Joshua N. Okundaye

African American Intergender Relationships a Theoretical Exploration of Roles, Patriarchy, and Love

Current expectations of men andwomen in society have undergone tremendous changes concerning roles and the expression of intimacy within intergender relationships. African American intergender relationships have not escaped these changes. Three theoretical perspectives are offered to enrich the discussion on African American intergender relationships: patriarchy, role, and love. This article posits that African American intergender relationships are defined within some particular significant parameters like patriarchy, gender roles, love, and a history of enslavement and discrimination. Current discussions of such relationships miss their complexity when they omit these conceptual perspectives and the unique historical and present-day experiences of African Americans. The Million Woman and Million Man Marches have made healing, nurturing, atonement, love, and acceptance national priorities for African Americans. This article promotes the incorporation of the perspectives—patriarchy, role, and love—as avenues of contributing to an enriched debate that will be beneficial to such national priorities.

The Impact of Mentor Mother Programs on PMTCT Service Uptake and Retention-in-Care at Primary Health Care Facilities in Nigeria: A Prospective Cohort Study (MoMent Nigeria)

Background:Nigeria is a key target country in the global effort toward elimination of mother-to-child transmission of HIV. Low coverage of prevention of mother-to-child transmission (PMTCT) interventions, adherence, and retention-in-care rates in HIV-positive pregnant women are contributing factors to high mother-to-child transmission of HIV (MTCT) rates. In Nigeria, rural areas, served largely by primary health care facilities, have particularly poor indicators of PMTCT coverage. Mentor Mothers are HIV-positive women who serve as peer counselors for PMTCT clients, provide guidance, and support in keeping appointments and promoting antiretroviral adherence and retention-in-care. The Mother Mentor (MoMent) study aims to investigate the impact of structured Mentor Mother programs on PMTCT outcomes in rural Nigeria. Design and Methods:A prospective cohort study will compare rates of retention-in-care among PMTCT clients who are supported by formally-trained supervised Mentor Mothers versus clients who receive standard-of-care, informal peer support. Study sites are 20 primary health care centers (10 intervention, 10 control) in rural North-Central Nigeria. The study population is HIV-positive mothers and exposed infant pairs (MIPs) (N = 480; 240 MIPs per study arm). Primary outcome measures are the proportion of exposed infants receiving early HIV testing by age 2 months, and the proportion of MIPs retained in care at 6 months postpartum. Secondary outcome measures examine antiretroviral adherence, 12-month postpartum MIP retention, and MTCT rates. This article presents details of the study design, the structured Mentor Mother programs, and how their impact on PMTCT outcomes will be assessed.

Education and Kinship Caregivers: Creating a New Vision

Current issues regarding the education of children with disabilities who are placed with kinship caregivers are highlighted using qualitative data on low-income African American kinship care providers who are 40–70 years old. Examined are the historical and social implications of kinship care, and the challenges facing the formal education of these children. Also explored are suggestions of kinship caregivers for improving the relationship between the school and their grandchildren. Kinship caregivers continue to highly value education as a priority for the children in their care. Despite difficulties in interacting with schools, kinship caregivers identify collaborative relationships they want with education providers.

Evaluating Religious Influences on the Utilization of Maternal Health Services among Muslim and Christian Women in North-Central Nigeria.

Introduction. Uptake of antenatal services is low in Nigeria; however, indicators in the Christian-dominated South have been better than in the Muslim-dominated North. This study evaluated religious influences on utilization of general and HIV-related maternal health services among women in rural and periurban North-Central Nigeria. Materials and Methods. Targeted participants were HIV-positive, pregnant, or of reproductive age in the Federal Capital Territory and Nasarawa. Themes explored were utilization of facility-based services, provider gender preferences, and Mentor Mother acceptability. Thematic and content approaches were applied to manual data analysis. Results. Sixty-eight (68) women were recruited, 72% Christian and 28% Muslim. There were no significant religious influences identified among barriers to maternal service uptake. All participants stated preference for facility-based services. Uptake limitations were mainly distance from clinic and socioeconomic dependence on male partners rather than religious restrictions. Neither Muslim nor Christian women had provider gender preferences; competence and positive attitude were more important. All women found Mentor Mothers highly acceptable. Conclusion. Barriers to uptake of maternal health services appear to be minimally influenced by religion. ANC/PMTCT uptake interventions should target male partner buy-in and support, healthcare provider training to improve attitudes, and Mentor Mother program strengthening and impact assessment.

Working with Children of Parents with Substance Use Disorders: Evaluation of a Course Module.

Social workers are in a position to identify the effects of substance use disorders (SUDs) on children and families and provide appropriate interventions in broad practice contexts. Unfortunately, many social workers are not trained to consider parental SUDs and their effects on children in the assessment process. A course module for training social work students on working with children of a parent(s) who has a SUD was developed to fill this gap. This study reports on an evaluation of this module that was conducted with 52 students in baccalaureate-level Human Behavior in the Social Environment courses. Significant increases in knowledge, self-efficacy beliefs, and perceived abilities were observed, and students reported high levels of satisfaction with the module.

Socio-Demographic Factors, Social Support, Quality of Life, and HIV/AIDS in Ghana

The increase in the access to biomedical interventions for people living with HIV/AIDS in the developing world has not been adequately matched with the requisite psychosocial treatments to help improve the effectiveness of biomedical interventions. Therefore, in this study the author seeks to determine whether socio-demographic characteristics and social support are associated with quality of life in individuals diagnosed with HIV/AIDS in Ghana. A convenience sample of 300 HIV/AIDS support group members was obtained via cross-sectional design survey. The Medical Outcome Studies (MOS) HIV Health Survey, the MOS Social Support Survey (MOS-SSS), and demographic questionnaire instruments were used to assess quality of life, social support, and demographic information respectively. Multiple regression analysis showed that there was a positive association between overall social support and overall quality of life (r = .51). It also showed that being younger, male, attending support group meetings for over a year, and having ≥ 13 years of schooling related to higher quality of life. Implications of the findings for practice, policy, and research in Ghana and the rest of the developing world are discussed.

A Socio-Ecological Examination of Treatment Access, Uptake and Adherence Issues Encountered By HIV-Positive Women in Rural North-Central Nigeria

ABSTRACT Background: In spite of the global decline in HIV infections, sub-Saharan Africa still accounts for a non-proportional majority of global new infections. While many studies have documented the importance of facilitating access to anti-retroviral therapy (ART) as a means of reducing infections, the relationship between interpersonal, community, healthcare facility, and policy-level factors and treatment adherence in Africa have not been well-described. The authors examined these factors in the context of prevention of mother-to-child transmission (PMTCT) of HIV in rural north-central Nigeria, where HIV burden is high and service coverage is low. Methods: Eleven focus groups (n = 105) were conducted among PMTCT clients, male partners, young women, and other community members from 39 rural and semi-rural communities to explore factors related to HIV and antenatal care service use. Data were analyzed using the Constant Comparative Method. Results: Irrespective of HIV status, participants reported barriers to access including long clinic wait times, transportation availability and cost, and the lack of HIV treatment medications. For HIV-positive women, stigma from family members, providers, and the local community affected their ability to obtain care and remain ART-adherent. In the face of these barriers, these women reflected on the importance of peer and community support, as well as the passage of laws to combat barriers to treatment access, uptake, and adherence. Conclusions: Facilitating treatment adherence may require not only focusing on the medical treatment needs of these women but also structural issues, such as the availability of providers and drugs, and systemic stigmatization of HIV-positive patients.

Gender and Children as the Moderators of the Relationship between Social Support and Quality of Life: An Empirical Study of People Living with HIV/AIDS in Ghana.

Although gender differences persist in the receipt of social support and the report of quality of life among people living with HIV/AIDS in Sub-Saharan Africa, the knowledge base on this topic is scant. For those living with HIV/AIDS, women tend to participate more than men in support group activities, but their gender predisposes them to lower quality of life. Therefore, this study seeks to determine what demographic factors moderate the relationship between social support and quality of life among those living with HIV/AIDS in Ghana. A convenience sample of 300 HIV/AIDS support group members who have experience participating in research studies and was obtained for use via cross-sectional design survey in September and October 2013. The Medical Outcome Studies (MOS) HIV Health Survey, the MOS Social Support Survey, and demographic questionnaire instruments were used to assess quality of life, social support, and demographic information respectively. Gender (male) F(3, 296) = 66.04, t = 2.26, p = .024) and having children (have children) (F(5, 294) = 40.34, t = 2.50, p = .013) moderated the relationship between social support and quality of life. Implications of the findings for practice, policy, and research in Ghana and the rest of the developing world were discussed.

Kinship and spirituality:utilizing strengths of caregivers.

Summary Kinship caregivers view spirituality and religion as integral and holistic in nature and an essential coping component to their survival as caregivers. This article examines the following eight spirituality and religious themes defined by a group of African American caregivers of children: spirituality and destiny; spirituality and drugs; faith and healing; spirituality and negotiation; surviving through faith; spirituality, religion, and community; religion; worship and the child; and the need for respite through worshiping and selfcare. Historical and social aspects regarding the role of spirituality and religion within the African American community are discussed. Qualitative data from a focus group of 19 low income African American kinship caregivers aged 40-70 years are used to present spiritual and religious clinical tools, techniques, and concepts for intervening with kinship caregivers.

Drug trafficking and addiction among low-income urban youths: An ecological perspective

Abstract Drug addiction and drug trafficking continue to be a major problem during adolescence and a primary cause of significant problems in adulthood. For low-income, urban, African American youths, these problems are compounded by environmental factors-such as communities that are depleted of resources, schools that are inadequately funded, family members who are unemployed-and other physical, legal, spiritual, social and psychological factors. These ecological factors have the potential to impinge significantly on the lives of those who become involved with drug use and sales. The problems resulting from these issues not only affect the individual but also family members, communities and the nation. This paper examines the patterns of drug addiction and trafficking among African American youths in poverty, with an eye toward answering the following questions: What is drug trafficking? What is the youths perception of drug addiction? What role does drug trafficking play in subsequent drug use? What is ...