Short and disrupted sleep is related to perceptions of neighborhood in pregnant African American women of low socioeconomic status.

African American women experience disproportionate cardiovascular disease risk, and altered central hemodynamics signal early vascular aging. For African American mothers, concern about their children's exposure to racism represents a salient psychosocial stressor, but its vascular consequences are unclear. We examined whether greater racism‑related Concern for Children (CFC) was associated with adverse longitudinal changes in central hemodynamics. African American mothers aged 30-46 years (n=236) underwent assessments of central systolic blood pressure (cSBP), augmentation index (AIx), pulse pressure amplification (PPA), and pulse wave velocity (PWV; n=205) at baseline and 4±1 years later. CFC was measured continuously (range 0-24) and categorically (high vs. low). Multivariable linear regression models examined associations between CFC and changes in central hemodynamics, adjusting for baseline values and sociodemographic, clinical, and psychosocial covariates. Logistic regression evaluated CFC and odds of newly developed high‑risk PPA (PPA<1.3). In fully adjusted models, greater CFC was associated with larger increases in AIx (b=0.30, 95% CI [0.11, 0.48]; P=0.002). At follow‑up, women with high CFC had AIx values 3.9 percentage points higher than those with low CFC (P=0.005). CFC was also associated with declining PPA (b=‑0.003, 95% CI [‑0.005, ‑0.001]; P=0.024) and greater odds of newly developed high‑risk PPA (OR=1.08, 95% CI [1.01, 1.15]; P=0.033). No associations were observed for cSBP or PWV. Greater racism‑related concern for children is associated with signs of early vascular aging in African American mothers, highlighting the cardiovascular consequences of racism‑related maternal stress.

Triple-negative breast cancer (TNBC), an aggressive subtype with poor prognosis, is of higher frequency in African American women and women of Sub-Saharan African origin. In France, legal constraints on obtaining health data on race, ethnicity, or nationality in cancer registries and medical records make it difficult to estimate the frequency of TNBC according to women’s origins. These constraints result from a historical “universalist” approach to French citizenship which prohibits the routine collection of ethnoracial data. An anonymous, statistical survey we conducted from a single-hospital case series of 780 women with breast cancer followed in a university hospital in Paris showed that TNBCs were at least 3 times more common in patients born in Sub-Saharan Africa than in patients born in France. The former consulted at a more advanced stage of the disease than the latter. The results of an ethnographic study of African women in the Paris region with breast cancer, conducted for several years, highlighted some explanatory factors: low breast cancer awareness, perceived causes distinct from biomedical etiology, the weight of shame and secrecy, prior recourse to local healing, difficulties in communicating with health professionals and navigating the healthcare system. Although considered a public health priority, TNBCs are an emblematic example of the limits produced by French race and ethnicity blindness in public health, epidemiology, prevention and health care.

African American women are disproportionately exposed to childhood maltreatment and intimate partner violence (IPV). We examined two dimensions of self-esteem as potential mediators of the childhood maltreatment-IPV association in 232 African American women living below the federal poverty threshold. Three childhood maltreatment subtypes correlated with exposure to physical IPV. Four childhood maltreatment subtypes correlated with exposure to nonphysical IPV and lower self-esteem according to women's self-perceptions (Self) but not their beliefs about how others view them (Other). Lower self-esteem on each dimension was associated with greater exposure to physical and nonphysical IPV. Mediation analyses with bootstrapping revealed that both dimensions of self-esteem were significant mediators. Findings suggest that culturally responsive interventions that bolster self-esteem may mitigate the effects of childhood maltreatment on African American women's relationships.

Interpersonal invisibility is a consequential form of stigmatization but is not well-understood. Existing work has largely focused on who feels invisible (between-person effects) rather than when people feel invisible (within-person effects). Five studies (N = 3,575) examine when people feel invisible. In Studies 1 and 2, Black, East Asian, and White American men and women report how invisible they feel to men and women motivated to protect themselves or to seek a romantic partner. Studies 3, 4, and 5 additionally explore invisibility to same- and other-race people. Results show that invisibility is dynamic: Participants report that they are invisible to some people and not to others, depending on the combination of their own race and gender with the race, gender, and goals of the other person. These findings speak to theories of invisibility and constitute a critical development in our understanding of when and why people feel invisible to others.

Compared to European American women, African American women are more likely to be diagnosed with triple-negative breast cancer (TNBC). This difference may be partially due to genetic factors. This study aims to investigate associations of African ancestry and risk variants with TNBC among African American women. We used data from 2,335 TNBC cases, 8,159 estrogen receptor (ER)-positive cases, and 9,814 controls included in the African-ancestry Breast Cancer Genetics (AABCG) Consortium. The proportion of African ancestry (%AFR) and local ancestry were estimated using samples from the 1000 Genomes Project as reference. Logistic regressions were performed for case-control (TNBC vs. control) and case-case (TNBC vs. ER-positive) comparisons, adjusted for age, study, genotype principal components 2-5, body mass index, and reproductive factors. Local ancestry-aware association analyses were conducted in 12 TNBC risk loci to identify ancestry-specific risk variants. In case-control analyses, no statistically significant association was found between %AFR and TNBC risk after adjustment for potential confounders. However, TNBC cases had a significantly higher mean % AFR (mean = 0.811, standard deviation, SD = 0.104) compared to ER-positive cases (mean = 0.798, SD = 0.110, P < 0.001). Females with %AFR of ≥ 95% had 1.62 times higher odds (95% confidence interval, CI: 1.16-2.25) of having TNBC rather than ER-positive breast cancer, compared to those with %AFR of 55.0-64.9%. Local ancestry-aware association analyses identified seven subtype-informative variants in or near MDM4, RP11-19E11.1, TERT, MRPL36, TCF7L2, C11orf65, and ANKLE1. All of them were significantly associated with TNBC as compared with ER-positive cases, and six of them were also associated with TNBC risk in case-control analyses. Large allelic odds ratios of 1.25 or higher were found in association with TNBC risk or subtype classification. The risk allele frequency for five of them is substantially higher in haplotypes of African ancestry than those of European ancestry. These findings support a significant role of African-ancestry specific genetic factors in determining breast cancer subtypes and highlight the need for future research to uncover possible pathways driving TNBC susceptibility.

Hypertension and preeclampsia are clinically distinct, yet biologically related conditions characterized by vascular dysfunction and elevated cardiovascular risk. Although genome-wide association studies (GWAS) have identified loci associated with blood pressure traits and preeclampsia, the functional mechanisms linking shared variants to gene regulation and clinical phenotypes remain unclear. We integrated GWAS summary statistics for hypertension, systolic blood pressure (SBP), diastolic blood pressure (DBP), and preeclampsia to identify shared variants (p ≤ 1×10⁻⁴). Cis-expression quantitative trait loci (eQTL) analyses were performed in whole blood using RNA-seq data from 180 African American women. Significant associations (FDR ≤ 0.05) were evaluated for replication across vascular, metabolic, and endocrine tissues in the Genotype-Tissue Expression (GTEx) project. Associations between gene expression and blood pressure traits were also assessed. We identified 4,792 shared GWAS variants, of which 4,663 were tested in eQTL analyses, yielding 1,837 significant variant-gene associations across 78 genes. Replication in GTEx confirmed 645 associations involving 24 genes, many showing cross-tissue regulatory effects. Three genes (C4B, HLA-C, and HLA-DQB1) demonstrated convergent evidence across GWAS, gene regulation, and expression-trait analyses. C4B expression was positively associated with hypertension and SBP, while HLA-C showed consistent negative associations with hypertension, SBP, and DBP. HLA-DQB1 expression was specifically associated with DBP, suggesting trait-specific effects. These findings highlight immune-related pathways as key mediators linking hypertension and preeclampsia. Integrating genetic, transcriptomic, and phenotypic data provides a framework for identifying functionally relevant loci and advancing mechanistic insights into cardiometabolic and pregnancy-related disorders. Shared genetic variants across hypertension, blood pressure traits, and preeclampsia converge on immune regulatory genes linking gene regulation to clinical phenotypes. GWAS summary statistics for hypertension, SBP, DBP, and preeclampsia were intersected to identify 4,792 shared variants, of which 4,663 were tested in cis-eQTL analyses in whole blood from 180 African American women ( left ). Shared variants regulate immune-related genes through cis-eQTL effects, yielding 1,837 associations involving 78 genes (FDR ≤ 0.05). Three convergent genes emerged: C4B (upregulated), HLA-C (downregulated), and HLA-DQB1 (upregulated), with 645 associations involving 24 genes replicated across eight tissues in GTEx ( center ). Expression-trait analyses confirmed that C4B expression was positively associated with hypertension and SBP, HLA-C expression was negatively associated with hypertension, SBP, and DBP, and HLA-DQB1 expression was specifically associated with DBP. These genes implicate complement activation, antigen presentation, and adaptive immunity as shared mechanisms contributing to vascular dysfunction in both hypertension and preeclampsia. eQTL indicates expression quantitative trait locus; FDR, false discovery rate; GTEx, Genotype-Tissue Expression project; SBP, systolic blood pressure; DBP, diastolic blood pressure; APC, antigen-presenting cell; TCR, T-cell receptor; MHC, major histocompatibility complex.

African American (AA) women face disproportionate cardiovascular disease (CVD) risk due to adverse social determinants of health (SDoH), including lower socioeconomic status (SES). Physical activity (PA) and plasma extracellular vesicles (EVs) modulate CVD risk, but their relationships with SDoH remain unclear. This study examines associations between SDoH, PA, and plasma EVs in a Washington, DC-based cohort of at-risk AA women. Participants (N = 24, Age: 57 ± 12, BMI: 35 ± 6, ASCVD: 9 ± 5) joined the Step It Up Community-Engaged, Digital Health Physical Activity Intervention pilot study. EVs were isolated from fasting plasma samples. Multivariable regression, adjusted for BMI and ASCVD 10-year risk, showed that neighborhood socioeconomic deprivation (NSD) was associated with decreased EV size (β=-0.49, p = 0.01), while higher daily step count was associated with increased EV size (β = 0.48, p = 0.02). EV miRNA cargo, including miR-1246, miR-28-5p, and miR-765, showed distinct expression patterns with EV size, NSD, and PA. In vitro, endothelial cell (EC) barrier integrity directly correlated with miR-28-5p (r = 0.73, p = 0.007) and miR-765 (r=-0.58, p = 0.049). EC migration correlated negatively with miR-28-5p (r=-0.67, p = 0.02). Findings highlight smaller EV size associated with high NSD and low PA, suggesting miR-28-5p may be a biomarker or mediator for CVD pathogenesis. PA interventions may mitigate adverse SDoH effects and establish EV miRNA cargo as biomarkers and/or intervention mediators.

The interplay between loneliness, cortisol, and NK cell function: The role of cortisol in NK cell dysfunction.

African Americans (AAs) tend to have unhealthy eating behaviors, less physical activity (PA) participation, and higher stress levels compared to people who are White. These variables also have bidirectional relationships. Ecological Momentary Assessment (EMA) methodology can be used to examine these relationships through repeated data collection. This narrative review aims to assess EMA studies that examine the bidirectional relationships between healthy eating, PA, and stress in AA adults. Four databases were searched for studies that met inclusion criteria. Two separate searches were completed: one for healthy eating and stress, and one for PA and stress. Two reviewers independently assessed articles to minimize bias, while resolving discrepancies through discussion. Of the 97 articles identified, four studies met inclusion criteria (one on diet, two on PA, and one on both). These studies used five daily prompts sent for sevendays and found that stress was associated with daily unhealthy eating and less daily PA, and increased PA participation was associated with less daily stress among AA women. No studies examined how healthy eating impacts stress or how both healthy eating and PA can influence stress, and three of the studies only included AA women. EMA methodology is useful for exploring how stress influences healthy eating and PA, and how PA impacts stress. Given the disproportionate stress burden among AA adults, future research should utilize EMA to explore how healthy eating impacts stress and the combined impact of healthy eating and PA on stress among this population.

Digital technologies are central sources of health information, yet meaningful engagement with online resources varies widely, even among individuals with regular Internet access. This study examined whether digital self-efficacy and stage of change for using the Internet to obtain health information predicted evaluation of a culturally tailored online health portal. A cross-sectional survey was completed by 206 adult African American women following structured exposure to a nutrition and physical activity website designed using both surface- and deep-structure cultural tailoring strategies. Measures assessed digital self-efficacy, stage of change for Internet-based health information use, attitudes toward website features, and overall portal evaluation. Bivariate analyses indicated that higher digital self-efficacy and more advanced stage of change were associated with more favorable portal evaluation. In multivariable regression models, stage of change and endorsement of valued website features emerged as significant independent predictors, whereas structural access indicators did not. Digital self-efficacy was associated with evaluation but did not retain independent significance after accounting for readiness. Regression diagnostics supported the stability of model estimates. Qualitative findings reinforced these results, with participants emphasizing clarity, usability, and culturally relevant representation as central to engagement. Integration of qualitative and quantitative findings demonstrated methodological triangulation, supporting the interpretation that engagement reflects both cognitive appraisal of design features and developmental readiness. These findings suggest that digital health engagement is a staged, psychologically mediated process rather than a direct consequence of access. Interventions that align with motivational readiness and incorporate culturally responsive design may enhance sustained engagement and advance digital health equity.

Neurofilament light (NfL) is a biomarker of neurodegeneration that increases with age, yet the trajectory of this increase and its susceptibility to psychosocial stressors remain unclear. Racial discrimination is a psychosocial stressor disproportionately experienced by African Americans (AAs) that may accelerate neurodegenerative processes. This study analyzed 15 years of longitudinal data from AA women to examine the relationship between racial discrimination reported at midlife and age-related changes in serum NfL (sNfL) levels. Because it is typically a chronic stressor, we hypothesized that racial discrimination at midlife would forecast accelerated age-related increases in sNfL levels across 15 years. Multilevel growth models were used to estimate linear and nonlinear trajectories of sNfL as a function of age. Results showed a significant acceleration in sNfL levels after age 40, resulting in a nonlinear growth function. Moreover, racial discrimination moderated the relationship between age and sNfL, with higher levels of discrimination reported in midlife associated with a more pronounced acceleration in sNfL, particularly in late midlife (after age 55). These findings suggest that racial discrimination may contribute to the acceleration of age-related changes in sNfL, a biomarker of neurodegeneration. They further indicate that magnitude of increases in sNfL with age may be sensitive to external stressors and so highlight the potential for targeted interventions to mitigate stress-related risks for accelerated sNfL among AA women.

ABSTRACT This qualitative explanatory study investigated risk-taking behaviors of sex practices and drug use associated with HIV-positive status among African American women. This study was conducted using a non-probabilistic sample of 252 African American women aged from 18 to 65. The data was analyzed using a t-test, Pearson correlation coefficient, and stepwise regression. Four research hypotheses were tested: Ha1: The HIV-positive group will exhibit significantly higher risk-taking behaviors compared to the HIV-negative group. Ha2: HIV-negative group will possess significantly greater knowledge of HIV compared to the HIV-positive group. Ha3: Knowledge of HIV is inversely related to risk-taking behaviors. Ha4: Demographic and socioeconomic factors (age, student status, sexual orientation) have a significant effect on HIV risk-taking behaviors and HIV knowledge. The data suggests that hypotheses one and four were supported, and hypotheses two and three were unsupported. Specifically, the data confirms hypothesis one. Respondents have higher HIV risk-taking behaviors than their HIV negative counterparts. Further, the data confirms that HIV risk-taking behaviors were primarily predicted by positive status (b = 3.816, p < .01, sr2 = .03) and bachelor’s education or higher (b = −4.848, p < .01, sr2 = .07). A key finding of this study is that HIV-negative and HIV-positive Black/African American female respondents were similar in their risk-taking behaviors. HIV-negative and HIV-positive Black/African American female respondents were identical in HIV knowledge.

MammaPrint (MP), a 70-gene expression profile assay, informs treatment decisions in early-stage breast cancer by classifying patients into high or low risk of recurrence categories. However, racial disparities in breast cancer outcomes necessitate an evaluation of MP's prognostic utility across diverse populations. This study explores differences in MP scores and associated outcomes among women of various racial backgrounds. We retrospectively analyzed women with early-stage breast cancer who underwent MP testing (2013-2023) at University Hospitals Seidman Cancer Center. Patients were stratified by self-reported race and MP scores (high v low risk). Clinical outcomes, including recurrence-free survival (RFS) and overall survival (OS), were compared using Kaplan-Meier and Cox proportional hazards models. Among 1,349 women, 15.7% were African American (AA), 83.4% White, 0.6% Asian, and 0.3% from other racial groups. Overall, 64.7% had low-risk and 35.3% had high-risk scores. AA women had a significantly higher proportion of high-risk MP scores compared with White women (49.1% v 32.7%). Although the 5-year RFS rates were comparable between AA and White women (76.5% v 77.2%), the 5-year OS rates were slightly lower for AA women compared with White women (77.8% v 78.2%). MP remained prognostic for RFS at 3, 5, and 10 years regardless of race. Multivariable analysis revealed no significant differences in OS (hazard ratio [HR], 0.94 [95% CI, 0.47 to 1.89]; P = .866) or RFS (HR, 0.83 [95% CI, 0.43 to 1.59]; P = .572) between AA and White women after adjusting for MP risk groups and other clinical factors. High-risk MP scores were associated with worse OS (HR, 3.06 [95% CI, 1.64 to 5.70]; P < .001) and RFS (HR, 2.68 [95% CI, 1.55 to 4.62]; P < .001) compared with low-risk scores. Other factors associated with worse RFS and OS were tumor size, nodal involvement, and age. Interaction models indicated no difference is OS or RFS in AA women and White women with either low-risk or high-risk MP, respectively. Despite AA women exhibiting a higher proportion of high-risk MP scores, survival outcomes were comparable with those of White women. These findings underscore MP's consistent prognostic performance across racial groups but further highlight the need to address additional clinical and social determinants influencing breast cancer outcomes beyond genomic risk alone.

This engagement award project evaluated the preliminary effectiveness of a culturally tailored psychoeducation session aimed at reducing mental health stigma among African American women and their social support networks.Participants included 25 community members, including African American women of reproductive age and members of their social support networks, engaged in a two-hour psychoeducation group session. This session addressed perinatal mood disorders, cultural and historical factors contributing to mental health stigma, impacts of untreated conditions, and culturally appropriate resources. Participants completed the Stigmatized Attitudes Toward Mental Illness Scale (SATMIS) before and after the psychoeducation session, along with a satisfaction questionnaire.Analysis revealed a large (Cohen's d = 0.98), significant reduction in stigmatized attitudes toward mental illness from pre-session (M = 62.4, SD = 10.2) to post-session (M = 48.9, SD = 9.7; p < .001). Most (92%) participants reported high satisfaction with the psychoeducation session.This engagement project provides preliminary evidence that a brief, culturally tailored psychoeducation group session can effectively reduce mental health stigma among African American women and their support networks. Given the disproportionate burden of perinatal mood and anxiety disorder (PMADs) and maternal mortality among African American women, this approach shows potential for addressing a significant barrier to mental health care utilization in this population.

Emerging trends and treatment strategies in ovarian cancer: A comprehensive review.

Impact of a community-centered intervention on knowledge, confidence, and attitudes toward clinical trials: A pilot survey study.

Cardiovascular disease mortality among women diagnosed with de novo metastatic breast cancer.

Objectives African American women continue to face power imbalances when engaging in heterosexual sexual contact with African American men, due to historical contexts, sexual scripts, and gender-based stereotypes that stem from discrimination. However, the impact of power imbalances on safe sex practices is poorly understood due to deep-rooted traditional gender roles. The goal of this scoping review is to better understand the literature on power imbalance and safe sex practices and identify gaps in knowledge that will better inform future interventions for African American women. Methods Online databases identified 548 papers published in the United States between 2004 and 2021, from which 18 selected publications were identified that included power imbalance concepts, such as condom negotiation and sexual risk taking. The study selection process was highlighted using the PRISMA diagram. Data were extracted and evaluated based on the interventions using thematic analysis. Results The review of outcomes and measures was guided by the utilization of theoretical frameworks and intersectional structural factors, such as gender imbalances and cultural norms. In many studies, women believed that men controlled sexual relationships and sexual and reproductive decision-making. African American women who reported less relationship power in their heterosexual relationships were less likely to suggest condoms in sexual encounters. Overall, relationship power was associated with condom negotiation behavior among African American women. Conclusion The findings from this scoping review suggest a large body of recent literature about power imbalance, as well as its impact on safe sex practices among African American women. Some findings suggest that African American women’s fear of violence hinders them from making healthy sexual decisions regarding their own health. However, more research is needed, as this scoping review sets the groundwork for future systematic reviews.

Triple-negative breast cancer (TNBC) is a very aggressive form of breast cancer and Black American (BA) women face disproportionately higher mortality rates than White American (WA) women. The molecular mechanism behind this disparate clinical outcome remains poorly understood. We find that BA TNBC patients exhibit higher protein expression of KRT17 compared to WA TNBC and non-TNBC patients and correlates to poor distant metastasis-free survival. Mechanistic studies in metastatic mouse TNBC tumors with higher Krt17 demonstrates higher Wnt signaling targets, cancer stem cells (CSCs), which positively correlates to several metastasis signatures, supporting clinical data. Consistently, KRT17high BA patient tumors display higher activated Wnt signaling. Furthermore, Krt17 regulates Wnt signaling to drive recruitment of γδ T-cells in both mouse and human samples, which can be reversed by targeting Wnt signaling, identifying the Krt17-Wnt signaling axis as a critical driver of clinical disparities and a novel targetable vulnerability for BA TNBC patients.