Publications by authors named "Henna Budhwani"

Background: Digital storytelling (DST) encourages participants to use technology to create narratives and share personal experiences. Although DST can amplify the voices of groups experiencing marginalization, it is unclear how DST has been used among young adults of color. We also lack a comprehensive understanding of DST's role in addressing health-related outcomes.

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During the COVID-19 pandemic, rapid changes in variant virulence, limited personal protective equipment availability, and diminished hospital capacity necessitated aggressive vaccine distribution. To promote COVID-19 vaccination to historically underserved populations, the National Institutes of Health funded a small group of clinical trials, including the Tough Talks for COVID-19 vaccine (TT-C) digital health intervention (DHI) randomized controlled trial (RCT). Black young adults, 18-29 years, who were unvaccinated or insufficiently vaccinated against COVID-19 were recruited via social media in Alabama, Georgia, and North Carolina and randomized to the intervention or standard of care control (N = 360).

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Objective: In the southern United States, adolescents are at elevated risk for HIV acquisition. In Alabama, school-based sexual health and HIV prevention education is strictly regulated and does not address the unique needs of sexual and gender minority (SGM) teenagers. To inform public health efforts, we assessed SGM adolescents' HIV prevention pre-exposure prophylaxis (PrEP) awareness and modality preferences by gender, race, and ethnicity.

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We compared self-reported vaccination to vaccine card data to assess concurrency in a sample of Black young adults in Georgia, Alabama, and North Carolina. We described vaccine card versus self-reported data over time and examined discrepancies in reporting between these two sources. Results indicated strong currency suggesting collection of self-reported data may be an acceptable proxy to requiring official vaccine documentation.

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Background: Negative attitudes toward vaccines and suboptimal vaccination rates among African American and Black (Black) Americans have been well documented, due to a history of medical racism and human rights violations in the United States. However, digital health interventions (DHI) have been shown to address racial disparities in several health outcomes, such as cardiovascular disease, HIV, and maternal health. The Tough Talks COVID (TT-C) study was a randomized controlled trial of a DHI designed to empower Black young adults in the United States South to make informed, autonomous decisions about COVID-19 vaccine uptake by addressing structural barriers and misinformation about vaccines.

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Eliminating stigmas that harm sexual and gender minorities (SGM) with HIV is necessary to end the epidemic; however, few validated stigma-reducing interventions for healthcare settings exist, and even fewer have been evaluated in Spanish-speaking contexts. Finding Respect and Ending Stigma around HIV (FRESH) is a healthcare setting stigma-reduction intervention that was adapted and tested to address HIV and intersectional stigmas that harm SGM with HIV in the Dominican Republic. Herein, we detail the intervention adaptation process and present feasibility, acceptability, and pre-post preliminary effectiveness results ascertained via paired t-tests.

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Introduction: The COVID-19 pandemic highlighted the centuries old issue of vaccine hesitancy and exposed healthcare inequities harming Black young adults. Despite vaccines being able to reduce COVID-19, human papillomavirus (HPV), and influenza morbidity and mortality, they are underutilized. An examination of socio-behavioral factors to understand motivators and barriers to vaccine uptake within Black communities is necessary to improve preventative health.

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Background: In Alabama, the undiagnosed HIV rate is over 20%; youth and young adults, particularly those who identify as sexual and gender minority individuals, are at elevated risk for HIV acquisition and are the only demographic group in the United States with rising rates of new infections. Adolescence is a period marked by exploration, risk taking, and learning, making comprehensive sexual health education a high-priority prevention strategy for HIV and sexually transmitted infections. However, in Alabama, school-based sexual health and HIV prevention education is strictly regulated and does not address the unique needs of sexual and gender minority teenagers.

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While people with HIV (PWH) experience high rates of end-stage kidney disease (ESKD), they were historically denied kidney transplantation and prohibited from organ donation, both elements of treating ESKD. It remains unknown to what extent such HIV criminalization laws correlate with the provision of transplantation education to PWH. We conducted this study to elucidate the relationship between these structural-level policies and individual-level outcomes.

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Article Synopsis
  • The study focused on understanding the stigma faced by MSM with HIV, transgender women with HIV, and healthcare providers in Dominican Republic healthcare settings.
  • Data was collected through focus groups and interviews, identifying four primary stigma themes: migrant stigma, religious stigma, SGM stigma, and HIV stigma.
  • The results highlight the severe impact of stigma on mental health, suggesting that effective interventions should tackle both structural barriers and cultural norms that contribute to stigma in HIV care.
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The population-level reductions in HIV incidence attributed to pre-exposure prophylaxis (PrEP) have not been fully realized among sexual, gender, and racial/ethnic minority youth. P3 (Prepared, Protected, emPowered) is a comprehensive mobile application (app) intervention developed to support PrEP adherence through gamification, medication tracking, and social engagement. A randomized controlled trial was conducted with 246 young men who have sex with men (YMSM) and young transgender women who have sex with men (YTWMSM) currently on or planning to begin PrEP.

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Article Synopsis
  • A study was conducted to assess mpox knowledge among Black young adults (ages 18-29) in Alabama, Georgia, and North Carolina to better target public health efforts.
  • Results showed a wide range of correct responses to mpox knowledge questions (26%-96%), with 26% unaware of the vaccine and 21% mistakenly believing the chickenpox vaccine offered protection against mpox.
  • Females generally had better knowledge than males, and no significant differences were found between states, indicating the need for regional educational initiatives to fill knowledge gaps and improve public health preparedness.
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Adverse pregnancy outcomes are associated with poor short- and long-term cardiovascular health. However, patients and their health care providers may not have knowledge of this risk or of the healthful practices that can reduce this risk. Childbirth care can be a pivotal time in the patient-clinician relationship to build awareness and spur prevention planning.

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Article Synopsis
  • The study developed and validated two brief measurement scales: the Mpox Stigma Scale (MSS) and the Mpox Knowledge Scale (MKS) to address knowledge and stigma as barriers to mpox-related care and prevention.
  • Conducted with 330 self-identified African American or Black participants aged 18-29 in Alabama, Georgia, or North Carolina, the study confirmed the psychometric properties of both scales using various statistical analyses.
  • Results demonstrated that the MSS and MKS showed strong reliability and valid correlations with stigmatizing attitudes, attitudes towards vaccination, and concerns about contracting mpox, emphasizing the importance of understanding stigma and knowledge in public health strategies.
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Background: Research has linked stigma surrounding preexposure prophylaxis (PrEP) to poor HIV prevention outcomes, including PrEP adherence. However, there remains a limited understanding of the mechanisms through which PrEP stigma affects PrEP adherence, specifically among sexual and gender minority (SGM) youth. In this study, we aimed to investigate the indirect effect of PrEP stigma on PrEP adherence through PrEP confidence and the moderating role of anticipated HIV stigma.

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Article Synopsis
  • - An exploratory study in Alabama aimed to improve HIV testing rates among Black young men who have sex with men (BYMSM) by interviewing both BYMSM and outreach workers about their experiences and recommendations for better outreach efforts.
  • - Data from 56 BYMSM (average age 24) and 12 outreach workers (average age 39, mostly male and Black) revealed five key themes: promoting testing earlier, increasing visibility and outreach efforts, creating connections through shared experiences, using nonjudgmental communication, and enhancing HIV knowledge among BYMSM.
  • - The study concluded that building trust is crucial for effective HIV testing promotion among BYMSM, with recommendations to start prevention discussions at a younger age and train outreach workers in
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Effective health communication between healthcare providers and patients is a cornerstone of quality healthcare. It underpins trust, comprehension, and patient-informed care. Robust research shows that effective communication, including the use of text messaging for communication can improve maternal/fetal and neonatal outcomes and patient satisfaction, particularly among vulnerable patients.

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Background: Approximately 20% of adults in Vietnam have hypertension, and management of this chronic condition remains challenging. This study aimed to assess the effectiveness of a multicomponent intervention in reducing blood pressure (BP) in adults with uncontrolled hypertension.

Methods: This cluster randomised controlled trial was conducted in sixteen communities (8 intervention and 8 comparison) in a rural setting in Vietnam (2017-2022).

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Background: HIV-related stigma, discrimination, and social marginalization undermines optimal HIV care outcomes. More research examining the impact of HIV-related stigma, discrimination, other interlocking forms of oppression, and antiretroviral therapy (ART) adherence is needed to optimize HIV treatment programming. This study uses data from two clinics in the Dominican Republic to examine client and healthcare worker (HCW) perceptions of HIV and intersectional stigmas among people living with HIV.

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Background: The maternal mortality and perinatal mortality rate in Cameroon are among the highest worldwide. To improve these outcomes, we conducted a formative qualitative assessment to inform the adaptation of a mobile provider-to-provider intervention in Cameroon. We explored the complex interplay of structural barriers on maternity care in this low-resourced nation.

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Experiencing HIV and intersectional stigmas in healthcare settings may affect antiretroviral treatment (ART) adherence among people with HIV (PWH), given their need for frequent interactions with clinical settings and healthcare providers. Considering the importance of reducing stigmas to promote well-being and the need to elucidate how stigma influences health across various settings, we examined how experienced HIV stigma in Dominican Republic healthcare settings impacts ART adherence through internalized HIV stigma and whether race or sexual orientation stigma moderates this relationship. Participants were 471 PWH (aged 17-71) who were recruited from two HIV clinics in the Dominican Republic in 2021-2022.

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In the United States, the use of pre-exposure prophylaxis (PrEP) has led to a substantial decrease in HIV prevalence and incidence. However, some populations, including young men who have sex with men (YMSM) of color, continue to be disproportionately impacted, highlighting the need for tailored interventions addressing barriers to adequate PrEP access. In collaboration with partner clinics, we recruited 19 PrEP clients and 19 PrEP providers ( = 35) to participate in hour-long in-depth interviews.

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Background: Newer antiretrivirals (ART) have shifted the metabolic experiences of people with HIV (PWH) from those of wasting syndrome to increases in body mass index (BMI). This study sought to examine the relationship between BMI and ART use among youth with HIV (YWH).

Methods: Charts from YWH ages 10-24 with at least two documented BMIs at least 6 months apart between 2017 and 2020 were included (N = 44).

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Gaps in knowledge remain related to understanding missed human immunodeficiency virus (HIV) visits and youth with HIV (YWH). This study examined data from an Alabama academic HIV clinic with clients aged 16 to 24 years old and found that non virally suppressed and older YWH were associated with missed visits among YWH.

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