Acculturation, coping styles, and health risk behaviors among HIV positive Latinas

Relations between stress, coping strategies, and prosocial behavior in U.S. Mexican college students

Objective: We explored the explanatory roles of active and avoidant coping in the link between stress and emotional prosocial behavior in U.S. Mexican college students. Participants: Participants included 148 college students (M_age = 23 years, 67% female, 84% born in the U.S.) who self-identified as Mexican or U.S. Mexican or noted that their parents or grandparents were of Mexican or U.S. Mexican origin. Methods: Introduction to Psychology students at state universities in California and Texas completed a self-report survey packet and received class credit for their participation. Data were analyzed via path analysis using Mplus 8.1 software. Results: U.S. Mexican college students' stress was indirectly associated with their emotional prosocial behavior through both active and avoidant coping strategies. Conclusions: Relations between stress and adjustment (i.e., emotional prosocial behavior) is dependent upon individuals' coping tendencies. U.S. Mexicans may cope with their stress by engaging in emotional prosocial behavior.

The coping skills and quality of life among rape survivors - A descriptive study from Kerala

BACKGROUND

Rape is one of the most heinous of acts. It constitutes a major violation of an individual's basic rights and intensely impacts their mental and physical health. Coping skills used to deal with the trauma could provide information on their quality of life (QOL).

OBJECTIVES

To assess the coping skills and QOL of rape survivors and to explore its association with their coping skills.

MATERIALS AND METHODS

Data were collected through a questionnaire, and coping skills were assessed using the Brief COPE scale and QOL using the World Health Organization quality of life questionnaire (WHOQOL-BREF). Results were analyzed using the Kruskal-Wallis H test and Spearman rank correlation.

RESULTS

Adaptive coping skills such as use of instrumental support, active coping, use of emotional support, self-distraction, and acceptance had higher COPE mean scores. QOL in the domain of physical health (mean = 52.71) had the highest mean score, followed by the domains of environment (mean = 51.35) and psychological health (mean = 48.37). Use of coping skills like active coping, use of emotional support, use of instrumental support, positive reframing, and acceptance had a significant positive correlation with the QOL in the domains of physical health and environment. Active coping and positive reframing were positively correlated with the QOL in the domain of psychological health, while positive reframing and humor were positively correlated with the social relationships domain.

CONCLUSION

Those who employed adaptive coping skills (active coping, use of emotional support, use of instrumental support, positive reframing, acceptance) showed significantly better QOL than those with maladaptive skills.

A multidimensional examination of psychological distress among Latina mothers with and without HIV

The Latino population is disproportionally affected by HIV in the United States. Latina women, in particular, have significantly higher rates of HIV diagnosis than their White counterparts. Latinas with HIV who are primary family caregivers face multidimensional challenges from caregiving demands to stressors related to chronic illness, acculturation, family functioning, and socioeconomic disparities, which may contribute to higher psychological distress than Latina mothers without HIV. However, to date, scant research has focused on the mental health needs of Latina mothers living with HIV (MLHs) and how these needs are similar or different to Latina mothers without HIV. Thus, using a multidimensional approach we: (a) examined the associations between HIV status, acculturation, family functioning, socioeconomic status, and psychological distress among Latina mothers and (b) identified how these associations differed between Latina mothers with and without HIV. Cross-sectional, self-reported data were obtained via face-to-face interviews from 221 Latina MLHs and 116 Latina neighborhood control mothers (NCMs) living without HIV in Los Angeles, California. Results from multivariate ordinary least square regressions showed that higher acculturation was associated with psychological distress among MLHs, whereas higher levels of family conflict and education were associated with psychological distress among NCMs. Findings highlight the differential mental health needs of Latina mothers based on HIV status. Our study findings provide social work implications for culturally responsive interventions that can address multidimensional stressors experienced by marginalized Latinas MLHs.

Coping styles in HIV positives and HIV negatives

Background

Choosing the most useful and versatile way to solve one's personal and social problems is one of the most important choices in individual life. The aim of this study was to compare the coping styles of people living with Human immunodeficiency virus positive and negative.

Methods

This is a Cross-sectional study that accomplished in Shiraz Behavioural Disease Counselling Centre in 2019 and 2020. For this purpose, in the first phase, 40 HIV+ and 40 HIV− patients were randomly selected to answer the questionnaire of dealing with the stressful conditions of Andler and Parker. In the second phase, the same questionnaire was filled out along with a reality distortion questionnaire from similar individuals (40 HIV+ and 40 HIV−).

Results

92% of the HIV population in this study was between 15 and 55 years and 8% was upper than 55 years. 90% of them had no university degree. Among all, 47.5% of them were, 48.5% were self-employed and 49% of them were infected sexually. The results showed that in the first stage there was a significant relationship between marital status and the chances of getting the disease in people, and after controlling the demographic factors, coping styles did not show a significant effect on the disease. In the second stage, the factors of age, sex, education, and marital status had significant effects on people living with HIV, but the effect of coping styles on people with HIV was not significant (P < 0.05).

Conclusion

Therefore, it can be concluded that demographic factors more than coping styles can affect the chances of high-risk behaviours; so, what is identified and measured as a coping style in people in the process that leads to the manifestation of high-risk behaviours or healthy behaviour does not matter much. It should be noted that the reason for rejecting the hypotheses of this study could be the effect of cultural and social factors of Iranian society.

Strategies for increasing impact, engagement, and accessibility in HIV prevention programs: suggestions from women in urban high HIV burden counties in the Eastern United States (HPTN 064)

BACKGROUND

Merely having the tools to end HIV is insufficient. Effectively ending the epidemic necessitates addressing barriers that impede engagement in biomedical and behavioral prevention and wide scale implementation and utilization of existing interventions. This qualitative study identifies suggestions for increasing access to, engagement in, and impact of HIV prevention among women living in cities in high HIV burden counties in the eastern US.

METHODS

Data analyzed for the current study were collected via a qualitative sub-study within the HIV Prevention Trials Network Study 064 (HPTN 064), a multisite observational cohort study designed to estimate HIV incidence among women residing in communities with elevated HIV prevalence who also reported personal or partner characteristics associated with increased risk of HIV acquisition. Focus group and interview participants in the qualitative sub-study (N = 288) were from four cities in the eastern US.

RESULTS

Thematic analyses revealed four themes describing women's most frequently stated ideas for improving prevention efforts: 1) Promote Multilevel Empowerment, 2) Create Engaging Program Content, 3) Build "Market Demand", and 4) Ensure Accessibility. We conducted additional analyses to identify contradictory patterns in the data, which revealed an additional three themes: 1) Address Structural Risk Factors, 2) Increase Engagement via Pleasure Promotion, 3) Expand Awareness of and Access to Prevention Resources.

CONCLUSIONS

Findings may be useful for enhancing women's engagement in and uptake of behavioral and biomedical HIV prevention resources, improving policy, and addressing multilevel risk factors.

TRIAL REGISTRATION

Clinicaltrials.gov: NCT00995176 , prospectively registered.

Immigrant Generational Differences in Social Support and Sexual Risk Behaviors Among Men Who Have Sex With Men in Seattle, Washington

Different immigrant generations may encounter distinct sexual opportunities with implications for HIV transmission. Yet, few studies have examined how immigrant generational status is associated with sexual risk behaviors among men who have sex with men (MSM). We explored relationships between immigrant generational status, social support, and sexual risk behaviors among English-speaking MSM using data from surveys conducted in Seattle, Washington, in 2014 (n = 323). We compared the sexual risk behaviors and social support of first-generation, second-generation, and third- and higher-generation MSM, and examined whether immigrant generational status and social support were associated with sexual risk behaviors using logistic regression models. Second-generation MSM reported lower friend social support than first- or third- and higher-generation MSM (p < .05). However, immigrant generational status was not associated with sexual risk behavior outcomes, even after accounting for social support. Results suggest that differences in immigration processes such as acculturation may be more predictive of risk behaviors than generational status alone.

The value of hope: development and validation of a contextual measure of hope among people living with HIV in urban Tanzania a mixed methods exploratory sequential study

BACKGROUND

Hope or hopefulness enhances coping and improves quality of life in persons with chronic or incurable illnesses. Lack of hope is associated with depression and anxiety, which impact negatively on quality of life. In Tanzania, where HIV prevalence is high, the rates of depression and anxiety are over four times higher among people living with HIV (PLH) compared to persons not infected and contribute annual mortality among PLH. Tanzania has a shortage of human resources for mental health, limiting access to mental health care. Evidence-based psychosocial interventions can complement existing services and improve access to quality mental health services in the midst of human resource shortages. Facilitating hope can be a critical element of non-pharmacological interventions which are underutilized, partly due to limited awareness and lack of hope measures, adapted to accommodate cultural context and perspectives of PLH. To address this gap, we developed and validated a local hope measure among PLH in Tanzania.

METHODS

Two-phased mixed methods exploratory sequential study among PLH. Phase I was Hope-related items identification using deductive, inductive approaches and piloting. Phase II was an evaluation of psychometric properties at baseline and 24 months. Classical test theory, exploratory, confirmatory factor analysis (CFA) were used.

RESULTS

Among 722 PLH, 59% were women, mean age was 39.3 years, and majority had primary school level of education. A total of 40 hope items were reduced to 10 in a three-factor solution, explaining 69% of variance at baseline, and 93% at follow-up. Internal consistency Cronbach's alpha was 0.869 at baseline and 0.958 at follow-up. The three-factor solution depicted: positive affect; cognition of effectiveness of HIV care; and goals/plans/ future optimism. Test-retest reliability was good (r = 0.797) and a number of indices were positive for CFA model fit, including Comparative Fit Index of 0.984.

CONCLUSION

The developed local hope scale had good internal reliability, validity, and its dimensionality was confirmed against expectations. The fewer items for hope assessment argue well for its use in busy clinical settings to improve HIV care in Tanzania. Hope in this setting could be more than cognitive goal thinking, pathway and motivation warranting more research.

TRIAL REGISTRATION

The intervention was registered in USA ClinicalTrials.gov on September 26, 2012, Registration number: NCT01693458.

Examining the Associations Between Immigration Status and Perceived Stress Among HIV-Infected and Uninfected Women

Stress is associated with poor mental and physical health outcomes. In the United States (U.S.), little is known about perceived stress and associated factors among HIV-infected and immigrant women. Here, we examine these associations within a sample of 305 HIV-infected and uninfected, U.S.-born and non-U.S.-born women who were part of the Women's Interagency HIV Study (WIHS) at three sites (New York, Chicago, and Los Angeles). Perceived stress was measured using the 10-item Perceived Stress Scale (PSS-10); HIV infection was serologically confirmed, and nativity status was self-reported. Bivariate and multivariable logistic regression were used to identify associations with perceived stress. The majority of participants were U.S.-born (232, 76.1%) and were HIV-infected (212, 68.5%). Mutlivariable analyses found the odds of perceived stress to be lower for those employed [adjusted odds ratio (AOR) = 0.31, 95% confidence interval (CI) = (0.15-0.63)], with high levels of social support (AOR = 0.45, 95% CI 0.26-0.79), and HIV-infected (AOR = 0.44, 95% CI 0.24-0.79). Perceived stress was positively associated with living in unstable housing (AOR = 2.54, 95% CI 1.17-5.51). Here, immigration status was not associated with perceived stress. We identified stress to be higher among women who were unemployed, unstably housed, or who had low social support. Community-based programs should tailor interventions to include stress reduction strategies for participants with identified risk factors to improve mental and physical health outcomes.

Alcohol use, mental health, and parenting practices among HIV-positive mothers

Mothers living with HIV (MLH) must balance childcare, their illness, and oftentimes other mental health problems/stressors. It is important to understand how a maladaptive coping strategy, (alcohol use) is linked to poorer parenting practices. We assessed the relationship between mental health/coping (anxiety, depression, alcohol use, social support) and parenting/family dimensions (communication, parenting style/stress, family routines/cohesion) among 152 MLH. Mothers reporting more psychiatric symptoms and less social support also reported poorer parenting practices and interactions. Further, MLH who used more alcohol reported less parenting involvement and fewer family interactions. Alcohol use, even at subclinical levels, can negatively impact the parent-child relationship.

Optimal Theory’s Contributions to Understanding and Surmounting Global Challenges to Humanity

In this article, we discuss challenges to and the triumphs of the production of psychological knowledge pertinent to human health and sustainable well-being, particularly as it relates to persons acknowledging African ancestry in hostile sociohistorical contexts. Primary attention will be paid to the advancement of the theory of optimal psychology, also known as optimal conceptual theory (OCT), a theory of human development culturally grounded in the wisdom tradition of African deep thought, identifiable from ancient civilization to contemporary times. The intention is to accomplish four aims: (a) present an overview based on one theoretical framework and practice of progress achieved in fulfillment of the Association of Black Psychologists mission, (b) provide an example of great successes employing OCT and belief systems analysis in a clinical practice for over 20 years, (c) share a small sampling of areas in the psychological and broader literature illustrating how OCT has been utilized, and (d) highlight areas of advancement in OCT and its expansion in the understanding of human functioning and development.

Hope, the Household Environment, and Sexual Risk Behaviors Among Young Women in Rural South Africa (HPTN 068)

We assessed the psychological trait of hope as an explanatory mediator in the relationship between the home environment and sexual risk behaviors among 2533 young women in rural South Africa. Hope mediated the relationship between average household age and sexual debut (mediated effect = - 0.003, p < 0.05), and between household consumption and sexual debut (mediated effect = - 0.019, p < 0.05). Both higher average household age (β = 0.01; 95% CI 0.00, 0.01) and greater household consumption (β = 0.05; 95% CI 0.02, 0.08) were marginally associated with higher hope. In turn, greater hope was associated with lower odds of sexual debut (aOR = 0.62; 95% CI 0.52, 0.74). These results provide important preliminary evidence of the role of the home environment in shaping protective psychological assets and healthy sexual behaviors. Continued exploration of the relationship between hope and the home environment may help to explain why young women in this context have a disproportionate risk for HIV.

Behavioral Interventions Targeting Alcohol Use Among People Living with HIV/AIDS: A Systematic Review and Meta-Analysis

Alcohol use is often reported among people living with HIV/AIDS (PLWHA) and is associated with increased sexual risk and poor medication adherence. This meta-analysis evaluated the efficacy of behavioral interventions addressing alcohol use among PLWHA. Twenty-one studies (N = 8461 PLWHA) that evaluated an individual-level intervention addressing alcohol use alone or as part of a more comprehensive alcohol/HIV intervention, included a control condition, and were available through December 2016 were included. Independent raters coded study, sample, and intervention content. Weighted mean effect sizes, using random-effects models, were calculated. Results indicate that interventions reduced alcohol consumption, increased condom use, and improved medication adherence relative to controls (d +s = 0.10-0.24). Plasma viral load was also reduced in intervention versus control participants (d + = 0.14, 95% CI = 0.02, 0.26; k = 7). These findings show that behavioral interventions addressing alcohol use can successfully reduce alcohol consumption and also improve HIV-related outcomes among PLWHA.

'Love and trust, you can be blinded': HIV risk within relationships among Latina women in Miami, Florida

OBJECTIVES

Latina women are disproportionately affected by HIV in the US, and account for 30% of all HIV infections in Miami-Dade County, Florida. The main risk for Latina women is heterosexual contact. Little is known about the relational and cultural factors that may impact women's HIV risk perception. This study aims to describe Latina women's perception of their HIV risk within a relational, cultural, and linguistic context.

DESIGN

Eight focus groups of Latina women (n = 28), four English speaking groups and four Spanish speaking groups, were conducted between December 2013 and May 2014. Women were recruited from a diversion program for criminal justice clients and by word of mouth. Eligibility criteria included the following: self-identify as Hispanic/Latino, 18-49 years of age, and self-identify as heterosexual. A two-level open coding analytic approach was conducted to identify themes across groups.

RESULTS

Most participants were foreign-born (61%) and represented the following countries: Cuba (47%), Honduras (17.5%), Mexico (12%), as well as Nicaragua, Puerto Rico, Colombia, and Venezuela (15%). Participant ages ranged between 18 and 49, with a mean age of 32 years. Relationship factors were important in perceiving HIV risk including male infidelity, women's trust in their male partners, relationship type, and getting caught up in the heat of the moment. For women in the English speaking groups, drug use and trading sex for drugs were also reasons cited for putting them at risk for HIV. English speaking women also reported that women should take more responsibility regarding condom use.

CONCLUSION

Findings emphasize the importance of taking relational and cultural context into account when developing HIV prevention programs for Latina women. Interventions targeting English speaking Latina women should focus on women being more proactive in their sexual health; interventions focused on Spanish speaking women might target their prevention messages to either men or couples.

Hope Matters: Developing and Validating a Measure of Future Expectations Among Young Women in a High HIV Prevalence Setting in Rural South Africa (HPTN 068)

Hope is a future expectancy characterized by an individual's perception that a desirable future outcome can be achieved. Though scales exist to measure hope, they may have limited relevance in low resource, high HIV prevalence settings. We developed and validated a hope scale among young women living in rural South Africa. We conducted formative interviews to identify the key elements of hope. Using items developed from these interviews, we administered the hope scale to 2533 young women enrolled in an HIV-prevention trial. Women endorsed scale items highly and the scale proved to be unidimensional in the sample. Hope scores were significantly correlated with hypothesized psycholosocial correlates with the exception of life stressors. Overall, our hope measure was found to have excellent reliability and to show encouraging preliminary indications of validity in this population. This study presents a promising measure to assess hope among young women in South Africa.

Social Support and Its Impact on Ethnic Identity and HIV Risk among Migrant Workers

Migrant workers are disproportionately affected by HIV due to poverty, social isolation, lack of access to and availability of health care services, acculturation, language barriers, constant mobility, and lack of knowledge. This study examined the impact of changes in social support on ethnic identity and HIV risk behaviors among migrant workers in South Florida. For this study, baseline and 6-month follow-up data were collected from an HIV intervention study among migrant workers in South Florida (n = 270) who reported unprotected sex in the past 30 days. The Multigroup Identity Measure was used to assess ethnic identity and the Social Provisions Scale examined the degree to which respondents' social relationships provide various dimensions of social support. Social support was a significant predictor of ethnic identity and of ethnic identity subscales, ethnic identity belonging and ethnic identity explore. There were small but statistically significant short-term changes in ethnic identity and ethnic identity subscales among the migrant workers over the 6-month time period assessed after controlling for the intervention. Future studies should be conducted over a longer period of time to better assess this relationship and possible factors to reduce HIV risk behaviors. There is a need to focus on improving the quality of health and reduce HIV and other risks experienced by this marginalized community.

A Predictive Model on North Korean Refugees' Adaptation to South Korean Society: Resilience in Response to Psychological Trauma

PURPOSE

This study investigated prediction of North Korean refugees' adaptation to the South Korean society and verified the goodness of fit between a hypothetical model and actual data in order to suggest the best model.

METHODS

This survey was conducted with 445 North Korean refugees living in a metropolitan area. Data were collected from September 1st to November 20th, 2012, and analyzed using SPSS Windows 18.0 and AMOS 17.0.

RESULTS

Traumatic experiences of North Korean refugees increased self-efficacy and psychological trauma. Acculturation stress decreased self-efficacy and increased passive coping. Self-efficacy affected active and passive coping, decreased psychological trauma, and increased resilience. Resilience is successful adaptation and refers to North Korean refugees' abilities to adapt effectively to stress. In particular, self-efficacy as the main parameter affecting resilience was confirmed.

CONCLUSIONS

The results suggest that resilience can be improved through self-efficacy. It was the most significant factor decreasing psychological trauma and increasing resilience. Therefore, we need to develop programs for self-efficacy. The results also provide basic data for policy making for North Korean refugees.

HIV-Related Mortality Among Adults (≥ 18 years) of Various Hispanic or Latino Subgroups--United States, 2006-2010

Hispanics or Latinos residing in the USA are disproportionately affected by HIV when compared to whites. Health outcomes for Hispanics or Latinos diagnosed with HIV infection may vary by Hispanic or Latino subgroup. We analyzed national mortality data from the National Center for Health Statistics for the years 2006 to 2010 to examine differences in HIV-related mortality among Hispanics or Latinos by sociodemographic factors and by Hispanic or Latino subgroup. After adjusting for age, HIV-related death rates per 100,000 population were highest among Hispanics or Latinos who were male (45.6, 95 % confidence interval [CI], 44.4 to 46.9) compared to female (12.0, 95 % CI 11.4 to 12.6), or resided in the Northeast (75.1, 95 % CI 72.2 to 77.9) compared to other US regions at the time of death. The age-adjusted HIV-related death rate was highest among Puerto Ricans (100.9, 95 % CI 97.0 to 104.8) and lowest among Mexicans (16.9, 95 % CI 16.2 to 17.6). Among all deaths, the proportion of HIV-related deaths was more than four times as high among Puerto Ricans (adjusted prevalence ratio = 4.3, 95 % CI 4.1 to 4.5) compared to Mexicans. To ensure better health outcomes for Hispanics or Latinos living with HIV in the USA, medical care and treatment programs should be adapted to address the needs of various Hispanic or Latino subgroups.

Rate of new HIV diagnoses among Latinos living in Florida: disparities by country/region of birth

HIV incidence in the USA is three times higher for Latinos than for non-Latino whites. Latinos differ in educational attainment, poverty, insurance coverage, and health-care access, factors that affect HIV knowledge, risk behaviors, and testing. The purpose of this study was to identify differences in demographics, risk factors, and rate of new HIV diagnoses by birth country/region among Latinos in Florida to guide the targeting of primary and secondary prevention programs. Using Florida HIV/AIDS surveillance data from 2007 to 2011 and the American Community Survey, we compared demographic and risk factors, and calculated annual and five-year age-adjusted rates of new HIV diagnoses for 5801 Latinos by birth country/region. Compared to US-born Latinos, those born in Cuba and South America were significantly more likely to report the HIV transmission mode of MSM; those born in the Dominican Republic (DR) heterosexual transmission; and those born in Puerto Rico injection drug use. Mexican- and Central American-born Latinos were more likely to be diagnosed with AIDS within a month of HIV diagnosis. The rate of new HIV diagnoses among Latinos declined 33% from 2007 to 2011. HIV diagnoses over time decreased significantly for Latinos born in Mexico and increased nonsignificantly for those born in the DR. Although this study was limited to Latinos living in Florida, results suggest that tailoring HIV primary prevention and testing initiatives to specific Latino groups may be warranted.

Race, coping strategies, and substance use behaviors: a preliminary analysis examining white and American Indian adolescents

The association between stress exposure and substance use has been the subject of numerous studies. However, no prior study has explored the role of coping strategies in moderating the stress-substance use association for American Indian adolescents. Our preliminary study of coping strategies and substance use among a sample (n = 568) of rural American Indian and white adolescents revealed a number of similarities across both groups, but also some important differences. Results of logistic regression analyses revealed that the relationship between an avoidant coping strategy and marijuana use differed for whites and American Indians. Study limitations and future research directions are discussed.

Acculturation and HIV-related sexual behaviours among international migrants: a systematic review and meta-analysis

This review examines the global literature regarding the relationship between acculturation and HIV-related sexual behaviours among international migrants. Seventy-nine articles published in English-language journals prior to July 2012 met the criteria for inclusion. We conducted a systematic review and subset meta-analysis of correlations between acculturation and five types of sexual behaviours including condom use, multiple partnerships, early sexual initiation, sexually transmitted diseases (STDs) and other unsafe sexual practices. Immigrants high in mainstream acculturation were more likely to have multiple partnerships, early sexual initiation, STDs and unsafe sex (rs ranged from 0.10 to 0.16), but acculturation was not associated with condom use (r = 0.02). Gender moderated the relationships between acculturation and multiple partnerships, STDs and unsafe sex. The relationship between acculturation and unsafe sex also varied across ethnicity. These findings suggest that acculturation may serve as a risk factor towards immigrants' HIV-related sexual health. We offered a theoretical framework and suggested applying cross-cultural and longitudinal designs in future research on acculturation and health behaviours.

Stress and coping in women living with HIV: a meta-analytic review

To examine effects between stressors and coping mechanisms on behavioral health outcomes a meta-analysis was conducted using forty empirical articles which sampled 7,602 adult women living with HIV/AIDS in the U.S. (M = 36.3 years). Three independent reviewers conducted searches in abstract databases from 1997 to present day. Articles reporting effect sizes amongst psychosocial stressors and coping mechanisms with indices of behavioral/mental health were selected. The meta-analyses revealed that in a time frame characterized by the widespread availability of anti-retroviral medication, poor mental health outcomes were predicted, in a similar manner, by psychosocial stress and HIV/AIDS symptomology. Significant effects were also observed with functional impairment, though to a lesser degree. Coping by avoidance and social isolation predicted more severe mental health outcomes. Spirituality and positive reappraisal predicted greater psychological adaptation than did social support seeking. Despite advancements in anti-retroviral treatment for women, HIV/AIDS symptoms and acute and/or chronic psychosocial stress pose the same threat to behavioral and mental health. In the face of these stressors, positive reframing appears to promote psychological adaptation in a way which may lead to positive health outcomes in women living with HIV/AIDS.

Intervention outcomes among HIV-affected families over 18 months

We evaluate the efficacy of a family-based intervention over time among HIV-affected families. Mothers living with HIV (MLH; n = 339) in Los Angeles and their school-aged children were randomized to either an intervention or control condition and followed for 18 months. MLH and their children in the intervention received 16 cognitive-behavioral, small-group sessions designed to help them maintain physical and mental health, parent while ill, address HIV-related stressors, and reduce HIV-transmission behaviors. At recruitment, MLH reported few problem behaviors related to physical health, mental health, or sexual or drug transmission acts. Compared to MLH in the control condition, intervention MLH were significantly more likely to monitor their own CD4 cell counts and their children were more likely to decrease alcohol and drug use. Most MLH and their children had relatively healthy family relationships. Family-based HIV interventions should be limited to MLH who are experiencing substantial problems.

A Multicultural Approach to Health Psychology

The North American continent comprises a diverse array of individuals. Although the majority of them prescribe to the beliefs and treatments of Western biomedicine, a substantial number also practice diverse approaches to health. This article summarizes the basic tenets of major non-Western approaches to health, including the main beliefs and treatments. It bases this discussion in the context of health disparities, the existence of which presents a major problem for health care in America, and with an eye toward aiding the development of cultural competence for clinicians and health care providers nationwide.

The impact of ethnic identity on changes in high risk HIV behaviors in sexually active migrant workers

Among migrant workers (MWs) in the US, HIV/AIDS prevalence may be as high as 13.5%. This serial cross-sectional study examines associations between Ethnic Identity (EI) in African American and Hispanic MWs and short-term changes in high-risk sexual behaviors. Baseline and 3-month follow-up data was collected from a larger HIV intervention study among MWs in Immokalee, Florida (n = 119) who reported unprotected sex in the past 30 days. The Multigroup Identity Measure was used to assess EI. A high EI score indicates less acculturation to one's new surroundings. Females had higher levels of positive behavior change. Lower EI was associated with higher levels of positive change in relation to HIV/AIDS risk behavior. Among Hispanics, education was negatively correlated with EI. Education was a predictor of behavior change. Future interventions should focus on reducing acculturation stress, which may prompt harmful coping behaviors, such as high-risk sex and substance abuse.

The Relationship between Sexual Coping and the Frequency of Sexual Risk among 'At Risk' African American Women

This study examines the relationship between one specific type of avoidant coping behavior-namely, having sex to cope with one's worries or problems-and the frequency with which 'at risk' women engage in risky sexual relations. Face-to-face interviews were conducted with 221 African American women drug abusers in the Atlanta, Georgia metropolitan area. The community identification process was used for recruitment, with additional recruitment done via targeted sampling. A variety of demographic characteristics, background and experiences measures, childhood maltreatment experiences, substance use-related measures, psychosocial and attitudinal items, and relationship characteristics were examined for their influence both on the frequency of engaging in risky sex and the extent to which women had sex to cope. Multivariate analysis revealed that having sex to cope was a statistically-significant predictor of the frequency with which women engaged in risky sexual behaviors. A separate analysis of the predictors of having sex to cope yielded seven items that were important for understanding the extent to which women engaged in sexual coping: age, number of health information sources, amount of physical abuse, reasons for not using condoms, overall attitudes toward condom use, level of partner communication, and the amount of help available from one's support network. The intervention-related implications of these findings are discussed, emphasizing the needs: to target younger women, to target and help survivors of childhood maltreatment to deal with unresolved issues, to make attitudes toward using condoms more conducive, to improve partner communication, and to bolster support network relationships.