None of Us Will Get Out of Here Alive: The Intersection of Perceived Risk for HIV, Risk Behaviors and Survival Expectations among African American Emerging Adults

Abstract

The Human Immunodeficiency Virus (HIV) significantly affects minority emerging adults, among whom the rate of new diagnoses is high and health disparities are more pronounced. Importantly, emerging adults today have limited knowledge of the earlier toll of the virus when it was identified as a killer. Among this population, perceptions of risk for HIV are low and sexual risk taking behaviors are high. The Get SMART Project is a behavioral intervention aimed to provide re-purposed HIV, alcohol, and substance abuse prevention education and HIV testing to African American emerging adults ages 18-24. The project was guided by the Health Belief Model, Community Promise, and Training for Institutional Procedures. Findings revealed that HIV testing is low. Marijuana and alcohol are drugs of choice. Emerging adults do not see themselves at risk for HIV, although they engaged in high-risk behaviors. Additionally, survival expectations influence behavior risk.

College students' underlying perceptions of COVID-19 threat, healthcare discrimination, and healthcare system inequities associated with self-rated health across racial/ethnic groups in the U.S.

“…Continued research in this area is warranted given worsening mental health among college students (52) and rising racial/ethnic disparities in college students' health due to COVID-19 health concerns (14,15). Public health research may also consider the unique circumstances of COVID-19 that influence health-related perceptions [e.g., stronger alignment of perceived COVID-19 threat and objective COVID-19 risk among minoritized racial/ethnic groups compared to other diseases (53)]. This may present an opportunity to apply evidence from the COVID-19 pandemic to other chronic illnesses that disproportionately burden minoritized racial/ethnic populations.…”

Stress and the Mental Health of Populations of Color: Advancing Our Understanding of Race-related Stressors

“…More research is needed to identify the determinants of these challenges and identify how they can be effectively addressed. A recent study (Edwards et al 2017) of 365 emerging adults (96% African American), aged 18 to 24 years old affiliated with a university in a northeastern metro area, sheds light on the significant stressful challenges that youth perceive. The young adults report that their biggest concerns were aggressive policing, high levels of community violence, and the instability of their housing.…”

Integrating Individual and Contextual Factors to Explain Disparities in HIV/STI Among Heterosexual African American Youth: A Contemporary Literature Review and Social Ecological Model

“…Other psychological factors such as cognitions and traits predict behavioral outcomes among African American youth, but not infection outcomes, suggesting that they may be less impactful psychological factors among this group. For example, cognitive-based risk factors associated with economic disadvantage, including hopelessness (Kagan et al, 2012;Kogan, Yu, et al, 2013;Sterrett et al, 2014), low future orientation (Edwards et al, 2017;So, Voisin, Burnside, & Gaylord-Harden, 2016) and low self-esteem are all associated with behavioral (Danielson et al, 2014;Ellis, 2014;Lopez et al, 2011;, but not infection outcomes (e.g., Salazar et al, 2005). Other cognitions and traits that have been consistently related to HIV/STI risk include impulsivity, which predicts increased behavioral outcomes (Byck, Swann, Schalet, Bolland, & Mustanski, 2015;Kogan, Cho, Barnum, & Brown, 2015;Stock, Gibbons, Peterson, & Gerrard, 2013;Voisin, Tan, & Diclemente, 2013b;Wood et al, 2013), and sexual communication (including condom negotiation) self-efficacy, which is related to decreased behavioral outcomes (Burns & Dillon, 2005;; in regards to other sexual self-efficacy (e.g., condom skills and refusal), the relationship with HIV/STI risk has been equivocal Childs, Moneyham, & Feldman, 2008;Jones, Tiwari, Salazar, & Crosby, 2018).…”