Afro-Caribbean Women Research Articles

Prevalence of Polycystic Ovarian Syndrome (PCOS) Like Symptoms in the General Practice of an Obstetrics and Gynecological Office on the Island of Tobago: A Retrospective Chart Analysis

Introduction: Polycystic ovarian syndrome (PCOS) is one of the most common endocrinopathies found in reproductive age women. It is characterized by anovulatory infertility, menstrual dysfunction, and hirsutism. It is thought to be associated with an increased risk of metabolic aberrations, including insulin resistance, hyperinsulinism and type 2 diabetes mellitus (T2D). Due to the racial disparities associated with insulin resistance and T2D, we hypothesized that the prevalence of PCOS like symptoms would be increased on the island of Tobago where women were predominantly of Afro-Caribbean descent. Study Design: A retrospective chart review of 1000 women seen in an obstetrics and gynecological office over a 7-year period was conducted. Inclusion criteria included race, body mass index (BMI)<50, and no diagnosis of a co-morbid endocrinopathy. Of the 1000 women, 884 Afro-Caribbean women were included in the analysis. PCOS diagnosis was made based on clinical signs and symptoms verified on ultrasound. The diagnosis was considered if a patient presented with ≥2 of the following signs and symptoms: infertility after >1yr of unprotected sex; irregular menses with periods >35 d, <21 d or <6/yr; overweight/ obese (BMI>25); hirsutism; and acne. Results: Within the study population, 15.7% of participants had irregular menses, 9.2% had infertility, 4.0% had hirsutism and 0.4% developed acne. The prevalence of PCOS based on clinical diagnoses and ultrasonographic evidence was 19.7%. No statistical difference (p<0.05) was found between the two groups with regards to BMI, age and parity. When stratified by age, differences in infertility were found in the 20-24 and 35-39 year old age groups with rates at 10.5 v 18.9% and 15.4 v. 30.2%, respectively. The incidence of irregular menses also differed among age groups, with PCOS patients reporting significantly higher percentages between 30-50%. Conclusion: PCOS appears to be a common disorder on the island of Tobago with a prevalence of 19.7%. This prevalence is higher than in North American studies but is in line with data excluding biochemical analysis. As PCOS is a heterogeneous disorder with diverse phenotypes and probable ethno-genetic variations, the next step would be to further characterize the characteristics of PCOS in the Tobago population. This includes obtaining a full battery of biochemical profiles of women diagnosed with PCOS-like symptoms and the consideration of gene environment interactions including exposure to endocrine disruptors thought to be involved in the etiology of PCOS.

BREAST CANCER SCREENING AMONG OLDER NON-HISPANIC CARIBBEAN BLACK WOMEN IN THE UNITED STATES

Abstract Breast cancer is one of the most common forms of the second leading cause of death—cancer, which impacts racial and ethnic groups differently. The mortality rate of breast cancer among Black women is 40% higher than that of non-Hispanic White women. Early detection is critical for improving survival rates and reducing health disparities by race and ethnicity over the life course. However, the heterogeneity (i.e., within-group differences) among Black women in the United States is often overlooked, and relatively little is known about specific sub-populations of Black women and breast cancer screening. Of those sub-populations, Afro-Caribbean women in the United States tend to have different demographic and cultural backgrounds (e.g., a higher % of immigrants), for example, from African/African American women. Thus, this study examined factors associated with breast cancer screening among non-Hispanic Caribbean Black women. Using seven waves (2011-2017) of the National Health Interview Surveys data, we analyzed a sample of non-Hispanic Caribbean Black women living in the United States (age 40-75 years; n = 552). The results of the binary logistic regression indicated that the years in the United States were positively associated with breast cancer screening in the past 12 months among non-Hispanic Caribbean Black women (odds-ratio = 1.39, standard-error = 0.15, p < 0.05), after adjusting for the selected covariates. However, age was not associated with breast cancer screening behaviors. Our findings support breast cancer prevention efforts specifically targeting middle-aged and older non-Hispanic Caribbean Black women who have newly immigrated to the United States.

Cultural expectations and perceptions of risk communication among Afro-Caribbean mothers and daughters in the United States.

Mothers are key influencers in daughters' decision making about risk behaviors. Much research on parent-child relationships and communication has been conducted among predominantly White, nonimmigrant families. However, parent-child relationships and communications about risk behaviors may significantly differ for Black immigrant families. In particular, transnational behaviors that serve to maintain multiple social identities with attributes from both the receiving and sending nations may shape communication about risky behaviors. The current study evaluated the association between transnational behavior and risk communication mediated by the mother-daughter relationship. A total of 285 first- and second-generation Afro-Caribbean women, most of whom (80%) identified as Black, were recruited via purposeful sampling from Caribbean organizations, Caribbean-focused social media, and Caribbean festivals. Participants (daughters) completed a survey assessing their transnational behavior, perceptions of their relationship with their mother (in terms of interdependence, connectedness, and trust in hierarchy), and perceptions of their mother's communication about sex, alcohol use, and other drug use. Only the relationship between transnational behavior and communication about drugs was fully mediated by connectedness. The relationship between transnational behavior and communication about both alcohol use and other drug use was partially mediated by other facets of the mother-daughter relationship. Findings confirm previous research on parent-child closeness and communication about difficult topics and suggest that such relationships can promote healthy communication in multiple cultures. Children who stay connected to their country of origin stay connected to parents and, therefore, may have greater opportunity to engage in integrated communication about possible risk behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Afro-Caribbean Women's Literature and Early American Literature

Afro-Caribbean Women's Literature and Early American Literature

Formal Social Control and Mental Health: Ethnic Variation among Black Women

The present study uses elements of the social stress and intersectionality theories to examine associations between forms of criminal justice contact and mental health among African American and Afro-Caribbean women. While mass incarceration disproportionately targets, detains, and affects Black populations, the experiences and consequences of criminal justice contact for Black women remain understudied. Utilizing the National Survey of American Life ( n = 3,011), this study examined ethnic-stratified associations between criminal justice contact and three mental health indicators among Black women—psychological distress, self-rated mental health, and post-traumatic stress disorder (PTSD). We assessed justice contact based on any contact (i.e., direct contact and/or family member incarceration), and then disaggregated contact into direct (i.e., personally experienced negative police interactions, arrests, and incarceration) and familial incarceration. Findings showed that any contact as well as direct forms of contact were associated with higher psychological distress for African American women and odds of PTSD for both groups. Furthermore, negative police interactions and family member incarceration were associated with psychological distress for African American women, while only familial incarceration worsened self-rated mental health for Afro-Caribbean women. This study yields important insights for research at the intersection of gender-ethnic status, spillover outcomes of formal social control, and mental health stratification.

Local Confederate Memorialization and Gender-Ethnic Variation in Mental Health among Black Residents

Memorials romanticizing the short-lived Confederate States of America remain scattered across public spaces. Yet, little research examines whether memorials are consequential for residents that live proximate to them. This study relies on insights from social stress theory to examine associations between the local presence of public Confederate memorials and the mental health of African American and Afro-Caribbean adults. Data for this study are merged from the National Survey of American Life (n=4,740) and the Southern Poverty Law Center’s census of Confederate memorials. We examine associations between counts of local Confederate memorials and depressive symptomatology, self-rated mental health, and substance use disorder. Results from gender-stratified generalized models show that logged memorial counts are curvilinearly associated with mental health among Black women such that psychological adjustment is typically poorest in counties with an average number of memorials. In these spaces, African American women experience significantly greater depressive symptoms than Afro-Caribbean women. Moreover, social cohesion—familial support, membership with a pro-Black organization, frequent contact with neighbors, and ethnic closeness—modifies associations between memorials and mental health such that women with high levels of cohesion typically experience buffered mental health impacts when residing proximal to memorials. This study highlights the importance of critically investigating stressors extending from white supremacy across social statuses and theorizing resourcefulness against antiblack racism.

Estrogen receptor positive breast cancer in an Afro-Caribbean cohort.

e12550 Background: Estrogen receptor-positive breast cancer (EBC) accounts for 78% of breast cancer (BC) cases in the United States, and with better prognosis compared to other BC subtypes. There is limited information on the incidence, presentation, and outcomes of BC in black women from the Caribbean. We describe the clinicopathologic features and treatment outcomes of EBC in this underrepresented immigrant patient population. Methods: This is a retrospective study conducted at Kings County Hospital, a public hospital in a Brooklyn, New York neighborhood with the second highest population of Afro-Caribbeans in the United States. Demographics and clinicopathological data of patients diagnosed with BC from 2015-2018 were collected from the hospital’s tumor registry. Descriptive statistics and Chi-square testing were used to analyze the data. Results: Of the 299 women with a BC diagnosis, 185 (62%) had EBC, with median age of 61, and median BMI of 29.9. Stratification by menopausal status revealed 75% of these patients were post-menopausal. 37% of pre-menopausal and 28% of post-menopausal women presented with lymph node involvement (LNI). At diagnosis, 61% of patients had localized disease, 30% regional LNI, and 9% distant metastases. Sub-analysis revealed 25%, 22%, 28%, 16% and 9% with stages 0, I, II, III and IV respectively. 39% of patients presented with Nottingham Grade 3, 50% with Grade 2, and 11% with Grade 1 disease. 25% of patients without LNI had Oncotype Dx testing. 22% of these had Recurrence Score (RS) less than 11, 50% RS 11-25, and 28% RS 26 or higher. Of the 27 patients who received neoadjuvant treatment, 22% had complete pathologic response, 37% had partial response, and 33% had disease progression. 81% of patients self-identified as Afro-Caribbean, 27% reported first- or second-degree relatives with a BC diagnosis and 22% first-degree relatives with non-breast malignancy. At time of data analysis, at median of 6 years, 75% of all patients were relapse and progression-free. Lasting response was correlated with cancer stage (p < 0.01) but independent of tumor grade and Oncotype Dx RS (p = 0.18 and p = 0.29, respectively). Conclusions: In our study, Afro-Caribbean women with EBC presented with high-grade tumors and high incidence of regional LNI. Pre-menopausal women had a higher incidence of nodal involvement. Notable was a strong family history of cancer implying inherited or familial cancer syndromes. Progression-free survival was lower than expected and correlates with disease stage, but not with low Oncotype Dx RS. Further research is warranted to investigate better prognostic tools for this population.

Pregnancy outcomes in systemic lupus erythematosus: experience from a Caribbean center

Background Systemic Lupus Erythematosus (SLE) is a chronic autoimmune multi-system disorder frequently affecting black women of childbearing age. No published data exist on the obstetric outcomes in a Caribbean population. Objective We analyzed pregnancy outcomes in an Afro-Caribbean cohort of women with SLE at a tertiary university hospital. Methods A retrospective cohort study was performed of all pregnant women with SLE prior to pregnancy from January 1990 to December 2021 at the University Hospital of the West Indies (UHWI), Jamaica. Maternal rheumatologic, obstetric, fetal/neonatal data were analyzed. Descriptive statistical analyses were performed. To determine if outcomes were associated with various factors, Spearman’s rho was followed by logistic regression analysis to estimate unadjusted odds ratios with statistical significance at p < 0.05. Results A total of 56 pregnancies in 47 women were identified with SLE. Live births were 87.5%, with 10.7% spontaneous miscarriages and no neonatal deaths. Prednisone was the most used drug in 67.9% of patients. 85% of women had an adverse outcome with an adverse fetal outcome occurring in 55% of cases. Prednisone was associated with an adverse fetal/neonatal outcome (Spearman’s rho = 0.38; p = .004). Conclusion In this first Caribbean series on SLE in pregnancy, reasonably successful pregnancy outcomes are achievable in Afro-Caribbean women managed in multidisciplinary centers.

Abstract P4-03-05: HER2 + Breast Cancer in Afro-Caribbean Women in New York City

Abstract Background: Human Epidermal Growth Factor receptor 2 (HER2) protein overexpression and/or amplification positive breast cancer accounts for 14% of breast cancer cases in the United States. The use of anti-HER2 targeted therapy in combination with chemotherapy has resulted in better response rates leading to better outcomes in patients with this breast cancer subtype. Few studies directly investigate breast cancer outcomes in Afro-Caribbean women in the U.S, and fewer studies have investigated HER2 positive (HER2+) disease in this patient group. We describe the clinicopathologic characteristics and outcomes of HER2+ breast cancer in this minority patient group. Methods: This is a retrospective study conducted at Kings County Hospital (KCH), a public hospital in Brooklyn, a New York City borough with the highest population of Afro-Caribbeans in the United States, outside of Miami, Florida. Data of patients diagnosed with breast cancer from 2015-2018 was collected from the hospital’s tumor registry. Clinical and pathologic data was collected and analyzed with descriptive statistics and Chi-square testing. Results: A total of 299 women with breast cancer were screened and 18% (54) had HER2+ disease. 63% (34) of these patients were post-menopausal, with median age 56. 78% self-identified as Afro-Caribbean. 19% (11) of patients reported first- or second-degree relatives with a breast cancer diagnosis, 22% (13) reported first-degree relative with non-breast malignancy. Half of the patients younger &amp;lt; 45 years age reported a positive family history of any type of cancer. 74% of patients presented with Nottingham Grade 3 disease, 31% with localized disease, without lymph node involvement, 52% with regional lymph node involvement, and 17% with distant metastasis. 63% of patients were estrogen receptor (ER) positive and 37% were ER negative. Post-menopausal women presented with higher rates of lymph node involvement at 70.4% vs. 50% in pre-menopausal women (p=0.17). 41% (22) of patients received neoadjuvant chemotherapy while 31% received adjuvant therapy with standard chemotherapy and anti-HER2 targeted treatment. Of the 22 patients who received neoadjuvant treatment, 14% had complete pathologic response, 68% had partial response, and 18% had disease progression. Treatment response to neoadjuvant therapy was independent of lymph node status (90.9% in local disease vs. 85.7% in lymph node involvement, p=0.66). The median progression free survival was 48 months, overall survival at 7 years was not reached, and mortality rate was 16.7%. Conclusions: In our analysis, Afro-Caribbean patients with HER2+ breast cancer presented with high grade tumor, high incidence of regional lymph node involvement, and ER positive tumors. Noteworthy was the presence of strong family history of cancers, suggestive of familial or inherited cancers. Pathologic complete response to neoadjuvant chemotherapy was remarkably less than anticipated, and further research is warranted to study tumor biology and responses to standard HER2 systemic therapies in these patients.

Insights into the vaginal microbiome in a diverse group of women of African, Asian and European ancestries.

Intra-continentally, vaginal microbiome signatures are reported to be significantly different between Black and Caucasian women, with women of African ancestry having the less well defined heterogenous bacterial community state type (CST) deficient of Lactobacillus species (CST IV). The objective of this study was to characterize the vaginal microbiomes across a more diverse intercontinental group of women (N = 151) of different ethnicities (African American, African Kenyan, Afro-Caribbean, Asian Indonesian and Caucasian German) using 16S rRNA gene sequence analysis to determine their structures and offer a comprehensive description of the non-Lactobacillus dominant CSTs and subtypes. In this study, the bacterial composition of the vaginal microbiomes differed significantly among the ethnic groups. Lactobacillus spp. (L. crispatus and L. iners) dominated the vaginal microbiomes in African American women (91.8%) compared to European (German, 42.4%), Asian (Indonesian, 45.0%), African (Kenyan, 34.4%) and Afro-Caribbean (26.1%) women. Expanding on CST classification, three subtypes of CST IV (CST IV-A, IV-B and IV-C) (N = 56, 37.1%) and four additional CSTs were described: CST VI Gardnerella vaginalis-dominant (N = 6, 21.8%); CST VII (Prevotella-dominant, N = 1, 0.66%); CST VIII (N = 9, 5.96%), resembling aerobic vaginitis, was differentiated by a high proportion of taxa such as Enterococcus, Streptococcus and Staphylococcus (relative abundance [RA] > 50%) and CST IX (N = 7, 4.64%) dominated by genera other than Lactobacillus, Gardnerella or Prevotella (e.g., Bifidobacterium breve and Anaerococcus vaginalis). Within the vaginal microbiomes, 32 "taxa with high pathogenic potential" (THPP) were identified. Collectively, THPP (mean RA ~5.24%) negatively correlated (rs = -0.68, p < 2.2e-16) with Lactobacillus species but not significantly with Gardnerella/Prevotella spp. combined (r = -0.13, p = 0.1). However, at the individual level, Mycoplasma hominis exhibited moderate positive correlations with Gardnerella (r = 0.46, p = 2.6e-09) and Prevotella spp. (r = 0.47, p = 1.4e-09). These findings while supporting the idea that vaginal microbiomes vary with ethnicity, also suggest that CSTs are more wide-ranging and not exclusive to any particular ethnic group. This study offers additional insight into the structure of the vaginal microbiome and contributes to the description and subcategorization of non-Lactobacillus-dominated CSTs.

Black Motherhood Politics in Costa Rica: Diasporic Genealogies and Links to the State

AbstractBlack women who seek and win elected office are changing the political landscape in the Americas. In Latin America, this shift became widely recognized when Epsy Campbell Barr became the first Black woman vice president in Costa Rica in 2018. Her election builds on the work of three generations of women whose engagement in formal politics is rooted in their intertwined identities as Black, women, and of West Indian descent. By recovering a racialized, gendered, and ethnicized lineage of community activism, relationships, and networking—which I call “Little’s links” to honor the legacy of the writer and activist Eulalia Bernard Little—I argue that in Costa Rica, Caribbean identity and Black motherhood politics have influenced Black women’s engagement in national politics. This account of these other (and mothers’) political routes to state power for Afro-Caribbean women in Costa Rica complements current explanations of Black women’s participation in national politics elsewhere.

Retrospective analysis of endometrial cancer among Afro-Caribbean women in Barbados 2008-2017.

Endometrial cancer data amongst Barbadian women was collected, to inform screening and management in this under-studied population. We analysed all recorded primary cases between January 1st 2008, and December 31st, 2017. Age-specific incidence, and crude mortality rates were calculated. Descriptive statistics characterized demographics, risk factors, prescription data and histopathology. Log-rank tests assessed simple group differences by EC type. Survival analysis based on tumour type was plotted using Kaplein-Meir curves. There were 270 recorded cases of EC, averaging 66 (8.8) years old (SD 8.75), with parity of 3.60 (2.3). Cases were postmenopausal with 257 (95%) experiencing postmenopausal bleeding. Of the 270 cases, 113 (42%) had type 1 tumours and 157(58%) had type 2 tumours. Weak evidence suggests the latter imparted worse survival (log rank test = 0.02). Estimated crude incidence rate was 18.64 per 100,000 women. Crude mortality rate from EC between January 1st, 2008 and December 31st, 2019 was 27%.

Triple negative breast cancer presentation in Afro-Caribbean women in New York City.

e18726 Background: In the United States, triple negative breast cancer (TNBC) accounts for 10-15% of all breast cancers. It also has a higher incidence and worse prognosis in black women. There is paucity of information on the incidence and presentation of breast cancer in black women from the Caribbean. The clinical and pathologic profile of TNBC in this immigrant underrepresented patient group is described here. Methods: This is a retrospective study performed at Kings County Hospital (KCH), a safety net hospital in Central Brooklyn, New York City with a predominantly Afro-Caribbean patient population. Data from patients diagnosed with breast cancer from 2015-2018 were collected from the institution’s tumor registry and the clinical and pathologic data of these patients were collected and analyzed with descriptive statistics and chi square testing. Results: Of the total 299 female patients with a breast cancer diagnosis, 60 patients (20%) had TNBC with median age 57 and Nottingham grade 3 in 90% (54) of the patients. At presentation, 43% (26) presented with localized disease, 55% (33) with lymph node involvement (regional), and 2% (1) with distant metastasis. When stratified by menopausal status, 46 patients (77 %) were post-menopausal and remainder pre-menopausal. Premenopausal women presented with higher rates of regional disease at 64% with compared to 50% in the postmenopausal women (p = 0.5444). BMI was similar in both groups (p = 0.9879). Of the 37 patients with documented country of origin, 84% (31) were from the Caribbean, and 27% of these patients identified as medical tourists from the Caribbean. 25% (15) of all patients reported 1st or 2nd degree relative with breast cancer and 18% (11) reported a first degree relative with malignancy other that breast cancer. 100% of patients younger than 44 years reported a family history of cancer. Genetic testing information was unavailable to these patients. Of the twenty patients (33%) that received neoadjuvant chemotherapy with standard treatment, two achieved complete response, 15 partial response, and 3 without response to treatment. Conclusions: In our study of African-Caribbean patients with breast cancer, the incidence of TNBC was high at 20% with most presenting with high-grade tumors, regional lymph node involvement, and young age at diagnosis. Notably this represents a high-risk cohort with significant family history of breast and other cancers suggestive of inherited or familial cancers. Response to standard neoadjuvant chemotherapy was less than expected, encouraging the need to consider neoadjuvant immunotherapy in these patients.

An Intersectional Analysis of Women's Social Role Engagement and Mental Health.

Guided by role theory and the intersectionality framework, this study assesses whether social role volume, role type, and role configuration influence the mental health of Non-Latina White, African American, Afro-Caribbean, Mexican, Cuban, Puerto Rican, Chinese, Filipina, and Vietnamese American women. Contemporary shifts in the primary roles (i.e., worker, spouse, parent) women occupy and in the ethnic composition of the U.S. necessitate a re-examination of how roles impact U.S. women's mental health. Moreover, family member and friend roles are relatively understudied. Drawing data from the nationally representative Collaborative Psychiatric Epidemiology Surveys (CPES) (N=7370), ordinary least squares (OLS) regression analysis is used to assess the relationship between role volume, role type, role configuration, and mental health for women across nine ethnic groups. We report ethnicity-stratified models. On one hand, role accumulation was psychologically beneficial for Non-Latina White, African American, Puerto Rican, and Chinese women. On the other hand, the psychological benefits of social roles diminished after accumulating three social roles for Cuban, Mexican, and Filipina women. The psychological influence of specific roles and role configurations for women was dependent on ethnicity. This study demonstrates the powerful impact of ethnicity on social role engagement as well as the influence of such roles on women's psychological health.

Stress Exposure and Physical Health among Older African American and Caribbean Black Women.

Objectives: This study assessed whether multiple stress exposures and stress accumulation explained differences in physical health among Afro-Caribbean and African American women in older adulthood. Whether specific stressors uniquely influenced the health of African American and Afro-Caribbean women was also examined. Methods: Data were drawn from the National Survey of American Life (NSAL) (N=867; 50 years and older). Physical health was assessed by multiple chronic conditions, functional limitations, and self-rated health. Weighted binary logistic regression and ordered logistic regression analyses were conducted. Results: Compared to Afro-Caribbean women, African American women had worse physical health and greater stress exposure. Nonetheless, stress exposure did not explain ethnic differences in physical health. The association between specific measures of stress and physical health was dependent on the stressor and physical health measure. Discussion: Findings emphasize the importance of ethnic variation in health and stress exposure among older US Black women. Study implications are discussed.

Surviving home: womanhood, contentious intimacy & the trauma of home in Tobago, 1900–1960

ABSTRACT Studies into Afro-Caribbean families focus primarily on the prevalence of matrifocal households or the subordination that characterised women’s role in the home. While these themes are critical to understanding the gender dynamics within Afro-Caribbean households, the proliferation of this narrow view of women’s roles as mothers or subordinated wives has contributed to an underestimation of the complexities of women’s lives within the home. This traditional narrative of Afro-Caribbean women presents a portrait of the home, domesticity and economic security derived from dependence on a man which was unlikely for many Caribbean women. This paper captures the frequently trivialised trauma associated with women’s experiences within the private sphere. The paper contends that while the dominant literature positions Afro-Caribbean women as revered heads of their households, many Afro-Tobagonian women endured years of misery within the home due to a culture of domestic violence, financial hardship and the social acceptance of extramarital affairs. This knowledge offers us a peek into the interiority of women’s lives and complicates our understanding of Afro-Caribbean women’s experiences from 1900 to 1960. This work is undergirded by oral testimonies from Afro-Tobagonians, newspaper articles and official documents.

UK Black hair matters: A thematic analysis exploring Afro-Caribbean women’s hair as representations of the socially constructed knowledge of identity and identity threats

Hair has the ability to visibly define ethnic difference, determine identity and impact self-esteem. Although empirical research has explored the hair texture altering behaviours of African American women, the experiences of Afro-caribbean women in the UK have been under-investigated despite being shaped by distinct cultural and historical contexts. Guided by the theoretical explanations of identity processes theory and situational identity and threats, semi-structured interviews of UK Afro-Caribbean women were used to investigate intergroup factors which affect their responses to intergroup relations and the salience of personal and social identity. Through the social constructionist epistemological approach, thematic analysis suggested that Afro-Caribbean women’s hair was subjectively positioned as a source of everyday subtle racism. The findings differ from American studies as UK Afro-Caribbean women describe the threat to identity as not only pervasive but endemic.

Anthropometric cut-offs to identify hyperglycemia in an Afro-Caribbean population: a cross-sectional population-based study from Barbados

IntroductionBody mass index (BMI) and waist circumference (WC) cut-offs associated with hyperglycemia may differ by ethnicity. We investigated the optimal BMI and WC cut-offs for identifying hyperglycemia in the predominantly...

Human Papilloma Virus Distribution Across the African Diaspora.

PURPOSEUnderstanding the distribution of human papilloma virus (HPV) subtypes in limited-resource settings is imperative for cancer prevention strategies in these regions. The objective of our study is to compare the prevalence of cervical HPV genotypes in women across the African diaspora.METHODSThis study was approved by the African Caribbean Consortium (AC3). Six member institutions (Benin, Ethiopia, The Bahamas, Tobago, Curacao, and Jamaica) provided independently collected HPV data. Prevalence comparisons across for each nation were performed followed by an assessment of anticipated 9-valent vaccine coverage. Chi-square or Fisher's exact tests were used with significance at P < .05.RESULTSOne thousand three hundred fifty high-risk (HR) and 584 low-risk (LR) HPV subtypes were identified in the entire cohort. The most common HR HPV subtype was HPV 16 (17.9%) of infections. The distribution of HR and LR subtypes varied by country. The proportion of HR-HPV subtypes covered by the current 9-valent vaccine was lower in African countries compared with the Caribbean countries (47.9% v 67.9%; P < .01). No significant difference was seen for LR subtypes (8.1% African continent v 5.2% Caribbean; P = .20). Marked variation in the proportion of infections covered by the 9-valent vaccine persisted in individual countries.CONCLUSIONSignificant variations in HPV prevalence were identified among African and Afro-Caribbean women. A large number of women in these regions are potentially uncovered by current vaccination formulation, particularly low-risk HPV infections.

Disrupting Monolithic Thinking about Black Women and Their Mental Health: Does Stress Exposure Explain Intersectional Ethnic, Nativity, and Socioeconomic Differences?

Guided by the intersectionality framework and social stress theory, this study provides a sociological analysis of Black women's psychological health. Using data from the National Survey of American Life (N=2972), we first examine U.S. Black women's psychological health through the intersections of their ethnicity, nativity, and socioeconomic status. Next, we assess the extent to which stress exposure (e.g., discrimination, financial strain, and negative interactions with family members) explains any discovered status differences in psychological health among Black women. Results reveal that foreign-born Afro-Caribbean women living in the United States experience a mental health advantage vis-á-vis their U.S.-born African American female counterparts. In addition, college-educated African American women experience fewer depressive symptoms but similar rates of lifetime PTSD relative to African American women without a college education. Last, though stress exposure was associated with poor mental health, it did not explain status differences in mental health. Overall, this study reveals that Black women, despite shared gendered and racialized oppression, are not a monolithic group, varying along other dimensions of stratification. The results suggest that other stress exposures and psychological resources should be explored in future work examining status differences in mental health among Black women.