Yzette Lanier

Abstract

INTRODUCTION: Pregnancy represents a stressful period for both women and their families. Whether the family maintains functioning during pregnancy could have significant implications on maternal and child health. In this study, we explored individual- and family-level factors associated with family functioning in adolescent and young adult mothers.METHODS: This study was a secondary analysis of 295 young mothers, ages between 15 and 21 years. Multivariate logistic regression models were conducted to estimate adjusted odds ratios of exploratory factors on the risk of being in high family functioning group. The parent study was approved by the Institutional Review Boards at Yale University.RESULTS: The mean score of family functioning was 5.14 out of 7. With the inclusion of individual-level factors (Model 1), significant associations were observed between high family functioning and having ever attended religious services (OR = 2.22, 95% CI: 1.20-4.09), low perceived discrimination (OR = 3.04, 95% CI: 1.60-5.75), and high perceived social support (OR = 3.74, 95% CI: 2.01-6.95). After including both individual- and family-level factors (Model 2), results identified significant associations between high family functioning and annual household income>$15,000 (OR = 9.82, 95% CI: 1.67-57.67, p = 0.011) and no experience of violence from any family members (OR = 4.94, 95% CI: 1.50-16.21, p = 0.008).DISCUSSION: The models of care should be structured to support the continuity of maternity care in which health care providers have the opportunity to discover and utilize each family's strengths to provide the optimal caring experience for young mothers and their families as a unit.

Abstract

Encounters with discrimination are a normative experience for many Black and Latino adolescents and young adults (AYAs); these experiences may be even more common for expecting AYAs. While the harmful effects of discriminatory experiences on mental and physical health have been well explored, relatively little is known regarding the impact of discrimination on relationship quality and sexual health—specifically HIV/STI risk. Using the Actor Partner Interdependence Model, we examined both actor and partner effects of discrimination on relationship quality and willingness to be non-monogamous in a sample of 259 pregnant adolescent and young adult couples. There was a significant indirect actor effect, such that one’s own discrimination was associated with a decrease in their own relationship quality which, in turn, was associated with their own greater willingness to be non-monogamous. The partner effect for the association of one’s partner’s discrimination on one’s own relationship quality was not significant. Findings highlight the need for more attention to the implications of discrimination on relational and sexual health.

Abstract

The Centers for Disease Control and Prevention Minority HIV Research Initiative (MARI) funded 8 investigators in 2016 to develop HIV prevention and treatment interventions in highly affected communities. We describe MARI studies who used community-based participatory research methods to inform the development of interventions in Black/African American and Hispanic/Latinx communities focused on sexual minority men (SMM) or heterosexual populations. Each study implemented best practice strategies for engaging with communities, informing recruitment strategies, navigating through the impacts of COVID-19, and disseminating findings. Best practice strategies common to all MARI studies included establishing community advisory boards, engaging community members in all stages of HIV research, and integrating technology to sustain interventions during the COVID-19 pandemic. Implementing community-informed approaches is crucial to intervention uptake and long-term sustainability in communities of color. MARI investigators’ research studies provide a framework for developing effective programs tailored to reducing HIV-related racial/ethnic disparities.

Abstract

The field of HIV research has grown over the past 40 years, but there remains an urgent need to address challenges that cisgender women living in the United States experience in the HIV neutral status care continuum, particularly among women such as Black women, who continue to be disproportionately burdened by HIV due to multiple levels of systemic oppression. We used a social ecological framework to provide a detailed review of the risk factors that drive the women's HIV epidemic. By presenting examples of effective approaches, best clinical practices, and identifying existing research gaps in three major categories (behavioral, biomedical, and structural), we provide an overview of the current state of research on HIV prevention among women. To illustrate a nursing viewpoint and take into account the diverse life experiences of women, we provide guidance to strengthen current HIV prevention programs. Future research should examine combined approaches for HIV prevention, and policies should be tailored to ensure that women receive effective services that are evidence-based and which they perceive as important to their lives.

Abstract

Depression represents a growing health problem and African American women (AAW) disproportionally experience increased risk and broad disparities in health care. This integrative review examines what is known about the equity of depression care provided to AAW. PubMed, PsychINFO, and Web of Science were searched through April 2020 for studies in peer-reviewed journals from 2015 to 2020. Across the studies (n = 7), AAW received inequitable care across a depression care cascade including lower rates of screening, treatment initiation, and guideline-concordant care. Here we explore individual-, relational-, and structural-level factors related to these disparities and implications for research, practice, and education.

Abstract

Background This study examined agreement between partners on perceptions of relationship quality and its impact on later (sexually transmitted infection [STI]) diagnosis in a sample of pregnant (adolescents and young adults [AYAs]) couples. Methods Two hundred ninety-six AYA couples completed structured surveys on relationship quality (satisfaction, cohesion, consensus, affectional expression) and STI diagnosis. An actor-partner interdependence model was used to assess actor effects (whether an individual's perceived relationship quality influenced their getting STI), partner effects (whether a partner's perceived relationship quality influenced the individual getting an STI), and interactive effects (whether an individual's perceived relationship quality interacted with a partner's perceived relationship quality and influenced in the individual getting an STI). Results No significant actor or partner effects were observed for positive STI screen. However, there was a significant interaction between actor and partner satisfaction (B = -0.47, exp(B) = 0.63 [95% confidence interval, 0.43-0.93], P = 0.020). When actor satisfaction was high, greater partner satisfaction was associated with lower odds of a positive STI screen at 12 months. A significant interaction between actor and partner affectional expression was also found (B = -4.40, exp(B) = 0.01 [95% confidence interval, 0.00-0.87], P = 0.043). When partner affectional expression was high, greater actor affectional expression was associated with lower odds of a positive STI screen at 12 months. Conclusions Findings suggest that concordant reports of relationship satisfaction and affectional expression are protective against future STI risk. Strengthening romantic relationships may be a promising strategy for preventing STIs in pregnant/parenting AYA couples.

Abstract

This study examines mental health symptoms among Black adolescents who were currently in mental health treatment and those who were not in treatment. The study uses a sample of Black adolescents (N= 154) and logistic regression was performed to determine which psychological factors were associated with exhibiting mental health symptoms. Both groups experienced high amounts of trauma exposure history, recent suicidality, substance use, and depressive symptoms. Nearly one in four adolescents in the out of treatment group met diagnostic criteria for anxiety disorders. Implications include better screening for mental health symptoms to ensure Black adolescent have access to mental health treatment.

Abstract

The years 2020–21, designated by WHO as the International Year of the Nurse and Midwife, are characterised by unprecedented global efforts to contain and mitigate the COVID-19 pandemic. Lessons learned from successful pandemic response efforts in the past and present have implications for future efforts to leverage the global health-care workforce in response to outbreaks of emerging infectious diseases such as COVID-19. Given its scale, reach, and effectiveness, the response to the HIV/AIDS pandemic provides one such valuable example, particularly with respect to the pivotal, although largely overlooked, contributions of nurses and midwives. This Personal View argues that impressive achievements in the global fight against HIV/AIDS would not have been attained without the contributions of nurses. We discuss how these contributions uniquely position nurses to improve the scale, reach, and effectiveness of response efforts to emerging infectious diseases with pandemic potential; provide examples from the responses to COVID-19, Zika virus disease, and Ebola virus disease; and discuss implications for current and future efforts to strengthen pandemic preparedness and response.

Abstract

Purpose: Recruitment and retention of adolescents and young adults (AYAs) in couple-based HIV prevention research can be difficult. This study’s primary objective is to identify factors that influenced Black and Latino AYAs to participate in couple-based HIV/STI prevention research. Design: In-depth, semi-structured qualitative interviews. Setting: Face-to-face interviews with couples recruited from the South Bronx, New York. Participants: Twenty-three heterosexual couples (46 individuals) aged 16-28 (M = 20.1, SD = 3.01). Methods: Participants completed 60 to 90-minute individual and dyadic interviews. All interviews were audio-recorded and transcribed. Thematic analysis was conducted to identify key themes. Results: Two levels of influence emerged from participants’ interviews regarding their reasons for study participation: 1) individual factors (interest in the study topic, study incentives, opportunity to help their community, and opportunity to learn something new), 2) interpersonal factors (positive interactions with the research team, partner’s desire to participate and relationship strengthening). There were key differences by gender and recruitment order. Conclusion: Black and Latino AYAs report multiple reasons for participating in couple-based research. Highlighting the benefits of study participation to themselves, their relationships, and their communities may be an important strategy for engaging AYAs in couple-based research.

Abstract

BACKGROUND: HIV prevention interventions which support engagement in care and increased awareness of biomedical options, including pre-exposure prophylaxis (PrEP), are highly desired for disproportionately affected Black/African American, Hispanic/Latinx and gay, bisexual, and other men who have sex with men (GBMSM) populations in the United States (US). However, in almost 40 years of HIV research, few interventions have been developed directly by and for these priority populations in domestic counties most at risk. We submit that interventions developed by early-career scientists who identify with and work directly with affected subgroups, and which include social and structural determinants of health, are vital as culturally tailored HIV prevention and care tools.METHODS: We reviewed and summarized interventions developed from 2007 to 2020 by historically underrepresented early-career HIV prevention scientists in a federally funded research mentoring program. We mapped these interventions to determine which were in jurisdictions deemed as high priority (based on HIV burden) by national prevention strategies.RESULTS: We summarized 11 HIV interventions; 10 (91%) of the 11 interventions are in geographic areas where HIV disparities are most concentrated and where new HIV prevention and care activities are focused. Each intervention addresses critical social and structural determinants of health disparities, and successfully reaches priority populations.CONCLUSION: Focused funding that supports historically underrepresented scientists and their HIV prevention and care intervention research can help facilitate reaching national goals to reduce HIV-related disparities and end the HIV epidemic. Maintaining these funding streams should remain a priority as one of the tools for national HIV prevention.