African American Clergy Recommendations to Enhance the Federal Plan to End the HIV Epidemic: A Qualitative Study.

African Americans in the southern United States continue to be disproportionately affected by HIV. Although faith-based organizations (FBOs) play important roles in the social fabric of African American communities, few HIV screening, care, and PrEP promotion efforts harness the power of FBOs. We conducted 11 focus groups among 57 prominent African American clergy from Arkansas, Mississippi, and Alabama. We explored clergy knowledge about the Ending the HIV Epidemic: A Plan for America (EHE); normative recommendations for how clergy can contribute to EHE; and how clergy can enhance the HIV care continua and PrEP. We explored how clergy have responded to the COVID-19 crisis, and lessons learned from pandemic experiences that are relevant for HIV programs. Clergy reported a moral obligation to participate in the response to the HIV epidemic and were willing to support efforts to expand HIV screening, treatment, PrEP and HIV care. Few clergy were familiar with EHE, U = U and TasP. Many suggested developing culturally tailored messages and were willing to lend their voices to social marketing efforts to destigmatize HIV and promote uptake of biomedical interventions. Nearly all clergy believed technical assistance with biomedical HIV prevention and care interventions would enhance their ability to create partnerships with local community health centers. Partnering with FBOs presents important and unique opportunities to reduce HIV disparities. Clergy want to participate in the EHE movement and need federal resources and technical assistance to support their efforts to bridge community activities with biomedical prevention and care programs related to HIV. The COVID-19 pandemic presents opportunities to build important infrastructure related to these goals.

Community Legal Systems: Targeting PrEP and HIV Education to Decrease Risk of HIV Transmission.

The southern U.S. has both high HIV and incarceration rates in comparison to its population. As in the rest of the country, HIV prevention is based on education, behavior change, and biomedical efforts, such as pre-exposure prophylaxis (PrEP). This study examined the implementation of an educational intervention and supportive services to obtain PrEP in a population of individuals (N = 218) involved in an Adult Drug Court (ADC) or on probation or parole (P-P). Nearly all ADC and P-P participants self-reported risk behaviors linked to HIV acquisition. Results supported the acceptance and usefulness of the intervention as rated by participants. Participants showed increased knowledge of HIV risks and testing post-education. In multivariate analysis, predictors of interest in using PrEP included low stigma beliefs, specifically their level of prejudice views, high depressive symptoms, and white race. The intervention shows promise. Given the high risk documented for ADC and P-P individuals, HIV prevention is a critical component for increased protective behaviors.

HIV Stigma: A Clinical Provider Sample in the Southern U.S.

PURPOSE: Dimensions of HIV Stigma perceptions have not been examined in medical providers in the southern U.S. This study examined the prediction of HIV knowledge on multiple dimensions of stigma beliefs. METHODS: We assessed clinical staff (N = 153) in rural clinics (2017) HIV stigma beliefs and knowledge. Using multiple regression, we examined the ability of knowledge to predict stigma beliefs organized into meaningful dimensions. RESULTS: There was high variability in HIV knowledge among the medical professionals surveyed with a score of 70/100 (i.e., a 'C'). Of the five stigma factors explored, only two had a score greater than 80 (ie., a 'B' score on the 'test'). Controlling for demographic factors, there was a significant effect of HIV Knowledge on Discrimination (F (4,146) = 2.02, p = 0.03), Prejudice (F (4,146) = 2.13, p = 0.04), Service Provision (F (4,145) = 2.30. p = 0.02), and Perceived Risk in Practice (F (4,91) = 5.75, p < 0.01). CONCLUSIONS: The relatively low knowledge score and link between knowledge and stigma beliefs indicated a need for continued basic HIV education. Increased education around HIV risk is critical in the eradication of HIV given the link between high stereotyping beliefs and low testing rate.

Current HIV Testing & Risk Behaviors among Students at Historically Black Colleges & Universities in a Southern State.

BACKGROUND/PURPOSE: HIV testing prevalence is low among young adults (YA) ages 18-24. Previous research supports routine testing among African-American college students. Historically Black Colleges and Universities (HBCUs) are uniquely situated to support HIV education and prevention efforts. This study aimed to assess current HIV risk behaviors and current knowledge of PrEP among HBCU students. METHODS: In collaboration with a partnering organization, we conducted HIV testing events and HIV risk assessment at four HBCUs in a southern state. RESULTS: Among participants (N = 615), most identified as African American (578, 94.8%), female (377, 61.3%) and 18-24 years old (540, 87.9%). Many (42.3%) had never been tested for HIV. Most reported they had been sexually active in the last year (533, 86.8%) with many reporting 2-5 partners (270, 43.9%). Among males (n = 236), 8.6% reported same sex partners. Many participants reported inconsistent condom use during vaginal sex (242, 46%). Most participants had not heard of PrEP (473, 86.2%). CONCLUSION: Considering most participants had one or multiple HIV related risk behaviors, and many had never been tested for HIV, HBCUs may be important venues to promote HIV risk reduction and regular HIV testing.

Improved classroom quality and child behavior in an Arkansas early childhood mental health consultation pilot project.

The aim of the current study was to examine the effects of early childhood mental health consultation (ECMHC) on teacher-level and child-level outcomes in the context of a partnership between community mental health centers in three regions of Arkansas and publically funded early education programs (14 intervention sites and 4 comparison sites). From 2005 to 2008, 193 teachers participated in the study, along with 1,448 children. Data-collection activities included structured classroom observations, teacher ratings of children's strengths and behavior, and teacher surveys to assess satisfaction with ECMHC services. Results suggest that teachers were highly satisfied with the consultation services and that teachers receiving the intervention had lower levels of permissiveness and detachment, with a trend toward higher levels of sensitivity in interactions with children in their classroom. In terms of child outcomes, we found that by the third year of the project, children at intervention sites were rated by their teachers as having fewer behavior problems and more protective factors.