Socio-structural factors, health disparities, and the uptake of biomedical HIV prevention for Black Men who have Sex with Men (MSM)

Presenter:mp3243
Morgan Philbin, PhD, MHS
Assistant Professor, Department of Sociomedical Sciences
Columbia University Mailman School of Public Health

Description:

Black men who have sex with men (MSM) are at significantly higher risk of HIV. This is due to a complex interplay between socio-structural factors and their own intersectional identities. In this webinar, Dr Philbin describes her ethnographic study examining how factors at all levels of the social-ecological model shape healthcare behavior for black MSM and how they access PreP, as well as her sub-study about structural barriers to access. Some of these barriers included misunderstanding about PreP’s effectiveness and side-effects, concerns that it would decrease others’ condom use, distrust in the pharmaceutical industry and healthcare providers, precarious housing, the structure of the labor market, gendered healthcare systems, institutional and normative gender rules, and stigma. Dr Philbin highlights the importance of reducing barriers at all levels, particularly at the structural level in areas of stigma, employment, and housing. The implications include the need to eliminate the relationship between employment and access to healthcare, enacting policies that regulate shift work (scheduling and pay), creating clinical spaces that welcome all types of men, and expanding the PreP Assistance Program.

Course Objectives:

1) Describe how factors not directly related to biomedical HIV prevention (e.g., the labor market, law enforcement, gendered expectations) influence how Black MSM approach HIV prevention and pre-exposure prophylaxis.

2) Give examples of how factors across multiple levels (e.g., structural, community, interpersonal) impact how Black MSM engage with biomedical HIV prevention.

3) Describe what types of multi-level approaches might facilitate Black MSM’s uptake of PrEP. Describe how can we balance the development of more proximate interventions (e.g., education campaigns) with large scale interventions (e.g., expanding insurance access) that might have a larger impact.

Continuing Education: 1.0 CPH, 1.0 CHES

Council on Linkages Core Competencies for Public Health Professionals (2014 Version)

2B8, 3A8, 4A2, 4A3, 4A4, 4A6

Click on the appropriate button to begin.

I do not work for a State or Local Health Department in NYS.


I do work for a State or a Local Health Department in NYS.

If you are employed by NYS or a local health department in NYS, we recommend that you register for this course through the NYS Department of Health Learning Management System (DOH LMS).

Critical Consciousness-based Health Promotion Interventions for Racial and Sexual Minority Populations

Presenter:pw2219_Wilson-Patrick_0

Patrick Wilson, PhD
Associate Professor
Sociomedical Sciences
Columbia University Mailman School of Public Health

Description:

Critical Consciousness involves becoming aware of the broader social, political, and cultural forces that perpetuate oppression and inequality. Helping to raise individuals’ awareness and recognition of such forces in their daily lives can fuel empowerment, self-esteem, and other precursors to positive health behavior change. In this webinar, Dr. Patrick Wilson will discuss how critical consciousness can be used to support behavior change interventions for marginalized groups, such as black MSM youth.

After participating in this webinar, attendees will be able to:

  • Define Critical Consciousness
  • Describe the Mobilizing our Voices for Empowerment (MOVE) intervention for young Black gay/bisexual men living with HIV
  • Discuss current and future critical consciousness intervention research

Continuing Education: 1.0 CPH, 1.0 CHES

Council on Linkages Core Competencies for Public Health Professionals (2014 Version)

1A1, 1A2, 1A3, 1A4, 1A5, 1A6, 1A7, 1A8, 1A9, 1A10, 1A11, 1A12, 1A13, 1A14, 1B1, 1B2, 1B3, 1B4, 1B5, 1B6, 1B7, 1B8, 1B9, 1B10, 1B11, 1B12, 1B13, 1B14, 4A1, 4A2, 4A3, 4A4, 4A5, 4A6, 4A7, 4B1, 4B2, 4B3, 4B4, 4B5, 4B6, 4B7, 4B8, 5A10, 5B11, 8A1, 8A2, 8A4, 8A5, 8B1, 8B2, 8B4, 8B5

Click on the appropriate button to begin.

I do not work for a State or Local Health Department in NYS.


I do work for a State or a Local Health Department in NYS.

If you are employed by NYS or a local health department in NYS, we recommend that you register for this course through the NYS Department of Health Learning Management System (DOH LMS).

Adapting Evidence-based Behavioral Interventions for New Settings and Target Populations

Many HIV prevention funding agencies require the use of evidence-based behavioral interventions (EBIs) previously shown to be effective through rigorous outcome evaluation. Often, the implementing agency’s setting or target population is different than those in the original implementation and evaluation. The Centers for Disease Control and Prevention Division of HIV/AIDS Prevention, in collaboration with internal and external partners, developed draft guidance to adapt an EBI to fit the cultural context, risk determinants, risk behaviors, and unique circumstances of the agency without competing with or contradicting the core elements and internal logic. The guidance described in this article provides a systematic approach to help agencies identify the most appropriate intervention for their target population and agency capacity, monitor the process, and evaluate the outcomes of the adapted intervention.

McKleroy V.S., et al. (2006). Adapting evidence-based behavioral interventions for new settings and target populations. AIDS Educ Prev., 18(4): 59-73

http://www.ncbi.nlm.nih.gov/pubmed/16987089

The ADAPT-ITT Model: A Novel Method of Adapting Evidence-based HIV Interventions

The Institute of Medicine (IOM) recommends the use of HIV prevention interventions with proven efficacy to avert new infections. Given the time and cost associated with the development, implementation and evaluation of efficacious HIV interventions, adapting existing behavioral interventions (EBIs) to be appropriate for a myriad of at-risk populations may facilitate the efficient development of new EBIs. Unfortunately, few models of theoretic frameworks exist to guide the adaptation of EBIs.

Over the past few years, the authors have systematically developed a framework for adapting HIV-related EBIs, known as the “ADAPT-ITT” model.This article summarizes key components of the ADAPT-ITT model and illustrates the use of the model in several case studies.  The ADAPT-ITT model consists of 8 sequential phases that inform HIV prevention providers and researchers of a prescriptive method for adapting EBIs.

Wingood, G.M., DiClemente R.J. (2008). The ADAPT-ITT model: a novel method of adapting evidence-based HIV Interventions. Journal of Aquired Immune Deficiency Syndrome, 47(1): S40-46

http://www.ncbi.nlm.nih.gov/pubmed/18301133