scholarly journals Using an Electronic Medication Event–Monitoring System for Antiretroviral Therapy Self-Management Among African American Women Living With HIV in Rural Florida: Cohort Study

10.2196/14888 ◽  
2020 ◽  
Vol 4 (2) ◽  
pp. e14888
Author(s):  
Robert Lucero ◽  
Renessa Williams ◽  
Tanisia Esalomi ◽  
Paula Alexander-Delpech ◽  
Christa Cook ◽  
...  
Keyword(s):  
United States ◽  
African American ◽  
Pilot Study ◽  
African American Women ◽  
The United States ◽  
Art Adherence ◽  
Event Monitoring ◽  
Women Living With Hiv ◽  
Rural Florida ◽  
Living With Hiv

Background HIV remains a significant health issue in the United States and disproportionately affects African Americans. African American women living with HIV (AAWH) experience a particularly high number of barriers when attempting to manage their HIV care, including antiretroviral therapy (ART) adherence. To enable the development and assessment of effective interventions that address these barriers to support ART adherence, there is a critical need to understand more fully the use of objective measures of ART adherence among AAWH, including electronic medication dispensers for real-time surveillance. Objective This study aimed to evaluate the use of the Wisepill medication event–monitoring system (MEMS) and compare the objective and subjective measures of ART adherence. Methods We conducted a 30-day exploratory pilot study of the MEMS among a convenience sample of community-dwelling AAWH (N=14) in rural Florida. AAWH were trained on the use of the MEMS to determine the feasibility of collecting, capturing, and manipulating the MEMS data for an objective measure of ART adherence. Self-reported sociodemographic information, including a self-reported measure of ART adherence, was also collected from AAWH. Results We found that the majority of participants were successful at using the electronic MEMS. Daily use of the MEMS tended to be outside of the usual time participants took their medication. Three 30-day medication event patterns were found that characterized ART adherence, specifically uniform and nonuniform medication adherence and nonuniform medication nonadherence. There were relatively few MEMS disruptions among study participants. Overall, adjusted daily ART adherence was 81.08% and subjective ART adherence was 77.78%. Conclusions This pilot study on the use and evaluation of the Wisepill MEMS among AAWH in rural Florida is the first such study in the United States. The findings of this study are encouraging because 10 out of 12 participants consistently used the MEMS, there were relatively few failures, and objective adjusted daily and overall subjective ART adherence were very similar. On the basis of these findings, we think researchers should consider using the Wisepill MEMS in future studies of AAWH and people living with HIV in the United States after taking into account our practical suggestions. The following practical considerations are suggested when measuring objective medication adherence: (1) before using an MEMS, be familiar with the targeted populations’ characteristics; (2) choose an MEMS that aligns with the participants’ day-to-day activities; (3) ensure the MEMS’ features and resulting data support the research goals; (4) assess the match among the user’s ability, wireless features of the MEMS, and the geographic location of the participants; and (5) consider the cost of MEMS and the research budget.

scholarly journals Antiretroviral therapy self-management: Pilot study of an electronic medication event monitoring system among African-American women living with HIV in rural Florida (Preprint)

2019 ◽  
Author(s):  
Robert Lucero ◽  
Renessa Williams ◽  
Tanisia Esalomi ◽  
Paula Alexander-Delpech ◽  
Christa Cook ◽  
...  
Keyword(s):  
African American ◽  
Antiretroviral Therapy ◽  
Pilot Study ◽  
African American Women ◽  
Art Adherence ◽  
Event Monitoring ◽  
Women Living With Hiv ◽  
The Us ◽  
Rural Florida ◽  
Living With Hiv

BACKGROUND The human immunodeficiency virus (HIV) remains a significant health issue in the United States and disproportionately affects African Americans. African-American women living with HIV (AAWH) experience a particularly high number of barriers when attempting to manage their HIV care, including antiretroviral therapy (ART) adherence. To enable the development and assessment of effective interventions that address these barriers to support ART adherence, there is a critical need to understand more fully the use of objective measures of ART adherence among AAWH, including electronic medication dispensers for real-time surveillance. OBJECTIVE To evaluate the use of the Wisepill Medication Event Monitoring System (MEMS), and compare objective and subjective measures of ART adherence. METHODS We conducted a 30-day exploratory sequential mixed-methods pilot study of the MEMS among a convenience sample of community-dwelling AAWH (n=14) in rural Florida. AAWH were trained on the use of the MEMS to determine the feasibility of collecting, capturing, and manipulating the MEMS data for an objective measure of ART adherence. Self-report sociodemographic information, including a measure of antiretroviral therapy (ART) adherence, was also collected from AAWH. RESULTS We found that a majority of participants were successful at using the electronic MEMS. Daily use of the MEMS tended to be outside of the usual time participants took their medication. Three 30-day medication event patterns were found that characterized ART adherence, specifically uniformed and ununiformed medication adherence and ununiformed medication non-adherence. There were relatively few MEMS disruption among study participants. Overall, adjusted daily ART adherence was 81.08% and subjective ART adherence was 77.78%. CONCLUSIONS This pilot study on the use and evaluation of the Wisepill MEMS among AAWH in rural Florida is the first known in the US. The findings of this study are encouraging because ten out of twelve participants consistently used the MEMS, had relatively few MEMS, and objective adjusted daily and overall subjective ART adherence were very similar. Based findings from this study, we think researchers can be confident in using the Wisepill MEMS in future studies of AAWH and PLWH in the US after considering our practical suggestions. The following practical considerations are suggested when considering measuring objective medication adherence: (1) before using a MEMS be familiar with the targeted populations’ characteristics; (2) choose a MEMS that aligns with the participants’ day-to-day activities; (3) ensure the MEMS’ features and resulting data support the research goals; (4) assess the match between user’s ability, wireless features of the MEMS, and the geographic location of participants; and (5) considering the cost of MEMS and the research budget.

The Meaning and Perceptions of HIV-Related Stigma in African American Women Living With HIV in Rural Florida

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Renessa S. Williams ◽  
Nichole E. Stetten ◽  
Christa Cook ◽  
Robert Cook ◽  
Miriam O. Ezenwa ◽  
...  
Keyword(s):  
African American ◽  
African American Women ◽  
American Women ◽  
Women Living With Hiv ◽  
Related Stigma ◽  
Rural Florida ◽  
Living With Hiv

Resilience resources among African American women living with HIV in Southern United States

AIDS ◽  
2019 ◽  
Vol 33 ◽  
pp. S35-S44 ◽  
Author(s):  
Shan Qiao ◽  
LaDrea Ingram ◽  
Morgan L. Deal ◽  
Xiaoming Li ◽  
Sharon B. Weissman
Keyword(s):  
United States ◽  
African American ◽  
African American Women ◽  
Southern United States ◽  
American Women ◽  
Women Living With Hiv ◽  
Living With Hiv

scholarly journals Exploring Experiences and Perceptions of Older African American Males Aging With HIV in the Rural Southern United States

2016 ◽  
Vol 11 (2) ◽  
pp. 221-232 ◽  
Author(s):  
Barbara J. Blake ◽  
Gloria A. Jones Taylor ◽  
Richard L. Sowell
Keyword(s):  
United States ◽  
African American ◽  
Rural Communities ◽  
African American Men ◽  
Qualitative Content Analysis ◽  
The United States ◽  
Health Concern ◽  
Treatment And Prevention ◽  
Age Related ◽  
Living With Hiv

The HIV (human immunodeficiency virus) epidemic in the United States remains a serious public health concern. Despite treatment and prevention efforts, approximately 50,000 new HIV cases are transmitted each year. Estimates indicate that 44% of all people diagnosed with HIV are living in the southern region of the United States. African Americans represent 13.2% of the United States population; however, 44% (19,540) of reported new HIV cases in 2014 were diagnosed within this ethnic group. The majority of cases were diagnosed in men (73%, 14,305). In the United States, it is estimated that 21% of adults living with HIV are 50 years or older. There exists limited data regarding how well African American men are aging with HIV disease. The purpose of this study was to explore the perceptions and experiences of older African American men living with HIV in rural Georgia. Data were collected from 35 older African American men living with HIV using focus groups and face-to-face personal interviews. Qualitative content analysis revealed six overlapping themes: (1) Stigma; (2) Doing Fine, Most of the Time; (3) Coping With Age-Related Diseases and HIV; (4) Self-Care; (5) Family Support; and (6) Access to Resources. The findings from this study provide new insights into the lives of rural HIV-infected African American men, expands our understanding of how they manage the disease, and why many return to or remain in rural communities.

scholarly journals African American Women and Domestic Violence: Addressing their Voice of Silence

2019 ◽  
Author(s):  
Bernice Kennedy ◽  
Chalice Rhodes (Former Jenkins)
Keyword(s):  
United States ◽  
Domestic Violence ◽  
African American ◽  
Black Women ◽  
African American Women ◽  
White Women ◽  
The United States ◽  
Slave Owner ◽  
American Women ◽  
Strong Black Women

Abstract Historically, during slavery, the international slave trade promoted normalization of violence against African American women. During slavery, African American women endured inhuman conditions because of the majority race views of them as being over-sexualized, physically strong, and immoral. This perception of the African American women as being highly sexual and more sexual than white women results in slave owner justifying their sexual violation and degrading of the African American women. The stereotypical representations of African American women as strong, controlling, dangerous, fearless, and invulnerable may interfere with the African American women receiving the needed services for domestic violence in the community. The Strong Black Women Archetype has been dated back to slavery describing their coping mechanism in dealing with oppression by developing a strong, less traditionally female role. The authors developed a model: The Multidimensional Perspectives of Factors Contributing to Domestic Violence of African American Women in the United States. This model depicts historically, the factors contributing to domestic violence of African American women in the United States. Also, this model addressed the African American women subscribing to the Strong Black Women Archetype to cope with domestic violence. Despite the increase in domestic violence in African American women, they focused more on the issue of racism instead of sexism in America. African American women have experienced the two obstacles of racism and sexism in America. However, African American women and men believe racism is more critical than sexism. Therefore, domestic violence in the African American population may remain silent because of cultural loyalty. However, the voice of silence of African American females is gradually changing with the upcoming generations.

Uprooting Racism: The Role of Nurses in Cultivating Improved Maternal Outcomes for Black and African American Women

2021 ◽  
Vol 27 (1) ◽  
pp. 61-65
Author(s):  
Jacquelyn McMillian-Bohler ◽  
Angela Richard-Eaglin
Keyword(s):  
United States ◽  
African American ◽  
African American Women ◽  
Allostatic Load ◽  
The United States ◽  
Individual Risk ◽  
Maternal Outcomes ◽  
Structural Racism ◽  
Practice Nurses ◽  
Individual Risk Factors

After controlling for education, socioeconomic status, and genetic factors, Black and African American patients in the United States are three to four times more likely to die in childbirth than are White patients. The literature is replete with strategies to improve maternal outcomes for Black and African American patients. Existing strategies focus on addressing poverty and individual risk factors to reduce maternal mortality, yet maternal outcomes are not improving for these patients in the United States. Recent literature suggests that a nuanced approach that considers the effects of individual and structural racism could improve maternal outcomes, especially for Black and African American patients. As nurses comprise the largest component of the health-care system, their collective power and influence can provide a powerful tool for dismantling structural racism. Some important concepts to consider regarding the care of the Black and African American population are cultural intelligence (CQ), allostatic load, and humanitarian ethos. By developing CQ and consistently including the four CQ capabilities (drive/motivation, knowledge/cognition, strategy/metacognition, and behavior/action) in all aspects of practice, nurses can help to uproot racism and cultivate experience to improve maternal health outcomes for Black and African American patients.

scholarly journals Moderating Factors in an Anti-stigma Intervention for African American Women with HIV in the United States: A Secondary Analysis of the UNITY Trial

2019 ◽  
Vol 23 (9) ◽  
pp. 2432-2442 ◽  
Author(s):  
Katrin E. Fabian ◽  
David Huh ◽  
Christopher G. Kemp ◽  
Paul E. Nevin ◽  
Jane M. Simoni ◽  
...  
Keyword(s):  
United States ◽  
African American ◽  
African American Women ◽  
Secondary Analysis ◽  
The United States ◽  
American Women ◽  
Moderating Factors ◽  
Women With Hiv
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