We Are Not Asking Permission to Save Our Own Lives: Black-Led Birth Centers to Address Health Inequities.

PURPOSE: While favorable outcomes of birth centers are documented, Black-led birth centers and maternal health models are rarely highlighted. Such disparities are manifestations of institutional racism. A nascent body of literature suggests that culturally affirming care provided by Black-led birth centers benefit all birthing people-regardless of race. Birth Detroit is one such maternal health model led by Black women that offers a justice response to inequitable care options in Black communities. METHODS: This article describes a departure from traditional White supremacist research models that privilege quantitative outcomes to the exclusion of iterative processes, lived experiences, and consciousness-raising. A community organizing approach to birth center development led by Black women and rooted in equity values of safety, love, trust, and justice is outlined. RESULTS: Birth Detroit is a Black-led, community-informed model that includes integration of evidence-based approaches to improving health outcomes and that embraces community midwifery prenatal care and a strategic trajectory to open a birth center in the city of Detroit. CONCLUSION: Birth Detroit demonstrates the operationalization of a Black feminist standpoint, lifts up the power of communities to lead in their own care, and offers a blueprint for action to improve inequities and maternal-infant health in Black communities.

The role of provider interactions on comprehensive sexual healthcare among young men who have sex with men.

Testing for both HIV and STIs is an essential component of comprehensive sexual healthcare for young men who have sex with men (YMSM). Using data collected from YMSM living in the Detroit metropolitan area (N = 304, ages 18-29; 51% Black, 25% White, 14% Latino), we examined YMSM's access to a medical provider in the prior year and tested whether a provider's conversation regarding HIV/STI prevention was associated with their type of testing behavior: Non-Testers, HIV-Only Testing, and HIV and STI Testing. Over half (56.7%) reported a routine provider visit in the previous year. Visits were associated with having insurance, provider comfort, and prior HIV and/or STI testing. Among YMSM who visited a doctor, our multinomial regression exhibited that those whose provider discussed HIV/STI prevention were most likely to have tested for both HIV and STIs, as compared to the HIV Only and Never Tester categories. Patient-provider communication regarding HIV/STI prevention is critical to motivate comprehensive sexual healthcare access among YMSM. Strategies that enable providers to discuss HIV/STI prevention with YMSM in a sex-positive manner may help maximize comprehensive testing.

Creating comprehensive, youth centered, culturally appropriate sex education: What do young gay, bisexual and questioning men want?

We examined young gay, bisexual and questioning men's (YGBQM) experiences with school-based sex education as they sought to learn about sex and sexual health, and their suggestions for improving same-sex education resources. Thematic analysis of 30 in-depth interviews with YGBQM (ages 18-24) underscored the discrepancies between the existing school-based sex education curricula and YGBQM's perceived sex education needs. Our results show that many youths' sexuality and same-sex sexual behaviors are excluded in sex education lessons; however, YGBQM noted that they sought out other resources (e.g., websites) to answer their questions. We discuss YGBQM's ideas for the creation of a sex and sexual health website that would be tailored for youth like themselves, including topics and features that an ideal website would contain. In addition, we present recommended changes to existing school-based sexual education curricula.