Emma Brown

HIV/AIDS is a health crisis for African Americans. African American women are exposed to HIV primarily through sexual behavior, which is an increased risk for women who use drugs. The study design was a mixed method consisting of an ethnography with ongoing participant observation and in-depth interviews and a questionnaire. The purpose of the questionnaire component was to explore drug use, sexual behavior, health history, and perceptions. The questionnaire was administered at months 6 and 18. Data for this report were derived from the first questionnaire with 30 respondents. The majority of respondents (82.7%) used polysubstances consisting of cocaine, marijuana, and alcohol. Between 33% and 50% exchanged sex for drugs or money, with less than half ever using condoms. About 37% perceived that they had no risk of acquiring HIV, whereas 52% perceived a 25% chance. The pattern of HIV testing in which 33% of the women were tested 10 times or more was unexpected because of the low perc...

Preventing HIV transmission is a major world health goal. The international nursing shortage and the cost of educational and healthcare require innovative approaches to meet this goal. The initiative described provided HIV education at three levels: to students in an R.N. to BSN program, lay health advisors (LHA's), and participants in a high-risk community. Students completed the traditional community needs assessment and teaching plans. Additionally, they contributed to funding proposals, implemented and evaluated their plan. They prepared LHA's as peer group educators. This was cost-effective and increased credibility in an African-American community. Using tested materials tailored to this population, six LHA's conducted 24 sessions in two months. Of the 168 community participants, 151 completed the pre-and post-test of HIV knowledge. Correct responses increased significantly overall from 81.9% to 88.3 (t = 4.88, df = 150; p = .001). The three items with the greatest change in correct responses related to African American HIV exposure, female condoms, and lubricants. Rationale for the project and recommendations for improvement are included.

Literature to guide HIV prevention outreach for southeastern rural blacks is limited despite the increasing prevalence of HIV infection in this population. Three men and one woman conducted HIV prevention outreach in three north Florida rural counties in teams of two. The workers received five days of training in additional homework assignments. The workers used HIV/AIDS outreach surveys to guide their 10- to 15-minute outreach visits. Five hundred seventy-four outreach contacts with blacks were made between January and June 2001 (329 in County 1, 176 in County 2, and 69 in County 3) with 347 women and 227 men. Eighty-four percent of the persons contacted accepted literature, 47.5% accepted male condoms, and 31.9% accepted female condoms. More women (99.4%) were knowledgeable about HIV/AIDS than men (92.5%), and they reported taking precautions against infection more often than men (98% vs. 90.3%). Many blacks in rural north Florida were receptive to an HIV prevention outreach program that provided information, literature, and condoms on the street and in homes. These findings suggest that HIV prevention outreach should be expanded to reach more rural blacks, who are increasingly at risk for HIV infection.

Injecting drug use and heterosexual contact are the major exposure categories for women acquiring human immunodeficiency virus (HIV). The purpose of this study was to explore the relationship of acquired immunodeficiency syndrome (AIDS) risk perception, perceived seriousness of HIV, drug use self-efficacy, sexual self-efficacy, and social support for HIV/AIDS risk behavior among female injecting drug users (IDUs). A random sample of 140 female IDUs was interviewed using a structured questionnaire. The data were analyzed by descriptive statistics and logistic regression. Self-efficacy for preventive sexual behavior and social support were predictive of condom use with primary partners P = .01 and P = .001, respectively. Self-efficacy for preventive drug use was predictive of risky injection behavior (P = .004) and risky injection location (P = .003). The results suggest that HIV prevention programs targeting female IDUs should include strategies that incorporate their support networks and strengthen preventive self-efficacy. Brief intervention strategies that nurses can carry out with female IDUs are suggested.

There has been limited HIV prevention intervention among Southeastern rural Blacks residing in Florida. The prevalence of HIV/AIDS among this population increasingly supports the need for HIV prevention intervention. The primary focus of this article is the process and outcome evaluations of the feasibility of recruiting rural Blacks to accept and participate in HIV prevention intervention and HIV testing and return for their test results. The interventions were conducted over a 5-month period. One hundred rural residents participated in the HIV prevention intervention, which was well received except for completing the preintervention and postintervention surveys. Thirty-nine percent of the adult participants consented to OraSure HIV testing, and 75% of those tested returned for their results. Community-based HIV prevention intervention, including condom demonstration, can successfully be conducted with rural populations. Rural Blacks will participate in HIV testing using OraSure.

... as receiving inconsistent monitoring with possible exposure to toxic substances (Kroll & Taylor, 2003); being physically separated from the mother due to social service intervention (Tyler et al ... Ossie's statement was typical of most mothers who had their children living with them. ...

HIV/AIDS disproportionately affects African Americans, yet knowledge gaps exist regarding their views of risks and effective prevention strategies. This focus group study of rural and small city African Americans who use drugs sought to assess these perceptions. Common views of HIV risks included drug use, physical appearance as an indicator of HIV status, intentional transmission, having multiple partners, unprotected sex, bisexuality, and unfounded trust. Trading sex for drugs and unprotected sex when high were seen as drug use/HIV risk links, while HIV education and condom use were identified as ways to decrease risk. Perceptions of effective strategies included community-based programs, gender specific groups, providing food or other incentives, and making the program fun. Healthcare professionals and parents were viewed as the best people to promote HIV prevention. Based on the findings, effective intervention for this target group should encompass ethnocentric community-based strategies that focus on HIV education, condom use skills, and drug risk reduction.

In 1996, grandparents were the sole providers of care for 269,000 grandchildren. Research findings indicate that grandmothers are usually the primary caretakers of grandchildren. Previous issues associated with raising grandchildren vary, but usually relate to the grandparents' health, financial concerns, or lack of social support. This qualitative descriptive study was designed to describe African American grandmothers' perceptions about the burdens of raising adolescent grandchildren. Using this approach, the researchers were able to study the richness and diversity of the grandmothers' perceptions. Data were collected from 35 grandmothers through a focus group (n = 7) and during a 4-day intervention research study (n = 28) entitled "Grandmother-Grandchild Health Promotion Program." Numerous concerns were voiced by both groups, but those stated most frequently were associated with the well-being of grandchildren (grandchildren's sexual behavior, potential drug use, and potential risk of encountering violence) and relational conflicts with adult children. Unexpected findings were the absence of stated concerns associated with the grandmothers' financial situation or health. Recommendations for intervention, clinical practice, and research are discussed.