Minority Health and Health Equity Archive
Permanent URI for this collectionhttp://hdl.handle.net/1903/21769
Welcome to the Minority Health and Health Equity Archive (MHHEA), an electronic archive for digital resource materials in the fields of minority health and health disparities research and policy. It is offered as a no-charge resource to the public, academic scholars and health science researchers interested in the elimination of racial and ethnic health disparities.
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Item A Prospective Study of Psychological Distress and Sexual Risk Behavior Among Black Adolescent Females(2001) DiClemente, Ralph; Wingood, Gina; Crosby, Richard; Sionean, Catlainn; Brown, Larry; Rothbaum, Barbara; Zimand, Elana; Cobb, Brenda; Harrington, Kathy; Davies, SusanABSTRACT. Objective. The purpose of the study was to examine the association between adolescents’ psychological distress and their sexually transmitted disease/ human immunodeficiency virus (STD/HIV)-associated sexual behaviors and attitudes. Method. Sexually active black adolescent females (N 522) completed, at baseline and again 6 months later, a self-administered questionnaire that assessed sexual health attitudes and emotional distress symptoms (using standardized measures, .84), a structured interview that assessed STD/HIV-associated sexual risk behaviors, and a urine screen for pregnancy. Results. In multivariate analyses, controlling for observed covariates, adolescents with significant distress at baseline were more likely than their peers, after 6 months, to be pregnant (adjusted odds ratio [AOR]: 2.0), have had unprotected vaginal sex (AOR 2.1), have nonmonogamous sex partners (AOR 1.7), and not use any form of contraception (AOR 1.5). Additionally, they were also more likely to: perceive barriers to condom use (AOR 2.2), be fearful of the adverse consequences of negotiating condom use (AOR 2.0), perceive less control in their relationship (AOR 2.0), have experienced dating violence (AOR 2.4), feel less efficacious in negotiating condom use with a new sex partner (AOR 1.6), and have norms nonsupportive of a healthy sexual relationship (AOR 1.7). Discussion. The findings suggest that psychological distress is predictive over a 6-month period of a spectrum of STD/HIV-associated sexual behaviors and high-risk attitudes. Brief screening to detect distress or depressive symptoms among adolescent females can alert the clinician to the need to conduct a sexual health history, initiate STD/HIV-preventive counseling, and refer for comprehensive psychological assessment and appropriate treatment. Among adolescents receiving STD treatment,those with even moderate emotional distress may be at heightened risk for further unhealthy outcomes. STD/ HIV interventions should also consider psychological distress as one potential risk factor that may impact program efficacy.Item HIV Risk Reduction Among African-American Women Who Inject Drugs: A Randomized Controlled Trial(2003) Sterk, Claire E; Theall, Katherine P; Elifson, Kirk W; Kidder, DanielA community-based HIV intervention for African-American women who are active injection drug users (IDUs) was evaluated. Seventy-one women (aged 20–54 years) were randomly assigned to one of two enhanced gender- and culturally specific intervention conditions or to the NIDA standard condition. Substantial decreases (p < .001) were found in the frequency of drug use and the frequency of drug injection as well as in the sharing of injection works or water and the number of injections. Trading sex for drugs or money, having sex while high, as well as other sexual risk behaviors were also reduced significantly. Furthermore, women in both enhanced intervention conditions were more likely to reduce their drug-using and sexual risk behaviors than were women in the standard condition. Results indicate the value of including additional components in interventions designed to reduce the risk of infection with HIV among women who inject drugs.Item C-REACTIVE PROTEIN AND OTHER MARKERS OF INFLAMMATION IN THE PREDICTION OF CARDIOVASCULAR DISEASE IN WOMEN(2000) Ridker, Paul M; Hennekens, Charles H; Buring, Julie E; Rifai, NaderBackground Since inflammation is believed to have a role in the pathogenesis of cardiovascular events, measurement of markers of inflammation has been proposed as a method to improve the prediction of the risk of these events. Methods We conducted a prospective, nested case–control study among 28,263 apparently healthy postmenopausal women over a mean follow-up period of three years to assess the risk of cardiovascular events associated with base-line levels of markers of inflammation. The markers included high-sensitivity C-reactive protein (hs-CRP), serum amyloid A, interleukin-6, and soluble intercellular adhesion molecule type 1 (slCAM-1). We also studied homocysteine and several lipid and lipoprotein measurements. Cardiovascular events were defined as death from coronary heart disease, nonfatal myocardial infarction or stroke, or the need for coronay-revascularization procedures. Results Of the 12 markers measured, hs-CRP was the strongest univariate predictor of the risk of cardiovascular events; the relative risk of events for women in the highest as compared with the lowest quartile for this marker was 4.4 (95 percent confidence interval, 2.2 to 8.9). Other markers significantly associated with the risk of cardiovascular events were serum amyloid A (relative risk for the highest as compared with the lowest quartile, 3.0), slCAM-1 (2.6), interleukin-6 (2.2), homocysteine (2.0), total cholesterol (2.4), low-density lipoprotein (LDL) cholesterol (2.4), apolipoprotein B-100 (3.4), high-density lipoprotein (HDL) cholesterol (0.3), and the ratio of total cholesterol to HDL cholesterol (3.4). Prediction models that incorporated markers of inflammation in addition to lipids were significantly better at predicting risk than models based on lipid levels alone (P<0.001). The levels of hs-CRP and serum amyloid A were significant predictors of risk even in the subgroup of women with LDL cholesterol levels below 130 mg per deciliter (3.4 mmol per liter), the target for primary prevention established by the National Cholesterol Education Program. In multivariate analyses, the only plasma markers that independently predicted risk were hs-CRP (relative risk for the highest as compared with the lowest quartile, 1.5; 95 percent confidence interval, 1.1 to 2.1) and the ratio of total cholesterol to HDL cholesterol (relative risk, 1.4; 95 percent confidence interval, 1.1 to 1.9). Conclusions The addition of the measurement of C-reactive protein to screening based on lipid levels may provide an improved method of identifying women at risk for cardiovascular events.Item Foundation Confronts the Disparities in Both the Disease Burden and Death Rates for African Americans Suffering From Heart Failure; Landmark Trial Signals Improved Quality of Care for African Americans with Heart Failure(2004) PR, NewswireBetween the ages of 45 and 64, African American males have a 70% higher risk for heart failure than Caucasian males. African American females between the ages of 45 and 54 have a 50% greater risk of developing heart failure than Caucasian females. The earlier onset of disease means higher rates of hospitalization, earlier disability, and higher rates of premature death (death before the age of 65)(1). This dramatic difference in health status and health outcomes can be attributed to a variety of factors, including lack of access to quality medical care. The National Minority Health Month Foundation (the Foundation) is pleased to recognize the potential advancements in treatment for heart failure in African Americans represented by the recently completed African American Heart Failure Trial (A- HeFT).