Article Database

Father Support is Protective Against the Negative Effects of Perceived Discrimination on CRP Among Sexual Minorities but not Heterosexuals

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Using Digital Data to Protect and Promote the Most Vulnerable in the Fight Against COVID-19

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The COVID-19 pandemic has illuminated the numerous, important ways in which digital data is critical in public health preparedness and response. Indeed, we are seeing a rapid increase in the types of data being generated and used to directly inform and evaluate public health policy, such as forecasting trends in disease incidence via changes in fever reports from aggregate digital thermometer data (1), assessing mobility decreases via aggregate mobile phone GPS data by city for evaluation of concordance with physical distancing interventions (2), and sourcing individual-level mental and behavioral health changes in relation to epidemic trends via smartphone surveys (3). Using data from such tools in infectious disease research is not new; satellite imagery have been used for ascertaining sub-city factors related to dengue incidence (4), mobile phone calling records for quantifying the impact of mobility in relation to malaria spread (5), and smartphone surveys to understand care-seeking, and other behaviors during influenza epidemics (6). However, this is a critical inflection point in the use of digital data for infectious disease research and practice; we are all witnessing how such data is actively being used to inform policies in real time, globally. Simultaneously, the latest COVID-19 research shows that there is elevated risk for older people, that per capita disease burden and relative healthcare system demand may be highest away from major population centers, and that there are disparate rates of testing and morbidity by racial group (7, 8). Given the advent and welcome sharing of digital data, we must do so in a manner that ensure the most pressing public health issues are addressed to mitigate further impact of the pandemic. Indeed, attention to what types of data are used and who is represented in the data will significantly advance current practice by improving inferences to better avert illness and death in the population.

The digital divide shows that the most vulnerable (e.g., elderly, certain socioeconomic or cultural groups) may not often have access to the same digital tools, nor follow the same patterns of illness and reporting as other populations (9). This may present issues when population-level inferences are to be made from data that is generated from digital tools that are primarily used and generation by urban, younger and higher socioeconomic groups. In the current COVID-19 pandemic situation, assessments of the efficacy of social distancing interventions, or measurements of community disease burden would guide policy incorrectly if certain populations were omitted from such analyses. These issues are not novel, they reflect challenges highlighted in recent work stressing that when statistical, machine learning, and artificial intelligence methods are implemented in practice, biases in, and properties of the underlying data used to train models must be accounted for (9–11). Thus, using data on its own without an understanding of who the data represents can limit validity of conclusions drawn (12). Especially given that many new data sources and technologies are opt-in and require specific technology access, these conclusions could potentially exacerbate health disparities. However, these challenges do not render the data without use. The COVID-19 pandemic has not only demonstrated potential immense utility of data for informing and evaluating large-scale public health interventions, but also the desire of many companies and data scientists to be helpful. Accordingly, we offer tangible strategies to ensure that such data are used in a manner that mitigates any added disparities that can occur by drawing inference from data without considering who is represented, but moreover how digital data and tools can be used to promote the most vulnerable. We describe three approaches for doing so, while being sensitive to privacy, legal, and organizational safeguards.

Relationship Cognitions and Longitudinal Trajectories of Sexual Risk Behavior Among Young Gay and Bisexual Men: The P18 Cohort Study

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This study examines how romantic relationship cognitions are associated with changes of condomless anal sex among emerging adult gay and bisexual men. The sample was drawn from 4-waves of a prospective cohort study (N = 598; Mage = 18.2). Results suggest that condomless anal sex increased over the emerging adulthood period. Romantic relationship fear was associated with increased receptive condomless anal sex. Perceptions of greater romantic relationship control increased the likelihood of having insertive and receptive condomless anal sex. Findings suggest that romantic relationship cognitions are important to consider when understanding longitudinal changes in condomless anal sex in this population.

Understanding Attachment Transitions Through the Lived Experiences of Young Black Gay and Bisexual Men

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We conducted a mixed-methods study to identify factors that influence transitions in attachment style between childhood and adulthood among 28 young Black gay and bisexual men (YBGBM) in the United States. We used a phenomenological approach to data integration, with the major component to the results being garnered from the qualitative interviews. We organized our results by four attachment transition groups: stable secure (secure attachment in childhood and young adulthood), stable insecure (insecure attachment in childhood and young adulthood), secure to insecure (secure in childhood and insecure in adulthood) and insecure to secure (insecure in childhood and secure in adulthood). Within each of the typologies, two major themes emerged: social support and religion. Generally, transitions from secure to insecure attachment were related to experiences of perceived rejection by a parental figure during adolescence that corresponded with sexual orientation disclosure. Transitions from insecure to secure attachment appeared to be related to the absence of an attachment figure early in life, but with the acquisition of an attachment figure during early to late adolescence. The findings from our study suggest a need for attachment-based approaches to social support interventions, as well as for an increased understanding of social and cultural factors that impact attachment changes among practitioners who use attachment-based therapy models for YBGBM.

The Smoking Behaviors and Cancer-Related Disparities Among Urban Middle Aged and Older Males Involved in the Criminal Justice System

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This study examined cancer knowledge, mental health and smoking in formerly incarcerated men. The Cancer-Health Research Study with Formerly Incarcerated Men in New York City used a cross-sectional research design to examine knowledge and cancer prevention (CKP) outcomes among 259 justice-involved males, ages 35-67. CKP was assessed using items from the National Cancer Institute’s Health Information National Trends Survey. Psychological symptoms were examined using the Brief Symptom Inventory. Of the 259 men who completed the survey, 76% of the respondents self-reported as current smokers. Current smokers smoked between one and 40 cigarettes per day. The mean number of cigarettes smoked per day was 10.37 (SD = 6.76). Sixty-three percent (n=165) of the respondents underwent cancer-screening tests. CKP scores ranged from two to 28; the mean was 15.05 (SD=5.49), indicating that the men scored very low in terms of CKP. CKP was negatively associated with the number of cigarettes smoked per day, τ = -.13, p = .01; participants with high knowledge scores smoked less daily. These results have important implications for enhancing access to cancer-health education in justice-involved settings.

Stress Levels are Associated with Poor Sleep Health Among Sexual Minority Men in Paris, France

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Conducting Health Disparities Research with Criminal Justice Populations: Examining Research, Ethics, and Participation

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This study explored the challenges of informed consent and understanding of the research process among Black and Latino men under community supervision (e.g., parole and/or probation). Between February and October 2012, we conducted cognitive face-to-face interviews using open-ended questions on the significant areas of research participation (i.e., the informed consent process, confidentiality, compensation, what is meant by human subject and clinical trials) among 259 men aged 35 to 67 under community supervision in Bronx, New York. Content analysis of the open-ended questions revealed limited knowledge concerning the understanding of research participation. The study participants appeared to generally understand concepts such as compensation after research participation and confidentiality. Participants demonstrated a lack of understanding of certain aspects of the research process—informed consent, human subject, Institutional Review Board, and clinical trials. These findings are informative to researchers conducting studies with criminal justice populations and Institutional Review Boards reviewing research studies.

Sex Differences in Virtual Network Characteristics and Sexual Risk Behavior among Emerging Adults

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Emerging adults (EAs)ages 18 to 24 account for a large proportion of all sexually transmitted infections (STIs), HIV infections, and unintended pregnancies in the United States. Given the increased influence of online media on decision-making, we examined how EA online networks were associated with sexual risk behaviors. We used egocentric network data collected from EAs aged 18 to 24 years old across the United States (N=1,687) to examine how online norms (e.g., acceptance of HIV infections, other STIs, and pregnancy) and network characteristics (i.e., network size and density; ties’ closeness, race, age, and sex similarities) were associated with participants’ unprotected vaginal intercourse (UVI) in the last 30 days. Findings suggested that in male EAs, there was a strong association between sexual norms, structural characteristics, and sexual risk behavior compared to females. Researchers and practitioners may wish to address online peer norms and EAs’ online network composition when developing online sexual risk prevention tools.

Participation in Research Involving Novel Sampling and Study Designs to Identify Acute HIV-1 Infection among Minority Men Who Have Sex with Men

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HIV-1 infection disproportionally affects African American and Latino men who have sex with men (MSM) and their inclusion in biomedical and behavioral research is critical to understanding and addressing HIV vulnerability. Using focus groups, we sought to understand the perceptions related to participating in biomedical research of acute/recent HIV-1 infection (AHI) using complex sampling and data collection methods to reach this hidden group at highest risk of acquiring and transmitting HIV. Given the potential impact of AHI on transmission in MSM, it is important to understand this intersection for HIV prevention, care and treatment purposes. The aim of this study was to understand how recruitment and data collection methods affect AHI research participation willingness particularly among MSM of color. Findings suggest that major barriers to research participation with complex sampling to identify AHI and intensive risk behavior collection such as diary methods are lack of anonymity, partner disclosure, and study fatigue. The authors explore implications for future study designs and development based on these findings.

Are Trajectories of Psychosocial Risk in Adolescence Linked to HIV Vulnerability In Emerging and Young Adulthood? An Eighteen-Year Longitudinal Study

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