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Multilevel Influences on HIV and Substance Use in a YMSM Cohort (RADAR), Chicago Metropolitan Area, 2015-2020 (ICPSR 37603)

Released/updated on: 2025-06-23
Geographic coverage: United States, Chicago, Illinois
Time period: 2015-02-01--2020-12-31

The National Institute on Drug Abuse (NIDA) funded RADAR in 2014 to collect multilevel, longitudinal data and biospecimens from an ethnically and racially diverse cohort of young, sexual and gender minorities (SGM; e.g., men who have sex with men (MSM), transgender women, gender non-conforming individuals) who were assigned male at birth (AMAB) (current core cohort n=1,113). The primary objective of this study is to apply a multilevel perspective to a syndemic of health issues associated with human immunodeficiency virus (HIV) in this population. The multilevel design focuses on individual, dyadic (i.e., sexual and romantic relationships), network (i.e., social, drug, and sexual connections) and biologic factors that may be associated with HIV. The cohort contains both HIV-negative and HIV-positive individuals, which allows for the development of a repository of biospecimens and HIV sequence data from both pre-infection and post-infection visits that will help facilitate future projects evaluating substance use, HIV risk, and pathogenesis.

A multiple cohort, accelerated longitudinal design was utilized by initially enrolling two existing SGM cohorts and then expanded through the use of convenience and snowball sampling methods. Enrollment criteria varied slightly based on the recruitment method, but overall inclusion criteria required participants to be AMAB, between 16 and 29 years of age, report having had sex with a man in the prior year or identify as a SGM, live in the Chicago metropolitan area, and be an English speaker. Study recruitment opened in February 2015. Participants are followed through the developmental period of late adolescence to early adulthood, which is a critical period of initiation and acceleration of sexual behavior and substance use. Study visits occur every six months.

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Simple Crosstabs

Combined Generations Wave 1 and TransPop surveys, United States, 2016-2018 (ICPSR 38421)

Released/updated on: 2024-08-29
Geographic coverage: United States
Time period: 2016-01-01--2018-12-31

This collection includes a combined dataset of the Generations study wave 1 (baseline) survey and the TransPop study transgender survey. The two studies have many overlapping variables, and they examined topics such as respondents' health outcomes and behaviors, experiences with discrimination, identity, and transition-related experiences. Data from these studies were merged to allow for analysis of the combined LGBT populations. This dataset has also been reweighted to be representative of these populations.

The complete Generations study data (baseline, wave 2, and wave 3 survey data) can be found under study number 37166, and the complete TransPop study data (transgender and cisgender survey data) can be found under study number 37938. For detailed information on the Generations and TransPop studies, including related publications, please refer to their respective DSDR/ICPSR study pages.

Curated
Simple Crosstabs

Community Health Center: Core Data Project, 2001-2002 [United States] (ICPSR 21520)

Released/updated on: 2023-12-13
Geographic coverage: Vermont, Rhode Island, Massachusetts, Maine, Connecticut, New Hampshire
Time period: 2001-01-01--2002-12-31
A survey was administered to any patient that presented for services at a health center between 2001 and 2002. Patients were asked to complete a brief survey with questions relating to demographic, relationship status, reason for choosing this health center, mental health status, and abuse history.
Curated
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Simple Crosstabs

Lay Conceptions of Sexual Orientation Groups: United States Convenience Samples, 2012 (ICPSR 38131)

Released/updated on: 2023-01-30
Geographic coverage: United States
Time period: 2012-01-01--2012-12-31
Researchers aimed to characterize certain features of lay beliefs and attitudes surrounding sexual orientation groups, with a particular focus on conceptions of bisexual people. In brief, participants were recruited without explicitly calling attention to their own sexual orientation, but with a number of intentional steps to make the study visible to sexual minorities. The study asked participants a series of questions about issues related to sexuality, gender, and sexual orientation. Most notably, in the middle section of the study, participants were randomly assigned to consider one group in-depth: heterosexual women, heterosexual men, bisexual women, bisexual men, homosexual women, and homosexual men. (The adjective structure was kept consistent for all 6 groups.) Participants responded to a number of attitude and belief items about their assigned target group, including beliefs about the controllability and stability of the group's sexual orientation and guesses about the personality characteristics of group members.
Curated
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Simple Crosstabs

Generations: A Study of the Life and Health of LGB People in a Changing Society, United States, 2016-2019 (ICPSR 37166)

Released/updated on: 2023-01-05
Geographic coverage: United States
Time period: 2016-01-01--2017-12-31, 2017-01-01--2018-12-31, 2018-01-01--2019-12-31

The Generations study is a five-year study designed to examine health and well-being across three generations of lesbians, gay men, and bisexuals (LGB). The study explored identity, stress, health outcomes, and health care and services utilization among LGBs in three generations of adults who came of age during different historical contexts. This collection includes baseline, wave 1, and wave 2 data collected as part of the Generations study.

The study aimed to assess whether younger cohorts of LGBs differed from older cohorts in how they viewed their LGB identity and experienced stress related to prejudice and everyday forms of discrimination, as well as whether patterns of resilience differed between different LGB cohorts. Additionally, the study sought to examine how differences in stress experience affected mental health and well-being, including depressive and anxiety symptoms, substance and alcohol use, suicide ideation and behavior, and how younger LGBs utilized LGB-oriented social and health services, relative to older cohorts.

In wave 2, respondents were re-interviewed approximately one year after completion of the baseline (wave 1) survey. Only respondents who participated in the original sample of participants were surveyed at wave 2 (i.e., the enhancement oversample was not included in the longitudinal design of this study).

In wave 3, respondents were re-interviewed approximately one year after the completion of the wave 2 survey.

Demographic variables collected as part of this study include questions related to age, education, race, ethnicity, sexual identity, gender identity, income, employment, and religiosity.

Self-published

Distinctive negative reactions to intermediate social groups (ICPSR 153661)

Released/updated on: 2021-10-31
Geographic coverage: United States
In a series of seven studies, we examined how participants interpreted and responded to "intermediate" social groups. Specifically, the studies captured reactions to novel groups designed to manipulate social group intermediacy (Studies 1-5), Black/White biracial people (Study 6), and bisexual people (Study 7). In each study, participants provided separate evaluations of an intermediate group and two comparison groups (e.g., Black/White biracial people, Black people, White people). Intermediate groups were consistently rated as less conceptually legitimate (e.g., less distinctive, not a "real" group) than other groups.These studies are described together in a single research report (Burke, Perry, Dovidio, & LaFrance). For details about the procedures, please consult that report and its accompanying supplementary document. For convenience, a draft (preprint) of the manuscript (84 pages) and a draft of the supplementary document (22 pages) are included with this deposit as a single PDF file (106 pages total). More recent versions of these documents may be available elsewhere.All of the experiments were conducted online and all employed convenience samples. Most participants were recruited via Amazon Mechanical Turk. Study 3 (the one that manipulated the population size of the intermediate group) and Study 4 (the one that manipulated how the spots were inherited) used Yale School of Management's eLab service, which permits people to sign up to participate in surveys in exchange for fixed probabilities of earning gift cards.The dates of the individual studies are listed below. The numbering (e.g., Study 1, Study 2) corresponds to the order of presentation in the research report, which deviates from the order in which the studies were conducted.Pilot - manipulation of color: February 2014Pilot - manipulation of spot size: April 2014Study 1 - novel groups control: July 2014 (manipulated intermediate/control and choice/trait)Study 2 - novel groups medium spots: May 2014 (manipulated presentation of intermediate group - big & small spots versus medium spots and early versus late in the procedure)Studies 3 and 4 - novel groups group size and inherit: January 2015 (manipulated group size and how the spots were inherited)Study 5 - novel groups ingroup: May 2015 (manipulated whether participant was an outside observer or a member of one group)Study 6 - racial groups: August 2014 (White, Black, biracial, Native American)Study 7 - sexual orientation groups: October 2014 (heterosexual, gay/lesbian, bisexual, asexual)These data files contain missing values coded as -99 in addition to the usual missing values that are simply empty. A value of -99 indicates that the participant saw the item but did not respond to it.I recognize that the documentation of this project could be more detailed. I have many projects that could benefit from additional public documentation. If you are using the data, please reach out to me via email and I can prioritize sharing more information about this one. My most up-to-date email address should always be available at saraemilyburke.com/contact.html.
Self-published

Need for structure: Categorizing ambiguous items as art or not art (ICPSR 145981)

Released/updated on: 2021-07-25
Geographic coverage: United States
Time period: 2013-07-08--2013-08-12
In four studies, I attempted to use an art categorization task to temporarily manipulate participants' need for structure, and possibly their attitudes toward bisexual people. The task involved categorizing ambiguous or unambiguous items as "art" or "not art."
Data were collected via Amazon Mechanical Turk in July and August 2013. Study 1 took place on 2013-07-08, Study 2 on 2013-07-24, Study 3 from 2013-08-01 to 2013-08-02, and Study 4 on 2013-08-12.
In all data files, a value of -99 indicates that the participant saw the item in question but did not respond to it.
I recognize that the documentation of this project could be more detailed. I have many projects that could benefit from additional public documentation. If you are using the data, please reach out to me via email and I can prioritize sharing more information about this one. My most up-to-date email address should be available at saraemilyburke.com/contact.html.
Self-published

Lay conceptions of sexual orientation groups - 2 group variant (ICPSR 146021)

Released/updated on: 2021-07-25
Geographic coverage: United States
Time period: 2013-05-13--2013-05-14
This study is similar to RCMD-108921. (In that study, we randomly assigned participants to consider one sexual identity group in depth -- heterosexual women, heterosexual men, bisexual women, bisexual men, homosexual women, or homosexual men. We kept the adjective structure consistent for all six groups, but we recognize that using "homosexual" rather than "gay and lesbian" has its downsides. Participants responded to a number of attitude and belief items about their specific target group, including beliefs about the controllability and stability of the group's sexual orientation and guesses about the personality characteristics of group members.)The current study has a similar design, except that participants were randomly assigned to evaluate two of the six groups instead of just one, enabling us to characterize participant responses in the context of more explicit comparisons between groups.Data were collected via Amazon Mechanical Turk from 2013-05-13 to 2013-05-14.A value of -99 indicates that the participant saw the item but chose not to respond to it.Participant R_b406N6jrCBsjxBj listed their full birth date in response to the birth year item on the demographics page. In the deidentified data file, I removed the day and month from this response, leaving the year.I recognize that the documentation of this project could be more detailed. I have many projects that could benefit from additional public documentation. If you are using the data, please reach out to me via email and I can prioritize sharing more information about this one. My most up-to-date email address should be available at saraemilyburke.com/contact.html.
Curated
Simple Crosstabs

Mapping LGBTQ Equality: 2010 to 2020, United States (ICPSR 37877)

Released/updated on: 2021-07-14
Geographic coverage: United States
Time period: 2010-01-01--2020-01-01

Mapping LGBTQ Equality: 2010 to 2020 presented the status of LGBTQ equality at the U.S. state level by examining a policy tally by the Movement Advancement Project (MAP), and encompassed nearly 40 LGBTQ-related laws and policies across all 50 states, the District of Columbia, and the five U.S. territories as of January 1, 2020. The report also compared the January 1, 2020 status of LGBTQ policy landscape to the status of those same laws as of January 1, 2010.

MAP's policy tally aggregated these laws and policies to gauge the LGBTQ-related policy landscape across the country. What emerged in 2020 was a patchwork of positive LGBTQ laws and policies, with variations both by region and area of law, as well as growth in both the policy accomplishments and challenges facing LGBTQ people over the decade of observation.

Areas of law and policy included: relationship and parental recognition, nondiscrimination, religious exemptions, LGBTQ youth-related laws, health care, criminal justice, and identity documents.

Curated
Restricted

Identifying Sexual Assault Mechanisms Among Diverse Women, New York State, 2016-2017 (ICPSR 37450)

Released/updated on: 2021-04-29
Geographic coverage: United States, New York (state), Buffalo
Time period: 2016-01-01--2017-12-31

This study offers novel insights into mechanisms associated with sexual assault (SA) among sexual minority women (SMW). Experiences of bias and stigma contribute to lower rates of SA reporting by this population. This results in victims with unmet needs and fewer criminal prosecutions of SA perpetrators. This study used a mixed-methods approach to collect data from lesbian, bisexual, and heterosexual women to instigate changes that would improve responses from law enforcement, victim services, and anti-violence programs that serve SMW.

This study comprised of three parts a: baseline survey, qualitative interview, and daily survey. Self-reported baseline questionnaires included topics like lifetime victimization (childhood sexual abuse, adult sexual aggression, and assault), discrimination, distress, mental health, alcohol use, and sexual history. The qualitative interviews focused on the most recent, and when applicable, the most salient adult sexual assault (ASA) incident. Interviews began by asking the participants to describe their ASA incidents with follow-probes asking about the victimization, perpetrator characteristics (gender and relationship to participant), and context of assault (role of alcohol or drugs and setting). Participants were also asked if they discussed the assault with anyone and their reasons for disclosure or non-disclosure. As well as short and long-term coping patterns. The daily survey asked participants about their mood, alcohol use, drinking contexts, and sexual experiences (consensual and non-consensual).

This study contains demographic information such as: age, race, income, education, and BMI.

Curated
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Simple Crosstabs

Project STRIDE: Stress, Identity, and Mental Health, New York City, 2004-2005 (ICPSR 35525)

Released/updated on: 2018-11-28
Geographic coverage: New York City
Time period: 2004-01-01--2005-12-31

Project STRIDE is a three-year research project that examines the effect of stress and minority identity related to sexual orientation, race/ethnicity and gender on mental health. The research describes social stressors that affect minority populations, explores the coping and social support resources that they utilize as they confront these social stressors, and assesses the associations of stress and coping with mental health outcomes including mental disorders and wellbeing. The study also explores the impact of various identity characteristics, such as whether an identity is viewed positively or negatively, or whether it is prominent or not to the relationship of stress and mental health outcomes.

The study, using extensive quantitative and some qualitative measures, is a longitudinal survey of 525 men and women between the ages 18 and 59 who are residents of New York City. Socio-demographic information collected about respondents included age, education, race and Hispanic ethnicity, adopting the measures developed and used by the United States Census Bureau in the United States population survey of 2000. In addition to these items, racial/ethnic identity was also assessed with the question "What is the country of origin related to your or your family's ethnic or national background, if any?" Respondents were allowed to select up to two nations from a comprehensive listing. For the purposes of the study, the instrument also assessed whether or not participants were natives of New York City or migrated as adults. Additional demographic variables include employment status, religion, relationship status, and sexual orientation.

Self-published

National Survey of Sexual Health & Behavior: Bisexualities Indiana Attitudes Scale (ICPSR 100265)

Released/updated on: 2016-09-20
Geographic coverage: United States
As bisexual individuals in the United States (U.S.) face significant health disparities, researchers have posited that these differences may be fueled, at least in part, by negative attitudes, prejudice, stigma, and discrimination toward bisexual individuals from heterosexual and gay/lesbian individuals. Previous studies of individual and social attitudes toward bisexual men and women have been conducted almost exclusively with convenience samples, with limited generalizability to the broader U.S. population. Our study provides an assessment of attitudes toward bisexual men and women among a nationally representative sample of heterosexual, gay, lesbian, and “other”-identified adults in the U.S. Data were collected from the 2015 National Survey of Sexual Health and Behavior (NSSHB), via an online questionnaire with a probability sample of adults (18 and over) from throughout the U.S. We included two modified 5-item versions of the Bisexualities: Indiana Attitudes Scale (BIAS), validated sub-scales that were developed to measure attitudes toward bisexual men and women. Data were analyzed using descriptive statistics, gamma regression, and paired t-tests. Gender, sexual identity, age, race/ethnicity, income, and educational attainment were all significantly associated with participants' attitudes toward bisexual individuals. In terms of responses to individual scale items, participants were most likely to “neither agree nor disagree” with attitudinal statements. Across sexual identities, self-identified "other" participants reported the most positive attitudes, while heterosexual male participants reported the least positive attitudes. Overall, attitudes toward bisexual men were significantly less positive than toward bisexual women across identities. As in previous research on convenience samples, we found a wide range of demographic characteristics were related with attitudes toward bisexual individuals in our nationally-representative study of heterosexual, gay/lesbian, and "other"-identified adults in the U.S. Additionally, as in previous studies, gender emerged as a significant characteristic; female participants’ attitudes were more positive than male participants’ attitudes, and all participants’ attitudes were generally more positive toward bisexual women than bisexual men. While population data suggest a marked shift in more positive attitudes toward gay men and lesbian women in the general population of the U.S., the largest proportions of participants in our study reported a relative lack of agreement or disagreement with the affective-evaluative statements in the BIAS scales. Findings document the absence of positive attitudes toward bisexual individuals among the general population of adults in the U.S. Our findings highlight the need for developing intervention approaches to promote more positive attitudes toward bisexual individuals, targeted toward not only heterosexual and but also gay/lesbian individuals and communities.
External data

Gender, Power and Latino Men's HIV Risk (ICPSR 35837)

Released/updated on: 2015-04-24
Geographic coverage: United States
The project has a 4-year ethnographic study design with two components of data collection to investigate issues of bisexuality and HIV risk among Latinos in the United States. The first component consists of in-depth interviews with behaviorally bisexual Latino men (N=160) from five research sites in the New York City metropolitan area. The first two years of the study are dedicated to the in-depth interviews component. The second data collection component of the study is an ethnography. This component lasts 3 years, beginning in years 1 and 2 with key informant interviews (N=25) and continuing in year 3 with ethnographic mapping and 25 group interviews with AIDS Service Delivery Organizations across the 5 research sites. The last year of the project focuses on using Intervention Mapping (IM) to analyze the data collected and design the pilot intervention to reduce HIV risk among bisexual Latino men.
Curated
Partially restricted
Simple Crosstabs

Civil Union Study 2000-2002, United States (ICPSR 31241)

Released/updated on: 2014-09-26
Geographic coverage: Vermont, United States
Time period: 2000-01-01--2002-12-31
Vermont was the first state in the United States to legalize same-sex relationships in mid-2000, so that same-sex couples could have the same legal rights as heterosexual married couples at the state level. Same-sex couples came to Vermont from all over the country to legalize their relationships. During the first year that this legislation was enacted, 80 percent of civil unions were acquired by out-of-state residents. In 2002, a project was conducted that compared couples who had civil unions in Vermont during the first year of that new legislation (July 2000-June 2001) with same-sex couples in their friendship circles who had not had civil unions, and with heterosexual married siblings (Solomon, Rothblum, and Balsam, 2004; 2005). The focus was on demographic factors, length of relationship, social support from family and friends, contact with families of origin, social and political activities, degree of "outness," and division of housework, child care, and finances. This was the first study to focus on same-sex couples in legalized relationships in the United States. It was also the first study to examine same-sex couples recruited from a population instead of a convenience sample, because civil unions are a matter of public record. Results indicated very few differences between same-sex couples in civil unions and those not in civil unions, particularly for women. Women in civil unions were more "out" about their sexual orientation, and more likely to consider themselves married than were women not in civil unions. Men in civil unions were more likely to have children, joint bank accounts with their partner, mutual friends with their partner, more connection with their family of origin, and to consider themselves married. They were less likely to have seriously discussed ending their relationship than men not in civil unions (Solomon et al., 2004). In contrast, both types of same-sex couples differed from heterosexual married couples in numerous ways. Same-sex couples were in their current relationship for a shorter duration, less religious, less likely to have children, more likely to share housework and finances, and less close to their family of origin than heterosexual couples. Women in same-sex relationships were more highly educated and perceived less social support from their family of origin than heterosexual married women. Men in same-sex relationships lived in larger cities, were less monogamous and more likely to agree that non-monogamy was acceptable, and perceived more social support from their friends than heterosexual married men. It is not surprising that same-sex couples differed from heterosexual couples. Prior research on lesbians and gay men from convenience samples that compared them to (a) United States census data (e.g., Bradford and Ryan, 1988), (b) their heterosexual siblings (e.g., Rothblum, et al., 2004; Rothblum and Factor, 2001), and (c) representative national samples (e.g., Laumann, Gagnon, Michael and Michaels, 1994) have consistently indicated demographic differences. It was also not surprising that same-sex couples in civil unions were quite similar to same-sex couples not in civil unions given that the first study was conducted after the first year of the new legislation. Consequently, that study was more about who chooses to have a civil union versus those who do not. It was less about how being in a civil union changes a relationship -- for that, follow-up research is needed. Demographic variables include age, race, education, religion, sexual orientation, income, and occupation.
Curated

Retention Challenges for HIV-Infected Primary Care Patients 2001-2004 [United States] (ICPSR 22220)

Released/updated on: 2010-08-30
Geographic coverage: Vermont, Rhode Island, United States, Massachusetts, Maine, Connecticut, New Hampshire
Time period: 2001-01-01--2004-12-31
This project examined HIV-infected patients who were lost to follow-up during calendar years 2001-2004 in order to identify reasons patients were leaving care. Sustaining and retaining HIV-infected patients in care has been a consistent challenge to primary care health systems. Continuity, enhancing wellness, and patient engagement are long-term goals in primary care. Factors that influence clients to disengage from care frequently result in patterns of episodic utilization that may compromise the patient's health status and increase their psychosocial vulnerability. The standard of care suggests that HIV-infected patients return for medical follow-up primary care visits four times a year. Since 2001, there have been over 495 patients that have been determined inactive. The project administered telephone and mail surveys to HIV-infected patients that no longer receive care at Fenway Health Center. The survey includes demographic questions, insurance questions, potential reasons for stopping care, and whether the participant is receiving care at another facility. Subsequently, the project connected interviewees into the Health System Navigation (HSN) Project to assist them with seeking HIV medical care. This was accomplished by including prescreener questions in the survey. If a patient is determined to be eligible, they will be invited to participate in the HSN Project.
Curated

Mental Health Concerns of Gay and Bisexual Men Seeking Mental Health Services, 2000 [United States] (ICPSR 22121)

Released/updated on: 2010-06-17
Geographic coverage: United States, New England
Time period: 2000-01-01--2000-06-30
This retrospective chart review was conducted on gay and bisexual men who presented for a mental health intake at a health center between January 2000 and June 2000 during which time intake procedures and assessments remained the same. Mental health intakes consisted of one- to three-hour clinical interviews conducted by psychologists and clinical social workers, who determined treatment recommendations and assignments. Current presenting problem(s) and history of them; prior medical, mental health and substance abuse treatment; current symptoms; areas of impaired functioning; and abuse history were included. Because mental health is a key component of overall quality of life, mental health providers who work with MSM can use these data to increase awareness of the types of mental concerns that are most distressing to this population.
Curated

Women's Health in Boston and Cambridge, 2000 [Massachusetts] (ICPSR 26583)

Released/updated on: 2010-06-16
Geographic coverage: United States, Massachusetts, Cambridge, Boston
Time period: 2000-09-01--2000-11-30
Using Random Digit Dial, this study tested the feasibility of using a brief telephone interview to assess sexual attraction, behavior, and identity among women. A neighborhood in Boston with a high density of lesbian residents was selected. The study used three criteria to identify a neighborhood that was expected to have a high density of lesbian residents. Neighborhoods were defined by a postal ZIP code so that potential respondents could easily identify whether or not they lived in the target area. The criteria used were: (a) a high proportion of never-married females aged 35 years or older (calculated as ratio of ZIP code area to city wide, United States Department of Commerce, 1990), (b) a high proportion of female-headed households who also reported an unmarried female partner in the household (United States Department of Commerce, Bureau of the Census, 1990), and (c) a high proportion of female patients from the ZIP code area among Fenway Community Health Center female patients (Fenway Community Health Center is a major health service provider to gay and lesbian populations in Boston and Cambridge). These criteria led to the selection of the Jamaica Plain neighborhood in Boston. Women were eligible if they resided in that area, were between the ages of 18 and 59 years, and spoke English well enough to be able to answer the interview questions. Phone interviews lasted a mean of 5.6 minutes. Respondents who identified themselves as lesbian or bisexual completed an additional specialized section that lasted a mean of 2.5 minutes and inquired about participation in and identification with the gay/lesbian community. In total, 1,250 numbers were dialed. Of them, 169 (14 percent) were nonworking numbers, 165 (13 percent) were not households (e.g., businesses), 235 (19 percent) were indeterminable (number was never answered by a person), and 681 (54 percent) were households. Of these households, 439 (64 percent) were successfully screened, 176 (26 percent) refused or delayed screening, and 66 (10 percent) could not be screened (e.g., language barriers). Of the screened households, 223 (51 percent) were not eligible. Of 216 eligible households, 202 (94 percent) women completed the interview.
Curated

Positive Connections: Connecting HIV-Infected Patients to Care, 2004-2006 [United States] (ICPSR 22482)

Released/updated on: 2010-06-16
Geographic coverage: United States, New England
Time period: 2004-01-01--2006-12-31
The research study Positive Connections tested the Health Systems Navigation (HSN) model, an intervention linking near-peer interventionists with underserved HIV-infected individuals to assist them to become engaged and retained in HIV medical care through supportive services and facilitated referrals. Working with a core group of local AIDS service organizations to identify unstable and out-of-care HIV-positive individuals, the HSN will enroll and provide health system navigation to participants. The principal goal was to enhance the probability that individuals from historically underserved populations would become engaged and retained in high quality, culturally competent HIV care. The theoretical basis for this intervention included individual behavior change models, social and community networks, and provider cultural competence. This project also sought to improve the understanding and the measurement of health care access problems by seeking to determine which problems have indicators and which do not, and to identify steps that can be taken to develop a reliable access monitoring system. The concept of Health Systems Navigator has been developed by the Multicultural AIDS Coalition.
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