Black Women Research Articles

Abstract 4119300: Prevalence and Outcomes of Atrial Fibrillation during Pregnancy and Puerperium

Background: Atrial fibrillation (AF) during pregnancy and puerperium is devastating for the mother and her family, yet data regarding incidence and outcomes are very limited. Objective: We aimed to investigate the incidence and outcomes of AF during pregnancy and puerperium in a large database. The value of the CHA 2 DS 2 -VASc score in predicting adverse outcomes during pregnancy was also assessed. Study Design: The National Inpatient Sample (NIS) database was queried to identify pregnancy-related hospitalizations from 2008 to 2017. Temporal trends in the incidence and outcomes of AF were extracted. The CHA 2 DS 2 -VASc score was calculated for all patients, and the score was classified into three groups: low-risk group (1 point), moderate-risk group (2-3 points), and high-risk group (≥4 points). Results: Among 40,996,860 pregnancy-related hospitalizations, 15,162 (0.037%) were diagnosed with AF. The incidence increased from 2.18 per 10,000 hospitalizations in 2008 to 4.87 per 10,000 in 2017 ( P trend < .0001). The proportion of patients with AF increased with advanced maternal age ( P trend < .0001). Subgroup analysis showed that the incidence of AF was higher in black women, lowest-income households, and elderly parturients ( P trend < .0001). The following factors were significantly associated with AF during pregnancy: age ≥45 years, lipid metabolism disorders, hypertension, obstructive sleep apnea, hyperthyroidism, and valvular disease ( P < .0001). The in-hospital mortality rate of pregnant women with AF was significantly higher than those without AF (OR = 2.26, 95%CI = 1.75-2.93, P < .0001). The mortality rate of AF during pregnancy was positively associated with an increasing CHA 2 DS 2 -VASc score ( P trend < .0001), which was 0.35% (95% CI: 0.24%-0.47%) in the low-risk group, 1.30% (95% CI: 0.98%-1.62%) in the moderate-risk group, and 2.18% (95% CI: 0.86%-3.51%) in the high-risk group. The incidence of stroke, acute myocardial infarction, acute heart failure, and cardiac shock during pregnancy was also significantly correlated with the increasing CHA 2 DS 2 -VASc score in AF patients ( P trend < .0001), with the highest prevalence in the high-risk group. Conclusion: The incidence of AF during pregnancy and puerperium increased consistently, associated with high maternal mortality. The CHA 2 DS 2 -VASc score can be an essential risk stratification tool to predict severe cardio-cerebral vascular events and even death in AF patients during pregnancy and puerperium.

Abstract 4141457: Forms of Childhood Maltreatment and Subclinical Cardiovascular Disease Risk in Black men and women

Background: Exposure to specific forms of childhood maltreatment have been associated with cardiovascular disease (CVD) risk factors and CVD events in adulthood. Heterogenous experiences of childhood maltreatment across race and sex exist, yet there is little evidence regarding these relationships and CVD risk in Black populations. Aims: To investigate the association between various forms of childhood maltreatment (emotional, general, physical, and sexual abuse) and surrogate markers of vascular dysfunction and test whether sex modify these associations. Methods: Forms of childhood maltreatment and indices of vascular function were assessed in a cohort of healthy Black adults without known CVD (n=404) from a large metropolitan southeastern city. Childhood maltreatment was assessed using the Early Trauma Inventory short form (ETISR-SF) consisting of physical, sexual, emotional, and general domains. A trauma severity index score was calculated by summing the indexes for each of the four domains. Higher scores are indicative of higher traumatic life events before age 18 years. Outcomes of central augmentation index (cAIx) corrected for a heart rate of 75 bpm and carotid femoral pulse wave velocity (CfPWV) were measured as indices of wave reflections and arterial stiffness using applanation tonometry (Sphygmocor Inc.), and central pulse pressure (CPP) was calculated as the difference between the aortic systolic and diastolic blood pressures. Associations between each domain and outcomes were assessed using multivariate-adjusted and sex-stratified linear regression models. Results: Mean age of the cohort was 53 + 10.3 years, 61% women. Exposure to emotional [ b = -1.5%, 95%CI: -2.7,-0.3] and physical abuse [ b = -1.3%, 95%CI: -2.5,-0.2] was associated with cAIx overall but not CPP or CfPWV after adjusting for sociodemographic, clinical factors, health behaviors, and depressive symptoms. Significant emotional abuseXsex ( P= 0.014) and physical abuseXsex ( P=< 0.001) interactions were identified for cAIx. Among women, physical abuse was associated with higher cAIx [ b =1.5%, 95%CI: 0.6, 2.4] and among men emotional [ b =-1.6%, 95%CI: -3.2, -0.0] and physical [ b =-1.7%, 95%CI: -3.1, -0.3] abuse was associated with lower cAIx. Conclusions: Exposure to emotional and physical abuse as children was associated with vascular dysfunction; moreover, exposure to physical abuse among women and not men have adverse clinical implications for CVD risk and prospects for enhanced preventive care.

The Otherness in Dolen Perkins-Valdez’s Take My Hand

In her recent historical fiction, Take My Hand (2022), New York Times bestselling author Dolen Perkins-Valdez explores the specific manifestations of post-slavery racism, particularly institutional racism. This is vividly portrayed through the experiences of Civil Townsend, a determined new nurse, who witnesses the systematic denial of reproductive rights and autonomy among impoverished African American females. Due to the novel being published within the last two years, there is a significant lack of extensive scholarly analysis on its critical themes. This research employs the postcolonial concept of Otherness to examine the oppression of black women in the narratives. It investigates how stereotyping and dehumanizing as facets of Otherness within a postcolonial framework, contribute to their oppression. It also gives an analysis of the causes and consequences of the practice of Othering. The study offers insights into the power dynamics between the dominant and marginalized racial groups, underscoring the persistent battle against racial stereotypes and institutional racism. The conclusions of this research underscore the notion that the ideology of Otherness is central to the oppression experienced by the African American female characters in the novel. It advocates that achieving equality involves recognizing and respecting differences ideologically.

Abstract 4122048: Disparities in Heart Failure-Related Mortality Among Reproductive-Aged Women in the United States from 1999 to 2019

Introduction: Heart failure (HF) majorly affects the elderly, but can also affect the younger population. This study aims to examine the trends of HF-related deaths among reproductive-aged women in the United States (US). Method: We conducted a retrospective analysis using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database, extracting data through ICD-10 codes I11, I13.0, I13.2, and I50 to find HF-related deaths among women aged 15-44 from 1999 to 2019. We examined demographic disparities in HF mortality rates over time, considering age, ethnicity, and geographic areas. Results were reported as age-adjusted mortality rate (AAMR) and 95% confidence interval (CI). Joinpoint regression assessed trend changes and annual percentage change (APC). Results: Between 1999 and 2019, a total of 43,683 women aged 15-44 died from HF in the US, with an AAMR of 3.5 per 100,000 (95% CI: 3.5-3.5). The AAMR increased from 2.6 in 1999 to 4.8 in 2019. Non-Hispanic Black women had the highest AAMR at 10.2, while Hispanics had the lowest at 1.8. Geographically, the South was the most affected region with an AAMR of 4.6, contributing to nearly half (48.9%) of all deaths. States including Massachusetts, Oregon, New Hampshire, and Minnesota had the lowest AAMRs. Rural areas showed a higher AAMR compared to urban areas (4.4 Vs. 3.3). The age group (35-44) accounted for the majority of deaths (73.7%). Conclusion: HF-related mortality among reproductive-aged women increased from 1999 to 2019, with the highest burden among non-Hispanic Black women and those in the Southern region. Enhancing access to care, particularly in rural areas, and implementing targeted prevention programs are vital to reducing mortality rates.

Unwrapping oppression: Black latinas in craft chocolate marketing

ABSTRACT This article examines how Black women from Latin America are portrayed on craft chocolate bar wrappers. The analysis is rooted in Lélia González’s qualificação ‘professional’ and Patricia Hill-Collins’s controlling images. González and Hill-Collins introduce the mammy, jezebel, matriarch, welfare queen, hot momma, mulata, doméstica and mãe preta, aiming at explaining how Black women’s oppression are ideologically justified through mass media. Drawing on a critical visual analysis of craft chocolate bar wrappers, I conclude that one figure emerges: the savage black woman – she is depicted as too wild to love and be loved, yet perfectly docile to serve and maintain ongoing colonial projects in the fine cocoa and craft chocolate industry.

Personal Networks and Cervical Cancer Screening among Black Immigrant Women.

Prior research has linked personal network characteristics with cancer screening uptake including Papanicolaou (Pap) screening, but less is known about the experiences of Black immigrant women (BIW) in the USA. We examined the relationship between network characteristics and Pap screening among BIW and explored how their network members influence their cancer related knowledge and prevention behaviors. A mixed methods study of BIW, aged 21-65years, in southeastern US included a cross-sectional survey (N = 204) and in-depth individual interviews (N = 13). We examined whether high-social connectedness, contact frequency, and social support were associated with Pap screening, using multivariable logistic regression models. Thematic analysis further assessed the roles of personal network factors on BIW's cancer preventive behaviors. Pap screening was more likely among BIW with high- versus low-social connectedness (OR: 2.68, CI: 1.12, 6.46). However, the impact of high-social connectedness was attenuated, after adjusting for demographic factors and health insurance. Our qualitative findings revealed that both BIW and their personal networks had limited knowledge on cancer and related prevention measures. Close network members, particularly mother-figures, provided support for BIW's care seeking efforts, including cancer screening, although some participants mentioned a lack of screening support. These findings suggest that Black immigrant communities may benefit from tailored cancer prevention interventions among close network members, to improve knowledge and support for cancer control behaviors.

The food environment and postdiagnosis weight gain among Black women breast cancer survivors in Maryland.

Weight management is included in the American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guidelines for its clinical impact on breast cancer (BC) survivorship. Few studies have examined the impact of neighborhood-level factors associated with postdiagnosis weight change among Black BC survivors. We recruited 100 Black female BC survivors to complete an online survey, including demographic, clinical characteristics, and lifestyle factors, between January 5, 2022 and August 18, 2022. We utilized the 2023 County Health Rankings Food Environment Index (FEI), which ranges from 0 (worst) to 10 (best), to capture the food environment as the primary exposure for postdiagnosis weight gain. We calculated postdiagnosis weight gain as percent weight change from time at diagnosis to time of survey. Participants were grouped into categories of stable weight (within ± 3%) or weight loss (≤ -3%) compared to weight gain (≥ 3%). We calculated adjusted odds ratios (aORs) for the associations between county-FEI, clinical factors, and postdiagnosis weight gain. Among the 95 women who reported weight measurements, we observed that women living in counties with an FEI ≥ 8.8 (at or above median) were significantly less likely to experience weight gain (aOR 0.09; 95% CI 0.01-0.77). Stage, age at diagnosis, years since BC diagnosis, and BC treatments were not significantly associated with weight gain. Postdiagnosis weight gain is associated with poorer food environments among Black BC survivors in Maryland. Our findings will inform larger prospective studies and future interventions among this population.

Thick Black women and misogynoir in the Caribbean

ABSTRACT It is well documented that thick Black female bodies are idealized in Afro-Caribbean communities. However, there is also a long and deep history of oppression of thick Black women in Caribbean spaces based on their race, gender, and body shape and size, which continues to inform the lives of thick Black women in postcolonial Caribbean societies. This paper is an exploratory, grounded analysis of thick Black women’s quotidian experiences in this dialectic, explicitly focusing on Jamaica. Using Caribbean research methodologies situated in decolonial feminist epistemologies, I explore the everyday realities of voluptuous Black women who have to negotiate white Eurocentric body discourses in contemporary Jamaican society. The study foregrounds the voices of thick Black women as they articulate their own lived realities with navigating ‘misogynoir’ in Jamaican public spaces.

Exploring Rural, Black Women's Lived Experiences With Physical Activity and Nutrition: A Photo-Elicitation Study.

Eastern North Carolina (ENC) residents have higher rates of type 2 diabetes, lower life expectancy, less physical activity (PA), and higher food insecurity than the rest of North Carolina. Black individuals in ENC may face health disparities due to systemic and societal barriers to PA and a nutritious diet; modifiable behaviors that may improve overall health. The purpose of this study was to explore the lived experiences of rural Black women who live in ENC and who meet the criteria for overweight and obesity in the context of PA and healthful diet promotion. Photo-elicitation was used to explore this population's specific experiences with PA and nutrition, including barriers and facilitators, through photos and focus groups. Participants (N = 14; 43.5 ± 8.7 years old; body mass index (BMI) = 34.6 ± 5.9 kg/m2) were Black women in the rural Southeastern United States. Recruitment strategies included community outreach, listservs, social media, and word of mouth. Using photos submitted, our team conducted focus groups and completed content analyses to identify themes to tailor the development of a future health promotion program for Black women. Overarching themes were (a) Reframing the Mindset, (b) Accountability, and (c) Cultural Relativity. Findings demonstrate that Black women living in rural areas desire culturally relevant PA and nutrition programming focusing on healthy lifestyles versus weight loss. Future practice and research should utilize these findings to develop and examine the health impact of a health promotion program designed for Black women by Black women on PA levels, diet quality, and quality of life.

A Composite Counternarrative of Discrimination as a Social Determinant of Health: Black College Women's Experiences of Gendered Racism.

Discrimination is a social determinant of health (SDOH) that negatively affects racially minoritized students and patients. Nurses and nurse educators must understand discrimination, including nuanced and intersecting ways that it negatively affects academic and health outcomes. In-depth interviews were conducted with 12 Black women at a primarily White institution in the Southeast United States. The interview guide, informed by critical race and intersectionality theories, explored experiences of gendered racism, particularly in the students' social environments. Narrative analysis was conducted, then a composite counternarrative was composed to portray experiences of gendered racism across multiple levels, including intrapersonal, interpersonal, and institutional. The composite narrative revealed experiences of multi-leveled gendered racial microaggressions that shape the daily lived experiences of Black college women students. Three main themes emerged: Limited Autonomy, Differential Treatment and Differential Assumptions, and Differential Access to Power and Resources. Gendered racism differs from White women's experiences of sexism and Black men's experiences of racism. Institutional efforts to support Black college women must be intentional in addressing the unique ways they experience discrimination in various settings on campus. Nurses' and nurse educators' understanding of gendered racism as a SDOH may ease the hesitancy in addressing health inequities. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

From caretaking to transaction: Women politicians, motherhood, and political authority in Kenya

AbstractFeminist scholars have noted how motherhood opens avenues for women to access political authority. For African and Black women, scholars have noted how presenting themselves as mothers in the political sphere allows them to capitalize on an identity that traditionally allowed them access to power. However, these perspectives on motherhood and politics privilege a perspective on motherhood that deems the role as selfless and sacrificial. In this article, I propose moving beyond the caretaking dimensions of motherhood when analyzing how women politicians utilize motherhood. Drawing on evidence from research among Kenyan women politicians between 2017 and 2020, I argue that political motherhood often emerges as a transaction. Rather than interpreting the actions of women politicians as an extension of maternalistic impulses into the political realm, I illustrate how women politicians present the benefits of motherhood in exchange for citizens’ votes. By diversifying the meanings of political motherhood beyond caretaking and communal roles, this article counters perspectives that assume women politicians are less corrupt or are the victims of patriarchal politics. Instead, by foregrounding the transactional dimensions of political motherhood, this article illustrates how women politicians strategically use gendered identities to build political authority.

Effective blind bilateral superficial cervical plexus block for tracheostomy tube insertion in a geriatric patient with Ludwig angina with hypertension in resource constrained area: a case report

IntroductionLudwig angina is a rare, rapidly spreading submaxillary, submandibular, and sublingual necrotizing life-threatening widespread cellulitis of the soft tissue on the floor of the mouth that can cause fatal complications because of airway obstruction. Currently, there are few published studies assessing the efficacy of superficial cervical plexus block for airway surgery and there is no agreement in the literature about airway management. The published recommendations differ and are based on the authors’ own experiences and available resources. This report aimed to provide insight into critical patient management by performing regional anesthesia with fewer complications to the cardiovascular and respiratory systems.Case presentationWe report the case of a 70 year-old hypertensive Black Ethiopian woman with American Society of Anesthesiologist–Physical Status class III and hypertension, who was admitted to the hospital for treatment by her surgeon. The surgeon diagnosed her with Ludwig angina. After adequate physical examination and laboratory investigation, she arrived at the operation room for exploration and drainage of the abscess with a superficial cervical plexus block. She arrived safely at the adult intensive care unit for frequent suctioning. The block was effective until 6 h after the procedure with visual analogue scale (2/10), her vital signs remained stable throughout the postoperative period, and then the tracheostomy tube was removed by the surgeon after 10 days. The patient’s hemodynamic status and breathing effort were satisfactory, and she was discharged 15 days later.Clinical discussionProper airway management is critical for the survival of patients diagnosed with Ludwig angina. According to recent studies, an increasing number of patients with Ludwig angina require intensive care unit admission for tracheal intubation and mechanical breathing. However, it is uncertain whether intensive care reduces the death rate in patients with Ludwig angina. Finally, it is suggested that studies with large sample sizes and strong levels of evidence be conducted to conclude the effectiveness of superficial cervical plexus block for airway emergency surgeries.ConclusionManagement of the airway in patients with Ludwig angina is challenging. Clinicians must take precautions and make sharp decisions on the basis of a variety of circumstances, including the availability of equipment at medical facilities, such as fiberoptic intubation equipment; the anesthetist’s level of experience, such as performing superficial regional block and good mask ventilation; and the patient’s medical status at the time of presentation. As a result, intervention needs to be quick so as to avoid airway obstruction and further complications.

Children's beliefs about Black and White men's and women's scientific knowledge: An intersectional approach.

Children are sensitive to other's knowledge and social characteristics when seeking out information, but little is known about how adults' gender and race interact to influence children's beliefs about adults' knowledge. In two studies, 5-8-year-olds (N = 257; 127 girls; 130 boys; 73% White) saw photos of Black and White men and women and rated each adults' science knowledge. In Study 1, children then viewed four adult faces together (one from each gender and race) and chose who knew the most and second-most about the answer to a scientific question. In Study 2, the selection task was modified so that children saw two faces from different categories and chose one, and children were then asked to identify one of four individuals as a scientist. In both studies, children also chose which of four individuals they would want to learn about science from. Children gave similar knowledge ratings to men and women and to Black and White individuals when they rated one adult at a time. However, when children selected the most knowledgeable adult, they showed an ingroup gender-based preference whose strength varied with child age. In both studies, children also showed an ingroup gender-based learning preference, but showed no preferences based on adult race. Children referred to adults' appearance most often when justifying their learning preference and which individual they believed to be a scientist. Together, these findings suggest that, for primarily White American children, a potential adult informant's gender may be more salient than race when evaluating science knowledge. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Increasing engagement in HIV prevention among cisgender women in New York City with sexual health self-testing kits: A MaxDiff analysis.

Despite accounting for approximately 20% of new HIV diagnoses in the United States, cisgender women are consistently under-represented and under-engaged in HIV prevention services such as HIV testing and pre-exposure prophylaxis (PrEP). Black and Latina cisgender woman (BLCW) are disproportionately impacted by HIV, and face additional barriers to accessing prevention services due to racial/ethnic bias, sexism, and their intersection. Offering self-testing for sexually transmitted infections (STIs) and HIV is one potential strategy for increasing access to-and engagement in-preventative sexual health care among BLCW. We conducted a study in consultation with the New York City Department of Health and Mental Hygiene (NYC DOHMH) and their collaborators in order to identify preferences for sexual health kits-including HIV and STI tests-among BLCW in New York City. We assessed the extent to which BLCW would be willing to accept and use HIV and STI self-testing. Additionally, we identified the components of potential sexual health kits that would make them most attractive and would most increase the reach of a sexual health kit program in NYC. Finally, we examined differences in acceptability and preferences (by demographic factors, sexual behavior, and past service utilization) that may impact the development of future programs and interventions. Self-testing for STIs and HIV represents a promising strategy for engaging BLCW in preventative sexual health services and increasing access to care.

Cultural Practices and Constitutional Rights in Widowhood: Lived Experiences of Black Widowed Women in Makapanstad Village in South Africa

This paper aims to examine the various cultural practices that apply to widows vis à vis their constitutional rights. The Constitution of the Republic of South Africa, 1996 (hereinafter referred to as the constitution) outlines inalienable human rights that do not prescribe their attainment requirements. This paper is part of a more extensive study conducted in the Gauteng province of South Africa. The research tools were piloted in Makapan village. The aim of this paper is to explain how cultural practices interact with constitutional rights and affect the lives of Black widows in Makapanstad village. The objective of the study is to describe the intersections in widowhood cultural practices, which are often not aligned with the constitution of South Africa. Qualitative research was used. Three widows were sampled in this paper. The research question that is addressed by this paper is the following: “What cultural processes in widowhood are still practiced by the community of Makapanstad that can be analyzed in line with the constitutional imperatives for the South African context?” The intersectionality theory was used in this study. Findings reveal that widowhood rites are gendered. Some Black cultural practices are embedded in culture and religion, and they undermine the constitution and human rights of widowed women.

Small Group Learning Communities as a Prototype for Intersectional Black Feminist Praxis in Higher Education

Through the creation and analysis of Small Group Learning Communities (SGLC) at a predominantly White university in the U.S. South, this study investigated how SGLCs operationalize intersectional Black feminist praxis via dialogue, liberation, and ethic of caring. The racialized and gendered organizational dynamics that govern institutions of higher education make it an ideal site for such an intervention. Through an instrumental case study of 13 SGLCs, we uncover how SGLCs served interrelated, but separate purposes: (1) affirmation, mentorship, and professional development among “Black women-focused” SGLCs; and (2) epiphanies of intersectional oppression and nuanced Black girl representation in educational settings among “Black women-affirming” SGLCs. Findings suggest that SGLCs are innovative prototypes for understanding, studying, and implementing intersectional Black feminist praxis. We submit that SGLCs can advance broader social justice and liberation agendas. Moreover, findings may inform efforts to center Black women in higher education.

A bibliometric analysis of research on black women: exploring social exclusion and racial discrimination (1977-2024)

Racism have been directed associated with social discrimination of black women caused by racial exclusion. We aimed to visualize the state-of-the-art black women and social and racial discrimination. A total of 214 English-language publications were analysis, comprising articles, books review, editorial, letter, meeting abstract, proceeding papers and reviews, sourced from the Web of Science Core Collection database spanning from January 1977 to May 2024. The results revealed: (1) Cultural Diversity & Ethnic minority psychology journal has published the most studies. The University of Michigan and University of California play the most important role in research related to black woman and social and racial discrimination. The USA is the main publishing country with significant academic influence. (2) Seanna Leath, Jioni A Lewis, J Camille Hall are the leading scholars in black women and social and racial discrimination. Regarding local impact per author, using the H-index, Cochrane Database of Systematic Reviews and Frontiers in Psychiatry appeared to be the most relevant. (3) The research frontier of black women and social and racial discrimination has significantly shifted from focusing on community, racism, intersectionality, structural racism, and discrimination.

Systemic hormone therapy after breast and gynecological cancers: an Italian expert group consensus opinion.

The specific Italian Group of Study of the Menopause formulated a consensus opinion on the use of estrogen therapy (ET) or combined estro-progestin hormone therapy (HT) after breast and gynecological cancers. This consensus is based on the risk of recurrence of the specific cancer during ET/HT, the presence of steroid receptors in cancer cells, the use of adjuvant hormone therapies and data on the use of ET/HT after cancer. The following positions were reached. ET/HT can be used after vulvar cancers and melanoma, but with great caution after the rare adenocarcinomas. ET/HT can be used after cervical cancer, but ET should be used with caution after adenocarcinomas. ET/HT can be used after International Federation of Obstetrics and Gynecology (FIGO) stage I-II estrogen-dependent endometrial cancers, except in Black women, and can probably be used after estrogen-independent endometrial cancers. ET/HT cannot be administered or should be used with great caution after most uterine sarcomas. ET/HT can probably be used after ovarian neoplasms except for granulosa cell tumors, and with great caution after low-grade serous ovarian carcinoma and serous borderline ovarian tumors. ET/HT can be used with great caution in women after estrogen receptor (ER)/progesterone receptor (PR)-positive breast cancer and is probably allowed after ER/PR-negative breast cancer.

Disparities in Cervical Cancer Knowledge and Trust in Information Sources Among Diverse American Women.

Cervical cancer rates have declined due to prevention and screening, but disparities remain. This study examines how trust and preference in information sources affect knowledge and behaviors, alongside demographic differences to identify health disparities. This study used Health Information National Trends Survey data and employed weighted chi-square tests and multivariate logistic regression to analyze associations between knowledge, behaviors, and demographic differences. The results revealed significant disparities in HPV awareness, with lower awareness among Black (OR, 0.521), Hispanic (OR, 0.398), and Asian (OR, 0.138) women compared to Whites. Age and education also played roles, as older and less-educated women were less informed. Trust in doctors was crucial; women with low trust in doctors (aOR, 0.499; 95% CI, 0.252-0.989) had lower odds of having heard of HPV. Preference for written materials as a primary information source (aOR, 0.312; 95% CI, 0.122-0.793) also correlated with lower HPV awareness compared to preferring information from doctors. Furthermore, women with low trust in charity organizations (aOR, 0.647; 95% CI, 0.461-0.909) were less likely to believe HPV causes cervical cancer, while those who preferred the internet as an information source (aOR, 1.544; 95% CI, 1.026-2.324) had higher odds of having heard of HPV compared to those preferring doctors. Minority populations, older women, and those with lower education levels had significantly lower HPV knowledge. These findings highlight the need for tailored communication, community outreach, policy initiatives, culturally sensitive approaches, digital health interventions, and strategies promoting patient-provider trust to address these disparities.

Mental Health and Substance Use Among Black Women Attending STD Clinics in Baltimore: The Role of Overt and Subtle Discrimination.

Black women are disproportionately impacted by mental health conditions, like depression, posttraumatic stress disorder (PTSD), and substance use harms. Experiences of discrimination may cause and exacerbate these conditions, but little is known about how distinct types of discrimination (overt vs. subtle) may be related to these outcomes. The current study sought to evaluate the associations between overt and subtle discrimination, mental health, and substance misuse outcomes among Black women. Data were drawn from ESSENCE, a retrospective cohort study (2013-2018) on sexual assault and HIV risk among Black women attending sexually transmitted disease (STD) clinics in Baltimore, Maryland (n = 199). Multivariable Poisson regression models tested the associations between overt and subtle discrimination, depressive and PTSD symptoms, and substance misuse while controlling for covariates. Nearly half (42.2%) of participants reported depressive symptoms, and over a third reported severe PTSD symptoms (35.2%). Higher levels of subtle discrimination were associated with increased risk of depressive symptoms (adjusted relative risk [aRR] = 1.32, 95% confidence interval [CI]: 1.16, 1.50, p < .0001), whereas higher levels of overt discrimination were associated with increased risk of severe PTSD symptoms (aRR = 1.22, 95% CI [1.02, 1.46], p = .0287). Neither overt nor subtle discrimination was significantly associated with hazardous alcohol use or daily marijuana use in adjusted models. We identified that subtle discrimination has a unique negative association with depressive symptoms, while overt discrimination is positively associated with PTSD symptoms. This information is critical for tailoring stigma reduction interventions and mental health supports for Black women.