HIV-Related Mistrust (or HIV Genocidal Conspiracy Theories) among African Americans Living with HIV in Rural Alabama.

We sought to determine the association between HIV-related medical mistrust (or belief in HIV conspiracy theories) and educational attainment among Blacks that are living with HIV. We analyzed data from the regional Survey on HIV in the Black Community in Alabama. HIV-related medical mistrust w or HIV Genocidal Conspiracy Theories were reported by majority of the patients. In multivariable analysis, controlling for income, education, and marital status, belief in conspiracy theories or HIV Genocidal Conspiracy Theories were significantly associated with higher education. The HIV-Related Medical Mistrust Scale item was independently associated with higher education. This finding speaks to the need for an improved understanding of the role of HIV related medical mistrust among African Americans to improve uptake of biomedical HIV prevention.

Conspiracy Beliefs about HIV/AIDS among HIV-Positive African American Men and Women in Alabama's Black Belt: A Mixed-Method Analysis.

Despite prior studies showing that a significant proportion of the general African-American population hold conspiracy beliefs about HIV/AIDS, limited research has investigated conspiracy beliefs among African Americans that are HIV-positive and the subgroups most likely to endorse such beliefs. I examined endorsement of HIV/AIDS conspiracy beliefs and their relationship to sociodemographic variables among 256 African Americans with HIV infection. Quantitative and qualitative methods were used in the study at an AIDS Outreach Organization clinic in Alabama that provides medical and social support services to HIV-positive persons. Patients reported agreement with statements capturing beliefs in HIV/AIDS conspiracies. Results indicated that about one-third subscribed to the notion that "AIDS is a form of genocide against Blacks" (29.7%) and some 27.7% of the respondents said that "AIDS was created by the government to control the black population." Regarding treatment-related conspiracy beliefs, over one-third (35.6%) somewhat or strongly agreed that "people who take the new medicines for HIV/AIDS are human guinea pigs for the government," while 29.9% somewhat or strongly endorsed the statement that "the medicine that doctors prescribe to treat HIV is poison." Results of multivariate analyses indicated that stronger HIV/AIDS conspiracy beliefs were significantly associated with educational attainment and age. A set of sociodemographic variables explained a small amount of the variance in conspiracy beliefs about HIV/AIDS (R2 range=0.13-0.14). Qualitative results indicated that conspiracy beliefs are barrier to medication adherence among these patients living with HIV/AIDS. Focus group discussions suggested that conspiracy beliefs can be important barriers to quality of life and infection control among HIV-positive individuals. These findings suggested that addressing conspiracy beliefs should be a significant issue in HIV/AIDS treatment and prevention programs in the 21st Century.

Household Food Insecurity Is Associated with Self-Rated Health Status among Single Mothers in Alabama's Black Belt Counties.

This study was conducted in Alabama's Black Belt Counties to examine the association between household food insecurity and self-reported health status. Data were collected from 400 households to measure household food insecurity and self-reported general health status using the U.S. Food Security Module. In bivariate analyses, household food insecurity was significantly associated with health status as some mothers from food insecure households were significantly more likely to rate their health as fair/poor. In regression analysis model controlling for potentially confounding variables, household food insecurity was still associated with poor self-reported health status. Food intake of some household members was reduced, and their eating patterns disrupted at times because the household lacked money for obtaining food. Policy changes to increase economic resources and access to federal food programs are needed to reduce household food insecurity in this region. Gendered experiences in the context of consequences of poverty should not be ignored.

Food Insecurity and Maternal Mental Health among African American Single Mothers Living with HIV/AIDS in the Alabama Black Belt.

BACKGROUND: Little is known about the relationship between food insecurity and depression among African American low-income single mothers living with HIV/AIDS in rural Alabama. Food insecurity is a neglected variable in bioethics, biomedical, behavioral, and health disparities research. METHODS: Regression analyses of data from a survey of African American single mothers living with HIV/AIDS in Alabama's Black Belt were used to evaluate the association between food insecurity and depression. RESULTS: As determined by the USDA food insecurity scale, about 53% of the sample was classified as food insecure. In the bivariate regression model, food insecurity was associated with depression. After controlling for sociodemographic variables, food insecurity remained positively associated with depression in this sample. CONCLUSIONS: Food insecurity places low-income African American women at risk of depression. Given widespread poverty among HIV-positive individuals in the Black Belt, access to food should be considered in HIV-related prescriptions and in health disparities research.

Conspiracy Beliefs about Antiretroviral Medications for HIV/AIDS among African Americans Living with HIV1.

The purposes of the present analysis are twofold: 1) to assess the extent to which African Americans that are living with HIV subscribe to conspiracy beliefs about antiretroviral medications for HIV/AIDS; and 2) ascertain the differences, if any, between men, women and educational attainment regarding these beliefs. Findings indicate that over one-third (36.6%) somewhat or strongly agreed that "people who take the new medicines for HIV/AIDS are human guinea pigs for the government," while 28.8% somewhat or strongly endorsed the statement that "the medicine that doctors prescribe to treat HIV is poison." One quarter of all the respondents endorsed the belief that "the medicine used to treat HIV causes people to get AIDS" (25.3%). Patients who were high school or beyond high school graduates were less likely than their peers with less education to endorse belief about HIV treatments. The calculated effect sizes confirm education's effect is meaningful in this sample. There are no gender differences in belief about HIV treatments.

Racial-Ethnic Disparities in HIV/AIDS and Health Care in the United States: Evidence from a Sociological Field Research in Alabama's Black Belt.

This paper examines African Americans' beliefs of psychosocial factors associated with racial HIV/AIDS and health disparities using an exploratory qualitative study. This research was conducted to determine how African Americans define their health and disease burden, the reasons for their plight; the problems they face; their coping strategies for providing daily necessities of shelter, transportation, and health care. If we ignore the voices of African Americans, we have dehumanized them, making their humanity invisible. Without hearing the voices of African Americans, our understanding of their social life and health issues is incomplete. Analyses from the top down miss the insights that only those experiencing racial health disparities can articulate. Their voices have important implications for policymakers interested in eliminating racial health disparities and promote equity in health. The focus groups discussions in the paper provide the voice, the presence, and the perspective of African Americans who live on the margins and are generally invisible to the rest of us. Issues surrounding racial health disparities are complex, difficult, and controversial. Results indicate that health insurance, lack of access to quality health care, environmental hazards in neighborhoods, poverty, lack of medical practitioners, unhealthy eating habits, poor life style choices, lack of African Americans in health care professions, lack of trust in white health care professionals and unemployment contribute substantially to racial health disparities in America. Health care is a by-product of the distribution of power and the organization of the society.

Educational attainment and self-rated health status among single mothers in rural Alabama.

Using previous data from a random sample of 300 single mothers from rural Alabama, multiple regression analysis indicated that food insecurity and employment status had a modest effect on self-rated health status, while educational attainment and income had the greatest effect. These variables explained 29% of the variance in health status. Social and economic policies that affect educational attainment and income distribution may have important consequences for health status in these rural areas.

Conspiracy beliefs about HIV/AIDS among HIV-positive African-American patients in rural Alabama.

This is apparently the first survey examining endorsement of HIV/ AIDS conspiracy beliefs and their relations to educational attainment among 205 HIV-positive African-American patients receiving care at an AIDS Outreach Organization in Alabama. 31% somewhat or strongly believed that, "AIDS is a form o genocide against African Americans," 29% strongly agreed that "AIDS was created by the government to control the black population," 56.1% agreed that the government is withholding a cure for AIDS, and 69.8% agreed that the government is withholding information about the disease from the public. 52% agreed that "HIV is a manmade virus," and 43.1% that "AIDS was produced in the governments laboratory." Respondents with high school or college education were less likely to endorse conspiracy liefs. Being open and sensitive to questions about conspiracy beliefs plus understanding the historical roots and social context from which such questions arise in African-American communities is needed to counter such beliefs.

Comment on Bridges and Kunselman (2005).

A case is made that a clear understanding of premature mortality of Status Indians due to suicide, homicide, and motor vehicle accidents must begin with a clear idea of what the indicator, potential years of life lost before age 75 (PYLL), is, and how it was measured or calculated.

Livelihood strategies of food-insecure poor, female-headed families in rural Alabama.

Previous studies suggest that households headed by single women in general, and particularly those by African-American females, are at greater risk for food insecurity and hunger. However, questions remain about how single mothers cope with food insecurity. This study examined how food-insecure, poor single mothers get food for themselves and their children. 100 African-American single mothers from rural Alabama were recruited and interviewed about their livelihood strategies up to two times during a 1-yr. period. The findings show that most of the mothers used numerous strategies to make sure that there was an adequate amount of food for the family. These strategies included work, government assistance such as food stamps, cash assistance from relatives and friends, food from food banks and churches, cohabiting, coresiding with a friend or relative, eating at a Senior Meal Program, and eating less. Psychological aspects of food insecurity included feeling depressed, feeling sad, feeling lonely, having trouble sleeping, and having trouble concentrating. These results suggest that preventive measures to reduce food insecurity among single mothers should remain a priority, and referrals to psychological counseling might help assist them in coping during this difficult time in their lives.