Differences in health-related quality of life among persons living with HIV/AIDS

We sought to identify differences in health-related quality of life (HRQoL) among a sample of HIV positive individuals receiving case management services in northern Florida. Our study consisted of 97 individuals receiving HIV case management that included 56 males (57.7%) and 81 African Americans (83.5%) who were 47.05 years old (SD = 9.33). HRQoL was measured using the HIV/AIDS Targeted-Quality of Life scale (HAT-QOL). Results show significant group differences in HRQoL by race, income, tobacco use, alcohol use, drug use, and CD4 cell count, despite only 43% of this sample being able to recall their most recent CD4 count. Translating these findings to inform practice, HIV care providers need to provide continuing education to patients about their disease status, knowledge, and treatment as it relates to self-care. Also, HIV care providers should be especially cognizant of the impact that tobacco, alcohol, and illicit drug use has on HRQoL for persons living with HIV/AIDS (PLHA) by working to assess social support, identify readiness for change, and make appropriate referrals for treatment.     

HIV/AIDS: Measuring an Evolving Virus

Many social work journal articles portray HIV as a chronic illness. Although HIV medical management has evolved, it is far from chronic for most of the world. With such rapid developments in the field of HIV/AIDS, this article examines validity of knowledge measurements developed pre-HAART. Further, what place does validity hold in the maintenance of these measurement devices? The authors review several widely used measurement scales utilized in developed nations—The Beliefs About Preventing AIDS, The HIV Knowledge Questionnaire, and The International IADS Questionnaire-English Version—to answer these questions and to promote understanding for social workers in the field of HIV/AIDS regarding validity of the instruments.     

IMPLICATIONS OF INTERNET TECHNOLOGY FOR MEDICAL SOCIOLOGY IN THE NEW MILLENNIUM

This research examines how parental heterosexism—negative attitudes toward homosexuals and homosexuality—and other family characteristics relate to the development of children's attitudes toward people with HIV/AIDS (PWA). Attention is directed to the overall relationship between parents’ and children's attitudes and to the potential mechanisms through which these linkages are manifested. Based on social learning theories of childhood socialization, a range of mechanisms is considered, focusing on heterosexist attitudes in parents and communication with children about AIDS. Findings indicate that parental attitudes concerning homosexuals influence children's attitudes toward PWA, implying that there can be negative as well as positive consequences of parents’ beliefs on children's attitudes. The possibility of negative parental effects on children's prejudices toward PWA suggests that in-school HIV/AIDS education at younger ages is more important than previously thought.     

Calendars on the Wall

This study explores the evidence of social and personal forces in discussions concerning sexuality in client/provider interactions about HIV/AIDS. It unravels the complex ways that such forces influence the interactions, each other, and, in turn, how interactions can influence the forces themselves. The interactions were observed using participant observation techniques, and were analyzed using a framework suggested by Giddens (1979) and augmented by the author. Analysis suggested that such forces as societal norms about sexuality, promiscuity, and monogamy and the guilt associated with their violation influence client/provider interactions about HIV/AIDS. Unraveling the mutual influences of the forces may provide an opportunity to identify possibilities for altering the reproduction of the system.     

The Game of Contacts: Estimating the Social Visibility of Groups

Estimating the sizes of hard-to-count populations is a challenging and important problem that occurs frequently in social science, public health, and public policy. This problem is particularly pressing in HIV/AIDS research because estimates of the sizes of the most at-risk populations-illicit drug users, men who have sex with men, and sex workers-are needed for designing, evaluating, and funding programs to curb the spread of the disease. A promising new approach in this area is the network scale-up method, which uses information about the personal networks of respondents to make population size estimates. However, if the target population has low social visibility, as is likely to be the case in HIV/AIDS research, scale-up estimates will be too low. In this paper we develop a game-like activity that we call the game of contacts in order to estimate the social visibility of groups, and report results from a study of heavy drug users in Curitiba, Brazil (n = 294). The game produced estimates of social visibility that were consistent with qualitative expectations but of surprising magnitude. Further, a number of checks suggest that the data are high-quality. While motivated by the specific problem of population size estimation, our method could be used by researchers more broadly and adds to long-standing efforts to combine the richness of social network analysis with the power and scale of sample surveys.     

Anatomy of Fear: Mead's Theory of the Past and the Experience of the HIV/AIDS “Worried Well”

The HIV/AIDS “worried well”—persons who believe themselves infected with HIV in the absence of any objective medical proof—have been well documented in the psychological literature but not the sociological literature. Adopting a symbolic interactionist perspective, I use George Herbert Mead's theory of the past to conceptualize the HIV/AIDS worried well experience by analyzing narratives written by persons who have been worried well. Empirically, I provide sociological evidence of the existence of the HIV/AIDS worried well. Theoretically, I expand concepts derived from studies of persons with chronic illness to the worried well and speak to the influence of Mead's theory of the past to sociology.     

JOB STRESS, DRINKING NETWORKS, AND SOCIAL SUPPORT AT WORK:

Most research examining the problem drinking behaviors of employees has sought to demonstrate that variation in alcohol consumption derives from nonrewarding or stressful aspects of modern work that promote intrapsychic stress and/or alienation. These inquiries have ignored additional job factors that might influence employee drinking patterns. We extend this literature by developing and testing a comprehensive model of influences on employee problem drinking. The model includes the simultaneous influences of stressful working conditions, participation in job-based drinking networks, and perceived social support on the job. Analyses of data from the 1991 National Employee Survey (NES) indicate that this explanatory model significantly improves our understanding of the job-related influences on employee problem drinking. We also demonstrate that each class of job factors has important mediated influences on problem drinking that result from their association with individualized job escapist-oriented reasons for drinking.     

Gauging the Acceptability of HIV Vaccines: An Exploratory Study Examining Knowledge,Attitudes, and Beliefs Among Injecting Drug Users in Viet Nam

ABSTRACT

In contrast to other countries in Southeast Asia, the HIV/ AIDS epidemic is in the initial stages in Viet Nam, although the rates have increased notably since 1997. This study examined attitudes towards the use of an HIV vaccine (when one becomes available) as a means for preventing the disease. Since injecting drug users are the great majority of those affected by the HIV/AIDS epidemic in Viet Nam, two focus groups (n = 18) were conducted among this population to identify potential barriers and incentives for HIV vaccination. Most were willing to be vaccinated if an HIV vaccine were available. Although there were some concerns about side effects, financial costs, and stigmatization, the benefits were seen to outweigh the risks. The findings may help governments better understand the potential demand for this type of vaccine and design social marketing campaigns for post-trial HIV vaccine dissemination in order to maximize potential uptake of an HIV vaccine.     

Thirty years on … the social representation of AIDS among French teenagers

Teenagers, who are particularly concerned by the HIV virus, are targeted by plans of HIV prevention, as they are just beginning their sex lives. Since certain recent studies reveal that teenagers are not using HIV prevention methods, we analyse social representations of HIV/AIDS among a group of 100 French high school pupils, thirty years after it appeared and after the first studies of the social representation of AIDS. The results of a free associations test show that both girls and boys have the same social representation of AIDS. The results of a complementary questionnaire tend to show that this disease has become less frightening and less stigmatizing and that girls have a more preventive state of mind.     

Preventing HIV/AIDS Among Trinidad and Tobago Teens Using a Family-Based Program

Summary

This paper describes a family-based HIV/AIDS prevention project currently underway in Trinidad and Tobago—an English speaking twin-island nation in the Caribbean. The project involves a partnership between U.S.-based researchers and a social service agency on the Islands. It describes the development and adaptation of the intervention and reports preliminary outcomes from a pilot intervention (n= 32). Findings indicate high participant retention; statistically significant pre to posttest changes in HIV/AIDS knowledge and awareness; parent/youth discussions at home; condom self-efficacy; and parental monitoring. Findings are discussed within the context of collaborative HIV/AIDS prevention research.     

Global HIV and AIDS: Calling all Social Work Educators

As the HIV/AIDS global pandemic continues to grow through a third decade, the need for social work educators to prepare social workers in distinct fields of practice with skills to assist those infected with and affected by HIV is of paramount importance. HIV/AIDS holds multi-level and multi-system effects for vulnerable populations. This article features global HIV and AIDS teaching resources beginning with common global practice challenges. Next, five teaching units focus on practice needs and challenges of divergent vulnerable populations including men who have sex with men, women, injecting drug users (IDU), commercial sex workers, and children orphaned by AIDS. Discussion questions, selected readings and electronic resources accompany each unit. The authors close the article with suggested recommendations for content integration into social work courses, and next steps for the profession.     

HIV Risk in Gay and Lesbian Adolescents

Adolescents, regardless of sexual orientations, are not increased risk for HIV infection. Although the number of infected adolescents remains small, the number of adolescent AIDS cases is approximately doubling each year. This suggests that the rate of HIV infection among adolescents is expanding in a similar fashion to that seen among gay men in the early years of the epidemic. The purpose of this paper is to provide a framework for understanding the problems of HIV infection as it related to the gay and lesbian adolescent. This framework is grounded in developmental theory, though key social, political, economic, and policy factors which are believed to contribute to the infection of HIV among gay and lesbian adolescents will also be presented. It will be argued that social practitioners who are working in the HIV and AIDS arena would do well to reexamine the paradigm, which governs existing practice methodology.     

Chapter 10: Issues in HIV/AIDS Service Delivery to High Risk Youth

Homeless and runaway youth engage in behavior that puts them at risk for infection with HIV, the virus that causes AIDS. Prevalence of HIV disease in homeless and runaway youth is higher than it is among other adolescents. In addition, homeless and runaway youth are often forced to engage in sex as a means of survival. Although they engage in high risk behavior, AIDS education programs have neglected them as a target group for education. To some extent, they have been included in other more general categories of persons with AIDS risk behaviors, such as men who have sex with men or intravenous drug users. However, the number of adolescents receiving age-specific HIV/AIDS information is far below the number infected (Hein et al., 1992). Often high risk youth are disenfranchised, having been forced from home by their families after disclosing their gay or lesbian identities. Lacking a political voice and having no spokesperson, they represent a group with complex unmet needs. These youth typically have immediate needs for food, shelter, and clothing. In addition, they often need medical management, mental health and drug counseling, crisis management, and HIV/AIDS information. These needs are often overwhelming to the agencies that serve youth. This article examines the barriers and issues that exist in providing services to high risk youth. Then, suggsetions for removing those barriers by empowering both service providers and youth are offered. Some of the suggestions are based upon the authors' own experience in providing HIV/AIDS in-service training to service providers to high risk youth. The article makes recommendations for policy on youth and HIV/AIDS.     

A systematic review of education for the prevention of HIV/AIDS among older adults

Through a comprehensive literature search, the authors of this systematic review identified 21 articles focused on primary prevention of HIV/AIDS for adults aged 50 and over. Three major challenges to providing HIV/AIDS education for older adults include health professionals' ageism, older adults' reluctance to discuss sexuality, and their misconception of their HIV risk. Clinical guidelines for social workers, nurses, and physicians identified the importance of sharing information and assessing risk, considering cultural diversity, and devising creative delivery strategies. Three models of HIV/AIDS education include group education programs delivered by social workers or other health professionals, peer education models, and one-on-one early intervention models including HIV/AIDS testing. Additional outreach and research on HIV/AIDS prevention among older adults is needed.     

Transferring a University-Led HIV/AIDS Prevention Initiative to a Community Agency

Summary

Given the urgent need for HIV/AIDS interventions that will reverse current infection trends among urban minority youth, identifying effective and socially relevant approaches is of primary concern. HIV/AIDS prevention initiatives that are housed in, and led by, communities may address the limits of laboratory-based inquiry for this complex and socially-situated health issue. In this article, we describe the process of moving a researcherled, HIV/AIDS prevention research program—the Collaborative HIV/AIDS Adolescent Mental Health Project (CHAMP)—from a university laboratory to a community mental health agency with the goal of strengthening program access, effectiveness, and sustainability over time. We outline the framework, timeline, and responsibilities involved in moving the program, research, and technology from its original university base to a local community agency. From the challenges faced and lessons learned during this complex transfer process, we hope to enhance understanding of ways in which we can narrow the gap between academic and community leadership of HIV/AIDS prevention research.     

Migration,Poverty, and Risk of HIV Infection: An Application of Social Capital Theory

A majority of current HIV/AIDS interventions are designed primarily after individual-based public health models and pay little attention to the socioeconomic environment in which HIV transmission occurs. This article focuses on outlining how migration acts as a conduit for disease transmission in South Africa and then proposes a macro-level prevention model based on social capital theory, thus then supplementing current prevention literature. It is based on the argument that social disruption and stresses from migration lead to sexual interactions during the migration periods that amplify the risk of HIV transmission among migrants.     

Sexual behavior and AIDS knowledge of young male prostitutes in Manhattan

Despite their presumed high risk for AIDS, there are almost no sexual behavior data available which are sufficient for the development and assessment of intervention programs for male prostitutes. This study was designed to obtain such data. Fifty 14–27‐year‐old male prostitutes in Manhattan were interviewed using structured instruments to assess sexual orientation, sexual behavior, knowledge of AIDS, and substance abuse. The sample was 50% homosexual, 26% bisexual, and 24% heterosexual. High rates of condom use were found for anal intercourse (average 85%). Subjects were safest in sex with male customers, less safe with male partners for pleasure, and least safe with female partners. Differential use of condoms plus other unsafe sexual activities continue to place the male prostitute at risk for HIV infection. AIDS knowledge was high and positively correlated with safety of sex. Drug and alcohol abuse and dependence were frequent, although there was little intravenous drug use. These and other variables were not significantly associated with degree of safety in sex. The methods employed in this study can be used to assess other populations of male prostitutes as well as intervention programs.     

Personal construct psychology methods for qualitative research

In this paper we discuss the unique influences of ethics assessment procedures on comparative qualitative research. These influences are particularly pronounced when researchers are from different disciplines and in different countries. Focusing on our experience conducting a study on the perceptions of young people regarding HIV/AIDS in two countries (Italy and Canada), we describe the impact of the ethics assessment procedures in our respective countries on recruitment, sampling and comparability of findings. We also raise issues related to differences in ethics assessment processes from a disciplinary perspective. We conclude by suggesting that our theory of technique approach, which focuses on studying how the choices made in research implementation influence the study findings, should be extended to include the impact of ethics assessment procedures.     

Predictors of Safer Sex on the College Campus: A Social Cognitive Theory Analysis

Abstract

In April and May 1989, the authors surveyed a sample of students enrolled on four college campuses in New Jersey (N ? 923) concerning their HIV transmission-related behavior, knowledge, and a variety of conceptual variables taken primarily from social cognitive theory that were thought to be potentially predictive of safer sexual behavior. Analyses of sexually active, unmarried students' responses indicated that men expected more negative outcomes of condom use and were more likely to have sexual intercourse while under the influence of alcohol or other drugs, whereas women reported higher perceived self-efficacy to practice safer sex. Regression analyses indicated that, among the factors assessed, stronger perceptions of self-efficacy to engage in safer behavior, expecting fewer negative outcomes of condom use, and less frequency of sex in conjuction with alcohol or other drug use significantly predicted safer sexual behavior. Enhanced self-efficacy to discuss personal history with a new partner was associated with a greater number of risky encounters. Implications of these findings for intervention efforts with students are discussed.