Journal of HIV/AIDS & Social Services

Recognizing that HIV testing provides a gateway opportunity to connect with at-risk populations, we explored an approach to collect, analyze and present data on the network of connections between HIV testing organizations and other health and social service agencies operating in Durham County, NC. We surveyed 26 health and social service organizations, including 6 providing HIV testing services, and presented the results including frequency tabulations, network visualizations and metrics, and GIS maps to the participating organizations...

Pain is highly prevalent among people living with HIV (PLHIV). Although the association between stigma and pain among stigmatized individuals has been well-established in the non- HIV chronic pain literature, little is known about the association between stigma and pain among PLHIV and the mechanisms that underlie this association. The present study examined the indirect effect of HIV stigma and pain via anxiety sensitivity (fear of anxiety symptoms). The sample included 97 PLHIV (60.2% male, M age = 48.40, SD = 7...

HIV stigma - both 'self-stigma' towards positive individuals and 'stigma by association' towards their families - is linked with adverse mental health. This study examined how stigma was associated with the mental health of parents and children in South Africa. Parent-child dyads (n=2477 dyads) in South Africa participated in a cross-sectional survey. For both parents and children, greater stigma was associated with their own reports of greater anxious and depressive symptoms. Parents reports of stigma was associated with children's greater anxious and depressive symptoms...

In this study, focus groups were conducted with 16 rural Women Living with AIDS (WLA) from Andhra Pradesh, India who had previously participated in a clinical trial wherein 68 WLA were randomized into either an Accredited Social Health Activists (ASHA) - Life (AL) intervention or a Usual Care program. Findings are discussed in terms of: a) mental health issues, b) perceived stressors, c) individual resources for coping with mental health issues, and d) role of Asha support in coping with mental health issues...

Gay, bisexual and other men who have sex with men (GBMSM) are at increased risk for HIV infection and disease progression. Also, HIV-positive GBMSM are among those less likely to be retained in care. In this study we analyzed sexual health knowledge (SHK) and various manifestations of stigma in a community sample of HIV-positive GBMSM in Puerto Rico. The sample reports overall low SHK scores, and lower score were associated with low educational attainment, unemployment, low income, and with self-identifying heterosexual participants...

Best practices in HIV care have the potential to improve patient outcomes and inform practice. We conducted a systematic review of best practices in HIV care that were published from 2003 to 2013. Practices that demonstrated success in achieving desired results based on their objectives were included in the review. Two themes emerged from the eight articles reviewed: (a) the importance of linking newly diagnosed people living with HIV to care and (b) the role of integrated and comprehensive service provision in improving patient outcomes...

Although cognitive impairment has been shown to adversely affect antiviral medication adherence, a subset of cognitively impaired adults nonetheless are able to adequately adhere to their medication regimen. However, little is known about factors that serve as buffers against suboptimal adherence among the cognitively impaired. This study consisted of 160 HIV-positive, cognitively impaired adults (Global Deficit Score ≥ 0.50) whose medication adherence was monitored over 6-months using an electronic monitoring device (MEMS caps)...

OBJECTIVES: To identify factors associated with HIV-transmission-related risk behavior among HIV+ African American men. METHOD: We examined biological, psychological, cognitive, and social factors and recent HIV-transmission-related risk behavior (i.e., needle sharing, unprotected sex, exchange sex) among a sample of HIV+ African American men. RESULTS: A binary logistic regression showed that individuals under age 50 (OR=4.2), with clinically-elevated masochism scores (OR=3...

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HIV transmission often occurs through heterosexual high-risk sex. Even in the era of HIV combination prevention, promoting condom use, and understanding condom barriers, remain priorities, especially among substance-dependent individuals. Men and women (N=729) in outpatient drug treatment participated in a five-session gender-specific risk reduction group or one-session HIV Education group. Condom barriers (Motivation, Partner-related, Access/Availability, Sexual experience) were assessed at baseline and 6-month follow-up...

This pilot study evaluated a 15 session classroom intervention for HIV and pregnancy prevention among grade 8-10 boys and girls (ages 14-17) in rural South Africa, guided by gender-empowerment theory and implemented by teachers, nurses, and youth peer educators. Pre- and post-intervention surveys included 933 male and female students in two intervention and two comparison schools. MAIN OUTCOME: condom use at last sex; secondary outcomes: partner communication; gender beliefs and values; perceived peer behaviors; self-efficacy for safer sex...

The sub-Saharan African region has been disproportionately affected by Human Immunodeficiency Virus (HIV) and Zambia has one of the highest HIV prevalence rates within this region. Moreover, new incidences of HIV infection are increasing most rapidly among those 15 to 24 years of age. Though young people are at high risk for HIV infection, street youth are even more vulnerable given their exposure to high risk behaviors. The current study examines multiple levels of social influence on HIV infection among 250 street youth in Zambia...

Routine population-wide HIV screening, early linkage and long-term retention in healthcare for HIV-infected individuals are key nodes of the HIV continuum of care and are essential elements of the National HIV/AIDS Strategy. Despite this, up to 80% of youth are unaware of their HIV infection status and only 29% are linked to HIV healthcare; less than half are engaged in long-term HIV healthcare, and far fewer maintain viral suppression. To fill this gap and to address the national call to action to establish a seamless system for immediate linkage to continuous and coordinated quality healthcare after diagnosis, this paper describes the processes and mechanisms by which the SMILE Program worked within the infrastructure of the ATN-affiliated Connect to Protect(®) (C2P) community coalitions to address structural barriers that hindered youth in their communities from being tested for HIV infection or linked and engaged in healthcare after an HIV positive diagnosis...

This study describes sexual health knowledge in perinatally HIV-infected (PHIV+) and perinatally-exposed uninfected (PHIV-) ethnic-minority youth, ages 9-16 years, residing in NYC (n=316). Data on youth sexual health knowledge (e.g., pregnancy, STDs, birth control) and caregiver-adolescent communication about sexual health were examined. Participants in both groups answered only 35% of the sexual health knowledge questions correctly (mean=6.6/19). Higher scores were found among youth who reported more communication about sex with caregivers (vs...

AIMS: This study examines the strategic contributions of three Frontline Practitioner (FP) attributes for effective HIV testing: risk assessment use, having specialized HIV training, and organizational test setting (nonprofit, forprofit, and public). METHODS: Data from 621staff in 159 organizations in Los Angeles County, are used to model individual and organizational correlates and use of risk assessment and measures of effective performance (volume of HIV tests, HIV seropositive tests, and referrals to treatment)...

Adolescent African-American females are disproportionately impacted by HIV, thus there is a clear need to understand factors associated with increased HIV-risk behaviors among this vulnerable population. We sought to explore the association between a dopamine D4 receptor gene (DRD4), a genetic marker associated with natural variations in rewarding behaviors, and self-reported alcohol-use and sexual risk-behaviors, while controlling for other known correlates of risk-taking such as impulsivity, sensation seeking, and peer norms among a group of high-risk African American female adolescents to evaluate whether this biological factor enhances our understanding of patterns of risk in this vulnerable group...

To inform future psychosocial interventions for HIV-infected women, five focus groups were conducted with 29 HIV-infected women (72% African-American). Sessions were audio-recorded, transcribed, and coded by two raters. HIV-specific stressors included difficulties with serostatus disclosure, HIV medication adherence, and HIV-related discrimination. Stressors not directly linked to HIV were described as more concerning and included mental health or substance use problems, relationship challenges, caretaking for children or grandchildren, and financial difficulties...

INTRODUCTION: Companion animals play important roles in the lives of people managing the many symptoms associated with a chronic illness such as HIV. This study explored meaningful examples of pets, particularly dogs, and their place in support networks among women living with AIDS/HIV. METHOD: Data were collected via focus group, as part of a larger Photovoice project. Qualitative analysis discovered three key related themes. RESULTS: Emerging themes included pet as spiritual custodian, pet as unconditional source of support, and pet providing a sense of purpose...

Girls in the juvenile justice system are at increased risk for contracting HIV/AIDS. Sexual risk behavior was examined in 166 females with juvenile justice involvement who were followed from adolescence to young adulthood. Results indicated that childhood sexual abuse increased the incidence of unsafe sex during young adulthood, which was subsequently associated with contraction of a sexually transmitted infection (STI). Further, girls' comfort in talking with their partners about safer sex practices during adolescence moderated the association between childhood sexual abuse and unsafe sex, such that girls who had been sexually abused and were uncomfortable talking to their partners about safer sex during adolescence had an 8...

HIV infection among young populations is increasing worldwide. Adolescents in mental health treatment have demonstrated higher rates of HIV risk behavior than their peers. This first risk behavior study of youth in psychiatric treatment in Brazil reports findings from a cross-sectional national sample of emerging adult psychiatric patients (18-25 years old). The prevalence of lifetime unprotected sex was 65.9%. Multiple logistic regression indicated that being married/in union; sex under the influence of alcohol/drugs; physical violence; earlier sexual debut; and depressive/substance use disorders were associated with unsafe sex...