‘Pain on Top of Pain,Hurtness on Top of Hurtness’: Social Discrimination,Psychological Well-Being,and Sexual Risk Among Women Living With HIV/AIDS

ABSTRACT

This qualitative study explored how a subsample (n = 26) of participants in Protect and Respect (N = 184), a safer-sex intervention for women living with HIV/AIDS (WLH/A), discussed their experiences of social discrimination and the impact of discrimination on their lives, psychological well-being, and risk behaviors during group intervention sessions. The majority of participants was Black (83%), earned less than $10,000 per year (80%), and acquired HIV through heterosexual sex (58%). Analyses demonstrated that social discrimination manifested in the women's lives as poverty, HIV/AIDS-related stigma, and gender inequality. These experiences caused intense psychological distress and limited WLH/A's ability to implement the safer-sex skills that they learned during the intervention. We discuss the applied and theoretical implications of our findings, advocating for HIV and sexual risk-reduction interventions that are based on an ecological framework that addresses holistically the individual, relational, and sociostructural factors that affect women's sexual risk behaviors.     

HIV/AIDS stigma manifestations during clinical interactions with MSM in Puerto Rico

HIV/AIDS stigma can have detrimental effects on physician/patient interactions when manifested by health professionals. Unfortunately, HIV/AIDS stigma is usually manifested in an intersectional manner with other preexisting stigmas, including stigma toward men who have sex with men (MSM). Therefore, our study aimed to examine the behavioral manifestations of HIV/AIDS stigma among physicians in training during simulated clinical interactions with MSM, and explore the interrelation between HIV/AIDS stigma attitudes and behaviors. We implemented an experimental design using Standardized Patient simulations with a sample of 100 physicians in training in Puerto Rico. Results show a significant difference in the two groups’ means (p?<?.001), with a higher number of stigma behaviors in the HIV MSM patient condition (M?=?6.39) than the common cold control condition (M?=?5.20). Results evidence that stigma manifestations toward MSM with HIV may continue to be an obstacle for public health in Puerto Rico, and that medical training to prevent stigma is still needed.     

The Second Closet: A Qualitative Study of HIV Stigma Among Seropositive Gay Men in a Southern U.S. City

ABSTRACT

Objectives: Stigma connected with HIV/AIDS has decreased considerably since the early epidemic yet affects those living with HIV in many ways. Little research, particularly qualitative research, concerning HIV stigma from the perspective of gay men has emerged. The present qualitative study aimed to fill this evidence gap by examining how HIV stigma is perceived and experienced by gay men who have become HIV-infected and how they respond to this stigma. Methods: Thematic analysis of 19 gay men's narratives identified six main themes. Results: Encountering HIV stigmatization was common and was linked to the physical stigmata identifying respondents as HIV-positive. Overwhelmingly, they found stigmatization to be most intensely felt within gay communities. One profound theme was internalized HIV stigma, referring to respondents’ internalized negative feelings about their HIV status. A related theme was the closeted nature of HIV. Lastly, regarding how the men dealt with the HIV diagnosis and experiences of HIV stigma, a theme of adaptation became clear. Conclusions: Although exploratory, the results can serve as a beginning framework for understanding and assisting seropositive gay men who experience HIV stigma. The findings are important because it is realistic to expect that in a climate in which HIV has become increasingly invisible and closeted and in which infections are on the rise, gay and bisexual men will be increasingly affected and infected by HIV.     

HIV knowledge mediates the relationship between HIV testing history and stigma in college students

ABSTRACT

Objective: HIV-related stigma is one of the strongest barriers to prevention and treatment. HIV prevalence in U.S. college students is estimated around 0.02%, but is thought to be drastically underreported. We examined the influence of HIV knowledge on the relationship between HIV testing history and stigma in college students. Participants: A random sample of 2343 students, over the age of 18, attending a large university in the southeastern United States completed the survey in January 2016. Methods: A mediation model was constructed in regression framework to explore the relationship between HIV testing history, knowledge, and stigma. Results: HIV testing history was associated with higher knowledge scores (a path: B = 4.08, p < .001) and higher knowledge scores were associated with lower stigma (b path: B = .01, p < .001). These results suggest that HIV knowledge partially mediates the relation between HIV testing history and stigma in college students. Conclusions: HIV testing history may decrease stigma by increasing knowledge. Results can be used to inform college health promotion practice on developing programs and services.     

How to Inform: Comparing Written and Video Education Interventions to Increase Human Papillomavirus Knowledge and Vaccination Intentions in Young Adults

Abstract

Objective: To compare the efficacy of 2 human papillomavirus (HPV) educational interventions on increasing HPV knowledge and vaccination intentions in college students. Participants: Male (n = 60) and female (n = 140) undergraduates (M _age = 20.4, SD = 2.3) recruited from a university in Montreal, Quebec, Canada, from October 2009 to March 2010. Methods: Using theory-based interventions, participants were randomly assigned to either a written HPV pamphlet, an HPV video, or a control. HPV knowledge and vaccination intentions were assessed pre and postintervention. Results: Low baseline knowledge and intentions were found across groups. Postintervention, participants in the written and video interventions had significantly higher knowledge and intentions than the control. No differences were found between written and video interventions on knowledge or intentions. Conclusion: This study, a first in comparing HPV educational formats, suggests that both written and video interventions are equally effective in educating about HPV and increasing young adults’ vaccination intentions.     

Caring Adults: A Brief Report Assessing Adults’ Needs in Feeling More Comfortable Having Sexual Health Conversations with Youth in South Texas

Abstract

Objectives: As part of a larger Substance Abuse and Mental Health Services Administration-funded project in South Texas, this study sought to understand adults’ needs with regard to engaging in sexual health conversations with youth and young adults.

Methods: A total of 223 participants were surveyed to assess comfort engaging in sexual health conversations. Data were analyzed using thematic coding. Stigma surrounding sexual health conversations underlined all themes.

Results: Differences by gender and sexual orientation in the data were noted. Stigma around sexual health topics reduced participants’ comfort.

Conclusions: To this end, interventions must go beyond psychosocial and educational programs and address societal factors that contribute to the stigma.     

Stigma and family relationships of middle-aged gay men in recovery

The primary objective of this study was to explore how middle-aged gay men in recovery cope with stigma and family relationships. For gay men, perceptions of acceptance of their sexual orientation and degree of social connectedness can play a role in their recovery from alcohol and substance use disorders. Yet gay men may have a more difficult time accessing certain family-level health resources because their families of origin may stigmatize, reject, or silence them on account of their sexual orientation. Semi-structured interviews were used to explore how participants in recovery constructed and coped with their experiences of stigma, family relationships, and alcohol and substance use. Participants (30 gay men ages 50 to 64) completed a questionnaire and interview. We used constructivist grounded theory method and minority stress theory as a theoretical framework to interpret the data. We identified the following themes: Internalization of Stigma, Changes in Coping Strategies, and Ongoing Stigma. Future research should explore how to incorporate familial support into gay men's recovery, address ongoing internalized stigma, and develop a social response to stigma, rather than leaving it to individuals to confront on their own.     

“I bled like you,brother, although I was a thousand miles away”: postwar Yiddish sources on the experiences of Polish Jews in Soviet exile during World War II

ABSTRACT

An estimated 230,000 Polish Jews escaped Nazi persecution during World War II by flight or deportation to the interior of the Soviet Union. This article examines early postwar Yiddish and Polish sources on their survival in Soviet exile such as poems, newspaper articles, and witness testimonies. Two sets of sources are analyzed in-depth, testimonies written by young people in Jewish Displaced Persons (DP) camps in occupied Germany and Yiddish poetry from Poland and the DP camps. The author argues that many former exiles were eager to write down their experiences. In doing so, they were aware of the complex nature of deportation and flight that characterized the experiences of Polish Jews in the Soviet Union. In their testimonies many young witnesses express their understanding that they too were “marked by the khurbn.” Whereas Yiddish poetry from the same period helps us understand how writers dealt with their own story of wartime survival outside the realm of German persecution. In their poetry they seek meaning in their own suffering and express their desire to establish a dialogue with other survivors.     

The Influences of Stigma on Sexuality among Sexual and Gender Minoritized Individuals in Urban India

Abstract

Indian sexual and gender minoritized (SGM) individuals face marginalization and discrimination. Objectives: This study examines stigma’s effects on sexuality among SGM individuals in urban India. Methods: We conducted 5 focus group discussions and 27 interviews with SGM-identified adults connected to SGM-advocacy organizations in 3 cities (Chennai, Bangalore, Kolkata). Results: Stigma affected sexuality in the following ways: gender-specific stigma and behavioral norms, sexual identity-specific stigma, partners’ stigma and buffering effects of partner, heterosexual marriage pressure, and limited sexual healthcare. Conclusions: Although there were similarities with stigma’s effects in Western environments, the unique Indian context necessitates further research for more targeted interventions.     

College students’ peer-helping behaviors and stigma of seeking help: Testing a moderated mediation model

Abstract

Objective: College students are most likely to seek psychological help from their peers. Internalized public stigma (ie, personal stigma) may prevent peer-helpers from aiding others, and such help-negating effects may depend on contextual factors such as race and gender. The current study examined a moderated mediation model in which the relationship between public stigma and peer intervention behaviors was mediated by personal stigma and moderated by race and gender categories. Method: Undergraduate students (N?=?5,183) from the national Healthy Minds Study completed measures of help-seeking stigma and peer-helping behaviors. Results: Conditional Process Modeling revealed that personal stigma fully mediated the link between public stigma and peer-helping behaviors. Gender (but not race) moderated these associations such that the indirect and direct effects were stronger from men than women. Conclusions: Peer-helper interventions may benefit from culture-specific re-norming messages and by addressing the role of gender in peer-helping.     

Lesbians’ Negative Affect Toward Sexual Minority People with Stereotypical Masculine and Feminine Characteristics

Abstract

We investigated lesbians’ negative affect toward gay and lesbian scenarios with feminine/negative characteristics. Seventy-one Italian lesbians responded to self-report questionnaires. Analyses tested that feminine gay man scenario (GF) would elicit negative affect more than the other three scenarios (feminine/masculine lesbian woman and masculine gay man) and that participants’ internalized sexual stigma would be a moderator of the relation between their self-perceived femininity and negative affect. When lesbians reported low self-perceived femininity, stigma levels did not affect the evaluation of the GF. Instead, when self-perceived femininity were higher, lesbians with high stigma reported more negative emotions than lesbians with low stigma.     

Consent requires a relationship: rethinking group consent and its timing in ethnographic research

ABSTRACT

Activist groups in ethnographic research re-negotiated our Ethics Committee’s expected order of securing consent before data collection, demonstrating the importance of researchers taking time to build relationships first. Although the Ethics Committee expected us to obtain group consent, the literature provides little guidance on how to do this. We developed a Memorandum of Understanding to summarize what forms of participant observation each group agreed to and how we would reciprocate. In this article, we (re)conceptualize consent, using analogies to consent in social contract theory and sexual relations to offer a critical perspective on what constitutes consent. We argue that taking time to build relationships before expecting research participants to consent and replacing informed consent with a negotiated agreement is a more ethical approach. We advocate for Ethics Committees to expand the meaning of ‘informed consent’ and review its timing, especially for ethnographic research with groups.     

Pushing back the margins: power,identity and marginalia in survey research with young people

The study of marginalia has not been widely discussed in social sciences research and occupies a marginal space in terms of methodological legitimacy. We highlight the value of paying attention to the ways in which participants speak back to the researcher. This paper draws on marginalia found in surveys written or drawn by young people in classrooms across South Wales, demonstrating how various notes and marks made spontaneously by participants can tell us something important and worthwhile about how young people engage with research. We position marginalia as a manifestation of complex power dynamics in the research process that illuminate participants’ negotiation of complex and multiple subjectivities in the literal margins and between the lines of the survey pages. Whilst the sensitive and rigorous analysis of marginalia is fraught with ethical and methodological challenges, we argue that paying closer attention to marginalia presents an opportunity for deeper engagement with participants when undertaking survey research.     

Help Seeking and Treatment Use Among Suicidal College Students

Abstract

Objectives: Many suicidal college students do not receive mental health treatment, and the reasons for this are not fully understood. This study examines how attitudes, beliefs, and social network factors relate to help seeking among suicidal students. Participants: A random sample of 8,487 undergraduate and graduate students from 15 US universities participated. Methods: A Web-based survey administered in spring 2009 examined correlates of mental health service utilization among students reporting serious thoughts of suicide in the previous year (n = 543). Results: Correlates of treatment use included perceived need, beliefs that treatment is effective, contact with service users, lower personal stigma, higher perceived stigma, fewer positive relationships, and sexual minority or Caucasian identity. Conclusions: Help seeking among suicidal students is associated with a range of personal and social network factors. Campus strategies to enhance help seeking should be tailored to address identified facilitators and barriers to treatment use among target populations.     

Pregaming: An Exploratory Study of Strategic Drinking by College Students in Pennsylvania

Abstract

Objectives: This exploratory study examined pre-event drinking, or pregaming, by US college students. Participants: 112 undergraduates from 10 Pennsylvania colleges participated. Method: A focus group, including a written questionnaire, was conducted at each institution. Results: Only 35.7% of the participants had not pregamed during the last 2 weeks. Pregamers consumed an average of 4.9 (SD = 3.1) drinks during their most recent session. Gender, class year, and other demographic variables did not predict pregaming. Heavier drinkers, and those stating that the average student pregamed 3+ times in the last 2 weeks, were more likely to report pregaming in the last 2 weeks. How much students drink when pregaming is influenced by how much they expect to drink later on. Conclusion: Pregaming presents a growing challenge for campus officials. Additional research is needed on the nature of the problem and which combination of prevention strategies might best address this behavior.     

Power in Dayton: A Replication of the Bonjean Technique in a Medium Size City

Abstract

In recent years, the relationship between personal bankruptcy and stigma has generated much discussion and speculation. However, virtually no research has examined the experiences of bankrupt debtors themselves. In this paper, we provide an analysis of bankruptcy stigma based on thirty-seven in-depth interviews with 19 married couples who filed for personal bankruptcy in 1999. The data demonstrate that stigma is a pervasive feature of contemporary personal bankruptcy and that bankrupt debtors rely upon a wide range of stigma management techniques employed by other stigmatized groups. We conclude by considering the implications of our findings for continued research on personal bankruptcy in the U.S. and for understanding, more broadly, the strategies and struggles for social agency among stressed and marginalized populations.     

Bisexual Stigma,Sexual Violence,and Sexual Health Among Bisexual and Other Plurisexual Women: A Cross-Sectional Survey Study

Bisexual women experience higher rates of sexual victimization relative to heterosexual and lesbian women, and worse sexual health outcomes. Though these health disparities are well documented in the literature, few empirical data have been published on what factors are driving these disparities. Further, research documenting sexual victimization and health of plurisexual (i.e., attracted to more than one gender) women group all participants as bisexual. We do not know whether these experiences are similar across subgroups of plurisexual women. The current study reports on data from a cross-sectional survey, analyzing the relationships between bisexual-specific stigma and sexual violence, as well as other sexual health outcomes, across a sexually diverse group of plurisexual participants. Findings indicate that bisexual stigma is a significant predictor of lifetime sexual violence (odds ratio [OR] = 1.99, p = .015) and verbal coercion (OR = 2.60, p = .004), but not other outcomes. There are differences across sexual identity categories, with bisexual participants being less likely to report sexual violence and verbal coercion, and less likely to access sexually transmitted infection/human immunodeficiency syndrome testing, compared to other plurisexual groups. Our findings support that bisexual stigma is an important factor to consider in understanding sexual violence disparities experienced by bisexual and other plurisexual women.     

Associations of physical exercise as a lifestyle habit with lean and fat body mass and handgrip strength and age in Asian men

Abstract

Background: We evaluated how the intensity of physical exercise as a lifestyle habit is associated with age, body composition and handgrip strength.

Methods: Total body composition was analyzed using DEXA. Exercise scores were derived from an administered questionnaire and the scoring was calculated using the Metabolic Equivalent of Task (MET). Handgrip strength was measured using a dynamometer.

Results: Age, independent of exercise intensity, was associated with declining lean mass, and handgrip strength and with increasing total body fat. A regular physical exercise regime of intensity greater than 1230 MET-min/week was associated with higher total lean mass and lean mass in the limbs, and handgrip strength and lower fat mass in the limbs.

Discussion: We have shown that age was associated with lower lean mass especially in the limbs and handgrip strength and higher total fat mass. Regular physical exercise as a lifestyle habit of any type and of sufficient intensity could help improve muscle strength in the limbs.     

Longitudinal changes in anthropometry and body composition in university freshmen

Objective: We investigated predictors of weight gain in college freshmen. Participants: A longitudinal cohort study followed a representative sample of freshmen (N = 264) from 8/2011 to 6/2012. Methods: Repeated measurements of anthropometry, dual-energy X-ray absorptiometry (DXA), physical activity, and diet were collected. We investigated predictors of 9-month weight gain using regression models. Results: 172 participants completed follow-up: 75% gained >0.5 kg. Mean weight change was +2.3 kg (SD 3.2) and +2.0 kg (SD 3.2) and mean adiposity change was +1.3% (SD 1.6) and +0.7% (SD 2.2) in men and women, respectively. In participants gaining >0.5 kg, weight increased 5.6% and body fat increased 1.6%. Anthropometric change in men occurred in the first semester, while women increased in both semesters. Leaner DXA-defined body composition at baseline was consistently associated with greater weight gain (p-values 0.029–0.049). Conclusions: Freshman weight gain is common and reflects increased adiposity. Leaner body composition at the beginning of college predicted greater weight gain in men and women during the first year of college.     

‘A ondi queras’: Ranchero identity construction by U.S. born Mexicans on Facebook

This study describes how transnational second‐generation Mexican bilinguals use a stigmatized variety of Mexican Spanish to communicate on Facebook and construct an identity. The stereotyped features of this variety index a ranchero identity. Historically, ranchero is an ambivalent identity for Mexican society in general. On the one hand, ranchero culture is a positive reminiscence of Mexico's agrarian past, while on the other, rancheros, along with indigenous Mexicans, are at the bottom of the hierarchy in Mexican society. A discourse‐centered, ethnographic analysis of digitally mediated conversations demonstrates how language use allows participants to reminisce about their collective past, maintain Mexican identities tied to their ancestors, fit their identities to contemporary U.S. Mexican culture, and distance themselves from the stigma associated with the ranchero background.