), (2) new STI diagnosis (clinician-diagnosed with either one of six STIs at 18-month or 36-month follow-up) in intervention participants (N=600) and control participants (N=300). We used Chi-Square tests to analyze the categorical variables and logistic regressions to examine the intervention effect on new STI symptoms and diagnoses. Compared to the control group, the intervention group was less likely (OR=.51, 95% CI=.33-.79) to report having new STI ...

Background: Malawi has experienced widespread food insecurity and associated health problems due ... more Background: Malawi has experienced widespread food insecurity and associated health problems due to drought, depleted soil, reduced crop diversity, and poverty. We are conducting a controlled, quasi-experimental evaluation of a food security intervention implemented by CARE Malawi, which includes farmer field schools to teach sustainable agriculture techniques and a village based savings & loan (VSL) microfinance model to increase economic stability and opportunity. Methods: We examined responses from program participants (N=600) and controls (N=300) at baseline and 18 month follow up using detailed household surveys that assessed household food security, economic situation, and farming and food production practices. Results: At baseline, 71% of intervention households and 73% of controls had experienced food insecurity (≥ one month with insufficient food in the past year). At follow up, these rates decreased to 45% and 56% respectively (intervention effect: p Conclusions: While bot...

Background: Malawi has struggled with widespread food insecurity and associated health problems f... more Background: Malawi has struggled with widespread food insecurity and associated health problems for years due to drought, depleted soil, decreased food diversity, and poverty. Sustainable agriculture may offer a solution by diversifying the range of foods grown and rehabilitating soils, resulting in more stable food supplies and better nutrition. Methods: As part of a larger study, we conducted a random household survey (N=1001) in the Kasungu district of central Malawi, and assessed food security and use of a variety of sustainable agriculture techniques. Results: 762 households (76%) experienced at least one month of food insecurity in the past year (Median = 3 months); 239 households (24%) reported being food secure. Food secure households were more likely to use vetiver grass (for erosion management) (23% vs 13%, p Conclusions: Use of sustainable agriculture methods was associated with food security among smallholder agriculturalists in Malawi. Interventions to increase the use ...

Global Public Health, 2013

The gender inequalities that characterise intimate partner relationships in Malawi, a country wit... more The gender inequalities that characterise intimate partner relationships in Malawi, a country with one of the highest HIV prevalence rates in the world, arguably place marriage as an important risk factor for HIV infection among women, yet few studies detail the complex interactions of marriage and risk. In order to develop HIV-prevention interventions that have lasting impacts in such communities, we need a deeper understanding of the intricacies of women's lives, how and why they are involved in marital relationships, and the implications of these relationships for HIV transmission or prevention. This article describes how women understand marriage's effects on their lives and their HIV risks. Drawing from focus group discussions with 72 women attending antiretroviral clinics in Malawi, we explore why women enter marriage, what women's experiences are within marriage and how they leave spouses for other relationships. Based on their narratives, we describe women's lives after separation, abandonment or widowhood, and report their reflections on marriage after being married two or three times. We then review women's narratives in light of published work on HIV, and provide recommendations that would minimise the risks of HIV attendant on marriage.

Health Care For Women International, Oct 29, 2010

The narrative case analysis of HIV infection in a battered woman, taken from a qualitative study ... more The narrative case analysis of HIV infection in a battered woman, taken from a qualitative study of women's experiences living with HIV/AIDS, conveys unusual insights into the context of violence that surrounded this woman's exposure to HIV. In her narrative, she describes the complex web of abuse she lived with day-to-day and the road she travels with AIDS as a result. Her abuse perpetrator infected her with HIV, and the whole atmosphere of violence, annihilation of self-worth, and oppressive restrictions likely contributed to the late-stage identification and treatment of her HIV-related disease. The discussion explores how domestic violence may place battered women at increased risk of becoming HIV infected. Clinical recommendations suggest that efforts to stop the battering of women and to prevent the spread of HIV in women must be combined to offer effective protection for women.

Nursing Research and Practice, 2013

Journal of Clinical Nursing, 2007

International Journal of Men's Health, 2006

... Living with HIV/AIDS AARON G. BUSEH SHERYL T. KELBER JEANNE B. HEWITT PATRICIA E. STEVENS Uni... more ... Living with HIV/AIDS AARON G. BUSEH SHERYL T. KELBER JEANNE B. HEWITT PATRICIA E. STEVENS University of Wisconsin-Milwaukee CHANG GI PARK University of Illinois at Chicago ... In one multi-ethnic study, however, Portillo et al. ...

Clinical Nursing Research, 2001

Nine mothers of diabetic children participated in a qualitative study about the factors that infl... more Nine mothers of diabetic children participated in a qualitative study about the factors that influenced them to consent to have their children involved in clinical research. They were asked to describe how they made decisions about involving their children in research, what motivated them to keep their children in research once they were enrolled, and how they evaluated the clinical studies their children had been in. Results suggest that mothers engage in a personal calculus before making a choice to consent.

ABSTRACT In this study we focused on the health of women in poverty who had participated in the U... more ABSTRACT In this study we focused on the health of women in poverty who had participated in the U.S. welfare system. The current work-based welfare program, Temporary Assistance for Needy Families (TANF), presents community health and public health challenges that have been largely ignored. Aims: The study aim was to analyze assets and constraints impoverished, community dwelling women perceive in themselves and their environments, which influence their capacity to care for and support themselves and their children. Methods: This longitudinal study used a narrative interview design as the dominant research method. The setting was a large urban county in the Midwest, and participants were 41 women who were terminated from TANF after using up their 5-year lifetime limit of cash support. Instruments were a semi-structured interview guide, and the HANES General Well-Being Schedule. Participants were interviewed up to four times over the course of a year; 157 interviews were collected between 2007 and 2009. Interviews were transcribed verbatim, and entered into NVIVO software to facilitate data management. Coded data were analyzed using multi-stage narrative analysis. Results: Findings suggest 1) health deficits, marginalization, limited social supports, and socioeconomic instability put excessive burdens on impoverished families and limit their ability to self management, and 2) a measure of responsibility for failures lies with the social policy itself. Conclusions: The study provides policy makers and health care decision makers with information about the health impact of welfare reform policy, and suggests innovative nursing solutions that are health protective of low income women with children.

Qualitative Health Research, 2009

American Journal of Public Health, 2009

Issues in mental health nursing, 2016

This study describes the psychosocial distress experiences of HIV-positive women in Kenya. In-dep... more This study describes the psychosocial distress experiences of HIV-positive women in Kenya. In-depth narrative interviews were conducted three times over six months between 2009 and 2010 with 54 HIV-positive women living in Kenya to explore how the women perceived psychological distress and the steps they took to find support to cope with their HIV-positive diagnosis. Thematic analysis revealed that the women described psychological distress as: physical and emotional shock, worry, and hopelessness and suicidality. The women reported receiving support to cope through spiritual connections, family and friends, others coping with HIV/AIDS, and health care agencies. This study heightens awareness of the critical value of understanding culturally relevant mental health evaluations in a limited mental health access context.

Qualitative health research, Jan 28, 2015

A key source of resiliency within HIV-affected African American communities is informal social su... more A key source of resiliency within HIV-affected African American communities is informal social support. Data from dyadic conversations and focus groups were used to address the following research question: What are HIV-positive African Americans' social support experiences within their informal social networks in response to HIV-related problems? Circumstances that exacerbated HIV-related problems included others' fear of contagion, reticence to be involved, judgment and rejection, and disregard for privacy. Support from HIV-negative others buffered the impact of problems when others communicate interest, take the initiative to help, or make a long-term investment in their success. Support from other HIV-positive persons was helpful given the shared connection because of HIV, the opportunity to commiserate about what is mutually understood, and the fight for mutual survival. Based on these findings, we offer suggestions for future research and social network interventions ai...

International Journal of Health Promotion and Education, Sep 26, 2013

Early HIV testing is critical to prevention and timely treatment. Missed opportunities for HIV di... more Early HIV testing is critical to prevention and timely treatment. Missed opportunities for HIV diagnosis can result in unnecessary deaths at a time when access to antiretroviral treatment proves life saving. While HIV prevention and treatment research has increased, less research exists on women's experiences with HIV diagnosis, despite the fact that women are most affected. Insights from local women are critical in designing culturally meaningful interventions that thwart missed opportunities for early HIV diagnosis. The purpose of our study was to uncover steps women took to know their HIV diagnosis. Using narrative inquiry methodology informed by post-colonial feminism, we interviewed 40 HIV- positive women in Kenya. Five themes emerged related to uptake of HIV testing for women: (a) spouse's critical illness or death; (b) years of suffering from HIV-related symptoms; (c) sick children; (d) prenatal testing; and (e) personal desire to know one's HIV status. These findings centered on women experiences provide an important basis for health promotion interventions related to HIV prevention, earlier detection, and treatment.

Http Dx Doi Org 10 1300 J013v44n03_01, Oct 9, 2008

HIV stigma is widely regarded as a major obstacle to effective HIV prevention, risk reduction, te... more HIV stigma is widely regarded as a major obstacle to effective HIV prevention, risk reduction, testing, and treatment. Research is urgently needed to anticipate, understand, and combat HIV stigma in the African American cultural context because African Americans have the highest HIV incidence, HIV/AIDS prevalence, and HIV mortality. The purpose of this analysis was to explore African American women's narratives of living with HIV to understand how they experienced and responded to HIV stigma. Twenty-nine HIV-infected African American women participated in this longitudinal qualitative study. Each narrated her life since HIV diagnosis in ten open-ended interviews conducted over the course of two years. A multi-staged narrative analysis was used. HIV stigma, which these African American women experienced on multiple levels, manifested internally as existential despair, socially as shunning and callousness, and institutionally as disregard. While participants were constrained by this multi-layered hegemonic cultural negativity about HIV, they refused to be determined by it. Their stories demonstrate how they resisted stigma. Over time, by enlisting support, facing the illness, disclosing only at strategic times, redefining stigma as ignorance, and becoming advocates, they were able to challenge and oppose the shame and discredit that HIV infection had brought into their lives. The elements of stigma resistance described in this study may be starting points for designing participatory interventions for and with African American women living with HIV.

ABSTRACT Malawi bears one of the heaviest HIV burdens globally (10.6% adult prevalence). The pres... more ABSTRACT Malawi bears one of the heaviest HIV burdens globally (10.6% adult prevalence). The presence of sexually transmitted infections (STI) increases HIV transmission, making controlling the spread of STIs critical. In a non-equivalent control group effectiveness study (SAGE4Health), we examined how a structural microfinance, food security, and gender empowerment intervention may temper HIV vulnerability in Malawi. We assessed two self-report outcomes: (1) new STI symptoms (reporting one of six STI symptoms at 18-month or 36-month follow-up), (2) new STI diagnosis (clinician-diagnosed with either one of six STIs at 18-month or 36-month follow-up) in intervention participants (N=600) and control participants (N=300). We used Chi-Square tests to analyze the categorical variables and logistic regressions to examine the intervention effect on new STI symptoms and diagnoses. Compared to the control group, the intervention group was less likely (OR=.51, 95% CI=.33-.79) to report having new STI symptoms at 36-month, controlling for symptoms presented at 18-month. This holds true for intervention men and women compared to control. Although not statistically significant, participants in the intervention group reported a higher percentage of newly diagnosed STIs at 36-month than the control. Among six STIs assessed, syphilis was the most commonly reported STI diagnosis (prevalence 2.3%-5.3%). This combined structural intervention appears to have contributed to a decrease in newly presented STI symptoms. Coupled with the increase in new STI diagnoses, this could mean that the intervention contributed to an increase in STI testing and a decrease in undiagnosed STIs in the intervention group.

Nurs Res, 1995

In this feminist narrative study using in-depth interviews and focus groups, a racially and econo... more In this feminist narrative study using in-depth interviews and focus groups, a racially and economically diverse sample of 45 lesbians described their access to and experience with health care. The multistaged narrative analysis revealed structural and interpersonal conditions uniquely faced by lesbians in obtaining health care services. At the macrolevel, heterosexist structuring of health care delivery was obstructive to lesbians' health care seeking, health knowledge, and health behaviors. At the micro, or individual level, health care providers' heterosexual assumptions competed against potentially supportive interactions with lesbian clients.

Background: Enrollment of diverse participants in genetic/genomic studies is a formidable task. W... more Background: Enrollment of diverse participants in genetic/genomic studies is a formidable task. With advancement in genetic science, questions persist regarding equitable distributions of benefits from discoveries to all sub-populations. U.S. Black African immigrants/refugees, who bear disproportionate disease burden, participate at low rates. Participation of Black African immigrants/refugees in genetics initiatives is desired to move the science forward. Purpose: This study explores barriers and enablers of Black African immigrants/refugees towards participating in genetic studies and suggests implications for public health research, policy, and practice. Methods: As the second stage of a community-based participatory research mixed methods study, in-depth interviews were conducted with (n = 34) Black African immigrants/refugees exploring perceptions of genetic/genomic research, approaches for achieving equitable distribution of benefits in discoveries and strategies to promote su...

Cultural diversity & ethnic minority psychology, Jan 6, 2015

Social support is an important resource that has been associated with better mental and physical ... more Social support is an important resource that has been associated with better mental and physical health outcomes among HIV-positive people. However, researchers have not adequately explored how social support functions among HIV-positive African Americans. The purpose of the current study was to understand whether HIV-related support resources are associated with relational functioning and HIV-related problems among a sample of HIV-infected African American dyads. Exactly 34 HIV-infected (i.e., seroconcordant) dyads compromised of HIV-positive African American adults and their HIV-positive adult "informal supporters" from 3 Midwestern urban cities completed psychosocial questionnaires and a communication task. Using the actor-partner interdependence model, we analyzed dyadic data to determine whether there were actor and/or partner effects within dyadic relationships on measures of conflict and HIV-related problems, communication about these problems, and health symptoms. ...

Malawi bears one of the heaviest HIV burdens globally (10.6% adult prevalence). The presence of s... more Malawi bears one of the heaviest HIV burdens globally (10.6% adult prevalence). The presence of sexually transmitted infections (STI) increases HIV transmission, making controlling the spread of STIs critical. In a non-equivalent control group effectiveness study (SAGE4Health), we examined how a structural microfinance, food security, and gender empowerment intervention may temper HIV vulnerability in Malawi. We assessed two self-report outcomes: (1) new STI symptoms (reporting one of six STI symptoms at 18-month or 36-month follow-up), (2) new STI diagnosis (clinician-diagnosed with either one of six STIs at 18-month or 36-month follow-up) in intervention participants (N=600) and control participants (N=300). We used Chi-Square tests to analyze the categorical variables and logistic regressions to examine the intervention effect on new STI symptoms and diagnoses. Compared to the control group, the intervention group was less likely (OR=.51, 95% CI=.33-.79) to report having new STI ...

Background: Malawi has experienced widespread food insecurity and associated health problems due ... more Background: Malawi has experienced widespread food insecurity and associated health problems due to drought, depleted soil, reduced crop diversity, and poverty. We are conducting a controlled, quasi-experimental evaluation of a food security intervention implemented by CARE Malawi, which includes farmer field schools to teach sustainable agriculture techniques and a village based savings & loan (VSL) microfinance model to increase economic stability and opportunity. Methods: We examined responses from program participants (N=600) and controls (N=300) at baseline and 18 month follow up using detailed household surveys that assessed household food security, economic situation, and farming and food production practices. Results: At baseline, 71% of intervention households and 73% of controls had experienced food insecurity (≥ one month with insufficient food in the past year). At follow up, these rates decreased to 45% and 56% respectively (intervention effect: p Conclusions: While bot...

Background: Malawi has struggled with widespread food insecurity and associated health problems f... more Background: Malawi has struggled with widespread food insecurity and associated health problems for years due to drought, depleted soil, decreased food diversity, and poverty. Sustainable agriculture may offer a solution by diversifying the range of foods grown and rehabilitating soils, resulting in more stable food supplies and better nutrition. Methods: As part of a larger study, we conducted a random household survey (N=1001) in the Kasungu district of central Malawi, and assessed food security and use of a variety of sustainable agriculture techniques. Results: 762 households (76%) experienced at least one month of food insecurity in the past year (Median = 3 months); 239 households (24%) reported being food secure. Food secure households were more likely to use vetiver grass (for erosion management) (23% vs 13%, p Conclusions: Use of sustainable agriculture methods was associated with food security among smallholder agriculturalists in Malawi. Interventions to increase the use ...