The Healthy Young Men's Study: Sampling Methods to Recruit a Random Cohort of Young Men Who Have Sex With Men

Recruiting a scientifically sound cohort of young men who have sex with men (YMSM) is an enduring research challenge. The few cohort studies that have been conducted to date on YMSM have relied on nonprobability sampling methods to construct their cohorts. While these studies have provided valuable information about HIV risk behaviors among YMSM, their generalizability to broader YMSM populations is limited. In this article, the authors describe a venue-based sampling methodology used to recruit a large and diverse cohort of YMSM from public venues in Los Angeles County, California. Venue-based sampling is a multistage probability sampling design that uses standard outreach techniques and standard survey methods to systematically enumerate, sample, and survey hard-to-reach populations. The study design allowed the authors to estimate individual, familial, and interpersonal psychosocial factors associated with HIV risk and health-seeking behaviors for a cohort of YMSM with known properties. Study participants completed an extensive baseline survey and over a 2-year period completed four follow-up surveys at 6-month intervals. The baseline survey was administered in both English and Spanish.     

HIV Prevention Programs in the Black Church: A Viable Health Promotion Resource for African American Women?

ABSTRACT

Nearly 40 million people worldwide are living with the human immunodeficiency virus (HIV). The Centers for Disease Control report that women account for more than 50% of the existing 40 million HIV/AIDS cases to date. Moreover, African-American women are infected with HIV/AIDS 25 times more often than white women and four times more often than Hispanic women, making HIV/AIDS the leading cause of death for black women ages 25–34. Given the increasing rate of transmission with this population, the purpose of this article was to review the existing literature to investigate the risk factors associated with African-American women with HIV/AIDS and identify an effective method of HIV prevention for them. A discussion of religion and African-Americans in terms of the Black church and its health promotion efforts was also included. The article concludes with a discussion of program elements of HIV prevention programs in the Black church and possible challenges faced for the programs.     

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).     

An Exploration of Mental Health Literacy Among African American Clergy

ABSTRACT

The purpose of this qualitative study was to explore African American clergy's mental health literacy with older congregants 60 years of age and older. Using a grounded theory approach, we recruited a purposive sample of 9 African American clergy representing diverse ages, denominations, locales, and educational levels. Data was coded and classified according to Kevin's (1976) Kevin, R. C. 1976. Factors influencing the judgment and referral of mental health presenting problems by clergymen and psychologists, Unpublished doctoral dissertation: University of Texas, Austin.  [Google Scholar] typology of pastoral counseling and Jorm et al.'s (1997) Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., Rodgers, B. and Pollitt, P. 1997. “Mental health literacy”: A survey of the public's ability to recognize mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia, 166: 182–186. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar] conceptual model of mental health literacy. Findings from data analysis revealed study respondents were adherents of Kevin's Religious–Community (R–C) model. Additionally, the following themes emerged: loss of cognitive functioning, psychosocial stressors, religiosity, and appreciation for professional assistance, cultural barriers, and key informants/familiarity with formal mental health providers which partially maps onto Jorm et al.'s conceptual model of mental health literacy.     

Religion and Spirituality as Defined by Older Adults

ABSTRACT

This exploratory qualitative study examined the intrinsic definitions of spirituality and religion across three different religious or ethnic groups of older adults – Jewish, African American Protestants and Caucasian Protestants. The study explores how older adults from these various backgrounds self-identify with the terms religion and spirituality. Because both African-Americans and Jewish older adults are underrepresented in the research on spirituality and religion, their inclusion lends insights to this topic and helps to anchor the findings in a cross-cultural context. Focus groups were employed to understand how these groups characterize their relationship to spirituality and religion. Social work professionals can utilize these findings to work more effectively with the diverse and complex issues of older adults.     

The economy of risk and respect: Accounts by Puerto Rican sex workers of HIV risk taking

Three‐hundred eleven female drug‐using sex workers in urban Puerto Rico were asked to describe their last negotiation with a client. They described efforts to protect themselves from many hazards of sex work, including violence, illness, and drug withdrawal. They also described efforts to minimize the stigma and marginalization of sex work by cultivating relationships with clients, distinguishing between types of clients, and prioritizing their role as mothers. Sex workers adopted alternating gender roles to leverage autonomy and respect from clients. Their narratives suggest that sex workers negotiate a world in which HIV is relative to other risks, and in which sexual practices which are incomprehensible from an HIV‐prevention perspective are actually rooted in a local cultural logic. Future HIV prevention efforts should frame condom use and other self‐protective acts in terms that build upon sex workers' own strategies for understanding their options and modifying their risks.     

Evaluation of school‐based AIDS education curricula in San Francisco

Students in 3 middle (n=385) and 3 high schools (n=254) in the San Francisco Unified School District participated in the evaluation of an AIDS education curriculum. Classes within‐schools were designated as either intervention classes or nonintervention classes. Students in intervention classes received 3 class periods of AIDS instruction with a newly developed curriculum. Students in nonintervention classes did not receive any special AIDS instruction. All students completed a pretest and posttest AIDS knowledge and attitude survey. The results indicated that AIDS instruction classes demonstrated a significant knowledge‐advantage, as well as change in attitudes (e.g., reflecting greater tolerance for attending class with students who may have AIDS or HIV infection).     

Latin America and the crisis (points for the balance of a decade)

The decade of the 1980s was catastrophic for the countries of Latin America because of profound transformations in the world economy, which started in the 1970s, the wilting of the state development programs that were imposed after World War II, and the collapse of socialism with the incipient transition to market economies. The crisis started because of the erosion of the world economic system as constituted under the Bretton Woods agreement; the drastic drop in the economic growth of market economies; the increased costs of living and the deterioration of the environment; the decrease in industrial capacity; and the emergence of transnationalization of production. In Latin America, the economic models that had been in place without solving underdevelopment became even more obsolete (import substitution, internal trade, and the role of the state). The crisis of socialism and the rapprochement of eastern European countries to western Europe also affected Latin America (e.g., Germany cancelled 30 mine exploration projects in Bolivia due to investments in East Germany). The structural readjustment policies of the International Monetary Fund and the World Bank resulted in currency devaluations, redistribution of government funds, elimination of various subsidies, reduction of public debt and social expenditures, reduction of public employment, and payment of external debt. The result was more inflation (in Bolivia, Brazil, Peru, and Argentina, inflation rates were 683.7%, 157.1%, 100.1%, and 326.2%, respectively, between 1980 and 1986), unemployment, and poverty in the lost decade of the 1980s. After 1982, state expenditures on roads, education, hospitals, and nutrition declined by 40% in Mexico. Even though most countries returned to democracy in the region, this was at the cost of the increased role of the military and the transnationals. The grand parties collapsed and in Venezuela, Mexico, and Colombia authoritarian tendencies survived into the 1970s degrading democracy. The states' socioeconomic regulatory role has to be redefined.     

Interethnic Contact, Curriculum, and Attitudes in the First Year of College

Since Brown v. Board of Education (1954), social scientists have argued that education is important to change in racial attitudes given opportunities for interethnic contact. Students today are presented, also, with opportunities for interethnic learning through curriculum and extracurricular programming. The importance of contact, curriculum, and residence hall programs for the attitudes of first-year college students from three ethnic groups was examined. Students ( n = 791) completed surveys at the beginning and end of the year. Regressions tested the relationships of these first-year experiences to intergroup attitudes (awareness of ethnic inequality, support for policies addressing ethnic inequality) at the end of the first year, controlling for initial attitudes and background. Contact and curriculum were related to attitudes for European American students .