J Natl Med Assoc
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Editorial Historical Article
The use of historical vital statistics when analyzing African-descended population heterogeneity.
This paper explores population substructure through an analysis of 726 individual death certificates representing African-American and West-Indian immigrant populations who died from tubercular infection in Manhattan, New York City, NY, 1890-1930. From the death certificate data, four classes of tubercular infection were derived: pulmonary, chronic pulmonary, acute/miliary tuberculosis and tubercular meningitis. ⋯ Through a Chi-squared analysis, the data demonstrated that: 1) color did not significantly influence the type of tuberculosis an individual died from, and 2) region of birth influenced the type of tuberculosis an individual died from. The results of this analysis lead to the conclusion that historical vital records, specifically death certificate data, are useful when exploring historical population substructure.
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HIV and AIDS disproportionately affect African Americans more than any other racial or ethnic group in the United States. Representing only 13% of the U. ⋯ The present incidence and prevalence of HIV/AIDS in the black community in the United States is of crisis proportions. The situation as it stands today is tantamount to a state of emergency for African Americans.
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HIV/AIDS continues to create a significant health crisis in African-American communities and health disparities within the United States. Understanding African-American sexuality within a culturally congruent and ethnocentric approach is critical to decreasing the HIV infection and transmission rates for African Americans. ⋯ Research trainings for new and established investigators and collaborations among health, community, religious, political organizations, and historically black colleges and universities are needed to disseminate relevant HIV prevention messages. Conducting research to better understand African-American sexuality will facilitate the development of behavioral interventions that address health, HIV and mental health risk reduction within the context of African-American life.
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It is estimated that nearly half of all African-American men who have sex with men (AAMSM) living in major U. S. cities are already infected with HIV. ⋯ In this paper, we briefly review what is known and what research questions remain in order to curtail the epidemic among AAMSM. Finally, we provide recommendations for future research that include the: 1) development of a national cohort of young AAMSM to prospectively study biological, behavioral, social and contextual factors that place AAMSM at risk for infection with HIV and other STDs; 2) adapting existing interventions in HIV prevention to the unique characteristics of AAMSM and evaluating their effectiveness; 3) evaluating factors such as intracommunity and familial discrimination against AAMSM that may lead to lack of disclosure; and 4) enhancing our understanding of how cultural and social factors can be used in a positive and self-affirming way to strengthen HIV prevention and care for AAMSM.
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Incarceration is a crisis among African Americans, and the prevalence of HIV/AIDS in incarcerated men and women is 3-5 times that of the general population. We explore the potential implications of the widespread incarceration of African Americans on HIV risk and HIV outcomes in: 1) the current and formerly incarcerated, 2) their sexual partners, and 3) the communities impacted by incarceration. We set forth a research agenda for understanding and ameliorating the negative impacts incarceration and conclude that the African-American population's ability to successfully address the HIV/AIDS epidemic requires a coordinated and evidence-based response to the challenge of effectively preventing, managing and treating HIV in populations affected by incarceration.