Effects of Brief Messages About Antiretroviral Therapy and Condom Use Benefits Among Black and Latino MSM in Three U.S. Cities

This pilot study examined effects of HIV prevention messages about self and partner benefits of antiretroviral therapy (ART) and condom effectiveness on increased intentions for behavior change. Data were from Messages4Men, a study examining prevention messages among 320 HIV-positive and 605 HIV-negative Black and Latino MSM. Men completed a computer-based assessment after message exposure, and multivariable models controlled for risky sex and demographics. A majority of HIV-positive men reported increased intentions for ART use; 22% reported partner benefit information was new. HIV-positive men with a detectable viral load had significantly greater adjusted odds of reporting intentions for ART use. Over half of HIV-negative MSM reported ART benefit information was new, and 88% reported increased intentions to discuss ART use with infected partners. Black MSM anticipated they would increase condom use in response to the self and partner benefit messages. Tailored messages on benefits of ART are needed for MSM.     

Risk-Taking Behaviors of Gay and Bisexual Men in New York City Post 9/11

Until now, the reactions of gay and bisexual populations have been largely overlooked in response to terror and disaster. This study assesses risk-taking behaviors in gay and bisexual men two weeks before and after the 9/11 attacks in Manhattan. For the purposes of this study, risk-taking behaviors include drug use and unprotected anal sex. These behaviors and associated desires were examined in relation to race/ethnicity, age, geographic location, and HIV status, within and across time. The results of this study demonstrate that HIV status may be a pivotal demographic feature in understanding risk-taking behaviors post disaster. No changes in drug use were reported pre and post 9/11. However, there was an increase in risky sexual behaviors in relation to serostatus, with HIV-positive men reporting a higher number of sexual partners post 9/11. In contrast, the number of sexual partners remained constant in HIV-negative men. There was also an interaction effect, demonstrating that HIV-positive men were more likely than HIV-negative men to act on their desire for sex. Thus, as a population already faced with the prospect of death, HIV-positive men may be a population more vulnerable in the face of terror and disaster.     

Consideration of future consequences and unprotected anal intercourse among men who have sex with men

This study of men who have sex with men (MSM) examined whether tendencies to consider the future consequences of one's actions were associated with sexual behaviors that place oneself at risk for HIV infection. A total of 339 HIV-negative MSM responded to the Consideration of Future Consequences Scale (CFC; Strathman et al., 1994) and to questions about their anal intercourse practices in the past year. In bivariate analyses, men with a stronger future orientation were less likely to engage in anal intercourse unprotected by a condom (p < .05). Multivariate analyses revealed that CFC accounted for significant variance in three of four measures of unprotected anal sex after statistically controlling for demographic covariates (education, income, ethnicity, age). CFC was a better predictor of sexual behavior and accounted for more unique variance than any of the demographic factors. Additional research is needed to confirm that CFC is an antecedent of behavior and to examine the feasibility and efficacy of focusing on CFC in HIV prevention interventions.     

The effect of stepchildren on childbearing intentions and births

This article reports on a study of the effect of stepchildren (children from previous unions) on couples' fertility intentions and childbearing behavior using longitudinal data from the National Survey of Families and Households. The results indicated that stepchildren negatively affect childbearing intentions and childbearing risks. Intentions to have a child are weakened by one's own previous biological children and the previous biological children of one's current spouse or partner. This effect varies by the parenting configuration of the couple and gender of the respondent. Among couples with stepchildren, intentions remain high until each partner has had a biological child. Unlike women, men's previous biological children do not affect their intentions of having a child. Stepchildren exert a weak negative effect on couples' childbearing risks, and this effect is mediated by the couples' childbearing intentions. The findings suggest that stepchildren should be incorporated into future models of fertility.     

Social status inconsistency and migration

We use NLSY79 panel data to extend the line of sociological research encouraged in the early work of Lenski by analyzing the effects of social status inconsistencies on the likelihood and direction of migration. Given that migration is often viewed as a way for individuals to locate prospective returns fitting for their qualifications, analysis of migration behavior offers an opportunity to examine the impact of status inconsistency. Key findings indicate that under-rewarded individuals, specifically relatively highly educated individuals in low status and low paying occupations, are more likely to migrate than are status consistent individuals. Over-rewarded individuals are less likely to migrate. These findings vary across metropolitan and nonmetropolitan places: individuals in nonmetropolitan areas who are under-rewarded or have mixed statuses have higher odds of migration than status consistent respondents. Individuals in metropolitan areas with inconsistent statuses are not more likely to migrate than status consistent respondents once other determinants of migration are entered in the analysis. Exploratory analysis shows migration increases the likelihood of achieving status consistency. Further examination of the interrelationship between migration and status inconsistency is recommended.     

Part 1: HIV as'the line in the sand'

There is a growing rift between HIV-positive and HIV-negative gay men, which finds expression in social, economic, structural and political divisiveness that, if not resolved, may 'kill' the "gay liberation movement." While disasters generally tend to create organizational solidarity, the AIDS crisis has operated in reverse, spawning a variety of competitive AIDS service organizations, alienating seropositive gays from the mainstream gay community, and in turn disenfranchising seronegative gay men as human and financial resources are redirected toward persons living with HIV and AIDS. Serostatus has become a social marker of societal status, operating in a bimodal discriminatory manner. Seronegative gay men experience discrimination from within the gay community as funding for and services to this sector diminish. Seropositive gay men (and the organizations that provide for some of their needs) have culturally, economically and socially dismissed the socio/psychological needs of seronegative gay men (survivor guilt, safer sex education, etc.) in favour of providing social and resource-based services to seropositive gay men. As the disparities in service and advocacy increase, the social distance between the gay movement and the AIDS movement correspondingly increases. If this trend continues, the social gap will serve further to push HIV-positive and HIV-negative gay men into polarized camps, resulting in a wider separation of the gay movement and the AIDS movement. The stigmatization of HIV-positive people will subsequently increase both within and outside the gay movement, and any ability to present a unified Gay Liberation front will correspondingly diminish. Additionally, the emergent notion within and without the gay communities that to be gay is to be HIV-positive will solidify. This will (a) further stigmatize all gay men in the eyes of the non-gay population, and (b) exacerbate the rift between HIV-positive and HIV-negative gay men within the gay community, reversing the stigma of HIV such that to be HIV-negative will be a marker of non-gay identity. In short, seropositivity will become the defining element of gayness.     

Trends in Spouses’ Shared Time in the United States, 1965–2012

Despite major demographic changes over the past 50 years and strong evidence that time spent with a spouse is important for marriages, we know very little about how time with a spouse has changed—or not—in the United States. Using time diary data from 1965–2012, we examine trends in couples’ shared time in the United States during a period of major changes in American marriages and families. We find that couples without children spent more total time together and time alone together in 2012 than they did in 1965, with total time and time alone together both peaking in 1975. For parents, time spent together increased between 1965 and 2012, most dramatically for time spent with a spouse and children. Decomposition analyses show that changes in behavior rather than changing demographics explain these trends, and we find that the increases in couples’ shared time are primarily concentrated in leisure activities.     

Sex differences in remarriage and spouse selection

This paper explores on an international basis the incidence of remarriage among total marriages, the levels and differences in remarriage rates among widowed and divorced males and females, and differences between males and females in spouse selection according to the previous marital statuses of spouse and bride or groom. Remarriage rates by sex and previous marital status are estimated using vital registration data in combination with census information; there are 47 countries that have such data. The results of the analyses indicate that there are a number of general patterns of remarriage and spouse selection that tend to hold across countries.     

Migration,Marital Change,and HIV Infection in Malawi

Research on the relationship between migration and HIV infection in sub-Saharan Africa often suggests that migrants are at higher risk of HIV infection because they are more likely to engage in HIV risk behaviors than nonmigrants, and they tend to move to areas with a relatively higher HIV prevalence. Although migration may be a risk factor for HIV infection, I instead focus on the possibility that the HIV positive are more likely to migrate. Using a longitudinal data set of permanent rural residents and migrants from Malawi, I find that migrants originating from rural areas are indeed more likely than nonmigrants to be HIV positive and to have engaged in HIV risk behaviors. The increased HIV risk among migrants may be due to the selection of HIV-positive individuals into migration; I find that HIV-positive individuals are more likely to migrate than those who are HIV negative. The explanation for this phenomenon appears to be marital instability, which occurs more frequently among HIV-positive individuals and leads to migration after marital change.     

Can spouses be trusted? A look at husband/wife proxy reports

This paper examines biases that may occur when models of couple behavior are estimated using one partner’s report of own and of spouse’s desired family size rather than independent reports obtained from both partners. When estimates of random measurement error are incorporated in a model of couple fertility expectations, proxy reports are valid indicators of spouse desires. In particular, there is little evidence that proxy reports are affected by systematic errors arising from projection of own beliefs onto the spouse. For desired family size, random measurement error in both proxy and self reports is of far greater concern than is systematic error.     

Seroadaptive Strategies of Vancouver Gay and Bisexual Men in a Treatment as Prevention Environment

British Columbia’s treatment as prevention policy has provided free access to highly active antiretroviral therapy (HAART) to all HIV-positive provincial residents since 1996. One outcome is an increase in HIV-positive gay and bisexual men (GBM) with suppressed viral loads. Previous cross-sectional analyses indicated that some Vancouver GBM now recognize condomless anal sex with men on HAART who report a suppressed viral load as a seroadaptive strategy. To test the hypothesis that this new strategy, termed viral load sorting (VLS), is recognized and used among by GBM in the Momentum Health Study, we analyzed longitudinal data for HIV-negative/unknown (n = 556) and HIV-positive (n = 218) serostatus participants. Analyses indicated that both groups reported VLS, and that serostatus and Treatment Optimism Scale scores were significant determinants in frequency and use. Results exemplify the medicalization of sex and Rogers’ Diffusion Of Preventative Innovations Model, and they have important implications for HIV research and GBM sexual decision-making.     

Uncovering the impact of the HIV epidemic on fertility in Sub-Saharan Africa: the case of Malawi

We evaluate the impact of the HIV/AIDS epidemic on the reproductive behaviour for all women in Malawi, HIV-negative and HIV-positive alike, allowing for heterogeneous response depending on age and prior number of births. HIV/AIDS increases the probability that a young woman gives birth to her first child, while it decreases the probability to give birth of older women and of women who have already given birth. The resulting change in the distribution of fertility across age groups is likely to be more demographically and economically important than changes in the total number of children a woman gives birth to.     

HIV disclosure and subsequent sexual behaviors among men who have sex with men who meet online

To assess HIV disclosure discussions and related sexual behaviors among men who have sex with men (MSM) who meet sex partners online, 28 qualitative interviews with Seattle-area MSM were analyzed using grounded theory methods and themes and behavior patterns were identified. MSM found a greater ease in communicating and could prescreen partners through the Internet. However, no consistent relationship was found between HIV disclosure and subsequent behaviors: some were safer based on disclosure while perceived HIV status led others to risky behaviors. Interventions need to promote accurate disclosure while acknowledging its limitations and the need for men to self-protect.     

Eliciting Survival Expectations of the Elderly in Low-Income Countries: Evidence From India

We examine several methodological considerations when eliciting probabilistic expectations in a developing country context using the Longitudinal Ageing Study in India (LASI). We conclude that although, on average, individuals are able to understand the concept of probability, responses are sensitive to framing effects and to own versus hypothetical-person effects. We find that overall, people are pessimistic about their survival probabilities compared with state-specific life tables and that socioeconomic status does influence beliefs about own survival expectations as found in previous literature in other countries. Higher levels of education and income have a positive association with survival expectations, and these associations persist even when conditioning on self-reported health. The results remain robust to several alternative specifications. We then compare the survival measures with objective measures of health. We find that activities of daily life, height, and low hemoglobin levels covary with subjective expectations in expected directions.     

An inquiry into self-identification with retirement

ABSTRACT

The aim of this qualitative study was to explore patterns in self-identification with being retired using deductive thematic analysis informed by the life course perspective. For this study, a set of women who self-identified as retired (n = 60) were asked to describe their current work status, major career interruptions, and factors that marked their retirement. This study provides important insights into the heterogeneity in women’s retirement including a subset of individuals who self-identified as retired, not based on their own work force transitions but on that of their spouse or peers. Findings highlight the importance of recognizing that the construction of retirement identity can be context driven, varied, and subjective.     

The politics of invisibility: homophobia and low-income HIV-positive women who have sex with women

HIV-positive women who have sex with women (WSW) have been overlooked by government researchers, health care providers and the AIDS service community. In addition to stigmas against homosexuality and HIV in larger society, low-income, African-American and Latina HIV-positive WSWs face culturally-based stigmas and are disproportionately affected by poverty, drug addiction, homelessness, sex work and abuse. Through an analysis of sixteen intensive interviews with low-income HIV-positive WSWs of color, I critically examine the physical, emotional and psychological needs of this population and their methods of coping with HIV. I also examine the participants' percepHIV-positive women who have sex with women (WSW) have been overlooked by government researchers, health care providers and the AIDS service community. In addition to stigmas against homosexuality and HIV in larger society, low-income, African-American and Latina HIV-positive WSWs face culturally-based stigmas and are disproportionately affected by poverty, drug addiction, homelessness, sex work and abuse. Through an analysis of sixteen intensive interviews with low-income HIV-positive WSWs of color, I critically examine the physical, emotional and psychological needs of this population and their methods of coping with HIV. I also examine the participants' percepHIV-positive women who have sex with women (WSW) have been overlooked by government researchers, health care providers and the AIDS service community. In addition to stigmas against homosexuality and HIV in larger society, low-income, African-American and Latina HIV-positive WSWs face culturally-based stigmas and are disproportionately affected by poverty, drug addiction, homelessness, sex work and abuse. Through an analysis of sixteen intensive interviews with low-income HIV-positive WSWs of color, I critically examine the physical, emotional and psychological needs of this population and their methods of coping with HIV. I also examine the participants' perceptions of available support networks and patterns of disclosure in order to raise awareness of their struggle against HIV and homophobia and to assist in empowering the low-income HIV-positive WSW community.     

Gender differences in substance use and initiation of sexual activity

Even though widespread efforts have focused on educating young adults about HIV and AIDS, many individuals continue to engage in behaviors that place them at risk. These behaviors include frequent experimentation with alcohol and other drugs prior to sex, engaging in sexual activity with different partners, and inconsistent safe sex practices (Butcher et al. 1991). The combination of these risky behaviors causes increased concern about the spread of HIV among those of college age. This study focused on two behaviors by examining the relationship between substance use during adolescence and early initiation of sexual activity in a sample of 950 subjects aged 19–21 in a mid-sized southern city. Results indicate that early use of alcohol and marijuana relates to earlier initiation of sexual activity and subsequent risky sexual behavior among young adults. Also, gender differences were observed for frequent users of marijuana and alcohol with males engaging in riskier sexual practices. Recommendations for interventions are made.     

Psycho-social issues related to counseling bisexuals

An increasing number of persons who experience bisexual feelings or behaviors are seeking professional counseling. This article explores the psycho-social issues related to counseling individuals and couples concerned about their own or their partner's feelings, fantasies, or behaviors with both men and women, and the appropriateness or inappropriateness of adopting a bisexual identity or developing a bisexual life-style. The steps for helping individuals to differentiate problems, handle confusion, and conceptualize bisexuality are outlined. The counseling process with bisexuals includes developing support systems, examining internalized homophobia and sex-role stereotyping, helping them deal with heterosexual concerns, and with issues which affect partners when one or both is bisexual.     

Subjective Well-being in Rural India: The Curse of Conspicuous Consumption

Using data on 697 individuals from 375 rural low income households in India, we test expectations on the effects of relative income and conspicuous consumption on subjective well-being. The results of the multi-level regression analyses show that individuals who spent more on conspicuous consumption report lower levels of subjective well-being. Surprisingly an individual’s relative income position does not affect feelings of well-being. Motivated by positional concerns, people do not passively accept their relative rank but instead consume conspicuous goods to keep up with the Joneses. Conspicuous consumption always comes at the account of the consumption of basic needs. Our analyses point at a positional treadmill effect of the consumption of status goods.     

Sexual identity distress, social support, and the health of gay, lesbian, and bisexual youth

Sex researchers and mental health clinicians have long recognized that the stigma surrounding homosexuality plays an important role in shaping the social psychological adjustment of gay, lesbian, and bisexual (g/l/b) people. In recent years, researchers have suggested that sexual identity- related distress may influence the physical health status of g/l/b people, primarily because of the ways these self-related feelings and beliefs impact patterns of health-related behavior. This study examines the influence of sexual identity distress and social support on g/l/b youth's drug and alcohol use, psychological distress, and risky sexual behavior. The data come from a services research demonstration program conducted at the Indiana Youth Group, Inc., a g/l/b youth development agency based in Indianapolis, Indiana. Results indicate that sexual identity distress is strongly associated with psychological distress, less frequent use of alcohol, and using fewer types of illegal drugs. Being out to more people in one's support network, however, attenuates the severity of youth's sexual identity-related distress. Youth who report more support ties to g/l/b people indicate engaging in more frequent risky sexual behavior. The implications of these findings for theories of g/l/b youth's sexual identity development are discussed.