Culturally tailored HIV-AIDS risk-reduction messages targeted to African-American urban women: impact on risk sensitization and risk reduction

African-American women recruited from low-income housing projects in Chicago (N = 106) were randomly assigned to view 1 of 3 20-min videotapes: a standard public health service tape on prevention of acquired immunodeficiency syndrome (AIDS), the same public health service tape but matching presenter and participant ethnicity and sex, or a tape that included the same content but was framed in a context specifically intended to increase cultural relevance. Participants who viewed the tapes presented by African-American women were significantly more sensitized to AIDS and were more likely to have discussed AIDS with friends, to be tested for human immunodeficiency virus (HIV) antibodies during the follow-up interval, and to request condoms at follow-up. These results support the use of culturally sensitive AIDS prevention messages targeted to specific populations, particularly to promote HIV-antibody testing.

Factors associated with severity of depression and high-risk sexual behavior among persons diagnosed with human immunodeficiency virus (HIV) infection

Whereas some people appear to cope after learning that they have human immunodeficiency virus (HIV) infection, others experience depression and suicidal ideation. In this study, 142 persons with HIV infection were administered the Center for Epidemiological Studies Depression Scale (CES-D). High levels of depression were predicted by lower perceived social support, attributions that health was influenced more by chance, high-risk sexual behavior practices, and greater number of HIV illness symptoms and greater duration of time knowing of one's own positive serostatus. Ongoing high-risk sexual behavior practices were predicted by higher levels of recreational drug use and of depression. These findings highlight the need for improved mental health services for persons with HIV conditions.

Culturally tailored HIV-AIDS risk-reduction messages targeted to African-American urban women: impact on risk sensitization and risk reduction

African-American women recruited from low-income housing projects in Chicago (N = 106) were randomly assigned to view 1 of 3 20-min videotapes: a standard public health service tape on prevention of acquired immunodeficiency syndrome (AIDS), the same public health service tape but matching presenter and participant ethnicity and sex, or a tape that included the same content but was framed in a context specifically intended to increase cultural relevance. Participants who viewed the tapes presented by African-American women were significantly more sensitized to AIDS and were more likely to have discussed AIDS with friends, to be tested for human immunodeficiency virus (HIV) antibodies during the follow-up interval, and to request condoms at follow-up. These results support the use of culturally sensitive AIDS prevention messages targeted to specific populations, particularly to promote HIV-antibody testing.

HIV-related risk and antibody testing: an urban community survey

The present study investigated patterns of human immunodeficiency virus (HIV) antibody testing in a diverse urban sample. Five hundred seventy-nine men and women (representing 88% cooperation and 67% response rates) were surveyed in Chicago's downtown at mass transit waiting areas. Participants completed measures of demographic information, sexual and HIV-risk behavior histories, information regarding HIV antibody testing status, and HIV/AIDS-related knowledge and perceptions. Results showed that only 36% of persons with histories of high-risk practices had been tested for HIV. Persons who had been tested, as compared to those not tested, were older in age and perceived themselves to be at greater risk. Results also showed a relationship between participants' knowledge of their own HIV serostatus and inquiring about their sexual partners' serostatus. As compared to persons not tested, those who had been tested were more likely to know their most recent sexual partner's HIV testing status. Results suggest that several factors found among gay men with regard to HIV testing may generalize to populations representing diverse HIV-related risk behavior patterns.

Community AIDS/HIV risk reduction: the effects of endorsements by popular people in three cities

OBJECTIVES

It is critical to extend community-level acquired immunodeficiency syndrome (AIDS) prevention efforts beyond education alone and to develop models that better encourage behavioral changes. Gay men in small cities are vulnerable to human immunodeficiency virus (HIV) infection due to continued high rates of risk behavior. This research introduced an intervention that trained popular people to serve as behavioral change endorsers to peers sequentially across three different cities.

METHODS

Populationwide surveys were conducted of all men patronizing gay clubs in each city to establish risk behavior base rates. After a small cadre of popular "trendsetters" were identified, they received training in approaches for peer education and then contracted to communicate risk reduction recommendations and endorsements to friends. Surveys were repeated at regular intervals in all cities, with the same intervention introduced in lagged fashion across each community.

RESULTS

Intervention consistently produced systematic reductions in the population's high-risk behavior (unprotected anal intercourse) of 15% to 29% from baseline levels, with the same pattern of effects sequentially replicated in all three cities.

CONCLUSIONS

This constitutes the first controlled, multiple-city test of an HIV prevention model targeting communities. The results support the utility of norm-changing approaches to reduce HIV risk behavior.

The disclosure of celebrity HIV infection: its effects on public attitudes

OBJECTIVES

Despite the magnitude of the acquired immunodeficiency syndrome (AIDS) epidemic, studies have shown low levels of public concern about human immunodeficiency virus (HIV)/AIDS. We investigated the effects of celebrity disclosure of HIV infection on the AIDS-related perceptions of urban men.

METHODS

Measures of AIDS-related perceptions were collected from 361 men waiting for mass transportation in downtown Chicago; 252 were assessed at three time points prior to and 109 were assessed at two time points after professional basketball star Earvin "Magic" Johnson's disclosure of his HIV infection.

RESULTS

Significant increases in concern about AIDS, interest in AIDS information, and talking with friends about AIDS occurred after celebrity disclosure of HIV infection.

CONCLUSIONS

Celebrity disclosure of HIV seropositivity demonstrated a marked change in AIDS-related perceptions among the men surveyed. Changes in awareness due to celebrity disclosure may lead to increased readiness to reduce risk and could be viewed as a window of opportunity for HIV prevention efforts.

Perceptions of AIDS susceptibility among minority and nonminority women at risk for HIV infection

Two hundred seventy-two women sampled from mass transit waiting areas in an urban center completed anonymous surveys of AIDS-related risk behavior, perceptions of susceptibility, and knowledge. Variable patterns of human immunodeficiency virus (HIV) risk behaviors were identified, with 22% of women reporting high-risk behavior. Perceptions of susceptibility were associated with an interaction between ethnicity and level of risk; nonminority women at high risk reported greater concern about AIDS than did minority women at high risk, who did not differ from women at low risk. With an array of life problems and inaccurate information about HIV transmission, minority women were found to be at continued risk for AIDS-related behavior. Implications for culturally sensitive and relevant AIDS prevention efforts are discussed.

Perceptions of AIDS susceptibility among minority and nonminority women at risk for HIV infection

Two hundred seventy-two women sampled from mass transit waiting areas in an urban center completed anonymous surveys of AIDS-related risk behavior, perceptions of susceptibility, and knowledge. Variable patterns of human immunodeficiency virus (HIV) risk behaviors were identified, with 22% of women reporting high-risk behavior. Perceptions of susceptibility were associated with an interaction between ethnicity and level of risk; nonminority women at high risk reported greater concern about AIDS than did minority women at high risk, who did not differ from women at low risk. With an array of life problems and inaccurate information about HIV transmission, minority women were found to be at continued risk for AIDS-related behavior. Implications for culturally sensitive and relevant AIDS prevention efforts are discussed.

Situational factors associated with AIDS risk behavior lapses and coping strategies used by gay men who successfully avoid lapses

While most gay men have reduced behavior practices at high risk for HIV infection, there is growing evidence that many also lapse to unsafe sex. This study examined situational factors related to risk behavior lapses as well as coping strategies used by men who successfully resist lapse urges. A convenience sample of 470 men patronizing gay bars or attending social organization meetings in four cities was surveyed. Forty-five percent of men were classified as "lapsers" (those who had had unprotected anal intercourse in the previous 6 months) and 24% were classified as "resisters" (those who successfully resisted urges to engage in this behavior). All provided information concerning the importance of factors related to the most recent occurrence of either unsafe sex or resisting unsafe urges. Most episodes of unsafe sex occurred outside monogamous relationships and with partners of unknown HIV serostatus, although simply inquiring about partner serostatus was relatively common. Lapsers rated affectionate feelings and wishing to please a partner as well as spontaneity of unsafe sex as the most important situational factors surrounding high-risk behavior. Resisters of unsafe sex urges reported active cognitive self-guidance, experience in safe sex, and recall of both AIDS fears and safety benefits as their most important coping strategies. Gay men who continue high-risk behavior may be overrelying on partner reports of negative serostatus. Lapse prevention approaches tailored to situations that create increased risk vulnerability must be developed. Teaching skills already used by men who successfully resist unsafe sex urges might be one approach.

HIV risk behavior reduction following intervention with key opinion leaders of population: an experimental analysis

BACKGROUND AND PURPOSE

Peer norms influence the adoption of behavior changes to reduce risk for HIV (human immunodeficiency virus) infection. By experimentally intervening at a community level to modify risk behavior norms, it may be possible to promote generalized reductions in HIV risk practices within a population.

METHODS

We trained persons reliably identified as popular opinion leaders among gay men in a small city to serve as behavior change endorsers to their peers. The opinion leaders acquired social skills for making these endorsements and complied in talking frequently with friends and acquaintances. Before and after intervention, we conducted surveys of men patronizing gay clubs in the intervention city and in two matched comparison cities.

RESULTS

In the intervention city, the proportion of men who engaged in any unprotected anal intercourse in a two-month period decreased from 36.9 percent to 27.5 percent (-25 percent from baseline), with a reduction from 27.1 percent to 19.0 percent (-30 percent from baseline) for unprotected receptive anal intercourse. Relative to baseline levels, there was a 16 percent increase in condom use during anal intercourse and an 18 percent decrease in the proportion of men with more than one sexual partner. Little or no change was observed among men in the comparison cities over the same period of time.

CONCLUSIONS

Interventions that employ peer leaders to endorse change may produce or accelerate population behavior changes to lessen risk for HIV infection.

HIV risk behavior reduction following intervention with key opinion leaders of population: an experimental analysis

BACKGROUND AND PURPOSE

Peer norms influence the adoption of behavior changes to reduce risk for HIV (human immunodeficiency virus) infection. By experimentally intervening at a community level to modify risk behavior norms, it may be possible to promote generalized reductions in HIV risk practices within a population.

METHODS

We trained persons reliably identified as popular opinion leaders among gay men in a small city to serve as behavior change endorsers to their peers. The opinion leaders acquired social skills for making these endorsements and complied in talking frequently with friends and acquaintances. Before and after intervention, we conducted surveys of men patronizing gay clubs in the intervention city and in two matched comparison cities.

RESULTS

In the intervention city, the proportion of men who engaged in any unprotected anal intercourse in a two-month period decreased from 36.9 percent to 27.5 percent (-25 percent from baseline), with a reduction from 27.1 percent to 19.0 percent (-30 percent from baseline) for unprotected receptive anal intercourse. Relative to baseline levels, there was a 16 percent increase in condom use during anal intercourse and an 18 percent decrease in the proportion of men with more than one sexual partner. Little or no change was observed among men in the comparison cities over the same period of time.

CONCLUSIONS

Interventions that employ peer leaders to endorse change may produce or accelerate population behavior changes to lessen risk for HIV infection.

Sexually deviant behavior and schizotypy: a theoretical perspective with supportive data

Sexual offenses against adults and children continue to increase annually. Although theory and research have helped explain the personality functioning and motivation of sexual offenders, most treatment approaches have been found to have high recidivism rates and have failed to address the heterogeneity of sex offender populations. In the present paper, we utilize the growing literature on schizotypic personality organization to describe a subgroup of sex offenders. Data from the sex offender personality literature which indicates signs of thought disturbances among some sex offenders are reviewed in the context schizotypy. We conclude that treatment programs which address the heterogeneity of sex offenders and employ interventions to treat cognitive disturbances will likely result in greater efficacy.

Cluster analytically derived MMPI profile subgroups of incarcerated adult rapists

Sex offenders are known to be heterogeneous in their patterns of personality functioning and behavior. The present study conducted a multivariate cluster analysis on the MMPIs of 120 incarcerated adult male rapists. The analysis resulted in the identification of five MMPI profile subgroups. Additional differences among subgroups were identified in the circumstances of the crime and responses to the Multiphasic Sex Inventory. Levels of psychopathology, as indicated by the MMPI, ranged from slight to extreme. Results are discussed with reference to previous MMPI research with sex offenders. Suggestions for future research are offered.

MMPI profile of women and men convicted of domestic homicide

The present study investigated the psychological characteristics of men and women convicted of domestic homicide. Demographic information and MMPIs were collected from women (n = 16) and men (n = 20) convicted of murdering their partners and men (n = 19) convicted of murdering strangers during the course of a crime. Analyses of variance indicated that women had significantly higher elevations of MMPI scales PA and SI than both groups of men, while men convicted of murdering strangers had higher elevations on scale MA than men convicted of domestic murder. These findings suggest different patterns of psychopathology among homicide offenders depending on the offender's relationship to the victim. Results are discussed with reference to previous research on domestic murderers and female offenders.

Empirically derived MMPI profile subgroups of incarcerated homicide offenders

Several classification systems have been developed to identify subgroups of criminals. Recently, investigations have attempted to derive empirical classifications of specific types of offenders. The present study investigated the occurrence of MMPI profile subgroups in a sample of incarcerated homicide offenders. One hundred and eighteen convicted male homicide offenders were the subjects. MMPIs were collected as a part of evaluations to determine eligibility for a work release program. Results identified four distinct profile subgroups, which ranged in levels of psychopathology from normal to severely disturbed. Subgroups are discussed with reference to previous research and the development of a taxonomic system for homicide offenders.

Mental health professionals and suspected cases of child abuse: an investigation of factors influencing reporting

The prevalence and effects of child abuse have been reported in numerous studies. Although mandatory reporting laws require professionals to report suspected cases of child abuse, studies have indicated that large percentages of mental health professionals report selectively. The present study investigates professionals' tendency to report and attribution of responsibility for child abuse. One-hundred and one mental health clinicians working within three community mental health centers (CMHCs) completed experimentally controlled vignettes manipulating victim age, type of abuse, and victim reactions during an interview. Results indicated 81% of the clinicians tended to report the presented case of child abuse. Clinicians' tendency to report depended on the level of certainty they had that abuse was occurring. Professionals' attribution of responsibility to the father and mother varied as a function of the type of abuse occurring. The impact of victim characteristics on clinicians' reporting is discussed.