HIV in US Communities of Color

Preface
Contents
Contributors
Chapter 1: Achieving Health Equity Among US Communities of Color at Risk for or Living with HIV
	Introduction
	Acknowledge and Address Structural Racism
	Improve Patient-Provider Relationships
	Diversify the HIV Workforce
	Summary
	References
Chapter 2: Epidemiology of HIV Infection in Communities of Color in the United States
	Introduction
	Epidemiology of HIV Infection in Communities of Color
		Changing Definitions
		Overview of the HIV Epidemic in Communities of Color
		Disparities in HIV Mortality
		Geographic Disparities
		Disparities in HIV Testing and Late Testing
	HIV Care Continuum
		The HIV Cascade and Blacks
		The HIV Care Cascade and Latinos
		HIV Care Cascade in Marginalized Populations
	Linkage to Care Disparities in Communities of Color
		Successful Interventions to Improve HIV Care Linkage
		ART Initiation and Prescription in Communities of Color
		Successful Interventions to Improve ART Initiation
	Care Retention and Achieving Viral Suppression
		Disparities in Care Retention and Achieving Viral Suppression
		Key Factors/Challenges in Achieving Viral Suppression
		Successful Interventions to Improve Viral Suppression
		Care Retention Challenges in Marginalized and Vulnerable Populations
	Vulnerable Populations
		Men Who Have Sex with Men
		Transgender Populations
		Adolescents and Young Adults Living with HIV
		People Who Inject Drugs
		People in Prisons and Other Closed Settings
		Women of Color and Those Who Are Pregnant or Postpartum
	The Way Forward
		Increase Awareness and Uptake of Existing Prevention Modalities
		Enhancing Access to Care and Treatment Services
		Addressing the Role of the Social Determinants of Health
		Research and Evidence Base
	References
Chapter 3: PrEP and the Black Community
	Background
	Knowledge of HIV Status
	Awareness and Knowledge of PrEP
	Seeking and Obtaining PrEP
	Taking PrEP
	Event-Driven PrEP
	Future PrEP Modalities
	Getting to Equitable Impact
	References
Chapter 4: HIV Prevention, Care, and Treatment Among Black Men Who Have Sex with Men (MSM)
	Introduction
	Theoretical Approaches to HIV Prevention in Black MSM Communities
		The Role of Stigma, Marginalization, and Structural Inequalities
		Integrating Interdisciplinary and Intersectional Approaches in Health Disparities
		Sociocultural Factors as Innovative Theoretical Frameworks
	Factors Related to HIV Prevention in Black MSM
		Preexposure Prophylaxis (PrEP) as Biomedical Prevention in Black MSM
		The HIV Care Continuum for Black MSM
		Building Innovative, Culturally Congruent Research on Black MSM
		Contextualizing Sex in Black MSM Communities: The Role of Sexual Contexts and Networks
		Experiences of Violence in the Context of HIV Prevention for Black MSM Communities
		Substance Use in Relation to HIV Sexual Risk Behavior in Black MSM
		The Influence of Immigration on Black MSM and Its Connection to HIV Prevention
	Psychosocial Support and Mental Health Needs for Black MSM
	Summary
	References
Chapter 5: HIV/AIDS and the Latino Populations in the United States: Epidemiology, Prevention, and Barriers to Care and Treatment
	Introduction
	Latinos in the United States
	Epidemiology of HIV/AIDS and Latino Populations
		HIV Incidence and Prevalence
		AIDS Incidence and Prevalence and HIV/AIDS Mortality
		HIV/AIDS and Geography
	Latinos and the HIV/AIDS Care Continuum
		HIV Testing and Diagnosis
		Linkage to Care
		Retention in Care
		Antiretroviral Use and Viral Suppression
	Latinos and HIV Prevention
	Current and Future Efforts
	Conclusion
	References
Chapter 6: Women of Color and HIV
	Epidemiology
	HIV Transmission
	Natural History
	Gynecologic Issues and Clinical Manifestations in Women with HIV Infection
	Human Papilloma Virus Infection and Cytologic Abnormalities
	Trichomonas vaginalis Infections
	Bacterial Vaginosis
	Candidal Vaginal Infections
	Gonorrhea and Chlamydia
	Syphilis Infections in HIV-Infected Women
	Herpes Simplex Virus Infections
	Contraception
	Preconception Counseling
	Nongynecologic Clinical Manifestations of HIV in Women
	HIV and the Older Woman
	Clinical Care of Women Living with HIV/AIDS
	References
Chapter 7: HIV and Immigrants from Sub-Saharan Africa and the Caribbean Living in the United States
	Introduction
	Immigration from Africa and the Caribbean
	HIV Epidemiology
	Location of HIV Acquisition
	Behavioral HIV Risk
	HIV Testing
	Biomedical HIV Prevention (Pre-exposure Prophylaxis)
	HIV Care and Treatment
	HIV-Related Stigma
	Promising Strategies and Interventions
	Recommendations
	References
Chapter 8: HIV in the South
	Demographics, Data, and Disparities
	Viral Suppression
	Drivers of the Southern HIV Epidemic
	Conclusion
Chapter 9: Neighborhood-Level Structural Factors, HIV, and Communities of Color
	Overview: Why Focus on Neighborhoods and HIV?
	Neighborhoods and Overall Health
	Assessment of Neighborhoods
		Measuring Neighborhood Characteristics
		Measuring Neighborhood Boundaries
	Research on Neighborhoods and HIV in Communities of Color
		Social Environment
			Residential Segregation
			Neighborhood HIV Prevalence
			Gay Neighborhoods and Other Neighborhood Sociodemographics
			Neighborhood Disadvantage
			Neighborhood Disorder and Neighborhood Violence
			Neighborhood Social Capital and Income Inequality
		Built Environment
			Neighborhood Built Environment, Including Availability of HIV Testing Locations
	Limitations of Existing Research
	Future Research Directions on Neighborhoods and HIV
	Conclusion
	References
Chapter 10: Substance Use Disorder and HIV
	Introduction
	Defining Terms and Principles
	Prevalence of Substance Use Disorder Among People with or at Risk of HIV in Communities of Color
	Link Between Substance Use and HIV
		Opioids
			Prevalence
			Risk Behaviors
			HIV Outcomes
			Opioid Use Disorder Treatment
		Alcohol
			Prevalence
			Risk Behaviors
			HIV Outcomes
			Alcohol Use Disorder Treatment
		Stimulants
			Prevalence
			Risk Behaviors
			HIV Outcomes
			Stimulant Use Disorder Treatment
		Tobacco
			Prevalence
			HIV and Other Health Outcomes
			Tobacco Use Disorder Treatment
		Cannabis
			Prevalence
			Risk Behaviors
			HIV Outcomes
			Cannabis Use Disorder Treatment
		Behavioral Treatments of Substance Use Disorders
		Treatment Considerations for HIV at Risk Who Have SUD
			Harm Reduction
			Pre-exposure Prophylaxis
	Role of Race in the Approach to Treatment of SUD
	Stigma
	Integration of HIV and SUD Treatment
	Conclusion
	References
Chapter 11: HIV Prevention, Care, and Treatment for Transgender Communities of Color
	Introduction
	Terminology
	Epidemiology
		Prevalence of Trans Identities
		HIV Prevalence
		HIV Vulnerability
		Engagement in Biomedical HIV Prevention
		HIV Care Continuum
	Challenges to Engagement in HIV Care and Treatment
	Interventiovns to Facilitate HIV Care Engagement
	Provider-Patient Interaction and Affirming Language (Best Practices)
		Gender-Affirming Medical Settings
		Provider Interactions
		Physical Exam
		Language Use
		Genital Examinations
	HIV Pre-exposure Prophylaxis: Screening and Prevention Recommendations
	Unique Treatment Considerations
		Hormones and ART
		Dolutegravir and Pregnancy
	Conclusion
	References
Chapter 12: Medical Mistrust, Discrimination, and the Domestic HIV Epidemic
	Introduction
	Medical Mistrust and HIV
	Psychological Perspectives on the Origins of Mistrust
	Why Is Mistrust Associated with HIV Outcomes? A Multilevel Perspective
	Potential Intervention Approaches to Address Medical Mistrust
	Recommendations for Next Steps on Medical Mistrust and HIV Research
	Conclusion
	References
Chapter 13: Incarceration and the HIV Epidemic
	Introduction
	Epidemiology of Incarceration and HIV and the Impact on Communities of Color
		Epidemic of Incarceration in the USA
		Epidemiology of Incarceration by Geography, Race/Ethnicity
		Prevalence of HIV in Jails and Prisons
		Factors Contributing to Overlap of HIV and Incarceration
		Incarceration, HIV, and Health Disparities
	HIV Prevention in CJ Settings
		Approaches to HIV Prevention in CJ System
		HIV Prevention: Behavioral Interventions
		Behavioral Outcomes and Changes in HIV Knowledge and Attitudes
		Gaps in HIV Prevention Behavioral Interventions in CJ-Involved
		Biomedical HIV Prevention – Substance Use Treatment
		Biomedical HIV Prevention – Pre-exposure Prophylaxis
	HIV Care Cascade Prior to, During, and After Incarceration
		Impact of Incarceration on HIV Care Cascade
		HIV Testing in Jails and Prisons
		HIV Care, Treatment, and Viral Suppression in CJ System
		Disparities in HIV Care Cascade Within Incarcerated Population
	Re-entry
		Transition from Incarceration to Community
		Re-entry Barriers and HIV
		Linkage to HIV Care Post-incarceration
		Linkage to Post-incarceration HIV Care Interventions
		Post-incarceration Viral Suppression Interventions
		HIV-Related Stigma and Relationship with Clinical Outcomes
		Stigma and Discrimination During Incarceration
		Intersectional Stigma During Re-entry
	Summary
		Future Directions
	References
Index