Sexual Aspects of Adaptation to HIV/AIDS

Following a pilot study to refine qualitative methods, a phenomenological study consisting of semi-structured interviews with 20 gay men was conducted The purpose of these interviews was to examine sexuality issues affecting HIV status, both pre- and post-diagnosis. The role of chemical abuse pre-diagnosis emerged as one of the most important factors influencing sexual activity. Following a seropositive HN diagnosis, significant changes occurred in the sexual behavior of the participants. These changes are outlined in this study along with suggestions made by the participants to resolve potential barriers to healthy sexual functioning.     

HIV/AIDS Knowledge Sources and Risk Behavior among Adolescent African American Males: Toward Developing HIV/AIDS Pedagogy

Black male adolescent HIV incidence and prevalence account for a disproportionate number of AIDS cases. Their cultural experiences are significantly different than other sectors of the U.S. population. Among adolescents, they constitute 37 percent of the cases, which is more than double their representation in the general adolescent population. The authors ask where do African American males receive information about HIV/ AIDS.     

Gender Differences in the Path From Sexual Victimization to HIV Risk Behavior Among Homeless Youth

ABSTRACT

Experiencing sexual victimization prior to becoming homeless is common among homeless youth and is associated with increased HIV risk behavior. This study examined mediating variables that underlie this association, adding to the understanding of gender differences in these paths. Participants were homeless youth in Los Angeles recruited through service access centers who completed a computerized self-administered interview in English or Spanish using an iPad. Findings indicate a high presence of sexual victimization across both genders. Female participants experienced posttraumatic stress disorder and subsequent engagement with exchange sex, whereas male participants were primarily involved in substance use risk pathways. Results indicate paths in the association between sexual victimization and HIV risk behavior differ between male and female homeless youth. Gender-specific, mental-health-informed interventions targeting sexual risk reduction are warranted.     

Factors Associated with HIV Sexual Risk Behavior in Male Couples of Mixed HIV Status

Abstract

There are concerns that rates of unprotected anal intercourse and new HIV infections among some gay men have remained at or returned to dangerous levels, similar to those seen in the first decade of the epidemic. Most research on sexual risk behavior of gay men has focused on individuals even though several studies have indicated that unprotected anal intercourse (the most risky of sexual behaviors) is most likely to occur between two men who are regular partners.

This study was conducted with 75 HIV serodiscordant (“mixed HIV status”) male couples. The goals were to assess the types and prevalence of sexual risk behaviors within these dyads, to identify reasons given for engaging in risk behavior with their partner of opposite HIV status, and to examine the association, if any, between risk behaviors and potential individual and partner related factors and context. Both members of the couple were included in all assessments.

There was a tendency for unprotected anal sex to occur more often among younger men, newer couples, Latino men, and men with less education. Lower risk perception and self-efficacy for condom use, desire for sexual spontaneity, intimacy, and personal and partner satisfaction were all related to sexual risk behavior. The men in these relationships also used specific “harm reduction” strategies, based on their own understanding of transmission risk. Therefore it is important to integrate biological and behavioral knowledge to develop effective prevention campaigns. And prevention programs need to consider the ongoing emotional needs of both the HIV seronegative (HIV-) and HIV sero-positive (HIV+) partner.     

Predictors of High-Risk Sexual Behavior Among Individuals Living with HIV Disease and AIDS

An important focus of the 1996 World Aids Conference related to the extent of unprotected sex among gay men, particularly those in their twenties. This paper will use logistic analysis to explore the extent of unsafe sexual practices among individuals living in Bexar County, Texas, who are HIV+ assymptomatic, HIV+ symptomatic, or have AIDS. Using survey research data, we assess the significance and impact of various independent factors on whether respondents reported they did or did not engage in unprotected sex. The most striking finding is that unprotected sexual activity is prevalent regardless of demographic and/or status differences among respondents. Findings reinforce the use of community planning processes, which emphasize the importance of sound behavioral and social science combined with efforts to include the affected constituency to create effective HIV prevention programs.     

High-Risk Sexual Behavior Among Students of a Minority-Serving University in a Community With a High HIV/AIDS Prevalence

Objective: The authors used a stratified cluster sampling design to inform campus sexually transmitted diseases prevention programs. Participants and Methods: They conducted a cross-sectional study of students (N = 1,130) at a large, urban, minority-serving university in South Florida using the 2004 National College Health Assessment Survey instrument. Results: Of the 1,130 participants, 14.0% reported risky sexual behavior (having more than 1 sexual partner in 1 year and not using a condom the last time they had vaginal intercourse), and 11.9% reported consistent risky sexual behavior (having more than 1 partner in 1 year and not using condoms most or all of the time during the past 30 days). In multivariable analysis, past-month alcohol use had the strongest independent association with both risky and consistent risky sexual behavior. Illicit drug use was marginally significant in both models. Conclusions: Administrators should address the use of alcohol and other drugs on campus in planning interventions to promote safe sexual behavior.     

An Exploration of Family and Juvenile Justice Systems to Reduce Youth HIV/STI Risk

Using in‐depth interviews with 20 probation youth (60% female; 35% White; 30% Hispanic; mean age: 15 years, range = 13–17), their caregivers (100% female; mean age: 44 years, range = 34–71), and 12 female probation officers (100% White; mean age: 46 years, range = 34–57), we explored how family and probation systems exacerbate or mitigate sexual risk. We conducted thematic analyses of interviews, comparing narratives of families of sexually risky (n = 9) versus nonsexually risky (n = 11) youth. Family functioning differed by youth sexual risk behavior around quality of relationships, communication, and limit setting and monitoring. The involvement of families of sexually risky youth in probation positively influenced family functioning. Data suggest that these families are amenable to intervention and may benefit from family‐based HIV/STI interventions delivered in tandem with probation.     

Sexual Behavior Among College Students in the AIDS Era

The sexual behavior of a 1988 midwestern college sample was compared to a highly similar 1982 sample to determine the impact of the AlDS epidemic. Contrary to expectations, sexual activity increased over the six-year period. More 1988 students had engaged in intercourse, and females had engaged in it more times with more partners. Age of first intercourse remained unchanged. Attitudes for both sexes became more permissive, and males also perceived their parents to have become more permissive. A continuing double-standard was suggested. For males there were increases in contraceptive frequency, contraception at last intercourse, and condom use. Increased condom use was probably not AIDS-induced, as there was no increase in use from first to last intercourse. Students' sexual, contraceptive, and verbal behavior suggested little concern about AIDS.     

Sexual Behavior Among College Students in the AIDS Era

The sexual behavior of a 1988 midwestern college sample was compared to a highly similar 1982 sample to determine the impact of the AIDS epidemic. Contrary to expectations, sexual activity increased over the six-year period. More students in the 1988 sample had engaged in intercourse. They had also had more partners for intercourse and more lifetime intercourse experience. Age of first intercourse remained unchanged, however. Attitudes for both sexes became more permissive and males also perceived their parents to have become more permissive. A continuing double-standard was suggested. There were increases in contraceptive frequency, in contraception at last intercourse, and use of more sophisticated contraceptive methods. Increased condom use did not appear to be AIDS-induced, as there was no increase in use from first to last intercourse. Students sexual, contraceptive, and verbal behavior suggested no obvious concern about AIDS.     

HIV Risk and the Freedom to Act Without Thinking: Alcohol Use and Sexual Behavior Among Adolescents on Probation

Through in-depth phenomenological interviews, 18 adolescents currently on probation describe how they make decisions about using alcohol and engaging in sexual behaviors. Two main threads emerge: they value spontaneity in sex and believe that they act spontaneously in regard to both sex and alcohol. At the same time, they describe being highly influenced by parents and peers. The researchers discuss the potential implications of these and other findings for HIV prevention and intervention.     

Marital Aspirations,Sexual Behaviors,and HIV/AIDS in Rural Malawi

We explore how marital aspirations are related to the sexual behaviors of adolescents and young adults in Malawi, where HIV/AIDS prevalence among adults exceeds 10%. We also consider whether the specter of AIDS is shaping ideals about marriage. By combining survey data (N = 1,087) and in‐depth interviews (N = 133) with young Malawians from the Malawi Diffusion and Ideational Change Project, we show that looking for and finding a suitable spouse are linked to sexual behaviors and, thus, HIV risks. Moreover, concerns about contracting HIV are closely tied to the ideal characteristics of a future spouse. Our findings draw long‐overdue attention to the importance of marital aspirations in understanding adolescent sexual behaviors and risks in the era of AIDS.     

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.     

Stages of Change Theory in Family Therapy for Sibling Sexual Assault

Family therapy understands the benefits of therapeutically supported dialogue amongst family members when there are challenging themes and topics that need to be discussed. This paper is an attempt to explore ways that family therapists can work with family members who are thrust into therapy rather than ‘voluntarily’ signing up for it. It applies ideas from the drug and alcohol field such as Stages of Change theory and Motivational Interviewing. The paper explores how these ideas and approaches might help family therapists to formulate a concept of resistance and to make helpful dialogue more likely. They are applied to families experiencing sibling sexual assault, where they become involved with a legal response that necessitates a therapeutic intervention.     

Psychosocial Factors That Contribute to HIV/AIDS Risk Behaviors Among Young Black College Women

Sustainable consumption is one of the most recent challenges in the field of education. This is the reason why a great number of international institutions have formulated strategies to foster more sustainable consumption. In Greece, certain educational programs have gradually begum to implement a policy aiming to sustainable consumption in the field of the new curriculum of studies for primary school. The intent of this study is to highlight the need to consider the pupils' consumer habits and behaviors in the purchase and management of products and services in reference with modern consumption patterns. Specifically, the aim of this article is to identify the pupils' sustainable and unsustainable practices, considering their personal dimensions of everyday living, and giving a particular meaning to consumer education in Greece.     

Sexual Risk Behavior in Young Adulthood: Broadening the Scope Beyond Early Sexual Initiation

A robust link between early sexual initiation and sexual risk-taking behavior is reported in previous studies. The relationship may not be causal, however, as the effect of common risk factors is often not considered. The current study examined whether early initiation was a key predictor of risky sexual behavior in the 20s and 30s, over and above co-occurring individual and environmental factors. Data were drawn from the Seattle Social Development Project, a longitudinal panel of 808 youth. Early predictors (ages 10 to 15) and sexual risk taking (ages 21 to 24 and 30 to 33) were assessed prospectively. Early sexual initiation (before age 15) was entered into a series of probit regressions that also included family, neighborhood, peer, and individual risk factors. Although a positive bivariate relation between early sexual initiation and sexual risk taking was observed at both ages, the link did not persist when co-occurring risk factors were included. Behavioral disinhibition and antisocial peer influences emerged as the strongest predictors of sexual risk over and above early sexual initiation. These results suggest that early sexual initiation must be considered in the context of common antecedents; public health policy aimed at delaying sexual intercourse alone is unlikely to substantially reduce sexual risk behavior in young adulthood.     

HIV/AIDS and homelessness

This article describes the results of research on the demographic, housing, psychosocial characteristics, and service needs of a sample of homeless people with HIV disease. Results show that respondents are similar in demographic and housing characteristics to the general homeless population. On average, respondents report high levels of stress and depression, moderate satisfaction with perceived social support availability, moderate beliefs in their ability to influence health related outcomes, moderate levels of self-efficacy, and low levels of physical and psychosocial disability. A range of services was identified as both helpful and useful in supporting a stable living arrangement. Implications for social policy, service provision, and research are discussed.     

A Preliminary Study of Body Image and HIV Sexual Risk Behavior in Black Gay and Bisexual Men: Implications for HIV Prevention

Nearly three decades since the onset of the AIDS epidemic, Black gay and bisexual men (BGBM) experience increasingly disproportionate rates of HIV and AIDS in the United States. The aim of this exploratory research investigation was to examine the relationship between body image and HIV sexual risk behavior in a community-based sample of 481 BGBM in the New York metropolitan area. Multivariable analyses demonstrated that men with a negative body image were less likely to use condoms during anal intercourse with a male sexual partner as compared to those respondents with a positive body image. These findings pose considerable implications for the influence of body image on HIV sexual risk behavior in BGBM.     

HIV/AIDS and Homelessness

This article describes the results of research on the demographic, housing, psychosocial characteristics, and service needs of a sample of homeless people with HIV disease_ Results show that respondents are similar in demographic and housing characteristics to the general homeless population. On average, respondents report high levels of stress and depression, moderate satisfaction with perceived social support availability, moderate beliefs in their ability to influence health related outcomes, moderate levels of self-efficacy, and low levels ofphysical and psychosocial disability. A range of services was identified as both helpful and useful in supporting a stable living arrangement. Implications for social policy, service provision, and research are discussed.