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Seizing opportunities for intervention: Changing HIV-related knowledge among men who have sex with men and transgender women attending trusted community centers in Nigeria
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Background Knowledge of HIV risk factors and reduction strategies is essential for prevention in key populations such as men who have sex with men (MSM) and transgender women (TGW). We evaluated factors associated with HIV-related knowledge among MSM and TGW and the impact of engagement in care at trusted community health centers in Nigeria. Methods The TRUST/RV368 cohort recruited MSM and TGW in Lagos and Abuja, Nigeria via respondent driven sampling. During study visits every three months, participants underwent structured interviews to collect behavioral data, received HIV education, and were provided free condoms and condom compatible lubricants. Five HIV-related knowledge questions were asked at enrollment and repeated after 9 and 15 months. The mean number of correct responses was calculated for each visit with 95% confidence intervals (CIs). Multivariable Poisson regression was used to calculate adjusted risk ratios and CIs for factors associated with answering more knowledge questions correctly. Results From March 2013 to April 2018, 2122 persons assigned male sex at birth were enrolled, including 234 TGW (11.2%). The mean number of correct responses at enrollment was 2.36 (95% CI: 2.31–2.41) and increased to 2.95 (95% CI: 2.86–3.04) and 3.06 (95% CI: 2.97–3.16) after 9 and 15 months in the study, respectively. Among 534 participants who completed all three HIV-related knowledge assessments, mean number of correct responses rose from 2.70 (95% CI: 2.60–2.80) to 3.02 (95% CI: 2.93–3.13) and then 3.06 (95% CI: 2.96–3.16). Factors associated with increased overall HIV-related knowledge included longer duration of study participation, HIV seropositivity, higher education level, and more frequent internet use. Conclusions There was suboptimal HIV-related knowledge among Nigerian MSM and TGW at that improved modestly with engagement in care. These data demonstrate unmet HIV education needs among Nigerian MSM and TGW and provide insights into modalities that could be used to address these needs.
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MPRC People
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Hongjie Liu, Ph.D.
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Hongjie Liu Publications
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Selena Ortiz, Penn State University
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Public Beliefs about Housing Affordability as a Key Social Determinant of Health and its Impact on Support for Affordable Housing Policy
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Coming Up
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Self-rated Health and Structural Racism Indicated by County-level Racial Inequalities in Socioeconomic Status: The Role of Urbanization
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Caryn N. Bell University of Maryland: Jessica L. Owens-Young American University: 2019-005
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Research
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Working Papers
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WP Documents
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Self-Rated Health and Structural Racism Indicated by County-Level Racial Inequalities in Socioeconomic Status: The Role of Urban-Rural Classification
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Recent attention to the interrelationship between racism, socioeconomic status (SES) and health has led to a small, but growing literature of empirical work on the role of structural racism in population health. Area-level racial inequities in SES are an indicator of structural racism, and the associations between structural racism indicators and self-rated health are unknown. Further, because urban-rural differences have been observed in population health and are associated with different manifestations of structural racism, explicating the role of urban-rural classification is warranted. This study examined the associations between racial inequities in SES and self-rated health by county urban-rural classification. Using data from County Health Rankings and American Communities Surveys, black-white ratios of SES were regressed on rates of fair/poor health in U.S. counties. Racial inequities in homeownership were negatively associated with fair/poor health ( β = −0.87, s.e. = 0.18), but racial inequities in unemployment were positively associated with fair/poor health ( β = 0.03, s.e. = 0.01). The associations between structural racism and fair/poor health varied by county urban-rural classification. Potential mechanisms include the concentration of resources in racially segregated counties with high racial inequities that lead to better health outcomes, but are associated with extreme black SES disadvantage. Racial inequities in SES are a social justice imperative with implications for population health that can be targeted by urban-rural classification and other social contextual characteristics.
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Retired Persons
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Caryn Bell, Ph.D.
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Caryn Bell Publications
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Seminar Series: Family and Neighborhood Interventions to Reduce Heart Disease Risk in East Los Angeles
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Alex Ortega, Principal Investigator, Center for Population Health and Health Disparities, Professor, Department of Health Services, University of California
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Coming Up
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Seminar Series: Kathryn Edin, Department of Sociology, Johns Hopkins University
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Fathers and Urban Poverty
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Coming Up
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Seminar Series: Life Course Effects of Risk Factors at Women's Birth on Reproductive Outcomes as Adults
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Amy O. Tsui, Director, The Bill & Melinda Gates Institute of Population & Reproductive Health, Professor, Population, Family & Reproductive Health, Johns Hopkins University
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Coming Up
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Seminar Series: Nonstandard Work Schedules Over the Life Course: A First Look
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Harriet B. Presser, Distinguished University Professor, Department of Sociology, University of Maryland
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Coming Up
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Seminar Series: Polygyny, Partnership Concurrency and HIV transmission in Sub Saharan Africa
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Georges Reniers, Assistant Professor, Office of Population Research, Woodrow Wilson School of Public & International Affairs, Department of Sociology, Princeton University
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Coming Up
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Seminar Series: Single Motherhood and Child Mortality in Sub-Saharan Africa: A Life Course Perspective
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Shelley Clark, Associate Professor, Department of Sociology, McGill University
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