Campus and Community HIV and Addiction Prevention (CCHAP): An HIV Testing and Prevention Model to Reach Young African American Adults.

The Campus and Community HIV and Addiction Prevention (CCHAP) project was a collaborative effort between three academic institutions and a community-based organization to conduct rapid HIV testing, assess substance use behaviors, and provide education on HIV risk behaviors for African Americans, 18-24, attending historically Black colleges and universities (HBCUs) and within the surrounding community. As a result of this partnership 2,385 participants received a rapid HIV test, with testing split almost equally between the campus and the community. The positivity rate was .6% (N = 15) with 10 newly diagnosed individuals accounting for 67% of the HIV positives. The results of the partnership provide evidence of a successful outreach program for both the campus and community, and identified a continued need for HIV testing and educational outreach for African American young adults 18-24.

A Call to Develop Evidence-based Interventions to Reduce Sexually Transmitted Infections in Juvenile Justice Populations.

Sexually transmitted infections (STIs), including human immunodeficiency virus (HIV) risk, are a significant health issue for young women (ages 16-21), especially African Americans with a juvenile justice history. Studies have found that 44% of young African American women have had at least one STI compared to 24.1% for all young women. The rate of STIs among young women with juvenile justice histories, particularly African Americans, is likely much higher than their non-detained peers. Yet, there are few evidence-based interventions (EBIs) designed specifically for the detained population. In 2014, the Centers for Disease Control and Prevention's Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention listed few programs that comprehensively included components related to mental health, intimate relationships and high risk sexual behaviors that would be salient for a detained population. Further, many EBIs have had limited or no long-term protective effect. We propose that interrelated factors (mental health, substance use, trauma and intimate relationships) can effectively decrease risk and increase protective behaviors for the detained population most at risk.

Substance Use Correlates of Depression among African American Male Inmates.

Substance use correlates of depressive symptoms among incarcerated adult male African American substance users were examined in the current study. Frequency of drug use was assessed with 12 items specific to an individual's substance use. The Patient Depression Questionnaire (PHQ-9) was used to assess symptoms of depression. Approximately 90% of the sample displayed symptoms of depression ranging from minimal to severe. Regression models revealed that three substance use variables demonstrated a significant predictor of depression, including alcohol (ß = .16, p= .03), hallucinogens (ß =-.17, p =.021), and ecstasy (ß =-.14, p= .05). The study findings indicate a need to consider the role of specific substances with regard to symptoms of depression. The results are discussed in the context of transition planning for jail inmates.

Factors associated with body mass index among African American breast cancer survivors.

BACKGROUND: Weight gain after diagnosis and treatment is common among breast cancer survivors (BCSs). Little information exists regarding associations between body mass index (BMI) and lifestyle factors and health-related quality of life (HR-QoL) among African American (AA) BCSs. The present study sought to determine associations between BMI, dietary intake, and physical activity as lifestyle modification strategies and HR-QoL among AA BCSs. METHODS: For this cross-sectional study, a lifestyle assessment tool was administered to 195 AA BCSs. Possible predictor variables included socio-demographic and medical characteristics, dietary intake and physical activity patterns, and physical health. The outcome variable was BMI. RESULTS: Many BCSs (63%) had BMIs ≥25 Kg/M2 and presented with stage I cancer (41%) at diagnosis. Among those presenting with late-stage cancer (IIIA, IIIB, IV), 76% were overweight or obese (p=0.0008). Eighty-four percent reported excellent-to-good physical health (p=0.0499) and were less likely to have higher BMIs compared to those reporting fair-to-poor physical health (OR=0.616 [CI=0.192-1.978]). Responders with graduate level education were more likely to have healthy body weights than those attaining high school or less educational levels (OR=2.379 [CI=0.617-9.166]). CONCLUSIONS: Most AA BCSs surveyed were overweight or obese, did not engage in recommended physical activity levels and failed to consume diets linked to breast cancer prevention. Interventions are needed to promote weight loss, improve dietary intake, and enhance physical activity among AA BCSs.

Community-based participatory evaluation: the healthy start approach.

The use of community-based participatory research has gained momentum as a viable approach to academic and community engagement for research over the past 20 years. This article discusses an approach for extending the process with an emphasis on evaluation of a community partnership-driven initiative and thus advances the concept of conducting community-based participatory evaluation (CBPE) through a model used by the Healthy Start project of the Augusta Partnership for Children, Inc., in Augusta, Georgia. Application of the CBPE approach advances the importance of bilateral engagements with consumers and academic evaluators. The CBPE model shows promise as a reliable and credible evaluation approach for community-level assessment of health promotion programs.

Psychosocial determinants of risky sexual behaviour amongst South African male prison inmates in KwaZulu-Natal and Mpumalanga Provinces.

PURPOSE: To inform future intervention programmes, the purpose of this paper is to explore the psychosocial and contextual determinants of intention to reduce risky sexual behaviour amongst inmates in South African prisons. DESIGN/METHODOLOGY/APPROACH: A cross sectional study using interviewer administered questionnaires was conducted with 357 inmates across four prison facilities in South Africa that were involved in a pre-release health education intervention for parolees in two provinces. FINDINGS: About 65 per cent of participants were first time offenders. Almost 50 per cent were unemployed prior to arrest and 66 per cent were married at time of incarceration. Self-efficacy, general life skills efficacy and sexual communication were the strongest predictors of intention to reduce risky behaviour upon release. High intenders were significantly different from low intenders in their self-efficacy, sexual communication, attitudes towards condom use and the perceived norm of sex being a non-utilitarian transaction. RESEARCH LIMITATIONS/IMPLICATIONS: One of the key limitations is the low literacy levels amongst prison inmates. Data also relied heavily on self reports of behaviours that may have occurred prior to the participants being incarcerated. ORIGINALITY/VALUE: It is concluded that the exploration of subpopulation specific behavioural determinants is a critical step in the development of effective, contextually-relevant, health education interventions.

Challenges and strategies of frontline staff providing HIV services for inmates and releasees.

Linkages to services for HIV-infected inmates are critically important; however, little is known about the challenges faced by staff coordinating these linkages. This qualitative evaluation describes the challenges and strategies of frontline staff involved in HIV-related services for inmates and releasees participating in the Centers for Disease Control and Prevention/Health Resources and Services Administration Corrections Demonstration Project. Eight focus groups were held during a national meeting of community-based organizations. Content analysis revealed multiple themes. This evaluation emphasizes the lack of and difficulty obtaining services for this population. Staff recognize the role of security and safety when working in facilities and have identified methods to coordinate and communicate to facilitate their work. Communication with key partners and colleagues is important to understand the challenges and identify strategies; however, political advocacy is important for increased awareness and resources. Consideration of these issues within an ecological framework may help frontline staff translate findings to practice.

Pathways to sexual risk taking among female adolescent detainees.

Sexual risk taking among female delinquents represents a significant public health problem. Research is needed to understand the pathways leading to sexual risk taking among this population. This study sought to address this issue by identifying and testing two pathways from child maltreatment to non-condom use among 329 White and 484 African American female adolescent detainees: a relational pathway and a substance use coping pathway. The relational pathway indicated that child maltreatment would be related to non-condom use via depressive self-concept and condom use self-efficacy. The substance use coping pathway suggested that depressive self-concept and alcohol-based expectancies for sexual enhancement would mediate the relationship between child maltreatment and non-condom use. As hypothesized, the relational pathway variables were associated with one another in the expected directions; however, evidence of mediation was not found. Support for mediation was found for the substance use coping pathway. Exploratory across group comparison analysis indicated that the relational pathway was significant for White girls whereas the substance use coping pathway was significant for African American girls. Limitations and implications for future research are discussed.

The BRAVE (Building Resiliency and Vocational Excellence) Program: evaluation findings for a career-oriented substance abuse and violence preventive intervention.

This article examines the effectiveness of a career-oriented intervention for preventing involvement with alcohol, tobacco, and other drugs (ATODs) and violence and for promoting resilient behavior among eighth-grade, African American middle school students (N=178; n=92 intervention and n=86 comparison) through the implementation of the Building Resiliency and Vocational Excellence (BRAVE) Program. Students were randomly assigned to either the intervention or control group. Students in the evaluation participated in the school-based BRAVE Program intervention and the standard public school curriculum. Comparison students participated only in the standard curriculum. Alcohol, tobacco, and other drug use and violent behavior were assessed for 178 students at baseline, post-test, and one-year follow up (one year after baseline). Results revealed a beneficial effect of the intervention on participants' frequency of use of alcohol (p<.04) and marijuana (p<.05), but no effect for violent behavior.

Transient populations: linking HIV, migrant workers, and South African male inmates.

Risk factors associated with the spread of HIV are common among South Africa's transient populations-migrant workers and prisoners. Social ills in South Africa have yielded a growing transient population. Importantly, the migrant workers and prisoners in this population are likely to subscribe to masculine beliefs. Migrants have proven to be an effective bridge in the spread of HIV from high-risk to low-risk populations. Although a relationship between the populations has yet to be established, the circumstances of migrant camps are similar to those of prison camps. Given the high levels of HIV in South Africa and the parallels between migrants (a population whose great HIV threat to the general community has already been established) and prisoners, the integration of former male inmates into the community may pose serious public health concerns.

Alcohol, marijuana, and perceptions of influence on social and sexual behavior among African American adolescent female detainees.

Juvenile detainees comprise a population that engages in high-risk behavior. This study examined sexual risk and substance use behavior and the perceptions of African American female adolescent detainees (N = 765) regarding the influence of alcohol and marijuana use on their social and sexual behaviors. Overall, 58% and 64% reported alcohol and marijuana use, respectively. Alcohol's perceived influence on sexual behavior (p < .001) was significantly different between those who drank and those who did not; marijuana's influence on social (p < .01) and sexual (p < .001) behavior was significantly different between those who used marijuana and those who did not. There is a need for further study of the influence of substance use on social and sexual behavior among African American female adolescent detainees.

Leadership development for health researchers at historically Black colleges and universities.

Historically Black colleges and universities (HBCUs) have traditionally been a magnet for Black students at all levels nationwide and have been an exemplar of mentorship models for preparing leaders in many fields. A research career development program for junior faculty scholars that leverages the unique strengths of HBCUs has the potential to promote diverse leadership in health research and advance practical understanding of how to address HIV/AIDS and related health challenges that ravage vulnerable communities. A program that creates institutional bonds between HBCUs and other academic institutions can create a groundbreaking framework for more-effective community-based participatory research. We present a rationale for supporting an HBCU-led collaborative research program, one that both advances junior faculty and explores the interrelationship between HIV/AIDS, mental health, and substance abuse through research in correctional facilities.

Male prisoners and HIV prevention: a call for action ignored.

US prison inmates are disproportionately indigent young men of color. These individuals are severely affected by HIV/AIDS, largely owing to the high-risk behavior that they engage in prior to incarceration. Researchers and practitioners have issued a call for the importance of offering HIV prevention services in prison settings. However, this call has largely been ignored. In this article, we outline reasons why these recommendations have been largely ignored, discuss innovative HIV prevention programs that are currently being implemented in prison settings, and offer recommendations for securing support for HIV prevention services in correctional settings.

Age-based correlates of substance misuse among convicted felons in Georgia.

OBJECTIVE: This study sought to identify variables that independently correlate with age and substance use among a sample of 187 convicted felons in Georgia. RESULTS: Results of regression analysis indicated that younger inmates were 2 times more likely than older inmates to report the occurrence of alcohol use (RR 2.07; 95% CI .37, 11.6) and three times more likely than older inmates to report some history of marijuana use (RR 3.07; 95% CI 1.52, 6.11). In addition, younger inmates were half as likely or less to report using sedatives (RR .53, 95% CI .22, 1.29), tranquilizers (RR .49, 95% CI .22, 1.29), crack or cocaine (RR .33, 95% CI .18, .62), heroin (RR .48, 95% CI .16, 1.25), and to having ever received treatment for a drug problem (RR .46, 95% CI .23, .90). CONCLUSION: In conclusion, age-based factors correlate with participant's history of substance use. Ascertainment of these variables among inmate populations has the potential to improve treatment decisions both during and after incarceration.