The influence of dual‐identity development on the psychosocial functioning of African‐American gay and bisexual men

To examine the influence of racial‐ethnic and sexual identity development on the psychosocial functioning of African‐American gay and bisexual men (AAGBM), 174 AAGBM completed questionnaire packets designed to assess their levels of racial‐ethnic and sexual identity development, self‐esteem, social support, male gender role stress, HIV prevention self‐efficacy, psychological distress, and life satisfaction. The results indicate that AAGBM who possess more positive (i.e., integrated) seif‐identification as being African American and gay reported higher levels of self‐esteem, HIV prevention self‐efficacy, stronger social support networks, greater levels of life satisfaction, and lower levels of male gender role and psychological distress than their counterparts who reported less positive (i.e., less well integrated) African‐American and gay identity development. Although higher levels of racial‐ethnic identity development were associated with greater levels of life satisfaction, sexual identity development was not.     

Condom use self‐efficacy among U.S.‐ and foreign‐born Latinos in Texas

The objective of this study was to assess the influence of condom use self‐efficacy on the reported condom use of Latinos. We conducted a rapid needs assessment study among U.S. and foreign‐born Latinos living in Houston, TX, to identify behavioral and psychosocial factors that influence their risk for HIV. Bilingual Latino interviewers conducted confidential face‐to‐face interviews with individuals living in apartment complexes or residential areas primarily populated by Latinos. A total of 152 participants completed the survey. Regression results indicate that education and gender influenced condom use self‐efficacy, which in turn influenced condom use in the last sexual encounter and with the primary sexual partner. However, gender and relationship risk were stronger predictors of condom use. Study results indicate that there are differences in condom use self‐efficacy and sexual risk behaviors between Latino men and women that need further exploration.     

Letters to the editor

Relatively little attention has been paid to the use and importance of labels used by men who have sex with men to describe insertive or receptive sexual behavior during intercourse. This study examines sexual self‐labels, sexual behavior, HIV transmission risk, and psychological functioning among 205 HIV‐seropositive men who have sex with men. The majority of participants (88%) identified as a “top, “ a “bottom, “ or “versatile. “ Tops were more likely to engage in insertive anal intercourse than bottoms, and bottoms were more likely to engage in receptive anal intercourse than tops, with versatiles reporting intermediate rates of both behaviors. Although the results suggest preliminary evidence regarding the predictive utility of self‐labels, sexual behaviors of self‐label groups were greatly overlapping. Differences were found among self‐label groups in gay self‐identification, internalized homophobia, sexual sensation seeking, and anxiety. Results suggest an added value in assessing self‐labels in addition to asking about sexual behavior.     

Linking Self‐Regulation and Risk Proneness to Risky Sexual Behavior: Pathways through Peer Pressure and Early Substance Use

The linkages between self‐regulation in childhood, risk proneness in early adolescence, and risky sexual behavior in mid‐adolescence were examined in a cohort of children (N=518) from the National Longitudinal Survey of Youth. The possible mediating role of two early adolescent variables (substance use and negative peer pressure) was also examined. Self‐regulation was assessed by maternal report at ages 8–9, and risk proneness, comprising aspects of sensation seeking and decision making, was assessed by adolescent self‐report at ages 12–13. Structural equation models predicting risky sexual behavior at ages 16–17 indicated that self‐regulation operated partly through early adolescent substance use, whereas risk proneness operated through early adolescent substance use and negative peer pressure. The overall model did not differ significantly for boys and girls, although there were gender differences in the strength of particular paths. These long‐term longitudinal results support the importance of early self‐regulation and risk proneness in setting the stage for adolescent sexual risk taking and implicate substance use and negative peer pressure as processes through which risk proneness and poor self‐regulation lead to risky sexual behavior.     

Predictors of sexual risk‐taking among new drug users

We studied predictors of HIV‐related sexual risk‐taking among individuals who initiated the use of heroin or metham‐phetamine during the past 5 years. Many studies have linked drug use to HIV risk, but most research has been based on samples of users with long‐established drug careers. We conducted face‐to‐face interviews with 153 adult new drug users in Atlanta, GA. Drug use was not a statistically significant predictor of sexual risk, but gender, age, race, homelessness status, childhood neglect, level of paranoia, and level of (dys)functionality in handling disagreements were associated with frequency of sexual risk‐taking. We discuss the need to incorporate new drug users in HIV/AIDS and other health‐related prevention and intervention programs.     

Forced Sexual Experiences and Sexual Situation Self‐Efficacy Among South African Youth

Nearly 20% of South African youth experience forced or coerced sexual intercourse. Understanding the factors associated with forced sex is important for informing prevention programs aimed at reducing sexual violence and HIV and AIDS. Multilevel regression models test the association between sexual situation self‐efficacy and forced sex among 2,893 South African adolescents. Findings suggest that youth are more likely to experience forced sex after periods of time when their levels of self‐efficacy are lower than their average levels of self‐efficacy. Furthermore, youth who are lower on their self‐efficacy compared to their peers are more likely to experience forced sex. Implications for prevention research are discussed.     

Parental Involvement Promotes Rural African American Youths’ Self‐Pride and Sexual Self‐Concepts

This study, an evaluation of the Strong African American Families Program, was designed to determine whether intervention‐induced changes in targeted parenting behaviors were associated with young adolescents’ development of racial pride, self‐esteem, and sexual identity. Participants were 332 African American mothers and their 11‐year‐old children in 9 rural Georgia counties. Families were randomly assigned to a control group or an intervention group. Unlike those in the control families, mothers in the intervention group reported increases in targeted parenting behaviors, which promoted self‐esteem, positive racial identity, and positive sexual self‐concepts among their children. These findings expand the study of African American youths’ identity development by including broader domains of identity and parenting processes other than racial socialization.     

Parent Psychological Distress: A Moderator of Behavioral Health Intervention Outcomes among Justice‐Involved Adolescents

We examined whether pre‐existing parent psychological distress moderated juvenile offenders’ substance use, sexual risk, and mental health outcomes in a randomized trial. Forty‐seven parent–adolescent dyads received either Family‐based Affect Management Intervention (FAMI) for adolescent substance use and HIV prevention or adolescent‐only Health Promotion Intervention (HPI). Parents’ self‐reported distress at baseline significantly moderated adolescents’ self‐reported marijuana use and alcohol use but not other outcomes at 3 months postintervention, producing crossover interactions. FAMI outperformed HPI when parents reported high‐level distress, whereas HPI outperformed FAMI when parents reported low‐level distress. This finding that the relative efficacy of interventions depends on the severity of parent psychological distress could inform efforts to match substance‐using, justice‐involved adolescents with the intervention most likely to benefit them.     

Adolescent Self‐Consciousness: Longitudinal Age Changes and Gender Differences in Two Cohorts

Adolescence is frequently described as a period of pervasive self‐consciousness, but an age‐related peak in adolescence is not consistently obtained, and higher self‐consciousness in girls is frequently obtained but not predicted by theoretical accounts. Two cohorts of adolescents (N=393), initially assessed at 13 and 15, completed public and private self‐consciousness measures 3 times in 4 years. They also reported social comparisons and social engagement. Public self‐consciousness decreased and private self‐consciousness increased in both cohorts, and girls scored higher on both measures, both in longitudinal and sibling replication samples (n=188). Public self‐consciousness appears to be a normative response to adolescent social challenges, with girls' higher levels largely attributable to their closer social engagement. Private self‐consciousness emerges as an individual difference in adolescence but is more likely to be salient and predictive of social behavior in adulthood.     

A longitudinal examination of risk and protective factors associated with drug use and unsafe sex among young African American females

This study prospectively examined associations among multiple theoretically informed risk (e.g., depression, sexual sensation seeking, and risky peers norms) and protective factors (e.g., social support, STI knowledge, and refusal to have sex self efficacy) on unsafe sex among 715 African American adolescent females aged 15–21 who participated in an STI/HIV prevention intervention. Generalized estimating equation models were used to assess associations between baseline characteristics and sexual risk over a 12-month follow-up period. Overall risk in this population was high: at baseline, nearly a third of women reported sex under the influence of alcohol or substances; ≥ 2 partners for vaginal sex, and casual sex partners in the 60 days prior to baseline, and nearly 75% of those reporting vaginal sex used condoms inconsistently. In multivariable analysis, when risk and protective factors were simultaneously considered, higher levels of sexual sensation seeking were associated with having multiple sex partners and inconsistent condom use. Greater perception of risky peer norms was associated with a higher risk of having sex under the influence of alcohol or drugs. In addition, higher sex refusal self-efficacy was protective against having multiple; casual; and concurrent sex partners. Incorporating these salient factors into prevention programs may be critical to the development of targeted interventions for this population.     

Situational Interest and Scientific Self‐Efficacy: Influence of an Energy Science Career Intervention

This study examined the efficacy of a career intervention aimed at promoting adolescents’ perceptions of scientific self‐efficacy (SSE), as well as interest in specific activities and careers relevant to energy science. One hundred thirty‐four adolescents (60 girls, 74 boys) completed self‐efficacy and interest measures on 4 occasions (Time [T] T1 to T4]) during the course of the 6‐day intervention. Results of latent change modeling yielded evidence of significant growth in SSE from T1 to T4. Results of a multiple regression analysis also revealed that situational interest in an energy science activity at T2 was a significant positive predictor of SSE at T4, thus offering further clarity regarding the theorized sequence of causal relations between interest and self‐efficacy. Findings call attention to the need for future research on the role of task‐level interest in the social cognitive career theory framework and highlight the importance of mastery experiences in the delivery of science, technology, engineering, and mathematics career interventions.     

An Emergent Phenomenon of American Indian Secondary Students’ Career Development Process

Nine single‐race American Indian secondary students’ career development experiences were examined through a phenomenological methodology. All 9 participants were in the transition period starting in late secondary school (age 18). Data sources included individual interviews and journal analysis. The phenomenon of American Indian secondary students’ career development process comprised 7 themes, which were integrated into 3 interacting dimensions: introspective, relational, and contextual. Findings reveal unique career development processes for American Indian secondary students living in tribal settings, including career decision process, career options, outcome expectations, and self‐efficacy. Implications for school counselors and counselor educators are discussed.     

Differences in psychological health and family dysfunction by sexual victimization type in a clinical sample of African American

We examined levels of sexual victimization among a sample of 249 14‐ to 19‐year‐old African American adolescent women. Victimization was common: 32.1% reported having been raped, 33.7% had experienced sexual coercion, and 10.8% reported an attempted rape. Only 23.4% had never been victimized. We investigated whether levels of psychological health and family dysfunction varied as a function of the type of sexual victimization. Girls who had been raped had lower levels of self‐esteem and mastery and higher levels of depression compared to girls who reported no sexual victimization. Significantly higher levels of family cohesion and significantly lower levels of family support were reported by girls who had been raped versus girls who reported no sexual victimization. These findings are a starting point for future studies by providing evidence that levels of mental health and family dysfunction vary by the type of sexual victimization experienced.     

Cumulative Risk for Early Sexual Initiation Among American Indian Youth: A Discrete‐Time Survival Analysis

Approximately 3 million teens are diagnosed with a sexually transmitted disease (STD) annually; STDs rates for American Indian young adults are among the highest of any racial/ethnic group. An important risk factor for STDs is early initiation of sex. In this study, we examined risk for early initiation with 474 American Indian youth ages 14–18, using 11 risk factors from three developmentally important microsystems (family, school, peers) along with several individual characteristics; a cumulative risk index was also calculated. Discrete‐time survival analyses showed that predictors of early initiation differed by gender. For young men, younger initiation of sex was predicted by lower grades, liking school less, having peers with less prosocial attitudes, a greater likelihood of having used alcohol or drugs at first sex, and having higher sensation‐seeking. For young women, earlier initiation was related to having mothers who had their first child at an early age and who had less formal education, to having parents who had divorced, dropping out of high school, using alcohol/drugs at first sex, and higher sensation‐seeking. Higher cumulative risk was associated with elevated risk of sexual initiation, although the degree of added risk varied with age for women. Cumulative risk deserves broader attention in understanding the early initiation of sexual intercourse.     

Self‐Esteem Trajectories among Ethnic Minority Adolescents: A Growth Curve Analysis of the Patterns and Predictors of Change

The current study presents a growth curve analysis of self‐esteem among Black, Latino, and Asian American high school students. A series of hierarchical linear models were used to examine patterns and predictors of change in self‐esteem over time. Results revealed an average increase in self‐esteem with age. Although boys and girls experienced similar trajectories of self‐esteem, ethnicity was a significant moderator of developmental change. Black adolescents reported higher self‐esteem, while Asian American adolescents reported lower self‐esteem, compared with their Latino peers. Latino adolescents experienced a sharper increase in self‐esteem over time compared with Black adolescents. The unique and conjoint effects of adolescents' experiences with peers, family, and school were examined in relation to self‐esteem trajectories. Results revealed that each perceived context was significantly associated with self‐esteem trajectories when examined independently, but family experiences emerged as most strongly related to changes in self‐esteem. Results underscore the need to examine change at the individual level, as well as the importance of studying the unique and conjoint effects of individual and contextual‐level variables on developmental processes among ethnic minority adolescents.     

A longitudinal qualitative evaluation of an economic and social empowerment intervention to reduce girls’ vulnerability to HIV in rural Mozambique

PurposeAn intervention including business training and health education was implemented in Mozambique, where girls are at elevated risk for acquiring HIV. As part of a mixed-methods evaluation, we describe perceived effects of the intervention on girls’ sexual behavior and school attendance.MethodsWe conducted 49 in-depth interviews (IDIs) with girl intervention participants (ages 13–19), 24 IDIs with heads of girls’ households, 36 IDIs with influential males identified by girls, and 12 focus group discussions with community members after the intervention ended and one year later.ResultsInformants said the primary intervention benefit was realized when girls had money to stay in or return to school and/or to buy necessities for themselves and their households—reducing their need for transactional or intergenerational sex. However, some girls did not make a profit and some businesses were not sustainable. Sometimes the intervention appeared to be implemented in a way to reinforce inequitable gender norms resulting in some girls feeling shame when they reengaged in risky sex after their businesses failed.ConclusionsEarning money enabled girls to potentially reduce their vulnerability to HIV. We offer recommendations for future multi-sector interventions, including the need to address potential harms in programs serving vulnerable girls.     

Relative Efficacy of a Pregnancy,Sexually Transmitted Infection,or Human Immunodeficiency Virus Prevention–Focused Intervention on Changing Sexual Risk Behavior Among Young Adults

Abstract

Objectives: Despite findings suggesting that young adults are more concerned about experiencing an unplanned pregnancy or contracting a sexually transmitted infection (STI) than becoming human immunodeficiency virus (HIV) infected, no empirical work has investigated whether the specific focus of an intervention may be more or less efficacious at changing sexual behavior. Participants: Participants were 198 college students randomized to 1 of 4 conditions: pregnancy intervention, STI intervention, HIV intervention, or a control condition during 2008–2009. Methods: The authors compared the efficacy of 3 theory-based, sexual risk–reduction interventions that were exactly the same except for an exclusive focus on preventing pregnancy, STI, or HIV. Condom use and risky sexual behavior were assessed at baseline and 4-week and 8-week follow-up. Results: Participants exposed to the pregnancy or STI interventions reported greater condom use and less risky sexual behavior than those exposed to the HIV intervention. Conclusions: The focus of sexual risk–reduction interventions may lead to differential behavior change among young adults.     

Linking Changes in Parenting to Parent–Child Relationship Quality and Youth Self‐Control: The Strong African American Families Program

A randomized prevention trial was conducted contrasting families who took part in the Strong African American Families Program (SAAF), a preventive intervention for rural African American mothers and their 11‐year‐olds, with control families. SAAF is based on a conceptual model positing that changes in intervention‐targeted parenting behaviors would enhance responsive‐supportive parent–child relationships and youths' self‐control, which protect rural African American youths from substance use and early sexual activity. Parenting variables included involvement‐vigilance, racial socialization, communication about sex, and clear expectations for alcohol use. Structural equation modeling analyses indicated that intervention‐induced changes in parenting were linked with changes in responsive–supportive parent–child relationships and youth self‐control.     

African American Adolescent Girls in Impoverished Communities: Parenting Style and Adolescent Outcomes

The relationship between parenting style and adolescent functioning was examined in a sample of 302 African American adolescent girls and their mothers who lived in impoverished neighborhoods. Although previous research has found that authoritative parenting, as compared with authoritarian, permissive, and disengaged parenting, is associated with positive adolescent outcomes in both European American, middle‐class and large multiethnic school‐based samples, these parenting categories have not been fully explored in African American families living at or near poverty level. Data were collected from adolescent girls and their self‐identified mothers or mother figures using in‐home interviews and self‐administered questionnaires. Parenting style was found to be significantly related to adolescent outcome in multiple domains including externalizing and internalizing behaviors, academic achievement, work orientation, sexual experience, and pregnancy history. Specifically, teens whose mothers were disengaged (low on both parental warmth and supervision/monitoring) were found to have the most negative outcomes.     

Women in India: The Context and Impact of HIV/AIDS

ABSTRACT

The response to the HIV/AIDS epidemic on the Indian subcontinent has been hampered by several factors, including societal stigma, lack of educational resources, lack of economic opportunities, and the competing priorities for a nation just growing and developing an infrastructure for education, industry, and health. In particular, Indian women are silent victims in this epidemic because they do not readily have a respected voice in decision making and priority setting for the government. The epidemic is increasingly affecting and infecting Indian women (e.g., female commercial sex workers, married women, and pregnant women). The status of Indian women has placed them at extreme disadvantage because India is a country with socially progressive laws but has been slow to change its social norms. The reported HIV prevalence is low although many researchers agree a large amount of underreporting occurs. For India to address this emerging epidemic among women appropriately, it should focus on three intervention areas: (1) short-term solutions such as treatment options for those already infected with HIV to prevent further infection to sexual partners and children; (2) intermediate solutions such as education for those who are uninfected but engaging in behaviors that may put them at risk, such as injection drug use, engaging in commercial sex work, engaging in extramarital sexual relations, and having sexual partners who are not monogamous; and 3) long-term solutions such as addressing the root causes of inequality (e.g., disparities in education and employment and unwillingness to change social norms).